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Is this adrenal fatigue/overtraining?

Old 10-09-18, 10:51 PM
  #51  
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Five months along, this issue unfortunately hasn't resolved itself. Haven't had my cortisol levels checked yet, however, I haven't developed any syndromes or diseases in this timeframe that I'm aware of, nor is there any residual fatigue, I just simply cannot ride a bike. I've cut back to one ride or less a week, but it has probably in fact worsened, limiting me to about 20 miles on flat road at ~16 mph pace. Heart rate is still elevated about 15-20 bpm, although in all this time, I'd imagine my loss of fitness would correlate with an increase in active HR anyhow. I feel great in general and mentally motivated to ride again, but just can't physically do it. If this is overtraining, can it really take one this long/longer to recover, even in the absence of any illnesses, fatigue, or soreness, or other symptoms?
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Old 10-10-18, 10:02 AM
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Originally Posted by Dreww10
Five months along, this issue unfortunately hasn't resolved itself. Haven't had my cortisol levels checked yet, however, I haven't developed any syndromes or diseases in this timeframe that I'm aware of, nor is there any residual fatigue, I just simply cannot ride a bike. I've cut back to one ride or less a week, but it has probably in fact worsened, limiting me to about 20 miles on flat road at ~16 mph pace. Heart rate is still elevated about 15-20 bpm, although in all this time, I'd imagine my loss of fitness would correlate with an increase in active HR anyhow. I feel great in general and mentally motivated to ride again, but just can't physically do it. If this is overtraining, can it really take one this long/longer to recover, even in the absence of any illnesses, fatigue, or soreness, or other symptoms?
Not overtraining, never thought it was. Get thee to a doctor, see if you can talk the doc into a hormone panel, esp. DHEA or anything else the doc can think of. Of course the usual full panel of blood markers incl. vitamins D and B12 and hematocrit. Tell the doc there's something bad wrong with you and you want a diagnosis. They hate to do that because it's a lot of work, but without a diagnosis there's really nothing to be done. Be persistent. Another thought: heart murmur? Physical exam and EKG? EKG actually pretty quick and cheap. You better have health insurance.

HRV is a diagnostic aid, though no one knows what it's diagnosing, just some unknown problem. Still it's something one can do oneself. Elite HRV for your smartphone works well. You'll need a HR transmitter, either a ANT+ or Bluetooth (Polar or other). You can compare your readings online with those of other Elite users. One has to use it for several days - one reading isn't very meaningful.
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Old 10-10-18, 05:34 PM
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Originally Posted by Carbonfiberboy
Not overtraining, never thought it was. Get thee to a doctor, see if you can talk the doc into a hormone panel, esp. DHEA or anything else the doc can think of. Of course the usual full panel of blood markers incl. vitamins D and B12 and hematocrit. Tell the doc there's something bad wrong with you and you want a diagnosis. They hate to do that because it's a lot of work, but without a diagnosis there's really nothing to be done. Be persistent. Another thought: heart murmur? Physical exam and EKG? EKG actually pretty quick and cheap. You better have health insurance.

HRV is a diagnostic aid, though no one knows what it's diagnosing, just some unknown problem. Still it's something one can do oneself. Elite HRV for your smartphone works well. You'll need a HR transmitter, either a ANT+ or Bluetooth (Polar or other). You can compare your readings online with those of other Elite users. One has to use it for several days - one reading isn't very meaningful.
I mean no discredit to your thoughts and experiences, because you've been a wealth of knowledge here on the forum, but all of my reading on the subject of overtraining says its evidenced by an increase in heart rate, not suppressed. I'm certainly open, however, to hearing/reading other facts if that is indeed incorrect.

One of the challenges I'm having, in addition to the natural increase in HR due to loss of fitness, is that I've never been in this position before. By that I mean I started riding six years ago and have never taken a break long enough to lose much, if any, fitness, and so I'm unsure if it's to be expected for 20 miles to be challenging after this much time off, or if I should be closer to where I left off. In other words, I may not even know when I'm recovered, because riding at all may taxing at this point.
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Old 10-10-18, 06:53 PM
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Originally Posted by Dreww10
I mean no discredit to your thoughts and experiences, because you've been a wealth of knowledge here on the forum, but all of my reading on the subject of overtraining says its evidenced by an increase in heart rate, not suppressed. I'm certainly open, however, to hearing/reading other facts if that is indeed incorrect.

