Just doing my bit for awareness re. people with ME/CFS, as I’m one of them. It’s life limiting at mild ,life destroying at moderate, and almost unfathomable at the upper end. Be good to the people in your life who have it. And pls (PLS) don’t act like they just didn’t try hard enough to get better.

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But if you keep triggering that response over and over you might permanently lower it, especially if you are older. I expect, one day, doctors routinely sending me/cfs patients to the physio won’t only be deemed inadvisable (as it is now in UK NICE guidelines), it’ll be classified as malpractice.

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This is because ME/CFS may very well be caused, in part, by your immune activation threshold being temporarily lowered (normal straight after a viral infection, especially a neurotropic one) but just for longer than usual due to a genetic susceptibility.

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Furthermore, there’s a real possibility such attempts to “push through” could set you up for a lifetime with the disease when you might have otherwise recovered. So when a doctor sends you to the physiotherapist to “rebuild your tolerance” they may actually be setting you up for lifelong ME/CFS.

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This includes replicated studies that show exercise while in the PEM state causes problems extending as far as *gut bacteria spilling into the blood stream* (probably due to the neurological dysfunctions causing a collapse in homeostasis - similar to what happens when you have the flu).

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