What could be causing sudden exercise intolerance?

[Jason Actualization]

10 hours ago, ZenAlex said:

I understand but it's not what you're thinking. It's not a case that I'm alone with my thoughts and I feel depressed WHILE exercising.

I can be alone with my thoughts just fine, but exercise/physical activity itself is causing me to feel like shit after.

Exactly, this is exercise-induced, again pointing back to a B12 deficiency. Here are just a few of my labs. Yes, ascending beyond the upper end of the B12 reference range is a good thing.

[Yimpa]

7 minutes ago, Jason Actualization said:

Yes, ascending beyond the upper end of the B12 reference range is a good thing.

Sweet, I saw that my own test from a few months ago showed that my B12 was a bit higher than the upper reference range. Thanks!

Do you take a b complex or b12 supplement?

[Jason Actualization]

10 hours ago, Yimpa said:

Sweet, I saw that my own test from a few months ago showed that my B12 was a bit higher than the upper reference range. Thanks!

Do you take a b complex or b12 supplement?

That's fantastic, the reference range for B12 is notoriously low and within it, has a 5-fold range, and to think that someone at the bottom of that range is going to be equal to someone closer to the top, is entirely misleading. I do not supplement any of the B vitamins as I prefer to derive them from whole food sources, namely beef, milk, eggs and basmati rice.

[ZenAlex]

11 hours ago, Jason Actualization said:

Exactly, this is exercise-induced, again pointing back to a B12 deficiency. Here are just a few of my labs. Yes, ascending beyond the upper end of the B12 reference range is a good thing.

Damn u got those b12 levels through food? Nice.

I'm currently eating Salmon 2-3 times a week, Tuna 1x per week, and something like Chicken/Beef once per week.

Also milk everyday, and an actimel. 

What are your thoughts on cholesterol? Part of me is concerned about eggs because of cholesterol

[ZenAlex]

On 13/02/2024 at 5:44 PM, Ulax said:

@ZenAlex Yep. Just would require more expertise and be less likely imo.

I've read numerous stories of people with severe cptsd recovering w/o meds. 

How are you feeling now on your medications? Any side effects?

Do u feel good in general?

[Charlotte]

@ZenAlex a lot of people with chronic fatigue syndrome and fibromyalgia were dismissed by their doctors for it being 'all in their head'. Many doctors have received long covid training around this issue. Can you see another doctor? 

Exercising - Yes, I still do. I can't work out really. At the beginning I couldn't even walk 5minutes (everyone is different, some begun worse than others). Now, my daily step count is approximately 7K which is not a lot for the entire day. Yes I am also experiencing the depression, anxiety and lightheadedness. My blood pressure, from out of no where is for whatever reason on the low side. But the lightheadedness can also be PEM (https://www.cdc.gov/me-cfs/healthcare-providers/clinical-care-patients-mecfs/treating-most-disruptive-symptoms.html#anchor_1528128659388) of which I do experience A LOT. PEM is fundamentally the exercise intolerance. A recent study done in long covid patience demonstrates what happens when PEM occurs physiologically:  (https://www.news-medical.net/news/20240108/Long-COVIDs-hidden-toll-How-does-post-exertional-malaise-affect-skeletal-muscles.aspx) 

I can assure you it is real and this isn't in your head. 

 

Join the long covid UK facebook groups and/or feel free to DM me. 

[Charlotte]

@ZenAlex be mindful you don't give yourself gout "I'm currently eating Salmon 2-3 times a week, Tuna 1x per week, and something like..." 

 

Regarding long  covid: Tell your doc you want a referral to the long covid clinic. 
 

[undeather]

Quote

What are your thoughts on cholesterol? Part of me is concerned about eggs because of cholesterol

Cholesterol is the most important risk factor for atherosclerosis.
That said, in most individuals egg intake does not have a deleterious effect on plasma lipid profiles.
There are some exceptions to this, sicne some phenotypes present themselves as so called "hyper-absorbers". 
Don't stress about it - just regularly check your cholesterol numbers. 

 

Quote

 

be mindful you don't give yourself gout "I'm currently eating Salmon 2-3 times a week, Tuna 1x per week, and something like..." 

 

 

Young, lean & physically active individuals just won't get gout if there isn't a significant genetic component running in the background (50-60% of uric acid variability is genetically determined)
So if his family history isn't full of gout-patients running around with swollen ankles, he should be fine.
It's not really a thing, even if you focus in on carnivore-dieters - who basically indulge in purine-rich foods like organ meats every few hours.

The average onset of gout is above 60 years old and usually manifests in metabolically unstable or kidney-patients.

Additionally, salmon or tuna are NOT necessarily very high in purines. 

