how can I stay in aerobic zone of exercise without knowing when anaerobic is kicking in?

[MeSci]

The PEM we are experiencing, seems to be heart related, and specifically a mitochondrial issue, specific to the heart in this instance (and Brain fog, the same, of the brain).

My understanding is that the heart rate is just an indicator of the abnormality that exertion causes, and that the mitochondria where the anaerobic ATP production causes the problem are (mainly) in the body part being used, thus the muscles in the case of physical exertion and the neurons in the case of mental exertion.

 

[ItoldthemIwasill]

Hi MeSci
Thanks for replying. I am really keen to learn more about this and other very interesting areas on this site. The level of science discussed here seems well in advance of what is discussed in the UK.

On this topic, I wouldn't disagree with you, though I would consider that the heart is consistently the body part being used, and consistently regardless of the type of activity. Since the heart delivers most of the raw ingredients for the Krebs cycle, as well as the oxygen itself, I think it may play a bigger role.

I have PEM, but my crashes are more often caused by stress triggers, which I am thinking is heart related, and the shortfall of heart ATP, then causes a knock on effect to the rest of the body due to impacting the blood flow around the body, and the impact on organs etc..

I have suffered from ME for 20 yrs, and now have Bradycardia, and am assuming that this has been caused by damage to the heart over that time. But I have no evidence of this, except that I am not a marathon runner, as suggested by my GP.

But the local muscle issues are undoubtedly impacted exactly as you describe, and I acknowledge that I am hypothesising with my theory here.

In terms of heart monitoring, I am still wondering whether to go Apple Watch or Mio. I would really value sleep monitoring, and I'm not sure either of them do that well... But I am sure something in the next 12 months will end up being perfect.

Who knows, if there is an algorithm to better understand any potential heart stress limit related to ME and PEM, maybe an App could be built to guard against stressing the heart.

Appreciate any other views on this area if people are still monitoring this thread. You all seem extremely knowledgable and I am looking forward to learning a lot more about this illness.
Thanks

 

[MeSci]

Hi MeSci
Thanks for replying. I am really keen to learn more about this and other very interesting areas on this site. The level of science discussed here seems well in advance of what is discussed in the UK.

On this topic, I wouldn't disagree with you, though I would consider that the heart is consistently the body part being used, and consistently regardless of the type of activity. Since the heart delivers most of the raw ingredients for the Krebs cycle, as well as the oxygen itself, I think it may play a bigger role.

I have PEM, but my crashes are more often caused by stress triggers, which I am thinking is heart related, and the shortfall of heart ATP, then causes a knock on effect to the rest of the body due to impacting the blood flow around the body, and the impact on organs etc..

I have suffered from ME for 20 yrs, and now have Bradycardia, and am assuming that this has been caused by damage to the heart over that time. But I have no evidence of this, except that I am not a marathon runner, as suggested by my GP.

But the local muscle issues are undoubtedly impacted exactly as you describe, and I acknowledge that I am hypothesising with my theory here.

In terms of heart monitoring, I am still wondering whether to go Apple Watch or Mio. I would really value sleep monitoring, and I'm not sure either of them do that well... But I am sure something in the next 12 months will end up being perfect.

Who knows, if there is an algorithm to better understand any potential heart stress limit related to ME and PEM, maybe an App could be built to guard against stressing the heart.

Appreciate any other views on this area if people are still monitoring this thread. You all seem extremely knowledgable and I am looking forward to learning a lot more about this illness.
Thanks

There have been abnormal heart findings in ME research, but I don't think that mitochondria have been found to be a part of these abnormalities - but perhaps these have just not been looked for. I wonder whether the heart aspect could relate more to autonomic nervous system control - so that like a lot of other issues with our ANS abnormalities (e.g. temperature control) - the heart just can't respond fast enough.

Lactate - a sign of anaerobic metabolism - has been found to be abnormally high in muscle in ME - even in muscle cells grown in vitro. So it seems pretty certain that there is local lactate build-up/acidification in the body part being used. But then, it seems logical that the same mitochondrial abnormalities will also exist in other parts of the body involved in exertion, such as the heart and lungs.

High blood lactate levels can be due to a range of causes - see Table 1 in this paper. One of these possible causes - insufficient oxygen delivered to cells - could be due to abnormal levels of nitric oxide, which has been discussed in several threads.

