![Infographic. A silhouette of a man's body. Title: SIGNS & SYMPTOMS.
- REDUCED COGNITION AFTER EXERCISE: ME/CFS cognition is normal at baseline however worsens. after physical exercise which indicates a state of PEM
- SMALL HEART SIZE: A reduced cardiac volume associates with a part of blood volume (plasma) that is also reduced. Cardiac size not associated with disease duration - deconditioning unlikely mediator of small heart.
- GUT PERMEABILITY (AFTER EXERCISE): Exercise causes gut bacteria to enter the bloodstream in ME/CFS but not in controls.
- EXERCISE RESPONSE (SYMPTOM PROFILE): Multiplicity of symptoms such as fatigue and muscle pain are signiciantly incre- ased following acute exercise and correlated with changes in brain activity.
- REDUCED MUSCLE OXYGEN UPTAKE Ability of cells to extract oxygen (which is needed for normal function of the mitochondria) from red blood cells is reduced compared to both idiopathic chronic fatigue and healthy controls.
- REDUCED BLOOD FLOW: Cerebral blood flow is reduced in ME/CFS during head-up tilt testing even in the absence of hypotension or tachycardia.
- NEURO-INFLAMMATION: Neuroinflammation has been found to be widespread in brain areas and associated with severity of symptoms.
- REDUCED GLUCOSE UPTAKE IN MUSCLES: Impaired muscle cell 5' AMP-activated protein kinase activation, reducing glucose uptake after simulated exercise of cells.
- GUT PERMEABILITY: Increased migration of the inflammatory bacterial toxin (LPS) from the gut into the circulation at rest.
- ACIDOSIS OF MUSCLES: Loss of capacity to recover from acidosis of the muscle on repeat exercise.
- 2-DAY EXERCISE RESPONSE (ANAEROBIC METABOLISM): Compared to Sedentary healthy controls ME/CFS switches to anaerobic metabolism more rapidly. Reduced performance is not due to cardiopulmonary deconditioning.
References:
[1] Van Campen, C. et al., Brain, Behaviour and Immunity, 2017
[2] Nakatomi Y., et al., Journal of Nuclear Medicine, 2014
[3] Jones, D. E. J., et al., European Joumal of Clinical Investigation, 2012
[4] Snell, C. R., et al., Physical Therapy, 2013
[5] Cook, D. B., Brain, Behaviour and Immunity, 2017
[6] Giloteaux, L., Microbiome, 2016
[7] Shukla, S. K., PLOS ONE, 2015
[8] Vermeulen, R. C. W., & Vermeulen van Eck, I. W. G.,
Journal of Translational Medicine, 2014](https://mecfs-med-ed.org/wp-content/uploads/2023/02/mortengroup.org_.uk_.png?w=880)
Signs and symptoms of ME/CFS
ME/CFS Medical Education Campaign
Promoting high-quality, up-to-date, evidence-based medical education on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long Covid.
ME/CFS Medical Education Campaign
Promoting high-quality, up-to-date, evidence-based medical education on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long Covid.
ME/CFS Medical Education Campaign 
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