I now believe that the key is hypothalamic dysregulation.
The hypothalamus becomes damaged by long-term chronic stress and trauma (explaining the tendency for PWMEs to be over-achievers, athletes, and people with histories of trauma and chronic stress).
The hypothalamus regulates various body functions: immune response (if it is behaving erratically, this explains why some of us have OVER-active immune systems while others have UNDER-active immune systems), REM sleep (hence the prevalence of sleep issues, and of course REM is the restorative phase of sleep, so that explains a LOT of things, including unrefreshing sleep, slow recovery, etc), and, crucially, the hypothalamus interacts with mitochondria (potentially explaining PEM, brain fog, and fatigue).
From there it's individual how it all plays out. I have low immune functioning, and the Epstein-Barr Virus has become active in my system. My immune system won't kill it, so I basically just permanently have mono, which explains why I have nausea that gets worse with exertion, the sore throats, etc.
I believe the collapse of my health was exacerbated by a vegan diet and resulting gut health issues and protein deficiency.
This video by Dr. Jacob Teitelbaum explains how to treat it effectively:
- although I have so far been unable to find a doctor who will help me do all these things.