Is there an easy way to measure aerobic threshold?

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Ok, here is my issue.

Like many of you, I have exertional intolerance. Mine is usually presented not as fatigue though, but as pain. I can go swimming for a little bit and be fine. However, I can extrapolate on intensity and experience post-exertional pain, tingling, petechiae, etc. That will take a little bit to recover from. It seems to affect mostly my legs, but I would not say symptoms are limited to that.

I think I have peripheral issues with the oxygen delivery, no sign of pulmonary or heart issue. Also, that seems to be the common theme among Covid long haulers: https://journal.chestnet.org/article/S0012-3692(21)03635-7/fulltext

I read all about Dr. Systrom and the iCPET. I think that should have been the gold standard for exercise intolerance, but unfortunately it isn't, so it is not something it is widely available outside his practice. I also do not have $20k+ laying around to travel abroad to US and get it soon (and they are also probably pretty backed up anyway).

I could probably get a regular CPET locally, if I wait. Then check the lactate levels, which should help to some extent.

But I would like something that would help me on a day-to-day basis, and could somehow objectively help me measure it, and also experiment with certain compounds. I want to know if Mestinon, Midrodine, etc. could increase that limit without risking further damage. When I happen to cross it, it is usually already too late. I do get some signs though.

There is a sensor called Moxy (https://www.moxymonitor.com/) that seems to try to do that, but I haven't heard of any reviews from the ME/CFS community. It tries to measure the SmO2, which is a metric used to measure oxygen delivery to the muscles. It is supposed to check if you are crossing the lactate threshold without having to go to a lab for that. I believe it is targeted for athletes that are trying to pace during endurance competitions.

I have no idea how reliable it is though. It seems pricey, but honestly, if it actually works, it is cheaper than the alternative, given that you can keep reusing it.
 
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It is supposed to check if you are crossing the lactate threshold without having to go to a lab for that.
That's very interesting! If it comes with an app that could alarm you (bc on the website they say it does real-time measurements) that would be sth that could be useful as a PEM warning device.
It's quite expensive though. So one had to be sure that this is really helpful.
 
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That's very interesting! If it comes with an app that could alarm you (bc on the website they say it does real-time measurements) that would be sth that could be useful as a PEM warning device.
It's quite expensive though. So one had to be sure that this is really helpful.
Yes, I want to make sure of that before making such a big investment. I could find 0 reviews coming from Long Covid/ME communities though. It seems to be a very niche product, so I guess that is expected. I found a more thorough review from an athlete's blog: https://fellrnr.com/wiki/Moxy
They also do a good job explaining the difference between using Sm02 and blood lactate: https://fellrnr.com/wiki/Muscle_Oxygen_Saturation

It is definitely not a trivial device for someone to get started. So one would have to invest money and TIME on it.
And I think we still need more research papers to back up its accuracy. Some recent papers shed a positive light though: https://www.spiedigitallibrary.org/...ration-on-a-0/10.1117/1.JBO.24.11.115001.full


If you page down this article linked below, under the section titled, "Hannah's Approach" they give a way to do an estimated anaerobic threshold. I'm not sure if that's exactly what you meant.

https://www.healthrising.org/blog/2...art-rate-monitoring-chronic-fatigue-syndrome/

Anyway, hope it's somehow helpful to you.
Thanks for the suggestion, Judee. I bumped into this strategy a while ago. I used to actually monitor my HRV through a very nice app called EliteHRV(https://elitehrv.com/). This one is free, and works with several heart rate monitors. I highly recommend it for anyone that wants to keep track of it.

I think there is some validity in using the HRV, but it is a bit disconnected as a metric. I believe there is more interplay between HRV and other factors as well.
For example, I found really easy to boost my HRV simply by doing diaphragm breathing while measuring. But we know we cannot fight PEM with breathing.
I also think there are some other limitations to its usage.