One of the challenges I'm having, in addition to the natural increase in HR due to loss of fitness, is that I've never been in this position before. By that I mean I started riding six years ago and have never taken a break long enough to lose much, if any, fitness, and so I'm unsure if it's to be expected for 20 miles to be challenging after this much time off, or if I should be closer to where I left off. In other words, I may not even know when I'm recovered, because riding at all may taxing at this point.
Overtraining is adrenal fatigue (at least that seems to be the case). Therefore, resting HR is elevated and active HR, especially over zone 2, is depressed. That's what I've personally observed and is the experience of others as well.

As you say, increased active HR could easily be the result of detraining. No, you should be nowhere near where you left off. It goes away so fast. I assume you've tried taking some hills hard and found your HR skyrocketed and you panted. That would be normal. However the extent of that increased HR might not be normal, hence my feeling about getting some blood work done. If your hematorcrit for instance is in the toilet, that might be a symptom of other problems. Even getting out for 20 once a week should cause some training effect, so that each week that ride should get easier. I don't think blogging is going to solve the problem, if there even is one. Doctor. Get a clean bill and start riding your heart out or not. The thing is, you've been having problems for a couple years: high HR at what should be a normal pace and it seems to be getting worse. That'd scare me, frankly.
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Old 10-11-18, 01:50 AM
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Get that thyroid thing rechecked. Doctors may say "It's within normal limits" but that doesn't mean it's right for you.

Back in early summer I got some bad advice from a nurse practitioner at my health network's geriatric clinic (yeah, at 60 I really dislike that whole concept). She told me to quit taking thyroid meds because my thyroid panel showed normal. Made no sense to me but I followed her instructions.

Huge, mistake. Within a few weeks I was wiped out, barely enough energy to get out of bed. Went to urgent care, the doc redid the thyroid panel. It was just barely within normal limits, but she said that doesn't mean it's normal for me. Started me back on levothyroxine. Took about three weeks before I began to feel better. Now it's six weeks and I'm starting to get back to normal.

But my heart rate is still all over the place. That's typical of both Hashimoto's (my first diagnosis about 17 years ago) and Graves diseases, and some endocrinologists say some patients flip-flop between Hashimoto's (hypo-thyroidism) and Graves (hyper), which makes diagnosis and treatment even trickier. My resting pulse can vary from 60-100. My low effort HR is 120, moderate is 140, high sustainable effort is 160, and maxed out for HIIT sprints of 15-60 seconds is 170-175. That's as high as I can crank up my heart rate.

The weird thing is my BP will drop to normal or even a bit low immediately after a workout, as low as 80/50 before stabilizing at 110-120/60-70. But my heart rate will remain 90-100 for an hour or longer after a workout. It takes hours before it drops to 70 or so. Again, a symptom of a wonky thyroid.

So don't go just by TSH and T4 panels that show you're within "normal" limits. It may not be normal or optimal for you.

Diet and rest are bigger factors as we get older. I felt great Wednesday morning and early afternoon, then crashed suddenly on the train ride home from the doctor's appointment. I'd planned on a ride when I got home but napped instead. Woke up after 10 pm, felt lousy, ate "breakfast" and now I feel fine again. So I'm going for a bike ride, even though it's 3 a.m.

Good reminder that I'm not 20 anymore and need to eat more regularly, even when I'm not hungry, and rest even when I think I'm not tired.

I got a second opinion this week and the doc said the same thing -- have the thyroid removed, most of it or all, depending on what they find in surgery and post-surgical section biopsy. So I'll be on thyroid meds the rest of my life. Fine with me, as long as I can keep riding and working out within reasonable expectations.
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Old 10-11-18, 09:52 AM
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Possibly, the early stages of, chronic compartment syndrome?
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Old 10-11-18, 10:47 AM
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Originally Posted by Dreww10
I mean no discredit to your thoughts and experiences, because you've been a wealth of knowledge here on the forum, but all of my reading on the subject of overtraining says its evidenced by an increase in heart rate, not suppressed. I'm certainly open, however, to hearing/reading other facts if that is indeed incorrect.

