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The Peril that is Post-Exertional Malaise (PEM)!

Post-exertional malaise (PEM) has been called ‘the illness within the illness’. It’s the defining and cardinal symptom of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). PEM is the worsening of symptoms following even minor physical or mental exertion, with symptoms typically worsening 12 to 48 hours after activity and lasting for days or even weeks.

When it comes to PEM, though, little about it is normal or familiar to people without ME/CFS. It's not just about overused muscles or needing a little extra rest.

PEM can range from moderately stronger-than-normal symptoms to completely disabling. In a mild case, the person may have extra fatigue, achiness, and cognitive dysfunction. In a severe case, PEM can bring on intense flu-like symptoms on top of extreme fatigue, pain, and brain fog strong enough that it's hard to even form a sentence or follow the plot of a sitcom.

That's hardly what the rest of us go through after a hike or a trip to the gym. Also abnormal is the amount of exertion it can take to put people in this state.

As with the severity, the exertion needed to trigger PEM theories case-by-case.1

For some, it might kick in after a little bit of exercise on top of a day's regular activities. For others, is incredible as it may seem, it can just take a trip to the mailbox, a shower, or sitting upright for an hour.

PEM manifests itself in several ways, including:

  •  Increased symptoms of pain & fatigue;

  •  Reduced physical activity levels;

  •  Abnormal exercise responses;

  •  Changes in cognitive function;

  •  Stress, anxiety and depression;

  •  Pain;

  •  Circadian rhythm/period changes causing sleep disruption; and /or

  •  Impaired pain regulation (central nervous system sensitivity).

PEM affects both the immune system and the brain.

Treating PEM:

There are treatment protocols that can be developed for sufferers. Elixir Compounding Pharmacy specialises in treating ME/CFS sufferers. We develop patient-centred treatment protocols based largely on advanced nutrient therapy. We offer complementary phone consultations where we assess symptoms and recommend an individualised treatment plan. So, if you or someone you know, contact Elixir today.

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