ME/CFS Amplifier & SMPDL3B Quiz (Compressed)

BA-GLA · Amplifier & SMPDL3B

This questionnaire explores your baseline pattern, deep crash (PEM) pattern, gut–liver axis, and a possible SMPDL3B phenotype. Answer based on your current typical baseline unless a question specifically asks about deep crashes.

Research tool only. This does not provide a medical diagnosis or treatment plan. Use it as a pattern-mapping aid to discuss with qualified clinicians and researchers.

Section A – Baseline Pattern

Daily pattern · light triggers

Answer these based on your typical baseline (not your worst-ever crash).

Key terms

Baseline – how you feel on a typical day when you have not recently overdone it (not in a full PEM crash).
Light physical activity – gentle movement such as 5–10 minutes of easy walking or light chores that most people would consider mild.
Orthostatic stress – symptoms that change when you are upright (sitting or standing), especially still standing (e.g., in a line).
Moderate exercise – brisk walking, cycling, or climbing stairs for several minutes at a pace you can usually manage when you are “doing okay” for you.

A1.After light physical activity (e.g., 5–10 minutes of easy walking), what usually worsens first?

Muscle heaviness, weakness, or burning (legs or arms feel “heavy” or “full of lead”). Head pressure, fog, or dizziness (feels like a blood flow / circulation issue). Heart racing, palpitations, or a shaky “adrenaline” feeling. Mainly flu-like fatigue or malaise without a clear muscle / brain / heart pattern. Nothing meaningful happens from that level of activity. None of the above / unsure.

A2.Standing still for 1–3 minutes (for example in a line), what usually happens?

Nothing significant – I feel about the same. I feel fatigue or heaviness in my legs or body. I get head pressure, fog, or a “swimmy” feeling. My heart rate jumps, I notice palpitations, or feel a shaky autonomic surge. I feel near-faint / collapse feeling and need to sit down quickly. None of the above / unsure.

A3.Heat exposure (normal warm room, shower, or kitchen), what best matches your usual reaction?

Normal warm environments cause no issues. I get mild issues in normal warmth, but only strong or extreme heat causes dizziness or fog. Almost any warmth triggers flushing, feeling too hot, or heart rate increases. Only cold causes problems for me; heat is usually fine. Both heat and cold seem to trigger symptoms. None of the above / unsure.

A4.Sitting upright for more than 1 hour (at a desk, on a chair), what usually happens?

I feel fine – no real change. I get muscle heaviness, stiffness, or fatigue in my back or legs. Head pressure or brain fog builds up. My heart rate changes or I notice autonomic symptoms (palpitations, internal shaking, etc.). None of the above / unsure.

A5.Walking uphill or climbing a flight of stairs, what tends to show up first or most strongly?

Muscle burning or weakness appears quickly in my legs. Head pressure, fog, or dizziness increases. My heart is racing, I get palpitations, or need to stop because of heart symptoms. General fatigue but no clear dominant system (muscle, brain, or heart). I struggle to start or complete stairs at baseline because my legs feel too heavy or weak. None of the above / unsure.

A6.Noise and bright light sensitivity in daily life (baseline):

I am sensitive to noise and/or bright light all the time. I am mainly sensitive when I am upright / standing or walking. I am mainly sensitive during crashes or PEM, not at my baseline. I’m not particularly sensitive to noise or bright light. None of the above / unsure.

A7.After a poor night of sleep, what tends to worsen the most the next day?

Muscle symptoms (heaviness, soreness, weakness) get clearly worse. Head pressure, brain fog, or cognitive overload gets worse. Autonomic symptoms worsen (heart rate, heat intolerance, internal shakiness). Gut / GI symptoms worsen. Mainly overall fatigue only, without one system clearly standing out. None of the above / unsure.

A8.Light everyday exercise (for example, light chores or a short walk beyond your normal), what usually gets worse?

Muscles feel heavier, weaker, or more easily fatigued. I get a “poor blood flow” sensation (cold hands/feet, low circulation feeling). Muscle burning or “lactic acid” feeling comes on quickly. Head pressure, brain fog, or sensory overload increases. My heart rate spikes, I feel heat intolerance, or a shaky autonomic feeling. I don’t react much to this level of activity. None of the above / unsure.

A9.After exertion, how does a warm shower usually affect you?

