Open access, https://www.mdpi.com/2072-6643/11/10/2270/htm Thought this was interesting Perhaps, in a sense, the same 'pathways' that cause those issues in people who overtrain are the same, or similar, ones that get triggered in PEM?
Overtraining/exertion and the gut has been linked to ME/CFS previously with the increased translocation of LPS from the gut to the blood, and bacteremia. It is very interesting. I wonder if increasing gut barrier integrity before exertion could decrease symptom burden and/or PEM.
To do aerobic activity, that is shift to anaerobic respiration, healthy people go to classes or the gym, but for many of us we reach that state by walking from bed to chair. This must mean that our bodies are facing the same challenges as an athlete who over trains. They would not have the same broken aerobic system as us but the consequences would be the same. Like someone trying to pay in a supermarket but not being able because they do not have enough money in their account having the same outcome as someone with plenty in their account but whose card has been frozen because they have been hacked.
Andy is correct It is a very potent toxin that the immune system reacts strongly to. This could explain the flu like feeling after overexertion. Or part of it, for some people. There are many things that affects this. Exercise increase LPS translocation also in healthy people, and normally the body can handle it. But with overexertion there is a theory that the integrety of the instestinal barrier decrease even more, leading to an increase of LPS and other stuff from the gut coming in contact with the immune system. There are of course a lot of other factors that affects this as well.. I was recently overjoyed that a protein I have to write a paper about for a course I'm taking is important for the instestinal barrier, and also capable of neutralizing LPS. Made my day to get to read about one of my favorite subjects and learning something new to boot! And while we're at it, some of the factors that can increase permeability of the instestinal barrier could also increase the permeability og the blood brain barrier, which could also be a factor in ME/CFS if there is neuroinflammation.