Ok, let's take a look at the "Activity" section of your protocol: Do you have a citation? I've seen no good research showing GET or other activity to aid in recovery, and plenty of research showing it doesn't help, and some showing that it's quite harmful. Pretty much every PWME I've spoken to finds any increase in activity to cause setbacks. Citation? Many people do stabilize activity levels before attempting GET (that's how it usually works in the clinics), and it is still harmful and not helpful for them. The sources cited are an article and a hypothesis. There seems to be no research demonstrating Rowe's hypothesis to be accurate. Furthermore, ME patients are rarely completely inactive except in the most severe cases when there is very little ability to move. It also does not follow that GET is the appropriate alternative to complete inactivity, even if complete inactivity did exist. I see no citation for Rowe advocating any of these treatments. Furthermore, many patients find the exercise-based therapies to be harmful, and many studies have shown them to be of no help in physical functioning. SSRI's also affect many patients badly. Citation? You seem to be suggesting that worsening symptoms should be ignored as a sign of illness, which is highly irresponsible given the damage that often results. Citation? I believe most research has disproven this hypothesis. The activities listed are not suited for moderate ME, which is still highly disabling. And even moderate ME patients will have priorities for their energy that have a more beneficial impact upon their lives - such as cooking dinner, going shopping, or even socializing. I also see no citation showing their effectiveness, and again, they are suggestions which many patients have found harmful. You link to http://www.iacfsme.org/CFSandExercise/tabid/103/Default.aspx in suggesting recumbant exercise, but have ignored much more important advice - that research has suggested that ME patients must remain under a certain heart rate to avoid triggering a pathological response. Subsets are also discussed, with the realization that while some cases more similar to fibromyalgia might be able to improve somewhat from exercise, and that others will suffer severe relapse. It seems inappropriate for you to give the same advice to both groups, especially since your advice is only potentially applicable at the very mild end of the spectrum and very harmful at the other end. That source also specifies that all symptoms should be gone in the morning, not after "12-24 hours" as you stated above. These calculations are likely over-simplistic and contradicted by actual research. They are recommending I get my heart rate up to over 140bpm, while the research indicates most ME patients need to stay between 90 and 110. 140 would be guaranteed to put me into a crash, and a bad OI day I'll be over 110 just sitting up. Do you have a citation that this is appropriate for ME patients? Sitting without my feet up for a length of time can cause extreme OI problems. Much as a sore back is unfortunate - and I do get one at times - lack of oxygen to my brain is far more unpleasant. I'm not going to argue about standing still really sucking, but lying down is necessary for many ME patients with OI issues. The alternative is called "passing out", and periodically laying down throughout the day can help prevent OI symptoms from becoming aggravated. Do you have any authority to cite for your assertion that lying down should be avoided. Citation? This may be good advice for people with simple OI problems uncomplicated by ME problems, but I have seen no research indicating it is useful for ME patients. Citation? My personal experience and what I've heard from other ME patients is that typical advice for training the body to compensate for OI does not work for us - or rather, it might work in the short term and then cause a crash due to the extra strain.