Post Exertional Malaise = Endothelial Dysfunction via SNS Overcompensation which decreases blood flow and oxygen perfusion to tissues which creates a hypoxic environment, reduced aerobic metabolism/less energy, and lactic acid buildup which drives neuroinflammation.
Body then doesn’t have enough ATP (energy) to recover so it must “borrow” energy from surrounding tissues which creates an energy deficit anywhere between 12-72 hours later. Body then turns into a flu like state to get the body to lay down and get in energy conservation mode.
Body can only slowly recoup the energy deficit because the body is primarily running on Anaerobic Metabolism (Glycolysis) and this is slow. So remember endothelial dysfunction drives hypoxia which then neuroinflammation follows. This can change throughout the body.
That is why ME/CFS patients have “traveling” inflammation from Brain (Brain fog) to Chest (Costochrondritis) to Gut (GI dysfunction). This mechanism fits nicely for us since we have AUTONOMIC Dysfunction particularly the SNS.
My theory is underlying Connective Tissue Disease which in turn causes lifelong immune dysregulation. This can be hidden for years/decades but each immune hit the body takes (infection/trauma/stress) makes the body more vulnerable.
During this time however we are completely healthy and living life BUT the immune system is still dysregulated. Finally, A Strong Viral (Covid, EBV) or Vaccine Trigger causes genes to switch over and the disease to turn “on.”
The immune response then causes the immune cells to turn on the connective tissues most likely due to cell mimicry (Spike Protein). This attack on the connective tissues are keeping the immune system turned on and Autoantibodies are produced.
This is driving dysfunction of the Autonomic Nervous System specifically in the brain. The immune system then breaches the Blood Brain Barrier (Found by @polybioRF) Remember, the Blood Brain Barrier is just a monolayer of endothelial cells connected by tight junctions.
The immune attack is most likely altering the function of the GPCR receptors these are found throughout the Brain including the brainstem and Body. The brainstem then Flips a switch where the autonomic reflexes are now dysregulated and Cerebral Autoregulation Altered.
Altered Brainstem Volume found Previously in ME and Long Covid Studies. Immune Cells are entering the brainstem (found via Special MRI) and then fluid follows (volume increases)
(ME Hypoperfusion Injury) The Autonomic Nervous System then Permanently compensates by increasing Sympathetic Dominance in order to respond to the acute decrease in Cerebral Blood Flow when upright. Some patients this doesn’t function well and others their’s “overcompensates.”
The Sympathetic Dominance of the Autonomic NS then chronically narrows many of the endothelial cells in the body (vasoconstriction). The greater the vasoconstriction the greater the severity of ME/CFS the patient has. (Severe patients present with Hypoxia at rest.)
So immune cells can cause dysfunction, you have immune cells particularly Macrophages going into the brainstem. The medulla oblongta is responsible for maintaining blood pressure in response to changes of position especially upright. This is abnormal in ME patients.
This in turn will trigger a blunted baroreceptor reflex and cardiac preload failure due to decreased cardiac output. The body will then compensate either by increasing Heart rate or by Increasing Blood Pressure or Both. If the patient has a decrease in BP then no compensation.
The GI barrier is also made up of endothelial cells and dysfunction of these will cause the permeability of the gut to increase which will allow small molecules and Proteins to “leak through.” This leak along with Sympathetic Dysfunction will trigger bacterial changes to gut.
The bacterial changes will produce gas and the abnormal involuntary smooth muscle movements will trigger the bloating. Sympathetic Dominance will also alter the rate of motility either diarrhea or constipation.
Blood now pools into the abdomen and limbs. This can give a heavy and weak feeling. Feels like cement. Ron davis found something in the blood that makes cells very sick. This is most likely a signaling molecule driven by the ANS.
An abnormally functioning SNS will also trigger the body to ineffectively clear viral fragments and in some cases bacteria. This explains not only ME/CFS and Long Covid but also Lyme disease. Notice viral fragments found in the connective tissues of patients.
Why? Because we have an abnormal immune response in our connective tissues due to underlying connective tissue disease. Sources: 
#LongCovid #pwME #Pots #MillionsMissing #VaccineInjuries #ChronicIllness #MECFS
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