Relation between lactic acid and fatigue / PEM

[Dechi]

He actually has pre-diabetes (glucose intolerance and beginning stages of insulin resistance) but he does not have a true metabolic disorder; his pre-diabetes comes and goes and only tends to be a problem when he's in a flare up or is sleep deprived, and he is vigilant about keeping it in check.

He checks his blood glucose frequently and during PEM it is always (or usually) normal.

I wonder if hypoglycemia could cause PEM in some people. I don't think I've heard of anyone getting triggered like this, but maybe in conjunction with other dysregulations it could be a factor?

Your husbands reactions sound like mine, in general. I used to have hypoglycemia the first year, because I kept training then, I didn't know better. I have what you describe as well after exercise, but I don't call it PEM. To me it's just exacerbation of my symptoms, and if I rest, it will go away in an hour, maybe 30 minutes. PEM is when I did so much that these smptoms will remain for 3-5 days, sometimes 15-20. Maybe he's so careful that he never gets PEM ?

 

[Basilico]

The post exercise symptoms your husband experiences I guess could be PEM, but because their timescale is a bit unusual (ie, instant onset, and very rapid clear-up), it might be worth considering other causes. There is some info about exercise intolerance in this Wikipedia article:

It might be exercise intolerance, a lot of those criteria definitely fit. But he get this same reaction sometimes from just standing for 10 minutes or doing really minor things when he's in a flare up...and other good days he can ride a bicycle for 45 minutes on hilly terrain, which is what makes me think it's PEM vs. exercise intolerance. Maybe this isn't correct. Anyway, I don't want to take over this thread, sorry for the minor highjack.

 

[Basilico]

Your husbands reactions sound like mine, in general. I used to have hypoglycemia the first year, because I kept training then, I didn't know better. I have what you describe as well after exercise, but I don't call it PEM. To me it's just exacerbation of my symptoms, and if I rest, it will go away in an hour, maybe 30 minutes. PEM is when I did so much that these smptoms will remain for 3-5 days, sometimes 15-20. Maybe he's so careful that he never gets PEM ?

It might be that he stops himself before he has a chance to get full blown PEM...is there such a thing as "mini" PEM? I'm still really unclear about what is and isn't PEM. The definition isn't very helpful; I find it to be vague.

Based on this definition, it's sounds like what he gets is PEM, especially since it says that it "can" last for days to weeks (which I'm assuming means it doesn't necessarily have to last that long) and "can" be delayed by 24-72 hours (but against doesn't have to be):

Post-exertional malaise (PEM) is a worsening of many ME/CFS symptoms as a result of physical or mental exertion. Patients, ME/CFS organizatons, clinicians and researchers that work in the ME/CFS field often referred to it as "the marker," i.e., the main symptom that differentiates ME and CFS from other fatiguing illnesses. PEM can last for days to weeks after the exertion.[1][2]

Worsening symptoms include chronic fatigue, flu-like symptoms, brain fog (cognitive dysfunction), unrefreshing sleep, chronic pain, orthostatic intolerance, neurally mediated hypotension, POTS and more. "As with the severity, the exertion needed to trigger PEM theories case-by-case. For some, it might kick in after a little bit of exercise on top of a day's regular activities. For others, is incredible as it may seem, it can just take a trip to the mailbox, a shower, or sitting upright for an hour." [3][4][5][6] Onset of PEM can be delayed 24-72 hours.[7]
http://me-pedia.org/wiki/Post-exertional_malaise

 

[Mary]

I was going to do a separate thread, but then I saw this one. I woke up this morning achey and tired (they usually go hand in hand). It wasn't PEM, not severe enough and I had not overdone anything. Fortunately it popped into my head to check my alkalinity/acidity with Ph paper and I was on the far end of acidic. I immediately took 1/2 teaspoon of baking soda in a glass of water (on an empty stomach) and within an hour my energy started coming back. A few hours later after breakfast I took more baking soda, so was actually able to get a few things done this morning.

In hindsight I think this happens to me a lot, only in the past it has not occurred to me to check my Ph on a regular basis. But I'm going to start doing so. (after all these years I cannot believe this is only now just occurring to me to do!- especially when the fix - baking soda - is so simple! )

I don't know if the achiness was due to lactic acid or something else, but the baking soda definitely helped. and my energy picked up as the achiness dissipated.

My diet is good(as good as I can get it), I don't eat a lot of sugar and not a lot of high-acid foods as far as I can tell, though of course it would be good to get more vegies.

So beyond lactic acid buildup due to exertion, however mild, I'm wondering if there are other problems peculiar to ME/CFS with whatever determines our acid/alkaline balance?

 

[PatJ]

So beyond lactic acid buildup due to exertion, however mild, I'm wondering if there are other problems peculiar to ME/CFS with whatever determines our acid/alkaline balance?

Maybe you should start a new thread asking for volunteers to check their PH balance when experiencing PEM vs when they feel 'normal'/not experiencing PEM.

Do you know if anyone has ever formally studied this in PWME?

 

[Mary]

Maybe you should start a new thread asking for volunteers to check their PH balance when experiencing PEM vs when they feel 'normal'/not experiencing PEM.

Do you know if anyone has ever formally studied this in PWME?

Good suggestion! I don't know if Ph has been studied in relation to PEM. I do know that baking soda has been recommended for helping to prevent or recover from PEM, although it's never helped prevent it for me, though I think it makes recovery a little easier.

I'm going to do a little more research (e.g., saliva vs. urine Ph, I'm not sure which is a better barometer - I just tested my saliva this morning). And maybe tomorrow will do a post about Ph and PEM and fatigue etc.