A very important and precise contribution.
Not only GET is problematic – the entire “graded” paradigm is. Thank you for this clear analysis!

#MECFS #PEM #NoGET #PEMisnotnegotiable

When PEM is misunderstood
-whether through ignorance or intent-
it leads to flawed studies, harmful therapies, and misguided guidelines.

This misunderstanding is not a detail:
Recognizing PEM correctly decides between safety and harm.

#MECFS #PEM #NoGET #NoRehab #PEMisNotNegotiable

The right stance on ME/CFS-
both therapeutic and medical-means:
acknowledging limits instead of pushing them.
Not asking what’s still possible,
but protecting what must not be lost.
#MECFS #PEM #PEMisnotnegotiable

Grateful to @putrinolab.bsky.social
& 80 co-authors for this powerful @bmj_latest piece.

“We ignore #PEM at the patient’s peril”

must guide #MECFS care.

What we’re witnessing is not an honest mistake – it’s chronic harm, fueled by ignorance.

#MEAwareness
#SevereME #PEMisNotNegotiable #NoGET

A cartoon-style digital illustration shows a boy resembling Bart Simpson standing in a green-walled classroom, writing repeatedly on a chalkboard. The phrase “Psychotherapy won’t fix” appears multiple times. The boy wears a red shirt and blue shorts, holding chalk in his right hand. A trash bin filled with crumpled paper sits nearby. Two yellow desks are visible in the foreground.

„Reframing beliefs”
won’t fix immune dysfunction, vascular issues, or mitochondrial failure.
#MECFS is not a thought disorder.
Rehab- no matter how it’s packaged-
harms people with #PEM.
This mindset creates the severely ill.
We need protection, research, biomedical care.
#PEMisnotnegotiable

Post-exertionelle-Malaise #PEM ist das wichtigste und entscheidende Symptom bei #MECFS. Für Betroffene ist es unfassbar schwer, damit umzugehen, ich spreche aus Erfahrung. Danke für die unermüdliche Aufklärung zu #PEMisnotnegotiable @bettinagrande.bsky.social ❤️‍🩹 Hier ein sehr guter Thread zu PEM 👇🏻

Chris Puta from Jena demonstrate:
Raman spectroscopy can detect post-exertional changes in immune cells after a 1-minute stand test in #MECFS patients with #PEM.
A step toward a biomarker.

Attention:
Even minimal exertion carries risk!
#PEMisnotnegotiable
#MEAwarenessDay x.com/grandebettin...

What gets ignored:
The unpredictability, the delayed collapse—
the reality of those affected.

And then come the same old lines:
“You just have to try.”
“Others manage too.”

If you don’t understand #PEM,
you destroy lives.

#PEMisNotNegotiable