In today's episode, Haylie Pomroy sits down with Dr. David Systrom, a pulmonary and critical care physician at Mass General Brigham and Assistant Professor at Harvard Medical School, to explore the science behind exercise intolerance in ME/CFS and long COVID.

Dr. Systrom breaks down the invasive cardiopulmonary exercise test (CPET) and what it reveals about blood flow, oxygen extraction, and mitochondrial dysfunction in patients who have been told their tests are normal. He explains why dysautonomia, small fiber neuropathy, and acquired mitochondrial dysfunction may be driving the fatigue, post-exertional malaise, and wide-ranging symptoms these patients experience every day.

He also shares details on two active clinical trials at Brigham and Women's Hospital, including the LYFT trial testing low-dose naltrexone, Pyridostigmine (Mestinon), and the combination of both, as well as a muscle biopsy study designed to understand the role of the mitochondrion in post-exertional malaise.

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Dr. David Systrom is a physician at Brigham and Women's Hospital. He is also an assistant professor of medicine at Harvard Medical School. He received his medical degree from Dartmouth Medical School. He then completed a residency in internal medicine at Emory University Hospital, followed by a fellowship in internal medicine at Massachusetts General Hospital. He is board-certified in internal medicine and pulmonary disease. An active investigator and director of the Massachusetts General Hospital Cardiopulmonary laboratory, Dr. Systrom regularly publishes research examining pulmonary hypertension, pulmonary vascular disease, right heart failure, and thromboembolic disease. He has authored over 130 peer-reviewed publications, has received funding from the National Institutes of Health and the American Heart Association, and has been named to the annual list of the Best Doctors in America. Dr. Systrom is a member of the American Thoracic Society, the American Heart Association and the American Physiological Society. He has special expertise in the pathophysiology of exercise intolerance in ME/CFS and Long Covid and is conducting clinical trials investigating the same

Haylie Pomroy, Founder and CEO of The Haylie Pomroy Group, is a leading health strategist specializing in metabolism, weight loss, and integrative wellness. With over 25 years of experience, she has worked with top medical institutions and high-profile clients, developing targeted programs and supplements rooted in the "Food is Medicine" philosophy. Inspired by her own autoimmune journey, she combines expertise in nutrition, biochemistry, and patient advocacy to help others reclaim their health. She is a New York Times bestselling author of The Fast Metabolism Diet.

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