Recovery Failure in POTS, Long COVID, ME/CFS and Related Disorders: A Unified Biological Framework
Dr Graham Exelby 2026 Abstract Successful recovery following infection, injury and physiological stress requires coordinated resolution of inflammatory signalling, restoration of microvascular function, tissue repair and rebuilding of physiological reserve. Although persistent inflammation, endothelial dysfunction, mitochondrial abnormalities and chronic hypoxic signalling have each been implicated in Long COVID, postural orthostatic tachycardia syndrome (POTS), myalgic...
Graham Exelby
52 min read
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome:An Endothelial–Neurovascular Hypothesis of Brainstem Oxygen Homeostasis Failure
Dr Graham Exelby 2026 Abstract Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic multisystem disorder characterised by post-exertional malaise (PEM), autonomic dysfunction, cognitive impairment, sleep disturbance and profound loss of functional capacity. Although abnormalities involving cerebral perfusion, endothelial function, neurovascular coupling, mitochondrial metabolism, immune activation and autonomic regulation have each been describ
Graham Exelby
4 min read
Understanding Long COVID: How a Viral Illness Can Become a Disorder of Neurovascular Dysfunction, Impaired Recovery and Loss of Physiological Reserve
Dr Graham Exelby 2026 About This Paper This document is a simplified companion to a series of more detailed scientific papers exploring Long COVID, POTS, ME/CFS and related disorders. The formal papers examine the underlying biology in depth, including neurovascular dysfunction, pericyte biology, autonomic regulation, inflammatory signalling, metabolism, recovery physiology and the renin–angiotensin–aldosterone system (RAAS). While these concepts are important, the scientific
Graham Exelby
5 min read
Understanding Recovery Failure in Long COVID, POTS, ME/CFS and Related Disorders: A Guide to Energy Production, Hypoxia and Recovery
Dr Graham Exelby June 2026 About This Paper This paper is part of the Understanding Series, a collection of companion guides designed to explain complex medical concepts in a practical and accessible way for patients, families and healthcare professionals. The aim of this paper is to explain how recovery may become impaired in Long COVID, POTS, ME/CFS and related disorders using straightforward language. Many important scientific concepts have therefore been simplified to imp
Graham Exelby
15 min read
Hashimoto's Thyroiditis, Thyroid Nodules and Cervical Drainage DysfunctionA Neurovascular–Lymphatic Model of Thyroid Inflammatory Persistence
Dr Graham Exelby 2026 Abstract Hashimoto's thyroiditis and thyroid nodules are traditionally viewed as manifestations of autoimmune and endocrine disease arising from genetic susceptibility, environmental triggers, loss of immune tolerance, thyroid autoantibody production, and progressive glandular dysfunction. While these mechanisms remain central to disease pathogenesis, they incompletely incorporate the regional venous and lymphatic anatomy upon which normal thyroid physio
Graham Exelby
16 min read
