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Thread: Possible dysautonomia after covid, Dr Dooms are saying to avoid weight training

  1. #11
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    Quote Originally Posted by Matt James View Post
    This is interesting to me because I probably had covid a few months ago (tested negative multiple times but was pretty damn sick) and my daughter *did* test positive around the same time. I've had a hell of a time getting back into training, between my recovery capacity being total shit and I also had some serious hypotension after squatting 245x5 my third workout back or so--being on the verge of passing out for 20 minutes. Anyway, I don't have any answers, but I have a couple questions, OP. Your doc says "anaerobic exercise doesn't have an oxygen demand." I'm not sure that's entirely accurate, there is a pretty big oxygen demand for a few minutes *after* the set. At least there was for me, when I was healthy. Second, you're going to have to explain the hypoxia thing to me. I understand that increased respiration due to "air hunger" can trigger a blood pressure drop in someone with dysautonomia... but hypoxia means you're not getting enough oxygen, right? That's not what's happening here unless I'm wildly misunderstanding it. Which I may be.

    Good luck. This sucks.
    Sorry for the slow responses.

    I *think* I feel better but I have NOT been weight-training, I've been doing calisthenics on a slow-ramp up. I started doing barbell exercises with an empty bar, and to be honest I feel great doing pullups and ring rows, no post-exertional malaise (PEM) or dyspnea after exercises. If I have the dyspnea, I get it upon waking up or after eating, and not after exercising.

    To answer this and a few above about proof from the doctor. So for one thing this was some doctor's visits + some online message exchanges with this doc, not a research seminar, so he didn't hand me a syllabus of references. However, he did point me to two NYT articles about long covid from Feb 2022. He happens to be a researcher. I looked up some stuff myself on what he was saying and it is essentially mitochondrial dysfunction, which can happen from viral infections (and even some antibiotic reactions, apparently). Here are two:

    Mitochondrial Dysfunction May Be to Blame in Long COVID-19 | Everyday Health (simpler to read)

    Part III: Long COVID and Mitochondrial Dysregulation (more detail)

    In these it's argued that covid breaks the normal functioning of the mitochondrial metabolic pathways, but the doctor argued this was particularly the case for anaerobic metabolism and I believe he said it was tied to the inflammatory aspect of long covid. The first article references aerobic activity though.

    He also said that his patients with the most severe long covid (some of which progressed to POTS) were his athletes. A powerlifter was one, a rock climber was another, and he said "my couch potatoes are mostly fine."

    What am I going to do? I'm going to a) take it easy and SLOWLY ramp up b) by starting with calisthenics and incorporating weight training again slowly c) I used to be 5x5 and 5x3 and below guy, max RM's my 5 sets that is, and I did this 3X a week (once a week was a light day). Instead, I'm going to hit higher rep ranges and lower weights for a while. Not because COVID, but because, hey, why not use this (not recommended) covid opportunity to reset and try something a little different. I'd like to cross-train pure strength training, volume/endurance with higher rep ranges, and power. Before, I was pure strength. I also did no cardio.

    I think I was beginning to overtrain when covid hit - I was already starting to feel run down for a few weeks. I also had a very heavy 5x2 session on day 2 or 3 after having been infected.

    Back to Matt James: I can't answer the specific details but what you described on the verge of passing out was something he warned me about with regards to weight training - I have a message from him where I asked about diaphragmatic bracing when squatting heavy, and he said to avoid it as IF I have Dysautonomia it will make it worse, and he said I could pass out under the bar, interestingly. He said it can proceed to POTS which he has seen happen.

    Also - I should probably have said hyperoxia - as the description is getting too much oxygen. Apparently breathing not diaphragmatically but from the chest he said, he believes increases greatly the chances of long covid, as the feeling of breathlessness is only a feeling (caused by the dysregulation of the autonomic nervous system). He observed (also in the clinical notes) that I was periodically sighing a lot as I was talking and stopping to breath from the chest (at the time I had a lot of breathlessness, even with no physical activity at all). I had then, and I continue to have now, all sorts of strange sleeping issues that got a lot worse with covid.