One of the challenges I'm having, in addition to the natural increase in HR due to loss of fitness, is that I've never been in this position before. By that I mean I started riding six years ago and have never taken a break long enough to lose much, if any, fitness, and so I'm unsure if it's to be expected for 20 miles to be challenging after this much time off, or if I should be closer to where I left off. In other words, I may not even know when I'm recovered, because riding at all may taxing at this point.
I just remembered that bolded part. When I could no longer ignore that same feeling is when I went to the doc about what turned out to be PMR (I think!). I kept saying to myself, "Well, I am another year older, maybe this is what people go through as they age?" And then I finally decided, when I could no longer ignore the pain, that was nonsense. I should feel fine, just like I've always felt. I.e. PROBLEM. So I did something about it, finally. Funny how we are. Is it just men? Tough guys, don't need help? We can work through it? However that is, I finally gave in and got help.

The tricky part, yet to be explored, is like @canklecat was saying, medical pros are not all equal. Sometimes you have to explore a little. My first and second doc didn't know really what's wrong with me for sure, other than that I have a problem. 3rd doc appointment coming up next week, a rheumatologist who'll probably order more blood work. Or maybe not. Maybe she'll just know, having seen this before, unlike docs 1 and 2.
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Old 10-11-18, 11:05 AM
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Originally Posted by Carbonfiberboy
Overtraining is adrenal fatigue (at least that seems to be the case). Therefore, resting HR is elevated and active HR, especially over zone 2, is depressed. That's what I've personally observed and is the experience of others as well.

As you say, increased active HR could easily be the result of detraining. No, you should be nowhere near where you left off. It goes away so fast. I assume you've tried taking some hills hard and found your HR skyrocketed and you panted. That would be normal. However the extent of that increased HR might not be normal, hence my feeling about getting some blood work done. If your hematorcrit for instance is in the toilet, that might be a symptom of other problems. Even getting out for 20 once a week should cause some training effect, so that each week that ride should get easier. I don't think blogging is going to solve the problem, if there even is one. Doctor. Get a clean bill and start riding your heart out or not. The thing is, you've been having problems for a couple years: high HR at what should be a normal pace and it seems to be getting worse. That'd scare me, frankly.
I checked my resting HR in the very beginning, when I was feeling fatigued and lethargic 24 hours a day, and it was normal (about 45 bpm); haven't checked it lately but I'd suspect it's increased now due to detraining. As noted above, I no longer have any symptoms whatsoever: no fatigue, no illness, insomnia, irregular weight less/gain, nothing. I feel 100% fine, and even after I ride I still feel great, I just don't have any endurance or power and HR is up. You're right, though, that slow recovery and cramping have been an ongoing issue.

The only thing I can recollect that was out of the norm at the time this began was I had been experimenting with consuming increasing amounts of pure salt in my bottles. I have to assume though that a heart condition caused by that would present other symptoms besides poor athletic performance, would it not?

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Old 10-11-18, 01:13 PM
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Originally Posted by Dreww10
I checked my resting HR in the very beginning, when I was feeling fatigued and lethargic 24 hours a day, and it was normal (about 45 bpm); haven't checked it lately but I'd suspect it's increased now due to detraining. As noted above, I no longer have any symptoms whatsoever: no fatigue, no illness, insomnia, irregular weight less/gain, nothing. I feel 100% fine, and even after I ride I still feel great, I just don't have any endurance or power and HR is up. You're right, though, that slow recovery and cramping have been an ongoing issue.

