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doi: 10.1053/j.jvca.2010.04.022 [DOI] [PubMed] [Google Scholar] 50.Mulkens CE, Staatsen M, van Genugten L, et al
This bioenergetic failure is the physiological root of post-exertional malaise (PEM), where even minor physical or cognitive exertion leads to a disproportionate and prolonged exacerbation of symptoms
[CrossRef] [PubMed] 171
Furthermore, this systemic oxidative stress contributes heavily to endothelial dysfunctiondamage to the inner lining of the blood vessels
