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Shah shalin S, Denham LV, Elison JR, Bhattacharjee PS, Huq T, Clement C, et al

Das et al

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Extensive research into muscle dysfunction in CFS/ME has shown that patients often exhibit a pathological overreliance on this anaerobic metabolism, even during incredibly low-level, everyday exertion

2+ , generating a large amount of reactive oxygen species (ROS) via the Fenton reaction and inducing a lipid peroxidation chain reaction (Stockwell et al., 2020) (Figure 4)

This may transform a physiological process into a pathological driver of chronic inflammation and tissue dysfunction, potentially contributing to diseases like endometriosis (Table 1)