[Dylan Crooks]

I am wondering if anyone has experience differentiating Over Training Syndrome (OTS) vs Chronic Fatigue Syndrome (CFS) vs Long Covid (LC).

I have been experiencing symptoms for a few months and decided to park my butt on the couch about 4 weeks ago with the exceptions of some daily walks. I also have been working with my PCP to get to the bottom of what may be going on. So far, all my blood markers have come back with normal ranges. PCP suspects CFS as of right now, but I think my symptoms need to last for at least 6 month to meet the diagnostic criteria.

Prior to downshifting,  I was running 2-4times per week, lifting 2 times per week, with some hiking, skiing, or other fun on the weekends. I also started a new and extremely stressful job in August after finishing graduate school. Admittedly, I was pushing through many days when I wanted to sit on the couch because movement has always helped me manage work and life stress.

 

Some of my symptoms fall into buckets of all three pathologies, but the one that are most pronounced are:

– Post Exertion Malaise (PEM); after a challenging day at work or skiing at the resort, I will barely be able to think and keep my eyes open, coupled with intense brain fog.

– Elevated heart rate at rest (about 10-15BPM higher) and during light exercise (walking).

– Intermittent head aches.

– Non-restorative sleep.

– Feeling as if my body struggles to shift into a para-sympathetic state; some tingling and twitching in face.

 

I wonder about Long Covid, because these symptoms became pronounced about 6 weeks after a bout of Covid at the end of December.

Also of note, is I experienced a similar episode near the end of the summer after I tried to cram in a lot of socializing and peak bagging in after completing my masters and prior to starting the new job. I rested about two weeks and gradually returned to activity and training, feeling mostly “normal” after about 5 weeks.

I have at times been extraordinarily exhausted by work since beginning, so I wonder if this summer incident was a Phase 2 OTS period that I never truly bounced back from, and have since dug myself into a deeper hole.

 

Any thought or questions to consider are appreciated! Thanks

[Scott Johnston]

Dylan:

What a bummer to have this problem and not know what it is or how to treat it.  The thing that I think all 3 of your possible causes have in common is the effect they have on your Central Nervous System (CNS).  Recently I have been reading about a promising treatment for long COVID that involves transcutaneous (non-invasive, through the skin) Vagus nerve stimulation.  The vagus nerve is part of the autonomic nervous system (ANS) that ramps up the parasympathetic side of the ANS.  Small electro-stimulus devices are on the market that specifically target the Vagus nerve which is close to the skin surface in the neck and ear.  They boost the activity of the nerve which in turn ramps up the parasympathetic system and turns down the sympathetic.  You should google this as there is a ton of information and studies on this subject.  My reading has caused me to wonder if this same treatment could help with OTS.

I’m sure by now you are getting pretty desperate for help. I encourage you to investigate this and make your own decision.  There are a few devices that are FDA-approved for this treatment and are being used for long COVID in many major institutions like Harvard, Mayo etc

Scott

[ircommando]

Agree with Scott what a bummer.  I hope by now you are finding some relief.  I have had covid three times now and it has always kicked my ass.  After the first bout I wasn’t able to get active again and started to think about long covid as a thing I was dealing with.  This was the same time that I started looking into mountaineering and fell in with evoke.  At the time I was aerobically deficient and so I started out with a relatively small volume of low end zone 2 work.  This felt super easy for me at the time but I stuck with it for 4 weeks before starting the 16 week mountaineering plan, which honestly starts pretty light in order to transition the athlete in.  I felt like all this light work really helped me get past the exhaustion and PEM I was experiencing.

The other thing I worked really well for me was breath work.  My focus with this was aid my body shifting into the para-sympathetic nervous system, so I do it a lot for post exercise recovery, but also if I feel exhausted and rest just isn’t restful enough.  One general idea governed my work and two specific exercises helped.  Generally when I wanted to calm down I  would try to focus on belly breathing.  For me this meant using my diaphragm to breathe and not my chest (chest breathing I tried to associate with hard work and/or exercise).  The two specific exercises were:

1.  Box breathing (breathe in for x seconds, hold x seconds, breathe out for x seconds, hold for x seconds, repeat).  This I did only belly breathing
2. The physiological sigh as described by Dr. Huberman This one I started with chest breathing and then slow shifted to belly only breathing to end my session.  I will occasionally do this when running/hiking if I am trying to stay in zone 2.  If I come to a short hill and don’t slow my pace enough and shoot into Z3 I will slow down a bit and do 2-3 physiological sighs.  I have noticed that it drops my heart rate between 3-10 bpm.  My experience is that you should NOT do this when trying to do high intensity work.  I thought it would be great for recovery periods in stuff like 30/30’s but my anecdotal experience was that it reduced my performance and any speed or Z3 work I was trying to do suffered

Good luck, hope you feel better,

Steve

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