No major change – I just feel normally tired or sore. I feel worse perfusion symptoms (dizzy, “faint-like,” or head pressure ramps up). I feel worse autonomic symptoms (heart rate spikes, internal shaking, or heat intolerance). I feel slightly better overall (muscles relax, symptoms ease a bit). I haven’t tried or I avoid warm showers after exertion. None of the above / unsure.

A10.Shortly after emotional stress (argument, bad news, sudden pressure), what usually shows up first?

Fatigue increases but nothing else clearly stands out. Head pressure or cognitive overload gets worse. Heart rate spikes, I feel shaky, hot, or in an adrenaline state. I crash quickly (within hours) after stress. I mainly feel a delayed crash 1–3 days later. None of the above / unsure.

A11.Standing up quickly from sitting or lying down, what happens most of the time?

I feel fine – no meaningful symptoms. I feel brief head pressure, fog, or momentary dimming. I get clear visual dimming, “blood draining,” or shimmering in my vision. My heart rate spikes, I feel palpitations, or an adrenaline rush. I almost faint or need to sit back down quickly. None of the above / unsure.

A12.Large water or salty drink (for example oral rehydration, electrolytes, or salty broth), what is your typical response?

No noticeable change. Mild improvement (for example, clearer thinking or better head pressure). Large improvement (standing and walking are easier, symptoms clearly improve). Sometimes makes me worse (sloshy feeling, flushing, feeling wired or overstimulated). None of the above / unsure.

A13.During or after moderate exercise (brisk walking, cycling, or climbing stairs for several minutes at a pace you can do), what tends to worsen the most?

Muscle symptoms: heaviness, weakness, or burning in the muscles is the main problem. Brain/perfusion symptoms: head pressure, mental fog, trouble thinking, or sensory overload is the main problem. Autonomic symptoms: heart rate spikes, strong palpitations, feeling too hot or shaky is the main problem. Mainly a general tired/fatigued feeling without a clear dominant symptom. I rarely attempt this level of activity, or my response is too variable to describe. None of the above / unsure.

Section B – Deep PEM / Crash Pattern

Worst crashes · PEM flavor

Answer based on your worst crashes after clearly overdoing it (post-exertional malaise, PEM).

Key terms

PEM (post-exertional malaise) – a delayed and prolonged worsening of symptoms after physical, mental, or emotional exertion.
Deep crash – your worst episodes, where function is clearly below baseline and recovery can take days to weeks.
Trigger – the exertion (or stressor) that clearly preceded the crash (e.g., big outing, overdoing chores, long conversation, heat exposure).
Multi-day low – a period of 2+ days where symptoms remain clearly worse than your usual baseline after a crash.

B1.In a full, deep PEM crash after overdoing it, which cluster is the most dominant overall?

Muscle-dominant: legs/arms feel heavy, weak, or “cemented”; moving around is very difficult; recovery takes days to weeks. Perfusion/brain-dominant: head pressure, cognitive shutdown, sensory overload, “can’t think at all” is the main problem. Autonomic-dominant: heart racing, temperature swings, shaky/wired feeling, unstable blood pressure or heart rate dominate. Crushing flu-like crash: heavy malaise and a “systemic flu” feeling dominate more than any one organ system. Mainly gastrointestinal / bile-toxic: nausea, upper abdominal heaviness, belching, “bile-ish” or poisoned feeling dominates. Mixed, but muscle symptoms are clearly the worst part. Mixed, but brain/perfusion symptoms are clearly the worst part. None of the above / unsure / crashes vary too much to answer.

B2.Timing of the deep crash after clear overexertion:

Within 0–6 hours (same day – I crash quickly). 6–24 hours later (often the next day). 24–72 hours later (1–3 days later, delayed “wall”). More than 72 hours later. It varies a lot / I don’t notice a clear pattern.

B3.During a full crash, what tends to make your symptoms noticeably worse?

Being upright – sitting or standing makes head/brain or dizziness much worse. Using muscles even a little – walking to the bathroom or small chores flare muscle pain/weakness. Any stimulation – noise, light, talking, or minor stress sends my heart/autonomics into overdrive. Eating meals or digestion clearly makes the crash feel worse. Nothing specific makes it worse / hard to tell.

B4.Recovery curve after a big deep crash (next 1–3 weeks):

I slowly regain brain clarity and blood-flow stability first; muscles catch up later. I slowly regain muscle strength and stamina first; brain/orthostatic symptoms lag behind. My autonomic / heart symptoms (racing, wired, tilt issues) calm down first, but I stay very fatigued. Everything improves together in a slow, flat way. I don’t usually get deep crashes / not sure.