 

Edited February 16, 2024 by undeather

[Charlotte]

@undeather I had gout at 23 from eating too much fish. Plus OP isn't physically active right now (I presume)

[undeather]

30 minutes ago, Charlotte said:

@undeather I had gout at 23 from eating too much fish. Plus OP isn't physically active right now (I presume)

Then you were one really unlucky woman!
Gout in women is even rarer, especially at normal weight. 

Anyway, I just wanted to point out that in his case, he shouldn't really worry about getting gout. 
3-4x fish a week is perfectly fine. 
 

Edited February 16, 2024 by undeather

[ZenAlex]

@undeather 

@Jason Actualization

 

[ZenAlex]

So my issues may not be b12 related then. I'll supplement anyway and see what happens.

[ZenAlex]

Do you reckon it could be my omega 3 levels instead? My test showed a shit range of 19:1 back in january before I stopped being vegan.

 

[Jason Actualization]

10 hours ago, ZenAlex said:

So my issues may not be b12 related then. I'll supplement anyway and see what happens.

Try to derive it from foods my friend.

The problem with these tests (MMA) is that they are drawn from the serum and don't shed light on how much actual stored vitamin B12 you have. You're on the right track now, and while unfortunate that these doctors will not sign off on a vitamin B12 shot, it's really just a matter of time until you properly recover from this deficiency.

[undeather]

8 hours ago, Michael569 said:

Hey Alex, 

I've just come back so excuse my ignorance. It seems like you have been going through some rough times lately. Health may, at times, become challenging to navigate and recover but it sounds like you're leaving no stone unturned in regaining it back. 

Was there another thread where you described everything that has been going on in more detail? Was there a timeline to how things have started evolving? Was there an event that has triggered the first onset of symptoms? 

I feel like there is way more to this story and I agree with some of the hypothses that have already been drawn here by others, as potential triggers or at least parts of the puzzle. 

Anyways, can you point me to a discussion where you have already talked about it all? I don't want you to be repeating yourself. 

 

[ZenAlex]

5 hours ago, Jason Actualization said:

Try to derive it from foods my friend.

The problem with these tests (MMA) is that they are drawn from the serum and don't shed light on how much actual stored vitamin B12 you have. You're on the right track now, and while unfortunate that these doctors will not sign off on a vitamin B12 shot, it's really just a matter of time until you properly recover from this deficiency.

I'm still getting it from food, but surely a b12 supp wont hurt? Although I am concerned about side effects lol.

[ZenAlex]

10 hours ago, Michael569 said:

Hey Alex, 

I've just come back so excuse my ignorance. It seems like you have been going through some rough times lately. Health may, at times, become challenging to navigate and recover but it sounds like you're leaving no stone unturned in regaining it back. 

Was there another thread where you described everything that has been going on in more detail? Was there a timeline to how things have started evolving? Was there an event that has triggered the first onset of symptoms? 

I feel like there is way more to this story and I agree with some of the hypothses that have already been drawn here by others, as potential triggers or at least parts of the puzzle. 

Anyways, can you point me to a discussion where you have already talked about it all? I don't want you to be repeating yourself. 

 

Been having issues - 

• I don't get tired during physical activity but it's triggering symptoms like tightness, lightheadedness, depression, irritability, anxiety. 
• It's not even high intensity exercise, it's just 40-1 hour walking sometimes less that brings it on.
• Exercise also sometimes triggering stomach issues, and many of the symptoms calm or go away once physical activity stops.
• Was vegan for 8 years. Had tonnes of blood tests. Planned my diet out very thoroughly. 
• B12 levels - 292 ng/l serum (150-1000 range for normal), 44 pmol/l active (37.5-150 range), MMA test surpringly normal. The results are low end of normal, so people are advising me I may have a deficiency in b12 which is possible, although I didn't address it for years because docs always told me I was fine. 
• Omega 3 ratio - Despite the fact when I was vegan I consumed chia and flax seeds daily + epa/dha supplement, and my cronometer showing a ratio of around 1:1 - 2:1 on a daily basis, my blood tests showed a 19:1 crappy ratio in favour of omega 6 
• Part of me would believe it's all just in my head and it's mental health impacting my physical health but if I stop physical activity, the symptoms calm themselves right down. Something about physical activity is fucking with me badly. 
• It's like a sort of exercise intolerance, although I still have energy, I feel shit emotionally/mentally after any significant physical activity. Also i get tightness around my body and lightheadness. It's not even high intensity exercise as I know that increases cortisol, it's literally just walking.
• I stopped being vegan about a month ago now, still mostly plant based, but eating fish 3x a week + 1x other meat like chicken, 2x 2 eggs per week and milk.
• I think I may be starting to feel better now, although it's difficult to tell at this stage.