The only thing I can recollect that was out of the norm at the time this began was I had been experimenting with consuming increasing amounts of pure salt in my bottles. I have to assume though that a heart condition caused by that would present other symptoms besides poor athletic performance, would it not?
Other than weight gain, I don't think you'd notice increased salt. No endurance or power: something's screwed up. Could be anything. Blood's not right? Mitochondria not right? Hormones not right? You seem to have no interest in going to a doctor to find out what's wrong. Post again after you've seen one and have all blood work and a diagnosis.

CFB out. The longer you wait to find out, the greater the danger.
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Old 10-11-18, 01:16 PM
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Originally Posted by Carbonfiberboy
Other than weight gain, I don't think you'd notice increased salt. No endurance or power: something's screwed up. Could be anything. Blood's not right? Mitochondria not right? Hormones not right? You seem to have no interest in going to a doctor to find out what's wrong. Post again after you've seen one and have all blood work and a diagnosis.

CFB out. The longer you wait to find out, the greater the danger.
All bloodwork is normal. Awaiting cortisol results.
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Old 10-11-18, 08:11 PM
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Originally Posted by McBTC
Possibly, the early stages of, chronic compartment syndrome?
Fascinating. I'd never heard of that specific syndrome before, although I was aware of asthma caused by exertion -- that's the main reason I have albuterol inhalers, for occasional exertion asthma.

But my symptoms are the opposite of those described for chronic exertional compartment syndrome. Sounds a bit like fibromyalgia. Try discussing stuff like that with most doctors. You'll get the House routine about lupus. Remember the medical show House with Hugh Laurie? There was a long-running joke: "It's not lupus. It's never lupus." Except sometimes it was lupus.

Often I feel at my best after warming up, during and for an hour or so after a good workout (other than HIIT, which just hurts and ain't ever fun). Whatever the body and brain do during and immediately after a good workout -- endorphins, oxytocin, dopamine, serotonin, etc. -- it's as effective for me as moderate opiates but with a mild stimulant kicker instead of opiate-type grogginess and lethargy. Pretty similar to a couple of cups of strong coffee.

The problem is the sensation of well being and reduced pain doesn't last. I'll wake up the next day feeling miserable, achy and groggy, almost like a hangover. And I quit drinking about three months ago, not because I drank too much -- I rarely drank more than one or two beers at a time, only a few times a week, about six beers a week. But because I didn't seem to be metabolizing alcohol properly anymore. Just one beer would cause hangover symptoms within an hour or two.

Every morning it can take me 2-3 hours just to begin to feel human again. So if I have any appointments or anything constructive to do that day I need to wake up hours earlier than usual just to be halfway prepared. Sometimes the rebound hits later while I'm still awake. That's annoying. I'm hoping getting the thyroid problem resolved will help.
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Old 10-12-18, 08:22 AM
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Originally Posted by Dreww10
All bloodwork is normal. Awaiting cortisol results.
Testosterone?
Vitamin D?
Hematocrit?
CRP?
CK?
TSH?
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Old 10-12-18, 10:50 AM
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Originally Posted by canklecat



Every morning it can take me 2-3 hours just to begin to feel human again. So if I have any appointments or anything constructive to do that day I need to wake up hours earlier than usual just to be halfway prepared. Sometimes the rebound hits later while I'm still awake. That's annoying. I'm hoping getting the thyroid problem resolved will help.
You can fix that in 60 seconds...

https://www.bikeforums.net/general-c...-work-etc.html

It's not hard -- just the reverse because the results are energizing and the most amazing thing is-- it always works... What makes it easy to try is realizing it's the change and the absolute amount of the change doesn't have to be that great or jarringly quick or long to do the trick!
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Old 10-12-18, 07:23 PM
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Originally Posted by McBTC
You can fix that in 60 seconds...

https://www.bikeforums.net/general-c...-work-etc.html

It's not hard -- just the reverse because the results are energizing and the most amazing thing is-- it always works... What makes it easy to try is realizing it's the change and the absolute amount of the change doesn't have to be that great or jarringly quick or long to do the trick!
That hot/cold shower jolt to kick dopamine in the pants worked great when I was younger and healthier. I did it often. Heck, just jumping on my bike and riding to work jumpstarted all the brain chemicals that lift the morning fog. I'd shower at work.

