PEM discussion thread - post-exertional malaise

[poetinsf]

And mental exertion uses minimal calories – fewer than the type of physical activities which the same patients are able to do without causing PEM. So if PEM can be caused by mental exertion that would be evidence that it’s not caused by the use of calories.

Whatever the damage caused by that calorie expenditure is confined in the brain and they'll need to be cleaned up or repaired by the brain immune system. No reason to think that such repair process won't cause PEM.

 

[Jonathan Edwards]

In any case, the notion of exertion as a subjective concept, at least pertaining to PEM, needs to be dispatched with.

But if it is the basis of a symptom that patients are expected to recognise it has to be subjective. They do not measure calories. If you want to get away from that then presumably exertion should not be used as a term. We should talk of power (calories per time would be power) or of total energy usage. So far I don't think we have established even which of those is relevant - and they are very different in implications.