On Tachycardia, Exercise, And Symptoms

[jangle]

For the past month I've been ramping up exercise again. This time around I'm incorporating other things into my workout regiment, namely weight lifting to try to boost vagal output and the stairmaster.

There have been numerous studies which documented reduced stroke volume in POTS patients, but there have also been studies which showed that even with normalization of stroke volume, symptoms persist - arguing against stroke volume as being the cause of the symptoms.

The stairmaster seems like a great exercise to reduce standing heart rate, it works the thigh muscles where most of the blood volume occurs in the legs (your legs hold a substantial percentage of your overall blood volume). So boosting that muscle pump will aid in blood flow back to the heart. Additionally it seems to target the heart and cardiovascular system well, which hopefully will lead to enlargement of the heart.

One of the things I notice however, with exercise - and this may be individual. But so far all exercise does is delay the time my tachycardia sets in. For example, without exercise my standing HR will go from 70s to 120s in about a minute. With exercise it still goes near the 120s (I think I maxed at 117) but now it takes 5 minutes. I guess that's improvement, but ultimately one wants to get the absolute standing HR permanently down.

I was wondering if this has been other's experience with exercise? I know from several of the papers people were able to get reduction in symptoms of their POTS without much reduction in heart rate values - and honestly I think the tachycardia is loosely correlated to symptom intensity. I believe the tachycardia is just an artifact of reduced NET proteins, and stems from being flooded with norepinephrine rather than as compensatory mechanism.

[Dizzysillyak]

Hi jangle,

Congrats on your exercise routine. It's interesting seeing if and how this helps you. Good luck with

this. Btw. My pt office has a machine that simulates the stair master while supine. That might work

better since you'd have proper blood circulation.

I tried but can't do any long term exercise routines due to cfs/pem but when I was trying this

I too decreased my hr and increased my endurance and muscle mass. I used to be athletic so

I miss exercising. I've noticed since trying this multiple times that it takes me a few weeks to really feel relaxed physicalky or mentally again.

What didn't change from exercising tho was the results of my pmttt. I still had a 30 pt hr increase, petite mal and sob

after 10 minutes. Imho, in my case the petite mal and sob are what's forcing me to lay down.

I say that because if I'm busy with laundry, vacuuming, etc my hr will go up to around 130 but I don't have

to lay down. It's standing up without moving my blood that's the problem. Hr during pmttt only gets

around 110.

I'm not sure what your last statement means. Can you explain that ? Thanks. D

[roxie]

That's what I've experienced. Like it might take a minute linger to get high but we're been discovering I have muscle problems so I don't know if that's related to why its so hard for me to exercise as well.

[Anoj]

does exercise help with pooling, as well as tachy? i usually see it in reference to tachy but not pooling.

i commend you on your protocol, jangle. exercise has always helped with my energy level. i have been enrolled in an rx exercise program off and on for the past 2 yrs. have just renewed my membership after a long break.

[Chaos]

I think I have to agree with Rama's statement on this one. It seems to me like "exercise just makes me tolerate exercise better". It doesn't really seem to do anything to change my POTS symptoms. Can't even say that it consistently changes how quickly my HR will go up. I've been in a massive relapse of symptoms for the past 3 months though so haven't been able to exercise at all like I was doing previously. But from what I remember when I was exercising a lot in the fall, it still seemed like POTS symptoms varied dramatically day to day, regardless of the fact that I was exercising consistently at a pretty high level 5 days a week at least.

[Chaos]

........Then I started doing interval training (anaerobic) and started having vastly more symptoms. Thought it might help bump me up to the next level since I was doing so much better. Boy was I wrong on that count!!!

That's why I found Dr. Klimas' research on her gene expression studies so fascinating. Where she showed that anaerobic exercise triggered autonomic dysfunction which was then followed by immune dysfunction. Have been wondering if that was what set up my massive relapse that I've been in. At the time I figured it was just coincidental but since reading about her research, I'm seriously wondering if I did it to myself- however inadvertently.

