This is a topic that used to come up frequently here. I was on Paradigm Change and came across these quotes from doctors who treat ME/CFS. Among them is a quote from Dr Shoemaker, the CIRS/mold guru. What he says is intriguing.
Personally, I have never had any worthwhile physical evaluations. I did have a cardiac stress test once. My heart rate reached the max before my body gave out. The doc didn’t really know what that meant, but we stopped since I had reached the target heart rate. ???
Anyway, here’s the link to the full article
https://paradigmchange.me/me/exercise-quotes/Here’s what Shoemaker had to say:
“Assessment of use of exercise as a therapeutic modality must begin with understanding the maximum delivery of oxygen (VO2 max) and the level of oxygen delivery at which not enough oxygen can be delivered to mitochondria to keep burning sugar efficiently as a fuel (anaerobic threshold). These measures, readily obtained in a standard pulmonary lab during stress testing, provide insight to baseline exercise capacity; each impacts on the exercise prescript
ion. Age matters here, as VO2 max of 24 ml/kg/min is indicative of severe disability in a 24 year old but the same disability rating is reached in a 60 year old at 16 ml/kg/min. Anaerobic threshold of 50% of VO2 max will prevent a 30 year old from achieving much benefit from efforts to use aerobic (i.e. delivering oxygen) exercise. Similarly, delayed recovery from normal activity (aka “push-crash” or “post exertional malaise”) will occur at anaerobic thresholds under 60% of those older than 60.
One cannot neglect the concept of glycogen storage potential here, as forced exercise beyond consumption glycogen reserves — as is invariably seen in low anaerobic threshold patients being told “No pain, no gain” — simply means that gluconeogenesis will occur, creating negative nitrogen balance. Exercise in these patients is “all pain and never any gain.”
In the presence of significant tissue inflammation, as shown by levels of T regulatory lymphocytes (CD4+CD25+) less than 14, the level of anaerobic threshold is functionally reduced by another 25-33%.
In patients with significant capillary hypoperfusion, as is commonly seen in CFS, manifested by C4a levels over 10,000 and lactate over 1.29 seen on magnetic resonance spectroscopy, the anaerobic threshold is further reduced by another 25-33%.
Simply recommending aerobic exercise in CFS is illogical. One must understand the individual’s physiology before telling anyone that exercise is indicated.”
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Has anyone had this standard pulmonary lab during stress testing that he talks about
?
What tests confirm capillary hypoperfusion?
I know I have something like this but don’t know how severe it is or how to prove it.
I went to physical therapy early this year. I was put on a hand bike at the base setting. I was able to do it but felt tired after. The next visit, they set it up one level. Within minutes, my heart was racing. My head got loopy, and I felt like I was going to fall over. I had to stop. That was kind of a shocker for me, as I didn’t realize how bad off I was. I had been thinking of getting a bicycle, but now I know there’s no way I could ride a bike.
The whole capillary hypoperfusion thing just sounds like something I have. Like blood/oxygen doesn’t get where it needs to go. I was hoping Serrapeptase might help with this. Not sure if it has. I did have some improvements in energy, but I correlated it with my 2 weeks of Alinia.