Some patients with a chronic fatigue syndrome may develop a worsening of symptoms following any significant exertion.

Clinical features: worsening of fatigue, malaise or other symptoms following any exercise that raises the heart rate.


Conditions associated with post-exertional malaise:

(1) chronic fatigue syndrome (CFS)/Myalgic encephalomyelitis

(2) Gulf War syndrome

(3) cancer-related fatigue


Ghali et al noted elevated serum lactate concentrations at rest in patients who develop post-exertional malaise. This could point to a mitochondrial impairment.

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