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My PEM episodes feel like a hangover

Discussion in 'Post-Exertional Malaise, Fatigue, and Crashes' started by Aerose91, Dec 15, 2013.

  1. Aerose91

    Aerose91 Senior Member

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    EXACTLY like a hangover. If I'm slightly too active I will wake up the next morning feeling extremely dehydrated; headache, eyes hurt, intense nausea, very sickly, bad anxiety etc..
    I'm wondering if some of this has to do with the fact that I have SIADH. A blood test showed that I have almost no anti-diuretic hormone so I am constantly dehydrated- but not to this extent. I only get the horrible hangover feeling upon overexertion. Anyone else like that?
  2. justy

    justy Senior Member

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    exactly the same for me - i always say i feel like i have been on a 3 day rave without the fun (may have only stayed up until 11.30pm!)
    Soundthealarm21 likes this.
  3. Aerose91

    Aerose91 Senior Member

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    Crazy! It's such a horrible feeling- I always thought that I'd be spared the hangovers since I stopped drinking. No luck. I wonder if this is a dehydration thing
  4. vamah

    vamah Senior Member

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    I feel similar also.
  5. bigmama2

    bigmama2

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    yes, my pem often feels like a hangover. it is so odd to be hungover without drinking alcohol. CFS expert dr Klimas and others say that cfs patients are chronically dehydrated. (maybe due to out low blood volume?) and we should drink lots of water and those who need it take electrolyte supplements (like nunn) or gatoraid.
  6. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    My PEM is like a hangover combined with flu symptoms.

    Have you been diagnosed with SIADH? It does not seem consistent with dehydration and a lack of ADH. There is a description of SIADH here. Many of us here have polyuria and dehydration due to a deficiency in ADH secretion, and I personally also appear to excrete large quantities of electrolytes too. Dehydration and electrolyte deficiency will cause hangover-type symptoms.

    Avoiding over-exertion and also consuming electrolyte-rich drinks (e.g. fruit juice) and increasing salt intake unless it is medically contraindicated, should help.
  7. alex3619

    alex3619 Senior Member

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    Much of the hangover feeling is due to activation of arachidonic acid, though dehydration does factor in too. I wonder if abnormal arachidonic acid mobilization might be involved?

    My hangovers last up to a month from consuming alcohol. I used to do this up till about maybe eight years ago, but only at New Years. I gave up alcohol for the rest of the year many years before that.

    My hangover response is biphasic. Alcohol causes a release of arachidonic acid, which will be rapidly converted to eicosanoids though I am unsure what spread of eicosanoids (which includes inflammatory hormones) are involved.

    When I get a real hangover, I start recovery about as normal. However another layer sets in, a layer I recognize as from too much arachidonic acid, achy and head-achy. This lasts about a week, when I shift to a response I recognize as insufficient arachidonic acid. I find myself in a deficiency state, feeling wired and with peeling skin. Then things head back toward usual.

    There has been very little investigation of eicosanoids in ME, though I have been writing about this for about 15 years now. Its been suspected since at least 1993 (look up Grey Martinovic CFS on PubMed) that eicosanoids are involved in crashes including PEM. I was one of Martinovic's patients.
  8. Firestormm

    Firestormm Content Team Lead

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    A common symptom associated with Sleep Apnea is a hangover in the mornings, directly associated with a lack of oxygen during sleep. Might be worth getting checked for that complaint as it can be treated, and many with ME are treated for Apnea. Like wot I is, in a few weeks time :)
  9. Aerose91

    Aerose91 Senior Member

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    Since the M.E. started, if i have even 1 sip of alchohol i will get the most intense anxiety and panic attacks for about 3 weeks. As much as i like having an occasional drink, ill never touch one again.
  10. Aerose91

    Aerose91 Senior Member

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    @MeSci
    I have an inneficient amount of ADH, my tests came back flatlined. i was told that was called SIADH, maybe my terminology is wrong. Either way im rampantly dehydrated.
  11. Soundthealarm21

    Soundthealarm21 Senior Member

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  12. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    Lack of ADH is more likely to be diabetes insipidus.

    I don't know what country you are in, but doctors in the UK, including at least one top endocrinologist, are extremely ignorant about this condition. They actually considered that I might have SIADH, when I was dehydrated and passing too much urine - the opposite of what SIADH causes!

    If you do some searches here you will find several threads referring to diabetes insipidus and a lack of ADH commonly found in ME (you'll have to search for vasopressin rather than ADH as the search box won't look for 3-letter search terms).

    I have been unable to get a test done for vasopressin - my GP said that it was a strange thing to test for!

    I take desmopressin, which helps a lot.
  13. Aerose91

    Aerose91 Senior Member

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    Yes diabetes insipidus is exactly what i have. i had a blood test for it soon after the ME started and my ADH was non existant. Do they kniw what causes this in ME patients? My doctor said its very difficult to recover from......
    No one has suggested desmopressin though, i wonder if i should bring that up.
  14. Andrew

    Andrew Senior Member

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    In the morning I feel like hangover and flu. I also drink 20 oz to 40 oz of water as soon as I get up because I'm so dehydrated. I was also diagnosed with very low level sleep apnea (the lowest possible), but using the machine to treat this keeps me awake.
  15. lnester7

    lnester7 Seven

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    Funny enough my PEM of the last 3 years disappeared when I upped the dose of midodrine (OI med) to 10mg twice a day. I have been PEM free going on 3 weeks maybe now? Is the first time (not counting the remissions) that I have been without it. I wonder if PEM is a sign of OI/??
  16. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    You should definitely ask for desmopressin.

    There is info about vasopressin and ME in this thread, including some links I posted.
  17. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    Do you know whether your electrolyte levels are OK? A high proportion of us are deficient in electrolytes, and drinking plain water can exacerbate such deficiency. Something like fruit juice may be better, as it contains electrolytes.
  18. MeSci

    MeSci ME/CFS since 1995; activity level 6

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    I don't have OI, but still get PEM.
  19. taniaaust1

    taniaaust1 Senior Member

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    In my case yes it can be (also a delayed reaction to being upright). It took me a very long time to figure that out but its clearly is I realised when I started to observe things more
    ahimsa likes this.
  20. lnester7

    lnester7 Seven

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    I guess what I am trying to say is: that is OI not been fully (or successfully treated).
    If you still have PEM. Keep trying to find a better combination or doses for you. If you are been treated for OI you shouldn't be extremly symptomatic????

    I don't know all I know is I read Posts on peple where they tinker with different combinations Vs me they gave me a ridiculously dose (not even the recommended one to start on) and sent me to go rot!

    Seeing cardio this week. Fight is on.

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