 

[ZenAlex]

14 minutes ago, Michael569 said:

Thanks for this. A few follow up questions. 

• What sorts of tests have you had done so far?
  • I saw the MMA, Active B12 results.
  • Anything else? 
• Have you undergone proper medical assessment for blood pressure, glucose metabolism and the usual manual examination in doctor's office? 
  • What was the initial prognosis of your doctor?
  • What have they ruled out so far? 
  • What did they think could be going on? 
• Can you describe the onset of the first symptoms and what was happenign in your life back then? How have you started noticing? 
• Have you recently overcome any infection - mild or moderate? 

• I've had comprehensive blood tests in 3 different places - twice by an NHS UK doctor, and had other tests in two other companies.
• b12 as mentioned above and Omega 3.
• Copper, zinc, folate, thyroid and a bunch of other nutrient based blood tests done. 
• Only things showing any concern is omega 3 and b12, although b12 is within normal ranges according to doc. 
• I was put on a 24 hour BP monitor. According to my doc, sometimes it was a "little low" but not out of healthy range, but she wasn't overly concerned about it because she said it could because I'm healthy. My BP, according to the one I use myself, sometimes goes down to 95-100 over 60/65, but rarely ever below what's considered healthy. She no longer seems concerned about this or is just chalked it down to anxiety. 
• It sometimes goes as high as 125-80, but calms down quickly, and often rests at 110/115-65/70. 
• I thought hypoglycaemia may have been the issue, but I used a GM and my blood sugar always seems to be in normal ranges. I even went out for a walk on an empty stomach first thing in the morning, came back and it was 4.2. 
• I was put on a 24 hour ECG - No issues raised. They said any irregularity detected was of no major concern.
• They now seem to be insinuating all my other symptoms as stress/anxiety,
• My stomach issues - They tested me for celiac but nothing showed. They again said stress could be causing it. They prescribed me an anti-spazm medication to take before every meal, but I have decided not to take it because of concerns about side effects and also doing my own experiments. They told me to take it for a month and they will call me back... lol.
• I have avoided eating gluten recently, but I also took a break from longer walks as physical activity aggrivates my stomach. 
• I will add gluten back into my diet soon and if my issues arise again, that may be an answer, but I'm also increase my walks again slowly, and if that aggravates it, then ok.
• But I'm hoping me being able to take a solid shit again now is due to my dietary changes (improved omega and b12) working well. We'll see. I'm going for a 7-8 thousand step walk tonight, and hopefully I will feel ok. Some walks can be very peaceful.

I was one walking 15 miles a day on the weekend an 8-10 miles a day on the weekdays. I miss it. It's better than meditaton.

Edited February 28, 2024 by ZenAlex

[ZenAlex]

15 hours ago, Michael569 said:

could you share the resuls here of your full blood count?, unless it is confidential info

Regarding that B12, what were the levels the very first time it was tested? What was your supplemental protocol before you were tested? What doses, how long and how often? And what type of administration (oral/sublingual/intravenal by GP etc) 

Any iron panel results? 

What was tested as a part of your thyroid profile? What markers specifically? What were the values? 

Can you share a link to this particular test? What was it called? Did it say "serum" or "red cell" fatty acid profile? 

This might be hard to answer but would you say this is your common resting blood pressure? Do you have a family history of low blood pressure? (mom, dad, siblings).

Do you have a personal history if it?

Do you often experience diziness when standing up fast or hight heart rate without any stimulus? 

yeah, that looks alright. Just curious, did you GP suggest HbA1C assessment? (long-term red blood cell glycation) 

What did they test exactly? Do you know what the marker was called? According to NICE there are possible variations in this and there are few rounds of tests when there is a risk of false negative that can be aplied. I assume they assessed only IgA Tissue TG (IgA tTG) ? Did they also look at Total IgA? 

What do you think about their stress hypothesis? Is there any chance you are experiencign panic attacks or mild anxiety attacks? 

Did your bowel movements change significantly before? In what way? 

 

Few more questions

• work/life balance? 
• Sleep quality? 
• Are there stressors where you live impacting you? (personal, relationship, work, recent trauma etc) 
• any mould presence in the house? Poor ventilation? Excessive use of gas cooking? Very high proximity to busy roads? High levels of polution? Old carpets? Very old building? Recent or less recent floodings? 
• Would you say you are relatively sentive to strong smells or bright lights or loud sounds? 
• migraines? 

 

Hello. 

Do you have an email? I can send you all the blood tests via email if you want because there's a lot of them. It would take a long time to screenshot everything.

[ZenAlex]

Btw thank you to all you again for helping me, I know you don't have to. I feel guilty.