Exercise-enduced CFS?

[Brooke]

Hi all,

I've been struggling with unexplainable fatigue for my entire life. I've been unable to figure out what's going on, even after speaking with doctors. I just stumbled upon your forum today and I'm hoping there's someone here who's had a similar experience. I used to think CFS was identifiable by its severe intensity and flu-like symptoms (which I don't have), but after reading a few threads, it seems that there may be more variability in that diagnosis?

Early life
- Prone to tiredness a a child. Would even put myself to bed for naps as a toddler.
- Frequent after school naps in middle school and high school. Likely worsened by my depression, which started at 12 years old and lasted for 8 years.
- Difficulty focusing in school (middle school through college) due to fatigue and concentration issues.
- Sleep study performed in high school. Results were completely normal.
- I did make the connection that pushing harder during sports = more napping after school.

Medical
- Celiac (mild), diagnosed in high school
- IBS-C
- History of depression (no major, long-lasting issues the last 8 years though)
- Possible mild general anxiety
- Seasonal allergies


This is where my problem really comes in.

My depressive episode was resolved at 20 and I started strength training wth barbells shortly after turning 21. I wasn't competitive with it at first. I definitely felt fatigued after workouts, but I hadn't noticed any sort of concerning pattern yet. A couple of years later, I became a certifed strength coach and began coaching full-time. That's when I decided to push myself hard. I worked with another coach during the period, who was much more experienced and had a reputation for making strong lifters.

During this 2 year period, I bulked, gaining 15lbs. I tracked my calories strictly. I was an online coach and has plenty of time to rest and life outside the gym wasn't too stressful. I don't have any children. All of this is to say recovery wasn't an issue.

This turned out to be one of the most miserable periods of my life. I would workout 4 times per week, about 2 hours each session, doing the traditional high intensity work. Nothing special. But it would completely wipe me out. I calculated that when I got home, I would have about an hour to shower and eat something before I would have to sleep. Naps were seldom less than 1 hour. Commonly 2 hours, sometimes longer. Sometimes I would nap two or three times in one day. I would always nap on my off days too. (I know many lifters take naps but, damn, that seemed like a lot. No way all the working parents I was coaching would put up with that.) If I ever tried to push through without napping, I would be a zombie. My productivty would tank. I could barely focus or stay awake. It was more efficient to take a nap and then work than to try to go without. I felt like my entire life was work, workout, sleep. I was sleeping my life away.

I should also mention that it seemed my fatigue would build up faster than it should. Depending on the advancement of a lifter, they'll need a deload (light week) after X number of weeks in order to disspate their fatigue and prevent burnout/overtraining. I would hit that threshhold really early, but my coach would rarely program deloads for me.

Lastly, I was more emotional during this period, although it's difficult for me to flush out how much was a result of the mental stress of the workouts themselves versus feeling chronically worn out.


Fast forward to today. I've been experimenting with different types of barbell training the past two years. First I reduced workouts to twice per week, avoided higher intensities (RPE-based work), focused more on higher reps per set (sets of 8-10, as opposed to 1-5). Now I'm dipping my toes in three weekly workouts, one exercise per workout but seeing if I can handle modestly higher intensites. I still experience the same exhaustion response if I push myself "too hard" during workouts, but it's not as bad as before since I'm not going all out every workout and I have more control over my schedule (so the fatigue isn't building up).


I just want to know if I have some form of mild CFS. I've dealt with a tremendous amount of guilt the past 6 years because of my fatigue. As a strength coach, it's difficult for me to talk about or admit that it's really holding me back from lifting the weights I feel like I "should" be lifting. It would be a relief to know that I'm not crazy. This isn't all in my head. I'm not just being a wimp.


Thank you.

 

[Hoopoe]

Hi

Accurately diagnosing CFS is not easy and it becomes more difficult when the person is mildly affected. In my opinion in your case one should maintain some suspicion that it's something else. There is certainly some similarity to CFS.

It sounds like you need validation and encouragement to overcome lingering doubts that maybe you're just imagining all this, are a wimp, etc. Your problem does not need to be CFS, or be diagnosed by a doctor, to be valid and real. Becoming more accepting of the fact that you have this health problem could help you manage it better.

It's normal to have health issues that your doctors can't diagnose (easily, or at all).

 

[Trish]

Hi Brooke, welcome to the forum. I'm sorry to hear about your struggles with your health. We have a rule on this forum that we do not attempt to diagnose people or to offer medical advice, so we can really only offer sympathy and general comments about how ME/ CFS is diagnosed and what the symptoms are.

Diagnosis of ME/CFS is done by a doctor from taking a careful medical history, doing tests to exclude other possible causes of the patient's symptoms, and comparing the patient's description of their symptoms with diagnostic criteria.

One feature of ME/CFS is that it is not something you're born with, though it can start in childhood. It often has a clear time of onset following an infection, though some people it seems to develop gradually.

Most diagnostic criteria for ME/CFS require the person to be able to do less than half the activity they could do before onset of the illness. Also feeling fatigued all the time and rapid fatiguability, both when doing physical activity and thinking activity, so the person is forced to cut back the activity and rest. Most also have some mix of symptoms of being ill, like muscle pain, headache, sore throat, difficulty being upright for long before needing to lie down, sleep problems, difficulty concentrating etc.

Then there post exertional malaise, which is what happens when the person exceeds their already reduced level of functioning. The effect is often delayed for a few hours or days after the extra activity, and involves much more than being more tired or sleepy. It involves at least a day, often much longer of feeling much sicker, with additional symptoms that aren't there all the time, and a big decrease in what they are able to do.

To give a simple example, someone with mild ME finds they are forced by their illness to give up sports and even things like heavy housework and often can't work more than part time, and a single episode of, for example, going for an extra half hour walk, or vacuuming a room, means they wake up the next morning feeling like they have the flu and unable to get out of bed, other than to stagger to the loo, for a few days.

Someone with more severe ME might find they can't even have a shower or prepare a meal without triggering post exertional malaiseand being stuck in bed again for several days feeling ill.

There is a long list of other conditions that can cause brain or muscle fatigue. That's why doctors should go through other possibilities before making a diagnosis. Common ones include poor diet, depression, anaemia etc. And sometimes it can't be explained by any specific cause, so all the person can do is adapt their life to manage it.

I hope you and your doctor can find answers for you, and you can find a way to cope with your feelings of guilt, perhaps with some supportive counselling. Being ill or responding differently than other people do to exercise is not your fault.