So your hypothesising is definitely along the right lines! I'm sure you will find more than enough to read here on the various issues. Maybe someone who has more expertise on algorithms will come along to help with that aspect - maths is not an area of my expertise.

Love the username BTW! A slight variation on Spike Milligan's self-epitaph? Very appropriate for ME.

 

[ItoldthemIwasill]

Thanks MeSci
Yes, its pretty pertinent isn't it!
I have no history of muscle pains, and maybe this is because I am more affected by stress crashes rather than exertion (though I def have these too sometimes), but potentially for me they are both heart related.

I had a look at that paper, and confess the science is beyond my ability to follow currently. I struggle with detail in the best of circumstances, which doesn't help understand these mechanisms.

What a ridiculously complex illness. For all our complaints about the lack of funding and interest in this area, all the research on all the bodies systems seems to suggest it is the most complex of issues, with knock on effects and compounding effects.

But I expect to get more into it over the next 12 months.
Cheers!

 

[MeSci]

I had a look at that paper, and confess the science is beyond my ability to follow currently. I struggle with detail in the best of circumstances, which doesn't help understand these mechanisms.

Try just Table 1.

 

[MeSci]

@ItoldthemIwasill - you have set me thinking about something. As all parts of the body and brain have mitochondria, I am wondering whether mitochondrial dysfunction in the hypothalamic/pituitary/adrenal (HPA) axis could be causing many/most of our problems.

The HPA appears to respond too slowly in ME, I think, hence poor autonomic nervous system function, poor temperature tolerance and control, orthostatic intolerance, poor control of fluid levels, and a lot more. Add to this dysfunctional mitos in the muscles and other neurons, and physical and mental fatiguability plus PEM might be expected to be diagnostic of ME.

So I think most of us accept that the HPA is abnormal, and most of us accept that the mitos behave abnormally - could this be a kind of unifying theory?

If so, are the mitos abnormal from birth, and something later exacerbates this, or is it always an acquired abnormality? If the former, would family studies throw light on it? Mitochondrial DNA is inherited through the maternal line, so maybe this could somehow explain (partly?) the higher prevalence of ME in women, and maybe those who have ME running in families have it mostly in female relatives.

Rambling a bit here - just thinking out loud. Can't co-ordinate my thoughts well at present - brain rather foggy.

Also strayed a bit from the initial topic - sorry!

 

[ItoldthemIwasill]

Well its on topic for me @MeSci.
My HPA Axis is definitely amiss. I hadn't thought that that might be down to Mito too, but as you say, of course it could. Certainly when I am ill compared to when I am well, I react completely differently to stress, and have seemingly normal levels of stress resistance when I am very well (rare). But repeated stress wears this resistance down quite quickly. It almost seems as if the parasympathetic nervous system doesn't work at all, and I have to suffer all the adrenaline and fear only. Mito dysfunction in the HPA would well be a factor couldn't it!

Interesting what you say about Mito DNA, as I suspect my Mother had a similar issue to me, though we never got near realising or understanding that.

I have to say that every day I feel like I get a step nearer to understanding what is going on in my body. To start with I would think they were massive strides in understanding, and that I would be able to recover straight away. However, it turns out there are 1,000+ factors, which are all interlinked, so its quite a journey.

 

[MeSci]

Well its on topic for me @MeSci.
My HPA Axis is definitely amiss. I hadn't thought that that might be down to Mito too, but as you say, of course it could. Certainly when I am ill compared to when I am well, I react completely differently to stress, and have seemingly normal levels of stress resistance when I am very well (rare). But repeated stress wears this resistance down quite quickly. It almost seems as if the parasympathetic nervous system doesn't work at all, and I have to suffer all the adrenaline and fear only. Mito dysfunction in the HPA would well be a factor couldn't it!

Interesting what you say about Mito DNA, as I suspect my Mother had a similar issue to me, though we never got near realising or understanding that.

I have to say that every day I feel like I get a step nearer to understanding what is going on in my body. To start with I would think they were massive strides in understanding, and that I would be able to recover straight away. However, it turns out there are 1,000+ factors, which are all interlinked, so its quite a journey.

Yup (to all of that!). I think that the anxiety and jitteriness may be due to noradrenaline rather than adrenaline, as I think that studies don't tend to find high adrenaline in ME, but they do find high noradrenaline, IIRC.

Have you checked out the threads where people talk about reducing anxiety with diet and supplements? It has certainly helped me. This is a good one.