An Assessment of Post-Exertional Neuro-Immune Exhaustion Malaise (PENE) (also referred to as PEM)

Here is a list of symptoms (39) made worse due to physical or cognitive exertion, from Table 4 of the Jason et al 2019 study entitled, ‘Assessment of Post-Exertional Malaise (PEM) in Patients with Myalgic Encephalomyelitis (ME)’ where 1534 ME patients responded to questions about PEM

Table 4

1. Reduced stamina and/or functional capacity
2. Physical fatigue
3. Cognitive exhaustion
4. Problems thinking
5. Unrefreshing sleep
6. Muscle pain
7. Insomnia
8. Muscle weakness/instability
9. Temperature dysregulation
10. Flu-like symptoms
11. Aches all over your body
12. Physically fatigued while mentally wired
13. Dizziness
14. Gastro-intestinal problems
15. Headaches
16. Ataxia
17. Increased heart rate/heart palpitations
18. Weak or stiff neck
19. Joint pain
20. Problems with speech
21. Sore throats
22. Muscle twitching
23. Night sweats and chills
24. Sore eyes
25. Nerve pain
26. Sore lymph nodes
27. Nausea
28. Tinnitus
29. Trouble breathing
30. Neurological symptoms
31. Excessive sleep
32. Loss of appetite
33. Migraines
34. Cardiac pain and/or arrhythmia
35. Brain twangs
36. Severe burning sensation all over skin
37. Paralysis/inability to move
38. Premenstrual symptoms
39. Decreased heart rate

Here is the link to the complete study by Jason et al:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468435/