Exercise Intolerance vs. PEM/Exertion Intolerance

[Pyrrhus]

Exercise Intolerance vs. Exertion Intolerance vs. PEM​

A common source of confusion are the terms "exercise intolerance" and "exertion intolerance", and how they relate to PEM. So here's a brief clarification:

• Exercise Intolerance is a medical term that refers to the inability to perform aerobic exercise. Even though the patient is trying their best to exercise aerobically, a physiological problem is depriving the exercising muscles of sufficient oxygen, resulting in rapid muscle weakness/soreness.
• Exertion Intolerance, on the other hand, is a general term that can refer to any bad reaction to any type of exertion, physical or cognitive.
• Post-Exertional Malaise (PEM), also known as Post-Exertional Symptom Exacerbation (PESE), is a type of exertion intolerance where there is an exacerbation of symptoms (and maybe some new symptoms) after minimal exertion.

Hope this helps!

 

[Rufous McKinney]

Hope this helps!

it does....

but couldn't BOTH exist in some of us?

I was once paralyzed, by a phone pole, thinking I could walk back to my apartment, which I could see across the street. But my muscles : hip flexors, paralyzed.

 

[Pyrrhus]

but couldn't BOTH exist in some of us?

Yes, ME often involves both PEM (exertion intolerance) and Exercise Intolerance (due to dysautonomia).

For more on the Exercise Intolerance, see:

Insights from Invasive Cardiopulmonary Exercise Testing of Patients with ME/CFS (Joseph et al., 2021)
https://forums.phoenixrising.me/thr...patients-with-me-cfs-joseph-et-al-2021.82907/

 

[livinglighter]

Is there any information about exertion intolerance?

 

[borko2100]

I've always wondered how different people experience "Exercise Intolerance". I think it is safe to say almost everyone with ME experiences it, but how they do probably differs from person to person.

I think there are several possibilities:

- general symptoms, such as dizziness, nausea, etc.
- rapid fatiguability / premature cardiovascular and muscular failure - muscle pains, being out of breath, etc.
- both of the above
- none of the above, but delayed PEM as a reaction to the exercise.

I wonder which one is the most common.

 

[Rufous McKinney]

Heaviness taking over....
Air hungar- in the lungs but the whole body is reporting on it
You look at the coffee you might normally want to have, and the idea of being more alert sounds awful.
No coffee today.
The eyes are meanwhile reporting on the autoimmune issues with whole ditty...every day my eyes have differing issues to report on- eyes pouring today
Digestion is going off; energy disappeared in the gut.....leakage is starting up worse

etcetera

 

[Pyrrhus]

- rapid fatiguability / premature cardiovascular and muscular failure - muscle pains, being out of breath, etc.

This accurately describes Exercise Intolerance.

- none of the above, but delayed PEM as a reaction to the exercise.

This is not Exercise Intolerance, this is a form of Exertion Intolerance.

Hope this clarifies!

 

[Pyrrhus]

Is there any information about exertion intolerance?

The main type of exertion intolerance is PEM, but there may be other forms of exertion intolerance, especially in severe ME.

Hope this helps!