now seems like a good time to post this. had it for a while but seid etc. are popping up. has the following idea been ruled out? === pem, pene (meicc) and exertion intolerance (iom) seem to refer to exertion causing crashes. sometimes it is claimed that if you do not have it, then you do not have the disease. sometimes it is claimed that if you do have it, then you do have the disease. question: is this concept slightly but significantly wrong? === consider what i will roughly call intolerances (or exposures): 1) exertion 2) stimulation 3) food or medicine reactions 4) social presence (think of whitney dafoe) 5) orthostatic -- being vertical 6) noise -- total and percussive 7) mold exposures 8) pesticide and chemical exposures like vinyl or gasoline fumes 9) motion 10) flashing 11) looming 12) light (think of darkened rooms) 13) social reasoning 14) eye contact 15) interpersonal conflict 16) pain 17) nausea 18) low blood sugar 19) too hot 20) too cold 21) emergency room doctors thinking you are not sick 22) having no support 23) medical procedures these cause crashes in many pwme. === why do we emphasize exertion more than intoleranaces? are we sure only m.e. has pem? are we sure only people with pem have m.e.? are we sure neither is the case for intolerances above thresholds? is that why? are crashes not relevant in m.e.? === some try to FIT INTOLERANCES INTO AN EXERTION FRAMEWORK: "stimulation makes your neurons exert which causes crashes". this is a non-insane hypothesis, but most interlocutors don't think about cells, so it is misleading at best. do we know whether it is biologically true? could this be premature? could it be theory shoehorning? === yet there seems to be an almost contradictory idea. some speak of intolerances as SEPARATE FROM EXERTION, WITHOUT INCLUDING THEM AS CRASH CAUSERS. for example, they call them symptoms, perhaps the ones that get worse from exertion. thus, pem is a META-symptom. is there science giving us confidence that EXERTION crashes and STIMULATION crashes are biologically distinct? should we draw a circle around exertion as the only META-symptom? === putting all this together: what if exertion/activity is not the only cause of worsening that scientists should focus on? could the emphasis on pem be misleading new good scientists? === exert is defined by wordnet: '3: make a great effort at a mental or physical task'. PHYSICAL and COGNITIVE is what most people think of as exertion. people DON'T think of "people standing there while you lie horizontal" causing a crash! but it can. could physical and cognitive exertion be MERELY the most CONSPICUOUS exposures in the most AVAILABLE subpopulations? === === ok, please be gentle with me. maybe i have the wrong end of the stick. but imo basic questions are worth asking. is this idea ruled out? i want to focus on the biological science. NOT QUESTIONNAIRES. especially measurements that are done on diverse presentations (severity, symptom profile, exposure history, etc.), courses (relapsing/remitting, progressive, exposure-worsened progressive, etc.), onset types (gradual, sudden, staged, etc.).