But the hot/cold shower trick doesn't do a thing to relieve the chronic fatigue and aches caused by the thyroid auto-immune disorder.

Heck, I've tried every supplement and voodoo potion recommended by the internet wise persons, nutrition quacks and voodoo practitioners. Extra iron, calcium, Vitamin C and B, potassium, magnesium, DHEA, pregnenolone, CBD, you name it, I've tried it. Any slight effect could be attributed to placebo effect. I'm looking for something with a definite, unambiguous, no fooling around effect.

Only thing that seems to help is ibuprofen, two or three cups of strong coffee, some stretching and 15-30 minutes of easy spinning on the indoor trainer. Still takes time. And the doc switched me from massive amounts of ibuprofen to twice daily diclofenac. Seems to help with the inflammation pain.

I've been back on thyroid meds going on six weeks now. Surgery to remove the dead half of the thyroid will be later this year, and they'll triple check for cancer. First biopsy showed no cancer and both endocrinologists and ENT docs I've consulted with say the risk of cancer is low with this disorder. Docs say it'll take time to feel close to normal again. I'm just impatient.
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Old 04-23-19, 03:02 PM
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Updating this thread.

Around the first of the year, sensing I wasn't going to accomplish anything by continuing to ride, I took a full month off, tried to ride once, took another month off, rode once or twice, and took another three or four weeks off. By the first of April, I had only gone 100 miles all year. In the latter part of this period, I was suddenly overcome with extreme fatigue and tiredness, which inspired me to find a good doctor to run a complete panel and start really getting to the bottom of things.

Everything in the bloodwork was normal with the exception of glucose (just 1 MG/DL high) and white blood cell count (3.8; 4.1-10.9 is normal range). My cortisol has been tested twice seven months apart (was 21 via an ACTH stimulation test, 18 via blood draw, both in range). Testosterone has climbed from 308 to 389 to now 534, so that's a positive. EKG with a cardiologist was normal. It was noted that my heart rate climbs about 35-50 bpm upon standing and blood pressure drops. HR drops back to around 75, blood pressure stays lower. Cardiologist noted that a hormone imbalance can make heart rate not only higher, but erratic.

At this stage, it still feels like my body has a governor on it when I attempt to ride. I extended my time to 2 hours on one occasion at a very slow pace on flat road, but there's just no "go" and anything beyond a very leisurely pace and there's the feeling off lactic acid buildup/soreness the way an all-out effort would have in years past. Still haven't suffered from insomnia, nor have I experienced any infections or illnesses.

Right now, to improve mood and perhaps boost testosterone and improve immune function, I'm riding 3-4 times a week for an hour at a very slow pace, but there's been no noticeable turn-around in performance.
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Old 04-23-19, 04:08 PM
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Originally Posted by Dreww10
Right now, to improve mood and perhaps boost testosterone and improve immune function, I'm riding 3-4 times a week for an hour at a very slow pace, but there's been no noticeable turn-around in performance.
Have you tried other types of workouts, running, hiking or swimming? Is it cycling specific or does it affect all types of activity?
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Old 04-24-19, 10:14 AM
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Originally Posted by GailT
Have you tried other types of workouts, running, hiking or swimming? Is it cycling specific or does it affect all types of activity?
I don't do any other disciplines, so I couldn't say. I can take walks, for what that's worth.
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Old 04-25-19, 08:07 PM
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Originally Posted by Dreww10
<snip>Cardiologist noted that a hormone imbalance can make heart rate not only higher, but erratic.<snip>
Frustratingly, nothing found. My mother-in-law had that from doctors for maybe 20 years. Diagnosis was possible insanity. Turned out she had MS. So did the cardiologist offer to order tests to see if in fact this was the case? Or is he just not interested in your case? Gotta be a doctor out there somewhere with a curious streak. Tough to find. Mostly they want the easy diagnosis and quick prescription. I've seen that over and over. What they want, above all, is quick patient turnover in the office. I know one doctor who keeps 5 exam rooms filled during office hours. Her quote, "My time is worth more than theirs."

Sounds to me like your mitochondria aren't functioning properly. But if that's the case, why?