Section C – SMPDL3B-Related Pattern (10-Question Block)

Shedding vs deficient vs non-dominant

These questions look at circulation, microcirculation, immune/inflammatory flares, volume/salt responses, and bile/food reactions to help estimate a possible SMPDL3B pattern.

Based on the BA-GLA / SMPDL3B disease concept v2.1. This is research-oriented and not a medical diagnosis or treatment guide. Answer based on your typical baseline pattern unless otherwise specified.

Key terms

Salt + water loading – roughly 1–2 g sodium (e.g., 2–4 standard 500–600 mg sodium tablets or equivalent salt) taken with about 500–1000 ml water over 20–40 minutes, unless medically contraindicated. A small salt tablet with a few sips of water is not a full salt load.
Vasodilating supplements – e.g., high-dose niacin, citrulline/arginine, beetroot/nitrate products, or other supplements that noticeably widen blood vessels or make you feel “flushed” or “opened up.”
Protein shakes – pea, whey, or casein-based shakes or blends (not pure collagen) with a typical serving of 15–30 g protein taken as a drink.
Pre-workout (non-caffeine) – products marketed to boost performance that do not primarily rely on caffeine (often contain creatine, beta-alanine, citrulline/arginine, etc.).
MCAS-like flare – episodes of flushing, burning, itching, swelling, hives, or feeling “inflamed and reactive” even from small triggers.

C1.Immediate symptom pattern with small triggers
For example: light standing, brief conversation, small positional changes, mild stressor.

Strong autonomic/inflammatory flare (flushing/heat/HR spike, wired/shaky), may be followed by a multi-day low/crash. Milder version of the above – some heat/HR/autonomic activation but not extreme. Mainly head pressure / “blood draining from head” / perfusion feeling, minimal flushing. Mainly toxic heaviness/fatigue without much flushing or HR change. Nothing consistent / unsure.

C2.Reaction to immune-type triggers (infection, vaccine)

Immediate flushing/heat/HR spike or MCAS-like flare, often followed by a multi-day low/crash. Moderate flu-like illness plus some heat/HR/autonomic activation, then multi-day fatigue. Mostly delayed crash 24–72 hours later, with fatigue and brain fog more than flushing. Mainly toxic/metabolic feeling (poisoned, heavy) with little flushing/HR spike, often lasting several days. No clear pattern / unsure.

C3.What does a “crash” feel like at its peak?

Hot, flushed, wired, lots of autonomic or MCAS-like symptoms (even if exhausted), may then settle into a low. Cool/flat/toxic heavy feeling, like metabolic shutdown, without much heat or MCAS activity. Head pressure / “blood flow” / perfusion sensation dominates. Mostly pure fatigue with no strong inflammatory, toxic, or perfusion signature. None of the above / unsure.

C4.Heat + upright (shower, kitchen, sauna)
Think about being warm and standing – e.g., hot shower, cooking in a warm kitchen, being in a sauna.

Triggers flushing/heat + HR spike or autonomic surge, can lead into a multi-day low/crash. Noticeable heat and discomfort, but I usually recover quickly. Grey-out / low-BP feeling / “blood draining from head” with little flushing. Mainly increased fatigue/weakness without much heat or HR change. Barely affects me.

C5.Cold reactivity
Consider both cold environments and cold hands/feet (winter, cold rooms, cold exposure).

Strong pain, stiffness, or white/blue hands/feet; cold is clearly destabilizing. Mild cold sensitivity – uncomfortable but manageable. Cold mainly triggers energy collapse / low-BP / shutdown without marked pain. Cold actually feels stabilizing or clarifying compared to heat. Cold barely affects me / unsure.

C6.Response to salt + water loading
Think of a proper salt load: around 1–2 g sodium taken with 500–1000 ml of water over 20–40 minutes (if safe for you). A small tablet with a few sips of water is not a full test.

Large improvement in orthostatic tolerance and head pressure, feels clearly stabilizing. Mild/moderate improvement – helpful but not dramatic. No clear change. Tends to make me worse (more flushing/heat/HR spikes or “leaky/wired”), sometimes followed by a low. Hard to judge / haven’t tested.

C7.Standing from lying/sitting (especially in warmth)
Think about the first 1–3 minutes after standing up, especially in a slightly warm environment.

