7 ms·

Study helps explain post-Covid exercise intolerance

46 points by Avshalom 3y ago

SuperNinKenDo 3y ago
As the article says, it's nice to have something to latch on to. But the article says that reconditioning doesn't work. What the hell am I supposed to do? I've been working out like crazy for the last year. My strength is up, my total endurance is up, but my stamina almost hasn't moved. I feel winded and oxygen starved only a couple reps later than when I originally started. Am I supposed to just accept that I'm permanently disabled? Anybody here have any experience or reading for me?
- alfonsodev 3y ago
  I'm not a doctor, so I just can say my anecdotal experience, take it like grain of salt. - Measure Vo2 max, and try to improve it monitoring it, there are some things that just work better for vo2 max, like HIT, and specific protocol of max intensity and rest, for example 4 min intensity followed by 4 rest, 4 times is one of them. Better explained at this Rhonda Patrick's video [1] - Additionally I notice a big improvement when doing hikes in high altitude, I did vomit few hours after coming down from Teide mountain, hiked from tele-spheric station up to 3200mts. I think I over did it for my fitness level, and didn't protect from sun properly, but after recovering I could feel a big improvement in my usual walks, and Apple Watch showed and increment of Vo2 bigger than usual. - Also this is more specific, and probably does not apply to you, but check your hormones. Because lack of sleep and stress, I had ACTH, Estradiol, Prolactin and Homa-IR out of whack, was nearly developing type 2 diabetes, fixing this made losing weight so much easier, and gym sessions way less tiring. - [1] https://youtu.be/IxYdkMmtjBs?si=NbSBryghetTA5LE4 https://youtu.be/IxYdkMmtjBs?si=NbSBryghetTA5LE4
  - andreareina 3y ago
    Per there article the tissues are not uptaking the oxygen that is present. In healthy people VO2max is primarily limited by supply not utilisation; increasing the oxygen supply (this is what VO2max protocols aim to do) is barking up the wrong tree.
    - alfonsodev 3y ago
      Thanks, that helps understanding it better. I guess what I'm trying to say to the commenter, is that it would be useful to measure those things (assuming they didn't) before thinking it falls into the category of those people in the study. The markers I mentioned are very easy to obtain, at least VO2max, and both cases can be reverted if the right specific type of training/intervention. I went from 30 to 38,7 Vo2 max in 10 months but I could only do it after fixing hormones, before training wasn't effective for me, and I even tried 20K steps day, without success. After hormones fixed, just 15k steps/day would increase slowly but steady my VO2 max.
    - cpncrunch 3y ago
      Its just one article, and a poor one at that. I would put much stock on it.
- steve_adams_86 3y ago
  I had the same experience coming out of a serious bout with pneumonia in 2016. I haven't improved much at all. I often wonder if covid does the same thing to people. The chronic issues with energy line up pretty much perfectly.
  - jerkstate 3y ago
    I get the sense that covid is “where the light is” in terms of the search for after-effects of sickness - I had a non-covid cold (at least several at home 15 minute tests were negative) in 2022 that had long symptoms, my sinuses and ear canals still feel different than before. It may be that covid does unique physiological damage, but it could also be that most severe sicknesses do some sort of permanent damage. I wonder how much of this is unique to covid, is my point.
    - Llamamoe 3y ago
      Blood vessel/nerve damage is likely specific to COVID, the more general energy utilisation disorders seemingly aren't, and are triggered by any kind of ongoing inflammation, and often seem to last after any sufficiently severe immune events, though it's possible that this is related to e.g. herpesviral reactivation.
      - garganzol 3y ago
        Energy utilization disorders inevitably cause nerve damage if left untreated. It can be a slow process, it can be fast, but the end result is nerve and tissue damage leading to a plethora of symptoms and secondary diseases.
        Llamamoe 3y ago
        Nerve damage does not necessarily mean irreversible consequences, depending on the degree. E.g. any amount of sleep deprivation, both in terms of quantity and quality, causes (minuscule) brain damage, but even people with severe sleep apnea mostly recover with treatment. Likewise, PDE5 inhibitors and presumably other med classes seem capable of nearly reversing mild-to-moderate nerve damage through local NGF release secondary to improved endothelial function and nerve blood supply.
