The term has always bothered me for some reason. Probably because I have weird ME and haven't felt that sort of "energy deficiency". Instead, my PEM was triggered by the type of muscle usage, rather than the effort or duration, which contradicts the "energy envelope" theory. The main problem I see with the term is that it's a widely accepted model of ME without--as far as I know--actual evidence. In science, that leads to ignoring alternative models that might be correct, or at least superior. It influences judgement of observations in a way that reinforces belief in the model, blinding people to contrary evidence that might lead to an important discovery.
The energy that powers cells is ATP, so is there clinical evidence that PWME reach a limit of ATP production earlier than normal people, with severe patients having a much lower measurable limit? Are there alternative theories for why people feel energetic or "fatigued"?
Some possibilities:
An accumulation of waste products or other chemicals that inhibits the usage of ATP. That should be clinically measurable.
Reduction in oxygen delivered to cells. No, that would affect ATP production, so not really different.
Abnormal temperature, which affects ATP utilization. Unlikely in-vivio, but a valid possibility until actually challenged.
A neurological effect making us "feel drained" even though the muscles are actually operating properly.
Of course the BPS crowd would propose a psychological cause, impossible to prove or disprove.
I'm not suggesting a specific better model, but rather trying to open up minds to consider other possibilities. Think of all the effort that went into trying to explain why the planets moved in strange patterns "above the flat Earth". There was a lot of resistance to a theory that had the sun at the center of the solar system. (Please don't tie me to a stake and burn me for challenging the "energy envelope" theory.) Maybe, if people question existing theories, someone will notice some data that doesn't fit them, and come up with a better theory.
The "energy envelope" model can be useful for managing PEM, but that doesn't mean that it's the correct model for understanding ME.
The energy that powers cells is ATP, so is there clinical evidence that PWME reach a limit of ATP production earlier than normal people, with severe patients having a much lower measurable limit? Are there alternative theories for why people feel energetic or "fatigued"?
Some possibilities:
An accumulation of waste products or other chemicals that inhibits the usage of ATP. That should be clinically measurable.
Reduction in oxygen delivered to cells. No, that would affect ATP production, so not really different.
Abnormal temperature, which affects ATP utilization. Unlikely in-vivio, but a valid possibility until actually challenged.
A neurological effect making us "feel drained" even though the muscles are actually operating properly.
Of course the BPS crowd would propose a psychological cause, impossible to prove or disprove.
I'm not suggesting a specific better model, but rather trying to open up minds to consider other possibilities. Think of all the effort that went into trying to explain why the planets moved in strange patterns "above the flat Earth". There was a lot of resistance to a theory that had the sun at the center of the solar system. (Please don't tie me to a stake and burn me for challenging the "energy envelope" theory.) Maybe, if people question existing theories, someone will notice some data that doesn't fit them, and come up with a better theory.
The "energy envelope" model can be useful for managing PEM, but that doesn't mean that it's the correct model for understanding ME.