Flushing/heat/HR spike or adrenaline surge, sometimes followed by a crash. Head pressure, fog, “blood draining from head” without marked flushing. Grey-out, near-faint, or extreme weakness with minimal HR increase or heat. Mostly fine; only mild/occasional symptoms. None of the above / unsure.

C8.Rich / fatty / fried meals

Flushing/heat/HR spike or MCAS-like symptoms, can trigger a crash or multi-day low. Upper GI “toxic heaviness”, belching, bile-like nausea or right-upper-quadrant tightness, often worsens baseline for hours–days. Mainly increased fatigue/weakness without much GI or flushing. Only mild GI discomfort / tiredness; recover quickly. No meaningful reaction / unsure.

C9.During mild–moderate exertion
Think about activities like short walks, light chores, gentle stretching – not maximal exercise.

Heat/HR/autonomic/MCAS-like reaction dominates and often forces me to stop. Muscle heaviness/ischemia dominates (“legs fill with lead”) with relatively little flushing. Head pressure / blood flow / perfusion sensations dominate. Immediate exhaustion/flattening without much HR response, even with light effort. None of the above / can’t attempt enough exertion / unsure.

C10.Timing and flavor of PEM/exertional crash

Symptoms start within minutes–hours with autonomic/MCAS/inflammatory flare (heat/HR spike), can evolve into a multi-day crash. I feel okay at first, then same-day worsening builds over several hours → may last days. Clear 24–72 hour delayed crash (classic PEM) with fatigue and brain fog more than flushing. More immediate flat metabolic shutdown – extreme fatigue/weakness without much heat or HR response, often lasting days. No clear crash pattern / unsure.

Section D – BA-GLA Dynamic Response

Fasting · meals · fat/choline · timing

These questions look at how your symptoms change with fasting, meals, fat/choline, time of day, exertion, and meal timing. Answer based on your typical pattern.

Key terms

Fasting – not eating for an extended period (for example, overnight before breakfast or intentionally delaying a meal).
Post-meal window – the 30–90 minutes after eating when digestion and bile flow are most active and symptoms may shift.
Fat/choline-rich foods – foods like eggs, fish, bone broth, organ meats, or choline/PC supplements that strongly engage bile-acid and hepatic pathways.
Delayed “sick” window – a delayed period 6–24 hours after exertion when nausea, gut upset, or a “poisoned” feeling can appear or ramp up.

D1.Fasting – Before breakfast, while still fasted:

I usually feel worse (nauseous, shaky, brain foggy, or dizzy) before I eat. I feel about the same before eating. I often feel better before eating than after.

D2.30–90 minutes after meals:

Brain fog, head pressure, or dizziness usually get worse 30–90 minutes after eating. Nausea, bloating, or gut discomfort usually get worse 30–90 minutes after eating. My heart feels more “wired / unsteady” or I feel autonomically unstable after meals. Nothing meaningful changes after meals.

D3.Response to fatty or choline-rich foods
Examples: eggs, fish, bone broth, organ meats, or choline/phosphatidylcholine supplements.

They often make me feel worse (nauseous, heavy, foggy, “poisoned,” or wired). I don’t notice a clear pattern with these foods. They often make me feel better (calmer, clearer, more stable).

D4.Time of day when symptoms are usually worst:

Morning – first 1–3 hours after waking are usually the worst. Early afternoon is usually the worst time. Evening is usually the worst time. It varies a lot / I don’t see a clear time-of-day pattern.

D5.Delayed “sick” feeling after exertion
After physical or mental exertion, do you ever get delayed nausea, gut upset, or a “sick” feeling 6–24 hours later (not immediately)?

Yes, often – this is a common part of my crashes. Sometimes – it happens, but not every time. No – I don’t notice this pattern.

D6.Skipping meals or eating much later than usual:

I get shaky, nauseous, lightheaded, or feel “crash-like” if I delay meals. I feel a bit worse but can manage if I delay meals. I feel the same or better when I delay meals.

Tip: You can screenshot or copy your results to share with a clinician or researcher.

Your pattern summary

Baseline amplifier pattern (Section A)

Deep crash amplifier pattern (Section B)

Amplifier scores (A + B + D)

SMPDL3B pattern (Section C · 10Q engine)

BA-GLA tilt (gut–liver–autonomic)

Reminder: This is a research-oriented pattern-mapping tool. It cannot diagnose ME/CFS, SMPDL3B abnormalities, or any medical condition. Always discuss results with a qualified clinician and consider them alongside clinical history, examination, and formal investigations.