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Post-Exertional Malaise

Meaning

Post-Exertional Malaise (PEM) is the hallmark clinical feature characterized by a disproportionate worsening of systemic symptoms, including profound fatigue and cognitive impairment, that is significantly delayed following even minor physical or mental exertion. This crash response indicates a fundamental failure in energy recovery mechanisms, particularly relevant in conditions affecting the HPA axis and metabolic capacity. We observe this as a significant decoupling of effort from recovery. The severity of PEM often correlates with underlying physiological dysregulation.