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this is paradoxical as severe and very severe patients are incapable of even the slightest exertion ( Probable predisposition and causes of ME/CFS The diverse symptom presentation and patient heterogeneity indicate that ME/CFS is likely to have a multifactorial origin ( Genetic predisposition Unfortunately, there is little consensus among researchers on the genetic, cellular, and molecular influences that alter the risk of developing ME/CFS ( 2 ) in large cohorts, and two of these studies reported non-zero results, suggesting a heritability risk for ME/CFS