Why Your Fatigue Gets Worse After Exercise (Post-Exertional Malaise Explained) w/ Evan H. Hirsch, MD
Wed Feb 04 2026
In this episode, Evan H. Hirsch, MD, unpacks one of the most frustrating and misunderstood symptoms of Long Covid and ME/CFS: post-exertional malaise (PEM).
If you feel worse after physical or mental activity (even simple things like doing the dishes or going for a short walk) you might be experiencing PEM.
In this episode, you'll learn:
What PEM is and how it impacts people with Long Covid and Chronic Fatigue Why traditional exercise recommendations can make things worse The role of mitochondria, adrenals, and hormone dysfunction in energy crashes The "Toxic 5" root causes behind PEM: heavy metals, chemicals, mold, infections, and nervous system dysfunction A powerful new study showing the biological damage exercise causes in Long Covid patients How to identify your baseline and pace activity to reduce symptom flares If you've ever been told to "just push through it," this episode will show you why that advice fails, and what actually works.
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We help you resolve your Long Covid and Chronic Fatigue (ME/CFS) by finding and fixing the REAL root causes that 95% of providers miss. Learn about these causes and how we help people like you, Click Here.
Do you have fatigue, brain fog, shortness of breath, muscle pain, or other strange symptoms? You might have Long Covid. Take our free quiz to find out if Long Covid is behind the mystery symptoms you're experiencing, Click Here.
For more information about Evan and his program, Click Here.
Prefer to watch on Youtube? Click Here.
Please note that any information in this episode is for educational purposes only and does not constitute medical advice.
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In this episode, Evan H. Hirsch, MD, unpacks one of the most frustrating and misunderstood symptoms of Long Covid and ME/CFS: post-exertional malaise (PEM). If you feel worse after physical or mental activity (even simple things like doing the dishes or going for a short walk) you might be experiencing PEM. In this episode, you'll learn: What PEM is and how it impacts people with Long Covid and Chronic Fatigue Why traditional exercise recommendations can make things worse The role of mitochondria, adrenals, and hormone dysfunction in energy crashes The "Toxic 5" root causes behind PEM: heavy metals, chemicals, mold, infections, and nervous system dysfunction A powerful new study showing the biological damage exercise causes in Long Covid patients How to identify your baseline and pace activity to reduce symptom flares If you've ever been told to "just push through it," this episode will show you why that advice fails, and what actually works. . We help you resolve your Long Covid and Chronic Fatigue (ME/CFS) by finding and fixing the REAL root causes that 95% of providers miss. Learn about these causes and how we help people like you, Click Here. Do you have fatigue, brain fog, shortness of breath, muscle pain, or other strange symptoms? You might have Long Covid. Take our free quiz to find out if Long Covid is behind the mystery symptoms you're experiencing, Click Here. For more information about Evan and his program, Click Here. Prefer to watch on Youtube? Click Here. Please note that any information in this episode is for educational purposes only and does not constitute medical advice.