VO2Max - exercise test

[Clodomir]

Hi,

Yesterday, I made a VO2 Max test ( to see the oxygen in your blood during an effort)! I am a woman, 45 years old, 48 kg, 157 cm.
A normal person ( not like me) as a result of 26 to 35. A CFS patient who can still work is between 20 and 22. If you are under, you can't work anymore. I am not working anymore.
My result was ... 8. Nearly a vegetable ... And I have also tachycardia... I didn't see me as bad as the result of this test shows me...
I am a little bit worried.
Have you also done this test and was the result as bad as mine?

Thanks a lot

Have a nice day.

Clodomir

 

[Tito]

In this study
http://www.cfids-cab.org/cfs-inform/Prognosis/andersen.etal04.pdf
They say at the very end,
"For instance, our patient 22 reported on the One-Time Measure (1999) that she had, on the whole, im- proved since 1994. She was housebound in both 1994 and 1999, and her overall score on the Repeated Measure was unchanged, though she worsened on Section 2, cognitive abi- lities. She, however, reported reduced fatigue, and that she now slept/rested only 17 h/day, instead of 21 as previously."

This is why results from CBT studies are unreliable. They ask patients how they feel, they don't measure it.

 

[Clodomir]

Thanks tito,

But I think my mesure is a fact that can't be denied, or refused. Maybe it is the mesure, we (the doctors) must use. It mesure the fatigue in an objective way. Even if it isn't plaiseant to hear ( and it isn't : I am still chocked).

Have a nice day

Clodomir

 

[Gamboa]

Hi,

Yesterday, I made a VO2 Max test ( to see the oxygen in your blood during an effort)! I am a woman, 45 years old, 48 kg, 157 cm.
A normal person ( not like me) as a result of 26 to 35. A CFS patient who can still work is between 20 and 22. If you are under, you can't work anymore. I am not working anymore.
My result was ... 8. Nearly a vegetable ... And I have also tachycardia... I didn't see me as bad as the result of this test shows me...
I am a little bit worried.
Have you also done this test and was the result as bad as mine?

Hi Clodomir,

I recently had a two-day cardiopulmonary exercise test in Ithaca, New York, a test which followed the Pacific Fatigue Lab protocol for ME/CFS. I had two different values regarding VO2 max so I'm not sure which one you are referring to.

My maximal oxygen consumption (VO2max) was 24.3 ( 6.9 METS) and was considered slightly low for my age and gender. My VO2max at anaerobic threshold (AT) was however, "very low" at 13.1 (3.75 METS), indicating a "low threshold for aerobic energy production."

I don't really understand it all yet but they calculated my AT as 100 beats per minute, which is low. Did they calculate your AT? Once you go into anaerobic metabolism you would experience fatigue. I bought myself a heart rate monitor and found that sweeping the floor carrying groceries, mowing the lawn, etc. all put me over my AT. This then causes fatigue. I didn't realize that I was going over my AT many times in a day. No wonder I don't feel well.

Gamboa

 

[Gamboa]

Here is a link to an article about the Pacific Fatigue Lab protocol.
http://www.research1st.com/2011/11/18/pfl-testing/

 

[Clodomir]

Hi Gamboa,

1. Lovely flower
2. I just receive the measure. When i will receive my protocol, i'll tell you. But I think my AT was 8... The doctor said that people who have this result stay bedbounded... But it is not totally my case: every day, I wake up, eat ( something simple), take a shower, put some clothes, chose one activity (feed the cat, or go in my garden and cut a few things, etc..), phone my sister or mother, listen to my kids and husband when they come home, then go to bed.
When I received the result, I was so chocked: I knew that I wasn't well because, I can't do lost of normal things, like mowing, sweeping, etc... But in my head, it wasn't so bad... Now, i realise...
But the doctor give me "hope" : lots of his patient have borrelia ( lyme disease) and maybe it is why I am so bad... I wait now for the result and if positive: IV abx, yerk... It seems to be not funny at all.

Maybe he will also prescribe me some oxygen, but I am not sure.