[Mytwogirlsrox]

Over time my HR went from the 150s to 90s standing. I was exercising, now I'm not and it's still in the 90s. So who knows.

I did notice that after exercise my HR was elevated for at least a day. For instance if my baseline standing is 110 then it would be 130 for at least a day after vigorous exercise, and 90-100 sitting

[lynnie22]

Although I haven't done a ton of exercise and still am pretty deconditioned, I have also noticed that my HR goes up for the day after exercise, both standing and sitting. Not sure what to do, except to keep exercising and hope that it calms down in time.

[Anoj]

So does exercise help, or hurt? I am confused.

[ramakentesh]

I'd echo chaos's comments completely. Exercise helps me to feel stronger and increase my ability tolerate exercise but it has no effect on the random fluctuations and relapses.

one thing I do find with exercise is that once I start I have to keep going or it catchs up with me. Another is that my general exercise tolerance varies considerably each day.

[ramakentesh]

I wonder if pots does have many different causal factors then it might be like trying to cure all fevers by removing tonsils? Lol.

[Relax86]

I always felt like weight training - light and careful - was helpful for my POTS. At the end of the day I still have setback days, good response and bad response to exercise. For me, if I'm not having any serious adverse reactions then why not just do it? I think it does help with stress management and it does make me happy to tolerate it. I feel like my improved conditioning in the last 6 months has helped me build a physiological tolerance to flares as well as emotional.

I'm also with Rama in that my general tolerance varies each day. Somedays I can lift 15's or 20's, other days I'm lucky to get in a set of 10 with 4's. At times I can jump rope for intervals or do some burpees and mentally I'm thinking "I have this thing beat!!".....it could be 1 day later or 1 week later that I'm on the couch with a kale smoothie or a brownie (depending on mental state) breathing thru some tachy crap, waiting to pass out making me feel just crazy. Cheers to the good days when they come

[Kellysavedbygrace]

Great topic and it hits home w me as I am about midway through an exercise holiday after someone online suggested my "crashing sounded like Post Exertional Malaise.". So the hypothesis I'm testing is, does the exercise hurt? This will be proven if my crashing, as measured by my symptom tracker improves showing any significant improvement over 50%. I've been planning a post to discuss how helpful it has been to exercise. A year ago I couldn't drive, couldn't go to the grocery store, go to church, etc. Now I am 50% functional and am measuring everything as scientifically as possible. I attribute my improvement in functioning in part to the meds and diet, but even more so to the exercise. So I'm in quite a quandary should I have significant improvement. Will post this thread soon.

Went from homebound and barely able to exercise to hour long strenuous aerobic and upright circuit training 3-4x a week. Took almost a year to get that improvement.

As for tachy- it has made little to no difference. Although I always exercise w a HR monitor as my HR escalates as much as 80bpm within 15 seconds of a new exercise. So I monitor closely to make sure it is down significantly before the next rep. As a side note it is interesting that my HR is typically higher just walking into the gym from the garage than it is at the end of my warm up. Funny.

Jangle, you'll make a great doc.

[Dizzysillyak]

When I tried this my ability to lift a certain weight didn't change. Only the number of reps I could do

changed. On my last day of pt before I gave up due to chronic pem (really couldn't think anymore)

was spent resting a long time after minimal sets using the same weights as I had previously.

For those noticing a difference could you be experiencing post exertional malaise (pem) ? Pacific

Labs has a test for this but I'm not sure they explain exactly what it means as far as chemical reactions

that are occuring.

I have to go slow on the recumbant bike because my muscles don't recover quick enough. Trying to pedal

quickly only leads to muscle spasms in my calves.

I have chronic low blood glucose and wonder if it's related. Thoughts ? .. D

[Dizzysillyak]

Kelly,

Increased stamina is normal for most who eliminate food intolerances, esp celiacs. Imho, it's

one of the reasons these special diets are so popular. Celiacs begin to absorb nutrients again

but I'm not sure if that's true for other food intolerances. Cytokines are reduced tho and that helps.

Good to hear you're feeling better. Hope it continues. D