- doix 3y ago
  > I feel winded and oxygen starved only a couple reps later than when I originally started. Isn't that a pretty good improvement? I was really happy when I went from 1 rep at 90% of my max to 3 reps. It took me a fairly long time and this was before COVID. Or perhaps I use a different definition of stamina? Regardless, the fact that there was an improvement shows that it can get better? Keep at it. If you've got the resources, a good PT might be able to help. Not one of those grifters that did a 3 week course, but someone with an actual understanding of sports science.
  - SuperNinKenDo 3y ago
    Yeah, I think we're thibking about this differently. I train high reps, like really high reps, in no small part for the exact reason that I run out of stamina really quickly and want to improve it. Also because I don't have money for gym or equipment, so many of my exercises are body-weight. I somewhat agree though, albeit with a sense of resignation rather than reassurance, that some improvement offers some hope that continuing will yield further improvement. PT is out of the question for now given the financials. We'll see in the future. Thanks for trying to encourage me though.
- Llamamoe 3y ago
  I'm not sure why this is only clicking for me now, as a person with chronic fatigue who always, invariably, gets really winded by about 300m no matter how regularly or how much I jog, and finds any strength exercise to be incredibly aversive after very similar amounts of exertion regardless of all other variables... agh.
- thenerdhead 3y ago
  I have long Covid. I am in the best shape of my life but sometimes have stamina issues. All I can say is that as I would take supplements that target mitochondrial function, I’d notice that to increase. I believe the root cause is viral persistence and will require monoclonal antibodies, antivirals, and synbiotics to repair. Just taking synbiotics recently has slowly been increasing my alertness and lowering my fatigue levels. Look up SIM01 clinical trial.
- deleted 3y ago
  [deleted]
an_aparallel 3y ago
since getting covid nearly 2 years ago: i have developed chronic acid reflux, lactose intolerance, alcohol intolerance, muscle weakness (which seems chronic at this point), weight loss (10kg)...im well over it - i relate @Superkinkendo. im at the end of my tether with the issues...but i supposed it could be worse...
- opwieurposiu 3y ago
  Wow, I developed alcohol intolerance a couple years ago, your comment made me realize it might be related to COVID. Apparently COVID can give you Histamine Intolerance: https://medium.com/@calebwilemon/covid19-survivors-alcohol-intolerance-9d97e91edf47 https://medium.com/@calebwilemon/covid19-survivors-alcohol-i...
  - polishdude20 3y ago
    What kind of symptoms do you get from alcohol now? I feel like I'm not able to drink as much as I used to before feeling sleepy but that could also be me getting older.
    - an_aparallel 3y ago
      just feels like poison...even hoppy zero alcohol makes me feel shit. though it doesnt taste that good - i cant drink more than 1x 2.5% or 3.5% beer without feeling like absolute crap. not to mention the gluggy feeling of the liquid itself...
      - polishdude20 3y ago
        What about vodka? If zero alcohol beer makes you feel bad, is it really the alcohol that's doing it? Also, what's a gluggy feeling?
- penjelly 3y ago
  chronic acid reflux and resulting post nasal drip since covid/vax for me too, its not fun
garganzol 3y ago
"compromised extraction of oxygen by the body’s tissues" = mitochondrial dysfunction.
halfjoking 3y ago
I had LongCovid 14 months. Korean Pine Needle pills made the most dramatic improvement, but there were a ton of supplements that helped along the way leading me to being cured of LongCovid over 2 years ago. I feel sorry for people who rely on doctors instead of methodical experimentation with supplements. Doctors just gaslight and provide no solutions - it’s been over 3 years they’ve had patients like this and best they can do is say “maybe cells aren’t using energy as well” with this research. Modern medicine is a joke, it’s just a sick people bankrupting scheme… at least with herbs/supplements you have anecdotal evidence from others and a history of cultures safely using those herbs.
- Llamamoe 3y ago
