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K.OhM.-J.WanJ.et al

One of the most debilitating and defining hallmarks of ME/CFS and Long COVID is post-exertional malaise (PEM), a severe, disproportionate exacerbation of symptoms following even minor physical, cognitive, or emotional exertion

These are then oxidized into CO 2 and H 2 O through mitochondrial -oxidation, TCA cycle, and electron transfer

Hydroxymethylglutaryl-CoA reductase activity is essential for mitochondrial oxidation of fatty acids to prevent lethal accumulation of longchain acylcarnitines in the mouse liver