Episode 146 – Research Review: The PEM Puzzle

Post-exertional malaise (PEM) is more than just feeling tired after activity — it’s a delayed and often severe worsening of symptoms that affects many people with ME/CFS and other energy-limiting conditions. In this episode, Anna unpacks what PEM is, why it happens, and what current research is beginning to reveal. Anna explains how PEM differs from everyday fatigue, explores emerging insights into energy production, inflammation, and stress responses, and discusses why “pushing through” can be harmful. She also reflects on what this research means in real life, and how it can support safer pacing, validation, and more compassionate approaches to recovery. This episode is a helpful listen if you want to better understand PEM, feel more validated in your experience, or learn how research can guide gentler, more supportive ways of managing energy. Useful Links Take the Chronic Fatigue Quiz: https://app.annamarsh.co.uk/quiz-page Instagram: https://www.instagram.com/anna__marsh_ Work with me: https://annamarsh.co.uk/work-together/ Website: http://annamarsh.co.uk/ Join the Nurturing Resilience Subscription: https://annamarsh.co.uk/nurturing-resilience/ Article Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC12408823/