  While you're right that doctors can often be some of the least competent and most unhelpful professionals to exist, I'd just like to highlight that most people spend thousands of tens of thousands of dollars on various supplements with no or limited results. And a lot of the time, the supplements have understudied or unnoticed side effects or risks, not to mention the fact that they target the actual root causes as rarely as the meds do. Not everyone can afford or has the heart for this either, and sooner or later, we NEED mainstream healthcare to have the answers.
cpncrunch 3y ago
Article isnt very impressive. No details given in results section for that 75% figure, no control group for that result, control group for other results is obese group from a different study, no corrections for multiple comparisons, etc.
incangold 3y ago
Almost every LC finding I read about mirrors research that has already been done on ME/CFS. We could be further ahead on this if we hadn’t been treating post-viral illness as psychogenic for so long. It would also help if the literal handful of ME/CFS specialist researchers and clinicians were pulled a little closer by LC doctors.
- thenerdhead 3y ago
  Yes agreed, but where has this study been replicated in the ME/CFS literature?
thenerdhead 3y ago
This is a big deal. Doctors are constantly telling patients they are “deconditioning” and encouraging exercise as a result. There is a large controversy of exercise clinical trials for that reason. Experiencing this first hand, I am in very good shape and have excellent stamina. On certain days when my mitochondria are hijacked(it is cyclical for my long Covid), you couldn’t tell the difference of me(young 30 year old gym goer) and an 80 year old man from walking up the stairs. The virus is persisting likely in our gut and hijacking our powerhouse of the cell! Many studies are showing this is likely the case.
- cpncrunch 3y ago
  Covid can indeed persist in the gut, but it just causes gi symptoms, and the virus is undetectable after 10 months https://www.cell.com/med/fulltext/S2666-6340(22)00167-2 https://www.cell.com/med/fulltext/S2666-6340(22)00167-2 So, I suspect your symptoms may be due to another mechanism. What is your resting heart rate, and how is your sleep?
  - thenerdhead 3y ago
    My RHR baseline(average) is 51. HRV baseline(average) is 95. I sleep very well & consistently but wake up feeling wired & tired (common in chronic fatigue I suppose). My cardio fitness averages to 52.9 which is a measurement of my VO2 max. I have read thousands of covid / long covid papers. I think you would be surprised at what symptoms persistent virus in the gut lead to: https://www.cell.com/cell/fulltext/S0092-8674(23)01034-6 https://www.cell.com/cell/fulltext/S0092-8674(23)01034-6 The books "I contain multitudes" and "Gut" are excellent recent titles helping bring light to the power of the gut. I personally think some other organs may be involved too and even the vagus nerve. But none-the-less covid is hijacking mitochondria: https://pubmed.ncbi.nlm.nih.gov/37556555/ https://pubmed.ncbi.nlm.nih.gov/37556555/
    - cpncrunch 3y ago
      Did you look carefully at that serotonin paper? It's pretty underwhelming. Check out the comments on s4me if you haven't already: https://www.s4me.info/threads/serotonin-reduction-in-post-acute-sequelae-of-viral-infection-2023-wong-cherry-et-al.35717/ https://www.s4me.info/threads/serotonin-reduction-in-post-ac... There is a lot of crap science published, and that serotonin paper is pretty poor. Anyway, it's up to you what science you want to pursue. I managed to recover from ME/CFS myself by looking deeply into the science, so I'd recommend looking further. Stress seems to be one of the major issues. Anyway, from what you say it sounds like your symptoms are pretty mild (correct me if I'm wrong here).
Madmallard 3y ago
I developed severe exercise intolerance after taking ciprofloxacin and have been told by several doctors at Pacmed in seattle, Kaiser, Scripps, and UCSD in San Diego that I developed deconditioning and just needed to exercise. I forced myself to walk up to 5-10 miles a day over a one year period to “correct it” since 2021. I still cannot run without extreme dyspnea in a very short period nor lift weights in 2023. I recently got diagnosed by an older cardiologist at Cedar Sinai with dysautonomia. I have gotten my VO2 max up to 42, however there are some cardiac abnormalities during exertion. I used to bike 20 miles a day and ran 7 minute miles on repeat the week before the ciprofloxacin. I didn’t “decondition”. I was poisoned by a well-known mitochondrial toxin in research. Any drug that causes peripheral neuropathy should be highly suspected. Really hard to trust the vast majority of doctors in this day and age.

