In ME/CFS there is something wrong with the aerobic metabolism, the set of metabolic pathways that require the presence of oxygen in order to extract energy from molecules like glucose and to use that energy to build ATP (see this blog post). We don’t know where the problem is, but this system is disrupted and if you try to use it, the next day its performances are even lower (Vanness, 2007), (Snell, 2013) and symptoms like brain fog and orthostatic intolerance get worse (Institute of Medicine, 2015). This system can’t be trained in most patients (if not all), contrary to what proponents of graded exercise therapy (GET) keep on saying. 

And yet, I think that many patients might still be able to train their anaerobic energy metabolism, with very short and intense exercises (weight lifting). For myself, I discovered some years ago that I could be housebound and still be able to perform weight lifting, granted that the weights were right next to my bed.

So, I am housebound, there is no way I could go to a gymnasium, I can’t ride a stationary bike for more than 5 minutes, I can’t sit for long periods, and yet I can perform weight training at home. And this fortunate discovery has allowed me to get all the benefits of exercise, without the severe worsening of symptoms I would go through if I walked in the outdoors.

Figure1. The blue line represents the reaction catalyzed by creatine kinase: a molecule of ADP has converted to ATP thanks to the phosphate group carried by phosphocreatine (see figure 2). The red line is the anaerobic glycolysis. The green line is the aerobic metabolism, the one I try to avoid in order to reduce the risk of having PEM afterwards.

Weight lifting is by no means a cure, the disease remains the same even if I manage to exercise regularly. For me the main benefit is with mood: while I lift weights I lift my mood too. And I probably feel better. I perform very short contractions with heavyweights, in order to avoid the use of aerobic energy metabolism (see figure 1). And I rest a lot between each series (the main activity in the hour or so of each session is in fact rest). I wait for my heartbeat to normalize before I start another series.

creatine kinase
Figure 2. The reaction catalyzed by creatine kinase: a molecule of ADP is converted to ATP thanks to the phosphate group carried by phosphocreatine.

The following video by Mark Vanness (University of the Pacific, California) is about the topic of anaerobic exercise in ME/CFS vs aerobic one.


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