You didn't mention hematorcrit. Was that taken?
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Old 04-25-19, 09:49 PM
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Originally Posted by Carbonfiberboy
Frustratingly, nothing found. My mother-in-law had that from doctors for maybe 20 years. Diagnosis was possible insanity. Turned out she had MS. So did the cardiologist offer to order tests to see if in fact this was the case? Or is he just not interested in your case? Gotta be a doctor out there somewhere with a curious streak. Tough to find. Mostly they want the easy diagnosis and quick prescription. I've seen that over and over. What they want, above all, is quick patient turnover in the office. I know one doctor who keeps 5 exam rooms filled during office hours. Her quote, "My time is worth more than theirs."

Sounds to me like your mitochondria aren't functioning properly. But if that's the case, why?

You didn't mention hematorcrit. Was that taken?
Hematocrit 43.2% (range is 38.0-48.0)

Cardiologist did refer me for an echocardiogram, but at $2,000, I decided to cancel out other things before doing that. He felt pretty confident my heart is fine, particularly given my age and how fit my heart still appears to be, despite so much time off the bike. But couldn't be certain without the test.
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Old 04-25-19, 11:01 PM
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Originally Posted by Dreww10
Hematocrit 43.2% (range is 38.0-48.0)

Cardiologist did refer me for an echocardiogram, but at $2,000, I decided to cancel out other things before doing that. He felt pretty confident my heart is fine, particularly given my age and how fit my heart still appears to be, despite so much time off the bike. But couldn't be certain without the test.
Yes, that's good, especially for not having been riding hard. You're talented. I'm no doc, but I have a hard-used heart and yours doesn't sound like a problem. Cardios pick that stuff right up.

So you're still at sea.
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Old 04-26-19, 05:51 PM
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One of the things I've done when I've had problems has been to do innocuous experiments on myself. Supposing it's a mitochondrial problem, regardless of the cause, one could try a little self-diagnosis by stimulating the mitochondria with supplements:

N-Acetyl-Cysteine (NAC) 600mg 2/day
Acetyl L-Carnitine 500mg 2/day
CoQ10 100mg 2/day
PQQ 20mg 1/day
All on Amazon.

A month of that either would make some difference - or not. Cheaper than doctors or doctor's tests which don't show anything abnormal. If that does make a difference, back to the doctors to find out why.
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Old 05-12-19, 10:15 PM
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Originally Posted by Carbonfiberboy
One of the things I've done when I've had problems has been to do innocuous experiments on myself. Supposing it's a mitochondrial problem, regardless of the cause, one could try a little self-diagnosis by stimulating the mitochondria with supplements:

N-Acetyl-Cysteine (NAC) 600mg 2/day
Acetyl L-Carnitine 500mg 2/day
CoQ10 100mg 2/day
PQQ 20mg 1/day
All on Amazon.

A month of that either would make some difference - or not. Cheaper than doctors or doctor's tests which don't show anything abnormal. If that does make a difference, back to the doctors to find out why.
Mitochondria is certainly a plausible theory...it's unfortunate that there is no easy way to test for it, though. Given I haven't incurred any symptoms in other organs, it isn't likely to be a widespread mitochondrial myopathy, but could be local to the muscles used for cycling, I suppose.
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Old 05-17-19, 01:51 AM
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@Dreww10, do you use any fitness apps or journal to keep track of exercise data?

I started using the Elevate extension with Strava to get a little more data over time. Turns out that while I don't necessarily *feel* any better than I did last year (recovering from shoulder injury and thyroid cancer), the data shows that since March my apparent cycling fitness has improved back to my pre-injury/illness level.

So while I'd like to *feel* better, at least I'm back to where I was. But without some data to offset my subjective impressions, I would have sworn that I'm slower, weaker and less fit.

In part I think it's my expectations. I'd like to be fitter, faster and stronger. But at 61 with some health challenges, I have to be realistic. One difficult change I've had to make is including more rest days. I get restless and want to ride, but I know I need more recovery time now. And it shows on my data too, both the ups and downs.
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