Sunday, 20 December 2015

Tiredness Update

This blog is an update in how I am feeling. I have not written it as I feel sorry for myself; I have written it for two reasons. Firstly, I hope it is useful or interesting for other people who have been through or will go through similar experiences. Secondly, a selfish reason, which is that it is great to have a blog written down as to how I am feeling and my thoughts at the time. I can then look back at any point and see my recovery (or lack of it). I really enjoy reading reports from inspirational runners who have just won a race but many people are suffering from various injuries and illnesses and it is really important that all this information is out there for people to read.

My symptoms seemed to have settled down, instead of just complaining about feeling tired I feel I can now catalogue them.
1)    Persistent exhaustion that has now been going on for 6 months. But there were also signs ever since I completed my Wainwrights run. So even 12 months ago after a long hard race it would take me two weeks to recover and feel up to running again.
2)    ‘Brain fog’. I cannot think straight or concentrate and my short-term memory is absolutely awful. This normally clears around midday and by the evening I feel back to normal. But on a good day it might clear at 10am, on a bad day it might never clear. When the ‘brain fog’ is bad I find it impossible to write a simple email or even remember a simple instruction.
3)    The persistent wish to go to sleep even when I have just had an 8-9 hour sleep.
4)    Disturbed sleep. If I am in a bad phase, I wake up in the middle of the night and cannot get back to sleep
5)    Regular headaches.

 I also now know three things that make it worse:
1)    A long fast fell run (90 minutes or more). Particular bad is a long hard run before breakfast. After this I can feel shattered for a week or more.
2)    A big drinking session. I have just had my works Christmas ‘do’. For three days after it I was exhausted and I found thinking and concentrating nearly impossible. All I wanted to do was lie in bed.
3)    A stressful situation, such as having to give a talk in front of a group of people. On the next day I will again by really tired and find even a slow run impossible.
What does not seem to cause any problems is a run (or jog) up to an hour, as long as I keep my heart rate down below 130 beats per minute. In fact being outside relaxing my mind seems to help.


As I mentioned in my last blog the doctors have given me a blood test and have found nothing wrong. So what is the problem? The symptoms are those that are found in either Chronic Fatigue Syndrome (CFS) or Over Training Syndrome. There are various theories about these illnesses and one of these concerns hormones, which brings me onto another possibility which is adrenal fatigue (where the adrenal gland is above the kidney and it is responsible for producing hormones particularly adrenaline and cortisol). This is still not a medically recognised condition and as such there is still a considerable amount of controversy about it, but the symptoms again correspond with what I am suffering from. At the moment I also like this diagnosis because there seems to be a scientific explanation of why the stresses I have put my body under for the last 18 months would have caused me to feel as I do.

Vicky Ware has produced an article for cyclists about adrenal fatigue here: http://www.cyclingweekly.co.uk/news/latest-news/is-your-adrenal-system-making-you-tired-198720 
Here are a couple more:
https://liveto110.com/epidemic-adrenal-fatigue/
http://elinorfish.com/i-think-i-have-adrenal-fatigue-should-i-stop-running/

I am not a biochemist and with my ‘brain fog’ as it currently is, I still cannot work out the full details of all this, but it does make sense to me. For example, in general the hormone cortisol is highest in the morning, whereas if you have adrenal fatigue this is not the case. This would therefore explain the reason why I feel so lousy in the morning. Also loads of cortisol is released during a long hard run, so for the next several days all the stores are exhausted and I feel absolutely shattered.

As for the future, I feel confident I will return to running at a top level. My mind-set has finally changed. As an ultra-runner I need to ignore my body when it is telling me to stop. I have to carry on pushing it and pushing it, accepting it hurts but ignoring the pain. Finally my body has caught up with me. So instead of fighting my body I now need to be very gentle and work with it (which is basically the treatment for any of the possible diagnoses). I can now happily accept that I am not going to run hard again until I have fully recovered and then wait a while afterwards. I am also going to avoid alcohol. Avoiding stresses in my life is harder but I know I can do it. I have no more talks planned in the near future and the work will become easier once I can think straight again. The human body has an amazing ability to recover if you look after it and that is what I need to do.




Here are a couple of pictures to finish the blog. These are when I did get to the top of a fell (Threlkeld Knotts) in November.



20 comments:

  1. Really hope you get over this soon Steve. Best wishes Dave

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  2. Really hope you get over this soon Steve. Best wishes Dave

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  3. Hope you get back to the top Steve, it's important to document the lower times as much as when you're running strongly. You've definitely put your body through some immense stresses with your adventures and races!

    Merry Christmas

    J.

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  4. Really useful post, the role of hormone metabolism is not well understood, more to the point its important to hear about the hard times as well as the sucesses. I hope you get back to where you want to be soon.

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  5. Top post Steve. Thanks for sharing and I hope the recovery goes well, not least as I want to watch more amazing movies of amazing achievements

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  6. I hope you feel better soon! Treatment is 95% diagnosis, so the more you can pin down the root cause, the better. Have you had a really good thyroid test? I went through a period of debilitation (severe fatigue, faint feeling, mental fog, balance issues, cold chills, weight gain, muscle aches, slurred speech, excessive drowsiness,etc.) Symptoms started about 3 months after my first 100-miler in March. Previous thyroid tests had shown a questionable diagnosis with low T3. My doctor ordered a new thyroid test through a company called Boston Heart that showed high TSH, an indication of hypothyroidism. He prescribed Nature Throid, and 3 months later, I'm about 80% better. Could probably get to 100% if I laid off running awhile longer:) Resting is so much harder than pushing your body for ultras! Kudos to you for your acceptance of what you need to do to fully heal!

