Anaerobic thresholds, fatty acid problems and autophagy dr. klimas’s exercise study – prohealth gas lighting


The traffic, everywhere we went, was consistently heavy. Plus, Google seemed to have entered into a Bermuda triangle of its own, frequently telling us to go down one street and then do a U-turn. We made it to the building with minutes to spare. As we rushed through the warren that is the Miami VA – corridors everywhere – our confused faces must have given us away as we were helpfully directed several times to our destination.

I was there for a men’s ME/CFS exercise study. I was going to get on the bike, and exercise as hard as I could while getting blood drawn several times during and then after the exercise test. electricity and circuits class 6 ppt Dr. Klimas’s team was then going to analyze 9 million data points (covering gene expression, cytokines, flow cytometry, cell function, neuropeptides) captured from the test. This was all happening because of Dr. Klimas’s foresight in having chronic fatigue syndrome (ME/CFS) included as a control group for a Gulf War Illness study.

The idea of getting an exercise test and immune and other data was enticing and had prompted the idea of an East Coast trip, which ended up consisting of stops in Miami (Klimas exercise study), Baltimore (Vicky Whittemore and Avindra Nath interviews), Nashville (Dysautonomia Conference), Tuscaloosa (Dr. Skip Pridgen) and Birmingham (Dr. Jarred Younger).

Graham Salmun, the young exercise physiologist who provided the test, was very welcoming and more than happy to provide answers then and later in email. (It turned out that Graham, a triathlete, had had his own, thankfully temporary ME/CFS-like experience when he’d suffered from overtraining syndrome and was unable to exercise for a month.) It was testament to the strength of Dr. Klimas’s research program that by the time he got to me he’d done over 140 exercise tests in ME/CFS and/or GWS patients.

Then Staci Stevens of Workwell – an exercise physiologist who has specialized in ME/CFS for years – took a closer look. Even after years of reporting on Workwell’s exercise results, I was astonished how much data she could get out of this report, which didn’t include several parameters (blood pressure, workload) that Workwell includes in its reports. (Those measures were taken but weren’t included in the data I was given.)

Heart Rate at Anaerobic Threshold – My resting heart rate was high (89 beats per minute (bpm)) and could have resulted from pre-test jitters. My heart rate at anaerobic threshold – the point at which most of my energy is being produced anaerobically – was a mere 98 bpm. gas engine tom That suggested, if the resting heart rate was correct, that I had a quite small activity window before my system spiraled into anaerobic energy production causing me fatigue and pain.

Ventilation and Breathing Frequency – my ability to move air in and out of my lungs – was very good – even better at 114% of predicted. That’s fairly unusual in someone with ME/CFS. But my breathing frequency (breaths per minute) at the end of the test was surprisingly low – just 30 breaths per minute compared to the expected 60. I was breathing more slowly, but possibly more deeply, as well. By the end of the test my body had been relying mostly on anaerobically produced energy for about 6 minutes. My lactic acid, which had built up enormously, should have been triggering my lungs to breathe more and more rapidly to buffer it. Staci suggested that the message to breathe more rapidly may not have gotten through.

Biological Validation – The Univ. of Miami group I visited does not do biological validation to calibrate their machine – something Workwell recommends. Biological validation involves using a healthy person with known values to help calibrate the machine. la gastritis My guess is that most exercise physiologists do not use biological validation, but in Staci’s experience, when biological validation is not used, the results tend to read higher (i.e. healthier) than actual. Therefore, my actual results might be lower.

Salmun believes that some people who do fine on the test probably have autonomic nervous system problems. Otherwise, lots of different problems are showing up in the exercise tests, but one general energy production issue in both ME/CFS and GWS stood out: reduced metabolism of the key substrate in aerobic energy production – fat. In fact, Graham had just presented on this subject in Minneapolis at the 2018 ACSM conference.

That 20-person study (14 ME/CFS patients; 6 healthy controls) measured fat oxidation rates during a maximal exercise test in ME/CFS. gas hydrates are used The results were astonishing with maximal fat oxidation rates almost 50% lower in the people with ME/CFS (healthy controls – 617 g/day; ME/CFS patients – 339.5 g/day). While small, the study suggested that people with ME/CFS were indeed having trouble burning fats for energy while exercising – and provided another indication that people with ME/CFS are using anaerobically produced energy far more than healthy people.

He referred to Booth’s study ‘Mitochondrial dysfunction and the pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)‘ which found that the more mitochondrial dysfunction there was, the more severe a person’s ME/CFS symptoms were. That quite large (n=191) 2012 study, which Sarah Myhill co-authored, proposed that a major immediate cause of the mitochondrial dysfunction was a lack of “essential substrates” (as Salmun found).

Salmun noted that our bodies tightly control the oxidation of fuels in order to use the most efficient processes to produce energy. Breaking down muscles into amino acids, which are then converted into glucose using a process called ‘gluconeogenesis’, is terribly inefficient and is used only when absolutely necessary, such as during prolonged starvation states. Gluconeogenesis has been described as “an extremely expensive investment with a negative return”.

That autophagy issue gave Graham Salmun a clue on some possibly helpful dietary tips for people with ME/CFS. Studies on intermittent fasting/time-restricted feeding (IF/TRF) suggest that it can help cells with mitochondrial damage enter into autophagy and kill themselves off safely. electricity history united states Removing the cells with damaged mitochondria could provide a novel way of reducing inflammation and improve one’s ability to utilize fats for fuel and increase ATP production. Salmun thinks this dietary measure might provide a lot of benefit, in particular, to people with ME/CFS with high levels of mitochondrial dysfunction.

The results of the exercise test were personally illuminating (heart rate at anaerobic threshold = 98 bpm! Really???) but more exciting was the news that the Miami team appears to be finding problems with fatty acid oxidation – a core part of mitochondrial energy production. My attempts at intermittent fasting have not worked out but it’s clearly helpful for some people with ME/CFS and I will try again to get some more autophagy going and turn down the inflammation a bit.

Lastly, Staci Stevens’s interpretation of the exercise test results simply reinforced how much information these tests can provide. Workwell and allied exercise physiologists recently published a paper that reports on the unique responses people with ME/CFS have to two-day CPET tests and tells exercise physiologists how to do them correctly. A blog on that is coming up shortly.