Possible reasons for exercise intolerance.

[MTRJ75]

I've been reading a lot about exercise intolerance recently. Whenever I feel well enough to do something, I feel like I need to exercise or do something productive, which puts me immediately back in a horrible state. I read about the success many have had with exercise and wonder what's making my experience so different. Here's a blog recently posted on Health Rising that may answer some of those questions by way of leaky gut: 

https://www.healthrising.org/blog/2023/07/19/convergence-gut-immune-metabolic-post-exertional-malaise-chronic-fatigue-syndrome/

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Not only did it find a higher incidence of leaky gut in ME/CFS but it found that the gut bacteria had persisted in the blood much longer in the ME/CFS patients.

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The antibody portion of the immune system was jumping into the action, but the early innate immune response that initiates a rapid inflammatory response (that was designed to neutralize the bacteria) was not.

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The symptoms of endotoxemia – “fatigue, cognitive changes, headache, nausea, increases in heart rate, and decreases in blood pressure” – are indeed, quite similar, to those seen in PEM.

The authors noted that if these bacterial toxins make their way to the blood vessels of the brain, they can turn on the microglia, producing neuroinflammation and problems with cognition.

This new study suggests that an inability to clear bacterial toxins from the bloodstream could be contributing to the brain fog found in ME/CFS.

 

This would certainly explain a lot, though not all, of the issues I'm consistently having after physical activity. 

[Macho319]

@MTRJ75Thanks for sharing. This is an interesting article. Question. Do you feel your symptoms most during activity or after? When you say horrible state what do you feel? My exercise Intolerance would be described as weakness and fatigue during activity and then exhaustion afterward. The next day is pretty bad for me too. I can have almost pain like fatigue the next day with episodes of feeling like I'll faint. 

[CheddarChaz]

I have POTS, and have successfully decreased my exercise intolerance quite a bit over the last decade. For me, they key was starting small and increasing exercise SO much slower than I wanted to. When I started out, all I could do was about 5 mins a day on an exercise bike or rowing machine--anything I could do sitting or lying down. Eventually I built short walks back in, then gradually longer walks and bike rides. Exercising in a pool can also help, because the water pressure increases your blood pressure a bit.

It's really hard to know where your limit is, because it can change so much from day to day. It's also really hard to have the discipline to do less than you think you can, so you don't wreck yourself for the next day. You won't succeed every time, but it's really worth it to get super familiar with where your limits are, so you can stay below them with some extra buffer room.

[MTRJ75]

Afterward. It's odd. Sometimes I don't even really start to sweat till afterwards. It's a weakness, blurry vision, almost a concussed like feeling, digestive distress plus another feeling all throughout my body I can't even explain. 

[Jyoti]

1 hour ago, MTRJ75 said:

It's a weakness, blurry vision, almost a concussed like feeling, digestive distress plus another feeling all throughout my body I can't even explain.

PEM?!  

I relate to all these symptoms.  I often say that all of my normal bodily functions just stop working right.  Circulation gets worse, temperature modulation out the window, digestion, breathing gets difficult, neuropathy blooms, sleep gets harder.....  Is that you @MTRJ75 or is it less intrusive?

[MTRJ75]

I don't think it affects sleep unless I'm active close to bed time, but more or less, yeah. 

[MikeO]

So what is PEM? is that like PMS?

[Macho319]

@MikeOLOL! I believe it's Post Exertional Malaise 🙂

[MaineDoug]

PEM it is! Of course I also have pEM (I made it up: pre-exertional malaise)! I find the hardest part is starting. I have been following the CHOP exercise program and it has helped greatly. Although I am limited by Left hip pain, “severe joint deterioration and extensive bone on bone”, and it feels just like it sounds, like walking on ground glass. But I have tolerated light exercise on a semi recumbent bike (bought used, like new, only $50). I pay a hip pain price, but I’m between a rock and a painful place! Must exercise for POTS and to prep for total hip, hoping for November! There’ll be no stopping me then!