    I'm no doctor but there are two harmless things you can do: 1 is the diaphragmatic breathing exercises (Coronavirus Recovery: Breathing Exercises | Johns Hopkins Medicine) and another is doing some light cardio.

    The doctor could be wrong about everything above. However, he has a number of patients and this is an international covid center and it's often mentioned in the medical literature and press.

    If there is skepticism here, it's this - that he will be inherently biased because the people coming in the door are already F'ed with long covid. There are plenty of others who recovered and you never hear about that.

    Personally if a disease lasts MONTHS I become concerned. I did not appreciate having lingering symptoms after 6-7 weeks, for example.

    Again my opinion - I think if we don't have post-exertional malaise, like we feel exhausted the next day or two days later, then we're probably okay. The breathlessness when doing anaerobic work is however, of concern to me and so I intend to take it seriously and very cautiously, with the expectation that my body will heal itself at some point.

  2. #12
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    Quote Originally Posted by Jovan Dragisic View Post
    You have been told by doctors, ok. But have you tried it yourself? Do the doctors say that you will get POTS from a single set of squats?
    I respect all the skepticism. I share it. However, anecdotes abound, where people become progressively less tolerant of anaerobic work and some develop POTS over time.

    I have no idea what the likelihood of it is. I'm going to pursue "cautious skepticism" and do a SLOW ramp-up. My only diagnostics tests so far have been cardiological, and I'll be doing an exercise test shortly that monitors I believe blood pressure and other characteristics while performing exercises. I'll definitely request they test me for POTS and anything else, as I don't see any evidence of it so far (evidence would be a big heart rate increase when going from lying down to standing up). So far the doctor is going by the fact that I had symptoms suggesting systemic inflammation that lasted more than a certain amount of time (in this case two months and counting), and going by his experience.

  3. #13
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    Quote Originally Posted by m00t View Post
    I respect all the skepticism. I share it. However, anecdotes abound, where people become progressively less tolerant of anaerobic work and some develop POTS over time.

    I have no idea what the likelihood of it is. I'm going to pursue "cautious skepticism" and do a SLOW ramp-up. My only diagnostics tests so far have been cardiological, and I'll be doing an exercise test shortly that monitors I believe blood pressure and other characteristics while performing exercises. I'll definitely request they test me for POTS and anything else, as I don't see any evidence of it so far (evidence would be a big heart rate increase when going from lying down to standing up). So far the doctor is going by the fact that I had symptoms suggesting systemic inflammation that lasted more than a certain amount of time (in this case two months and counting), and going by his experience.
    Imagine you had a 405 squat for three sets of five before Covid. So you go in to the gym and do a single set of five at 315. You might not make it, I don’t know. But say you do make it. Next session you do two sets of five. You still feel ok. So next session you do three sets of five, the session after that you add five pounds and off we go. What is the likelihood of developing POTS if all of your training sessions go by ok? What is the rationale the doctors are giving for not allowing you to try this?

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    My only diagnostics tests so far have been cardiological, and I'll be doing an exercise test shortly that monitors I believe blood pressure and other characteristics while performing exercises. I'll definitely request they test me for POTS and anything else, as I don't see any evidence of it so far (evidence would be a big heart rate increase when going from lying down to standing up).
    You haven't had a tilt-table test yet?

    In these it's argued that covid breaks the normal functioning of the mitochondrial metabolic pathways, but the doctor argued this was particularly the case for anaerobic metabolism and I believe he said it was tied to the inflammatory aspect of long covid. The first article references aerobic activity though.
    Why do you think squats are usefully classified as an "aerobic" or "anaerobic" activity? As someone already pointed out, this indicates your doctor does not understand how your condition relates to strength training.

    Quote Originally Posted by m00t View Post
    The doctor could be wrong about everything above. However, he has a number of patients and this is an international covid center and it's often mentioned in the medical literature and press.
    Who? Can you visit the cardiology division at SUNY Downstate?

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    I had watched this video before getting COVID, and I credit its advice for helping me recover quickly:

    The Case for Sunlight in COVID 19 Patients: Oxidative Stress

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    Here's a paper about mitochondrial dysfunctional post-covid, shortness of breath I experience(d): Mitochondrial dysfunction in lung ageing and disease

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    It might be worth getting a second opinion.

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