I'll give you more infos, in a few weeks.

Thanks for your answer,

Have a good day

Clodomir

 

[mellster]

Having always been fairly sporty (but not athletic) before my onset, I clocked 16 METs on the treadmill stress test when I was sick last year, but it doesn't always correlate nicely with the Vo2Max, mine is less if I use the 12 minute running test vs the treadmill stress test. I acknowledge that I have never been as ill as others, but those tests do not capture the whole picture. From the 16 METs results I should be able to run marathons, but I'm not. I agree with Gamboa that it is unrelated to your AT, this is a more complex topic than just one value. 8 is low though, I have read that some people improve their cardiorespiratory system with inhaled glutathione, which I tried briefly and had good results.

 

[searcher]

I had a VO2 of 7 at my AT (which was 86.) Clodomir: Was your VO2Max 8 or your VO2 at AT? I am similar to you-- I am not bedbound and can cook for myself; what shocked me about having such a low score was that I have major cognitive and digestive problems but didn't consider myself that physically impaired. But maybe I am just getting used to always going over my threshold.

I have also been trying to come to terms with having such a bad result. I am mostly trying to reduce my physical activity to see if I improve some of my other symptoms, but it doesn't seem to change anything.

 

[pemone]

My maximal oxygen consumption (VO2max) was 24.3 ( 6.9 METS) and was considered slightly low for my age and gender. My VO2max at anaerobic threshold (AT) was however, "very low" at 13.1 (3.75 METS), indicating a "low threshold for aerobic energy production."

I don't really understand it all yet but they calculated my AT as 100 beats per minute, which is low. Did they calculate your AT? Once you go into anaerobic metabolism you would experience fatigue. I bought myself a heart rate monitor and found that sweeping the floor carrying groceries, mowing the lawn, etc. all put me over my AT. This then causes fatigue. I didn't realize that I was going over my AT many times in a day. No wonder I don't feel well.

I have much the same situation. My AT is at around 115 beats per minute, and low levels of exertion put me at or above that number. So effectively many tasks of daily living put me in glycolysis, generate lactic acid, and give me symptoms similar to a metabolic acidosis.

 

[Valentijn]

My VO2max is 11.9. My AT was calculated at 130 bpm, but probably should have been lower - my resting heart rate was abnormally elevated due to OI symptoms. If I keep it under 110 I seem to avoid most problems.

 

[gregh286]

My vo2max was 12.9 (40%)
max. Ventilation was 30l/min.

Pathetic.

 

[ryan31337]

Digging up an old thread to add my results:

AT:
VO2 = 12.7ml/kg/min
HR = 98bpm
RER = 1.09

VO2 Max:
VO2 = 19.6ml/kg/min
HR = 147bpm
RER = 1.52(!)

Good luck arguing that I didn't try hard enough with an RER of 1.52

This is pretty shocking to me. Right now at the time of the test I am way better than I was a few months ago at the peak of a crash, across a wide spectrum of symptoms/capabilities. I can't imagine what the results would've been if I had taken it back then. Though I could probably guess... some sort of cardiac event!

 

[Sea]

Good luck arguing that I didn't try hard enough with an RER of 1.52

Well done! I hope you don't pay for it too much.
How old are you? That's quite a low maximum heart rate there that should get you some further investigation

 

[Sea]

My maximal oxygen consumption (VO2max) was 24.3 ( 6.9 METS) and was considered slightly low for my age and gender. My VO2max at anaerobic threshold (AT) was however, "very low" at 13.1 (3.75 METS), indicating a "low threshold for aerobic energy production."

Just to clarify for those still wanting to compare their results, it is VO2 at AT not VO2max at AT. VO2max is only for the result at peak workload.

 

[ryan31337]

Hi @Sea, thank you. I'm OK, it kicked off a train of migraine & GI upset alongside the obvious fatigue, things that were under control before. Haven't suffered too badly otherwise though, still functioning at a reduced rate. I hit the mito supplements & electrolytes/salt water immediately.

