Make Visible: Chronic Illness Explored30 Jun 2025

#17 PEM: measuring the threshold and understanding the cause with Dr. Rob Wüst

What is the threshold over which PEM is induced in chronic illness? This is a hugely important question for sufferers, and one for which Rob Wüst is trying to find an answer.

Assistant Professor in Musculoskeletal Health and Physiology at the Vrije Universiteit Amsterdam, Dr. Rob Wüst is able to see the physiological impact of Long Covid and ME/CFS in skeletal muscle abnormalities.

In his latest study (currently in preprint) he finds that “Skeletal muscle properties in long COVID and ME/CFS differ from those induced by bed rest”, and the abnormalities that he observes in the muscles of this cohort of patients correlate with the Post-Exertional Malaise (PEM), autonomic dysfunction and wearable data that he gathered in another recent study.

In this week’s episode Wüst explains to Emily Kate Stephens how he observed exercise-induced worsening of symptoms in almost half of Long Covid patients when they exceeded their ‘ventilatory threshold’ but the much of the time this is from everyday activities such as hanging the laundry or carrying the groceries. But they discus

He discusses the physiological clues emerging from exercise testing and muscle biopsies in patients when viewed alongside wearable data and expounds on the circulating theories on this, including mitochondrial dysfunction, local hypoxia, and ion channel abnormalities. And he explores the parallels and distinctions between Long Covid and ME/CFS and why interdisciplinary collaboration is vital to unlock these complex, multi-systemic diseases.

The Impact of Bedrest Study 2024

Skeletal muscle adaptations and PEM in LC 2024

Should we be careful with exercise in PEM in LC? 2025

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Episoder(36)

#35 Vagus nerve stimulation for chronic illness and better health with Dr Elisabetta Burchi

SCIENCE: What if a small, non-invasive device could help regulate your nervous system, reduce inflammation, improve cognitive function, and support recovery from chronic illness? Dr Elisabetta Burchi,...

29 Mai 1h 1min

#34 Fibromyalgia and chronic pain management with Ryan Bourdo, Physical Therapist

STRATEGIES: Physical rehabilitation for chronic pain conditions. If you live with fibromyalgia, ME/CFS, EDS or chronic pain, you've likely heard that exercise may help. You've also probably learned, t...

15 Mai 55min

#33 Hypermobile Ehlers-Danlos Syndrome (hEDS) undiagnosed for 23 years with Dr Lucy Foulkes

STORIES: Undiagnosed Hypermobile Ehlers-Danlos Syndrome (hEDS) | Chronic Pain, Diagnosis & Living with Complex Chronic Illness For 23 years, Dr Lucy Foulkes has lived with chronic pain, migraines, end...

1 Mai 1h 13min

#32 Hidden Virus, Immune Exhaustion & the Brain: Long Covid, ME/CFS and post-viral illness with Dr Avindra Nath (NIH)

SCIENCE: Long Covid | ME/CFS | Neuroinflammation | Clinical Trials What happens to the brain when a virus takes hold and why do some people never fully recover? Dr Avindra Nath has spent his career at...

24 Apr 57min

#31 POTS: Symptoms, understanding, and management with Dr Tae Chung

STRATEGIES: Understanding Postural Orthostatic Tachycardia Syndrome (POTS) - Practical Strategies for Diagnosis and Treatment “80- 90% of POTS patients are disabled to a certain extent - people who ju...

3 Apr 57min

#30 Navigating medical appointments with Dr Alba Azola

STRATEGIES: How do you navigate medical appointments when you’re living with a complex chronic illness? Too often, patients with energy-limiting conditions are told there’s “nothing to be done.” Many ...

20 Mar 52min

#29 Long Covid: what has six years taught us?

SCIENCE: Long Covid awareness, understanding and research. Long Covid Awareness Day (15th March 2026) marks six years since the COVID-19 pandemic unleashed its long tail of Long Covid on millions arou...

6 Mar 1h 5min

#28 From Olympic hopeful to Long Covid: Oonagh Cousins’ story

STORIES: Oonagh Cousins - Olympic Hopeful to Long Covid Advocate When professional rower Oonagh Cousins was pre-selected for the Tokyo 2020 Olympic Games, her dream was within reach. But when COVID-19...

20 Feb 53min