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This structural damage causes further mitochondrial failure and even more ROS leakage, creating a continuous "doom loop" of profound energy depletion, systemic inflammation, and the hallmark symptom of post-exertional malaise (PEM)

10.1016/j.steroids.2012.03.011 40

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Lancet 390(10103):16641675 Athauda D, Gulyani S, Kumar Karnati H et al (2019) Utility of neuronal-derived exosomes to examine molecular mechanisms that affect motor function in patients with Parkinson disease: a secondary analysis of the exenatide-PD trial

Excessive alcohol consumption can deplete glutathione reserves, impair liver function, and hinder detoxification