46 points by Avshalom 3y ago

As the article says, it's nice to have something to latch on to. But the article says that reconditioning doesn't work. What the hell am I supposed to do? I've been working out like crazy for the last year. My strength is up, my total endurance is up, but my stamina almost hasn't moved. I feel winded and oxygen starved only a couple reps later than when I originally started. Am I supposed to just accept that I'm permanently disabled? Anybody here have any experience or reading for me?

alfonsodev 3y ago
I'm not a doctor, so I just can say my anecdotal experience, take it like grain of salt. - Measure Vo2 max, and try to improve it monitoring it, there are some things that just work better for vo2 max, like HIT, and specific protocol of max intensity and rest, for example 4 min intensity followed by 4 rest, 4 times is one of them. Better explained at this Rhonda Patrick's video [1] - Additionally I notice a big improvement when doing hikes in high altitude, I did vomit few hours after coming down from Teide mountain, hiked from tele-spheric station up to 3200mts. I think I over did it for my fitness level, and didn't protect from sun properly, but after recovering I could feel a big improvement in my usual walks, and Apple Watch showed and increment of Vo2 bigger than usual. - Also this is more specific, and probably does not apply to you, but check your hormones. Because lack of sleep and stress, I had ACTH, Estradiol, Prolactin and Homa-IR out of whack, was nearly developing type 2 diabetes, fixing this made losing weight so much easier, and gym sessions way less tiring. - [1] https://youtu.be/IxYdkMmtjBs?si=NbSBryghetTA5LE4 https://youtu.be/IxYdkMmtjBs?si=NbSBryghetTA5LE4
- andreareina 3y ago
  Per there article the tissues are not uptaking the oxygen that is present. In healthy people VO2max is primarily limited by supply not utilisation; increasing the oxygen supply (this is what VO2max protocols aim to do) is barking up the wrong tree.
  - alfonsodev 3y ago
    Thanks, that helps understanding it better. I guess what I'm trying to say to the commenter, is that it would be useful to measure those things (assuming they didn't) before thinking it falls into the category of those people in the study. The markers I mentioned are very easy to obtain, at least VO2max, and both cases can be reverted if the right specific type of training/intervention. I went from 30 to 38,7 Vo2 max in 10 months but I could only do it after fixing hormones, before training wasn't effective for me, and I even tried 20K steps day, without success. After hormones fixed, just 15k steps/day would increase slowly but steady my VO2 max.
  - cpncrunch 3y ago
    Its just one article, and a poor one at that. I would put much stock on it.
steve_adams_86 3y ago
I had the same experience coming out of a serious bout with pneumonia in 2016. I haven't improved much at all. I often wonder if covid does the same thing to people. The chronic issues with energy line up pretty much perfectly.
- jerkstate 3y ago
  I get the sense that covid is “where the light is” in terms of the search for after-effects of sickness - I had a non-covid cold (at least several at home 15 minute tests were negative) in 2022 that had long symptoms, my sinuses and ear canals still feel different than before. It may be that covid does unique physiological damage, but it could also be that most severe sicknesses do some sort of permanent damage. I wonder how much of this is unique to covid, is my point.
  - Llamamoe 3y ago
    Blood vessel/nerve damage is likely specific to COVID, the more general energy utilisation disorders seemingly aren't, and are triggered by any kind of ongoing inflammation, and often seem to last after any sufficiently severe immune events, though it's possible that this is related to e.g. herpesviral reactivation.
    - garganzol 3y ago
      Energy utilization disorders inevitably cause nerve damage if left untreated. It can be a slow process, it can be fast, but the end result is nerve and tissue damage leading to a plethora of symptoms and secondary diseases.
      - Llamamoe 3y ago
        Nerve damage does not necessarily mean irreversible consequences, depending on the degree. E.g. any amount of sleep deprivation, both in terms of quantity and quality, causes (minuscule) brain damage, but even people with severe sleep apnea mostly recover with treatment. Likewise, PDE5 inhibitors and presumably other med classes seem capable of nearly reversing mild-to-moderate nerve damage through local NGF release secondary to improved endothelial function and nerve blood supply.
doix 3y ago
> I feel winded and oxygen starved only a couple reps later than when I originally started. Isn't that a pretty good improvement? I was really happy when I went from 1 rep at 90% of my max to 3 reps. It took me a fairly long time and this was before COVID. Or perhaps I use a different definition of stamina? Regardless, the fact that there was an improvement shows that it can get better? Keep at it. If you've got the resources, a good PT might be able to help. Not one of those grifters that did a 3 week course, but someone with an actual understanding of sports science.
- SuperNinKenDo 3y ago
  Yeah, I think we're thibking about this differently. I train high reps, like really high reps, in no small part for the exact reason that I run out of stamina really quickly and want to improve it. Also because I don't have money for gym or equipment, so many of my exercises are body-weight. I somewhat agree though, albeit with a sense of resignation rather than reassurance, that some improvement offers some hope that continuing will yield further improvement. PT is out of the question for now given the financials. We'll see in the future. Thanks for trying to encourage me though.
Llamamoe 3y ago
I'm not sure why this is only clicking for me now, as a person with chronic fatigue who always, invariably, gets really winded by about 300m no matter how regularly or how much I jog, and finds any strength exercise to be incredibly aversive after very similar amounts of exertion regardless of all other variables... agh.
thenerdhead 3y ago
I have long Covid. I am in the best shape of my life but sometimes have stamina issues. All I can say is that as I would take supplements that target mitochondrial function, I’d notice that to increase. I believe the root cause is viral persistence and will require monoclonal antibodies, antivirals, and synbiotics to repair. Just taking synbiotics recently has slowly been increasing my alertness and lowering my fatigue levels. Look up SIM01 clinical trial.
deleted 3y ago
[deleted]