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  7. Thanks for sharing Steve, you're an inspiration!

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  8. Hi Steve, See some of the publications by Richard Budgett: https://www.uclh.nhs.uk/OurServices/Consultants/Pages/DrRichardBudgett.aspx
    He gave me some very useful advice when I did this to myself a few years ago. He was in the same crew as Steve Redgrave when they won gold in LA in 1984.
    Good luck with your recovery.
    Anne Buckley

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  9. Thanks for all the great comments, I really appreciate them. It is really interesting to see how many other people have suffered from similar problems. There seem to be a variety of reasons for the tiredness and the key seems to be finding out the cause and allowing the body the chance to recover.

    Merry Christmas.

    Steve

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  10. Hope the new year sees you getting over this and back where you were.
    Good Luck

    Alan Dent

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  11. All very worrisome, hope you find an answer soon. I haven't been reading the blog recently but I'm assuming Lyme disease has been discounted?
    All the best,
    Anita Evans (BL Orienteering)

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  12. It's an all too familiar problem with ultra runners and I'm concerned that as people; mainly amateurs push themselves to do as many 100 milers as possible, one that'll increase exponentially.

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  14. Couldn't hurt to look in to sending off to the BCA labs in germany for a testing kit. They're very good with misdiagnosed Lyme related issues it may help to shed some light on what's going on with hormones etc in your body.

    My wife suffered similar symptoms for several years though not as a result of over training. She sent off for tests to be done at BCA and got a diagnosis which allowed her to move forward.

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  15. Hi Steve,
    Thanks for sharing your story--I can certainly relate! As I discuss in the blog post on my website to which you linked above, fatigue-related problems are seemingly more and more common, especially in active people like you and I. We figure our healthy running lifestyle should give us more energy, and usually, it does.

    But when our total stress load becomes too great (as you explain what that was like for you), then the body simply can't handle it any more, and that's when everything starts to feel very difficult and the fatigue overwhelms.

    What worked so well for, and for other runners I've worked with, is using mindful running as the tool by which to reduce stress and restore one's health and energy. It's well documented just how effective a meditation (or mindfulness) practice can be for reducing stress, though starting a seated practice can be daunting for people like us to who like to be on the go all the time.

    But that's the beauty of mindful running: you get the benefits of mindfulness while you run. It's easy for any runner to start using and personally has revolutionized my running (I run better and recover faster and no longer am plagued with injury). Plus, it lets me manage my stress better than anything else I've ever tried.

    Keep it up and let us all know how it goes!

    Run well, be well,
    Elinor Fish
    www.ElinorFish.com

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  16. Hi Steve - thanks for posting this. It's interesting to me both as a mental health nurse/therapist, and also as a fell/ultra runner (was anyway). I had a very similar experience myself after a year BG training, doing the BG, then Lakeland 100 and a few other long distance events the following year. My symptoms were almost exactly the same as yours. A 30 minute run would leave me completely wiped out for days and the 'brain fog' and exhaustion was very difficult. It felt like a chemical switch had been tripped and there was no way of recovering. Even light exercise only made it worse.
    I only began to recover after a long lay off and I literally built up my running from 10 minute sessions in a very gradual way to avoid tripping the fatigue switch. I also think it helped when I resigned myself to starting literally from scratch instead of trying to keep up fitness. As you say it helps to take any pressure off. Hope you find your way through it soon and get back to enjoying the hills. Walking and properly taking time to enjoy the scenery may be a good start.

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  17. Having read through your post and all of the above comments, I feel I want to add some comment as well. Now that's quite hard for me as it's hard to imagine what you've been through and the effect it's had on you.

    Nevertheless it's good to see how you have a positive approach and plan to return to a top level. I doubt if it could ever be proved one way or the other, but I'd like to think having the right mindset, attitude and optimistic outlook can make a real difference. I wonder if it does make a difference?

    All good wishes,
    Doug.

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  18. It is far from my place to start wittering on about supplements and the like, and the multiple of anecdote is certainly not evidence. However, having been through varying stages of fatigue, listlessness and overreaching (perhaps not overtraining, but definitely getting there), the thing I found useful as a month long supplementation was Adrenomax from a company called Nutri. Whether it works for anyone else, I don't know, and whether that is an avenue you wish to explore, ditto, but thought it worth a mention.

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  19. Saw your blog by chance and have shared your symptoms for 3 years having been very active in the outdoors - much better now. Diagnosis varied from CFS, then diabetes as blood glucose raised, and now SIBO (Small Intestine Bacterial Overgrowth). Def get Lymes double checked, but if you have drunk from dodgy water sources and get a bit of improvement from any antibiotics - or from eating a low carb diet - then perhaps get this one checked out. Ditto leptospirosis. Good luck in feeling better.

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  20. Thanks for the the comments on my blog, I really appreciate them all. I still have an open mind about what is causing my symptoms so I am taking on-board any suggestions. An ideas about recovery strategies I am also trying to incorporate.

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