I'm 31 but on beta blockers, only a low dose cardioselective variety though. This was organised by a cardiologist so hopefully i'm in good hands

I wasn't asked for RPE but I felt like I had more in me and that my leg muscles gave up before I was at 100%. That said, I haven't exercised to max on beta blockers before and I'm comparing against swimming (my exercise of choice pre-crash), so perhaps on the 'easier' bike it is normal to feel like that. The graphs did show the beginnings of a VO2 plateau alongside a peak PETO2 so perhaps I was pretty much there.

 

[ryan31337]

Interestingly I've just been back (6 days post & definitely still more fatigued) for lung function tests. I don't know the results of the ABG yet but things seemed way off during the capnography hyperventilation test. I was setting the alarm off with low CO2 before even starting (~25mmHg resting, definitely not hyperventilating). Hyperventilation was very tough on me and it then apparently took an abnormally long amount of time to creep back up, still only peaking at 25mmHg or so.

This is all new to me so I'm learning as I go. I appreciate hypocapnia in general has been discussed before and isn't a surprise, but can any explain a link between dumping an enormous amount of CO2 relative to O2 during the CPET but then hypocapnia at rest a week later?

 

[Sea]

The graphs did show the beginnings of a VO2 plateau alongside a peak PETO2 so perhaps I was pretty much there.

Yes that's what determines it. Once you reach that point even if you still felt there was a bit left in you it would run out very quickly. Beta blockers probably does explain the lower heart rate. I don't know if they would effect the VO2max as well.

That's interesting about the low CO2. I don't know enough to make any useful comments. It sounds like your cardio knows the right tests to run for you though.

 

[pemone]

Well done! I hope you don't pay for it too much.
How old are you? That's quite a low maximum heart rate there that should get you some further investigation

You were commenting on Ryan's low VO2 numbers. His aerobic threshold (AT) was only VO2 = 12.7ml/kg/min.

I think you missed entirely the point of this test by calling out his heart rate. The point to care about is the VO2 number itself. He is going into full glycolysis and accumulating lactic acid rapidly while getting in very low oxygen. This doesn't suggest a mechanical limitation on the heart. Rather, it points out that he went into glycolysis at O2 levels far below what his lungs and heart are capable of breathing in and pumping. Focus on O2. That's what I am seeing in so many CFS patients. CFS patients are literally suffocating for oxygen, in spite of having good lungs and good hearts. The O2 is in their blood (as can be demonstrated by various hemoglobin tests). But the O2 never gets to the mitochondria because the VO2 numbers suggest an inability to do aerobic metabolism.

The best explanations I have seen for these dramatic low VO2 and VO2Max numbers are that there is some kind of constant inflammatory process going on in the body. Some kind of innate immune system activation is increasing cytokines and these are literally crowding out red blood cells and preventing them from squeezing into the narrowest capillaries and delivering O2 to the deepest tissues in the body. That is what causes the sensation of brain fog. The brain is suffocating. That is what is creating the sensation of muscular weakness. After any exertion the body is forced into glycolysis and muscles are suffocating for oxygen.

I have been trying intermittent fasting - to stimulate autophagy - for the last few weeks and this is actually having profoundly beneficial effects. I am starting to recover some of my aerobic capacity, and it remains to be seen how much more improvement I will continue to see. If there is actually some underlying - and hidden - parastic pathogen at work, I think autophagy offers a direct play at eating the pathogen and controlling its intracellular populations.

 

[Dechi]

Following

 

[Sea]

I think you missed entirely the point of this test by calling out his heart rate. The point to care about is the VO2 number itself

No I'm not missing the point at all. There is more than 1 point of information to be gained from the test. I agree the VO2 at AT and the VO2max are of great concern - but Ryan already knew that.

Being unable to reach near maximum heart rate is a recognised finding in a CPET which Workwell Foundation has pointed out occurs in some of the ME/CFS patients they test, often enough for them to include it as one of the abnormalities to look for in these patients. In Ryan's case though it is most likely because of the beta blockers.