an_aparallel 3y ago

since getting covid nearly 2 years ago: i have developed chronic acid reflux, lactose intolerance, alcohol intolerance, muscle weakness (which seems chronic at this point), weight loss (10kg)...im well over it - i relate @Superkinkendo. im at the end of my tether with the issues...but i supposed it could be worse...

opwieurposiu 3y ago
Wow, I developed alcohol intolerance a couple years ago, your comment made me realize it might be related to COVID. Apparently COVID can give you Histamine Intolerance: https://medium.com/@calebwilemon/covid19-survivors-alcohol-intolerance-9d97e91edf47 https://medium.com/@calebwilemon/covid19-survivors-alcohol-i...
- polishdude20 3y ago
  What kind of symptoms do you get from alcohol now? I feel like I'm not able to drink as much as I used to before feeling sleepy but that could also be me getting older.
  - an_aparallel 3y ago
    just feels like poison...even hoppy zero alcohol makes me feel shit. though it doesnt taste that good - i cant drink more than 1x 2.5% or 3.5% beer without feeling like absolute crap. not to mention the gluggy feeling of the liquid itself...
    - polishdude20 3y ago
      What about vodka? If zero alcohol beer makes you feel bad, is it really the alcohol that's doing it? Also, what's a gluggy feeling?
penjelly 3y ago
chronic acid reflux and resulting post nasal drip since covid/vax for me too, its not fun

garganzol 3y ago

"compromised extraction of oxygen by the body’s tissues" = mitochondrial dysfunction.

halfjoking 3y ago

I had LongCovid 14 months. Korean Pine Needle pills made the most dramatic improvement, but there were a ton of supplements that helped along the way leading me to being cured of LongCovid over 2 years ago. I feel sorry for people who rely on doctors instead of methodical experimentation with supplements. Doctors just gaslight and provide no solutions - it’s been over 3 years they’ve had patients like this and best they can do is say “maybe cells aren’t using energy as well” with this research. Modern medicine is a joke, it’s just a sick people bankrupting scheme… at least with herbs/supplements you have anecdotal evidence from others and a history of cultures safely using those herbs.

