Who else has a similar energy / fatigue timing during the day?

[borko2100]

So here's what happens to me.

Almost every day it's the same story. Wake up feeling somewhat OK. Then 2 hours later suddenly start feeling like crap, my symptoms flare up and I want to lay down or sleep. This transition happens very fast, sometimes in a matter of minutes. This state continues for about 10 hours. Then suddenly, in less than 30 minutes my energy shoots up again.

How could symptoms and energy levels have such a consistent pattern? Circadian rhythms maybe? Rhythm of the immune system? It makes no sense at all.

EDIT: I would also like to note that my depression levels follow the exact same pattern too. I have read that neuroinflammation is associated with depression. Dr. Younger found neuroinflammation in ME / CFS patients. Furthermore, I've read that the microglia (immune cells in the brain) follow a daily rhythm. So could all of this be explained by neuroinflammation? So, in my case, it's low right after waking up, then it ramps up and then at the end of the day it ramps down again.

Here's a graphical representation, hopefully this explains what happens more clearly:

Anyone else noticed something similar? Are there any other diseases that show such a pattern? Thanks.

 

[ryan31337]

Hi @borko2100,

2 things come to mind from my own experience.

The first is not an exact fit for what you describe but its worth considering if your food intake plays a role. You don't mention what your symptoms are, but if they have any resemblance to reactive hypoglycemia type events that could be another clue. Certainly a sudden crash anywhere between 30mins to 4hrs after eating would be quite common. I found it largely self-corrected within 30mins and I'd have more energy again until the next crash, which happened after eating again, but it could be prolonged if I kept snacking.

Traditionally doctors would only be wary of this sort of event in patients after bowel resection and that sort of thing, but an Endocrinologist I saw that was experienced in POTS/EDS said it is a very common issue for those with dysautonomia. It seems to develop slowly, it was only after years of gradual progression that it started to present with clear hypo-like attributes. I wouldn't be surprised if many of the patients here that report strong energy improvements on low-carb diets are benefiting from this effect in part. The good news is its very easy to investigate, you just have to go a couple of days eating minimal carbohydrate and certainly no sugars, you'll know very quickly if its important or not.

The second thing fits exactly with what you describe. A crash that comes on mid morning and lasts until the early evening, profound fatigue and somnolence. Different from PEM because it hits with no explanation and disappears again just as fast, whereas PEM from over-exertion lingers and lifts slowly over days, without much sleepiness. In my case these events are joined by focal joint inflammation or loose bowel movements. I have been recently diagnosed with an inflammatory arthritis, so it is very likely a systemic implication of that for me.

Ryan

 

[borko2100]

@ryan31337 interesting ideas.

Unfortunately, I am almost certain food has nothing to do with it. The reason I say this with such certainty is because through the years I've done many (probably 40-50?) 1 day+ fasts, where I don't eat anything the entire day. This pattern occurs whether I eat anything or not.

As far as symptom go, my main symptoms are mostly neurological: spasms, paresthesias, neuro-type pain (stabbing, burning, etc.), thermo-regulation problems, bladder hyperactivity, etc. Besides that I also get facial pain, quite severe depression and sleepiness.

Thanks for your input.

 

[Seven7]

Then my next guess is some type of OI issue, Have you heard of Do it yourself poors men tilt table test? If you monitor your HR is it going on and what is your BP doing (so this will indicate crash variability in this).
I would monitor myself (BP and HR) and see if you can find a pattern. (not intended as medical advice, just my humble opinion). When you feel bad do you lay or sit or change positions?

 

[ryan31337]

I agree, should definitely be looking at autonomic dysfunction and small fiber neuropathy with those symptoms. A good OI/POTS doctor is probably the best route for that.

 

[Cipher]

I tend to feel better in the evening, it's the time of the day I most often get things done. I don't know the reason for this, maybe something to do with cortisol? Here's some threads regarding this:
https://forums.phoenixrising.me/threads/anyone-feel-a-little-better-at-night.54349/
https://forums.phoenixrising.me/threads/why-do-we-feel-better-at-night.52204/