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Given how Post-Exertional Malaise is thought to be unique to ME/CFS and not experienced by sufferers of other fatiguing conditions i'm wondering whether there is research that has demonstrated that PEM is not present in these other conditions. Namely, i'm interested in whether PEM was ruled out as being present in chronic Lyme disease. Because if PEM *is* present in chronic Lyme disease, or Post-Treatment Chronic Lyme, then it would seem to be almost indistinguishable from ME/CFS, and thus may actually be the same thing, with the only difference being that those arriving at ME/CFS through a Lyme path had Borrelia as their triggering event rather than the more common viral trigger. I'm happy to hear any thoughts or references you lot can share on this.