Llamamoe 3y ago
While you're right that doctors can often be some of the least competent and most unhelpful professionals to exist, I'd just like to highlight that most people spend thousands of tens of thousands of dollars on various supplements with no or limited results. And a lot of the time, the supplements have understudied or unnoticed side effects or risks, not to mention the fact that they target the actual root causes as rarely as the meds do. Not everyone can afford or has the heart for this either, and sooner or later, we NEED mainstream healthcare to have the answers.

cpncrunch 3y ago

Article isnt very impressive. No details given in results section for that 75% figure, no control group for that result, control group for other results is obese group from a different study, no corrections for multiple comparisons, etc.

incangold 3y ago

Almost every LC finding I read about mirrors research that has already been done on ME/CFS. We could be further ahead on this if we hadn’t been treating post-viral illness as psychogenic for so long. It would also help if the literal handful of ME/CFS specialist researchers and clinicians were pulled a little closer by LC doctors.

thenerdhead 3y ago
Yes agreed, but where has this study been replicated in the ME/CFS literature?

thenerdhead 3y ago

This is a big deal. Doctors are constantly telling patients they are “deconditioning” and encouraging exercise as a result. There is a large controversy of exercise clinical trials for that reason. Experiencing this first hand, I am in very good shape and have excellent stamina. On certain days when my mitochondria are hijacked(it is cyclical for my long Covid), you couldn’t tell the difference of me(young 30 year old gym goer) and an 80 year old man from walking up the stairs. The virus is persisting likely in our gut and hijacking our powerhouse of the cell! Many studies are showing this is likely the case.

cpncrunch 3y ago
Covid can indeed persist in the gut, but it just causes gi symptoms, and the virus is undetectable after 10 months https://www.cell.com/med/fulltext/S2666-6340(22)00167-2 https://www.cell.com/med/fulltext/S2666-6340(22)00167-2 So, I suspect your symptoms may be due to another mechanism. What is your resting heart rate, and how is your sleep?
- thenerdhead 3y ago
  My RHR baseline(average) is 51. HRV baseline(average) is 95. I sleep very well & consistently but wake up feeling wired & tired (common in chronic fatigue I suppose). My cardio fitness averages to 52.9 which is a measurement of my VO2 max. I have read thousands of covid / long covid papers. I think you would be surprised at what symptoms persistent virus in the gut lead to: https://www.cell.com/cell/fulltext/S0092-8674(23)01034-6 https://www.cell.com/cell/fulltext/S0092-8674(23)01034-6 The books "I contain multitudes" and "Gut" are excellent recent titles helping bring light to the power of the gut. I personally think some other organs may be involved too and even the vagus nerve. But none-the-less covid is hijacking mitochondria: https://pubmed.ncbi.nlm.nih.gov/37556555/ https://pubmed.ncbi.nlm.nih.gov/37556555/
  - cpncrunch 3y ago
    Did you look carefully at that serotonin paper? It's pretty underwhelming. Check out the comments on s4me if you haven't already: https://www.s4me.info/threads/serotonin-reduction-in-post-acute-sequelae-of-viral-infection-2023-wong-cherry-et-al.35717/ https://www.s4me.info/threads/serotonin-reduction-in-post-ac... There is a lot of crap science published, and that serotonin paper is pretty poor. Anyway, it's up to you what science you want to pursue. I managed to recover from ME/CFS myself by looking deeply into the science, so I'd recommend looking further. Stress seems to be one of the major issues. Anyway, from what you say it sounds like your symptoms are pretty mild (correct me if I'm wrong here).

Madmallard 3y ago

I developed severe exercise intolerance after taking ciprofloxacin and have been told by several doctors at Pacmed in seattle, Kaiser, Scripps, and UCSD in San Diego that I developed deconditioning and just needed to exercise. I forced myself to walk up to 5-10 miles a day over a one year period to “correct it” since 2021. I still cannot run without extreme dyspnea in a very short period nor lift weights in 2023. I recently got diagnosed by an older cardiologist at Cedar Sinai with dysautonomia. I have gotten my VO2 max up to 42, however there are some cardiac abnormalities during exertion. I used to bike 20 miles a day and ran 7 minute miles on repeat the week before the ciprofloxacin. I didn’t “decondition”. I was poisoned by a well-known mitochondrial toxin in research. Any drug that causes peripheral neuropathy should be highly suspected. Really hard to trust the vast majority of doctors in this day and age.