Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: briligg on 10/04/2011 02:32:28
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I have had a fatigue problem since my early teens at least - i don't remember a time when i didn't feel tired a lot of the time. I could go on and on about that, but let's just say i didn't treat it as a medical issue until i was about 30. I am now 43, and i am still struggling to find ways to reduce my fatigue. Extensive diet changes have helped, exercise helps as long as i limit it carefully.
Where we live in Mexico is 7000 ft above sea level. When i go home on visits to the Toronto area, which is only about 400 ft above sea level, i feel GREAT. When i lived in Toronto, i definitely did not feel great. Sure, some of it is just the pleasure of being home, but wow - i get up at 6 a.m. every day because i don't want to be in bed anymore, and it is hard to express how much that is unlike me. On our visits we tend to have long days, often with a lot of walking, and i handle it just fine.
Recently i saw a doctor here in Mexico because at this time of year i tend to get a minor sense of a lack of air, which has now become noticeable enough to do something about it. I was given pills to dilate my bronchii, and told that because of the extreme dryness and sudden temperature changes of this season in this region, complaints like mine are common at this time of year.
I was also advised to condition my lungs by spending 2 minutes every day blowing bubbles through a straw into a yoghurt container filled with water. I have done that, and have now increased it to three
minutes, and intend to increase it more, on a hypothesis that i could help my fatigue in general by increasing my lung capacity as much as i can.
Could that work? Since i have now lived at high altitude for 8 years, is it possible i will keep some of the improved lung capacity that has given me long term, when we move up to southern Ontario?
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Ok, i'm going to take a stab at partially answering this myself, based on reading i've done since i posted this. When people who have grown up at lower altitudes spend time at high altitude, their body manufactures more red blood cells so they can absorb enough oxygen to maintain their normal level of activity. By doing physical exercise at high altitude, athletes also strengthen their diaphragm and other breathing muscles, so that when their oxygen needs increase, those muscles have an easier time increasing the rate and volume of breathing to provide more oxygen (and eliminate more carbon dioxide).
Because i grew up at near sea level, when i return to that altitude, my body detects that i no longer need the boost of the extra blood cells i have, and it starts to eliminate them. If i spend more than two weeks there (which i sadly have not in almost 8 years) i will no longer be receiving extra oxygen from those extra red blood cells. (Project: how can i fool my body into keeping the extra cells? Long-shot: if i take a little aspirin each day to thin my blood, maybe that would help? I once had a blood test here that showed my blood was 'thickened'. Now i understand why. If my body didn't feel a need to thin it once my immediate oxygen needs were no longer an issue, maybe it would let me keep some of those extra cells....)
If i continue to do exercises to strengthen my breathing muscles, i will continue to benefit somewhat from being able to breathe a little more deeply and perhaps a little more frequently without expending more energy in the task, because exercise improves the efficiency of muscles. If i combine that with cardiovascular exercise at an appropriate level, blood supply to my whole body will also be improved, also helping somewhat in improving my energy levels.
That's the limit of the 'natural' approach. I have started drinking unsweetened cocoa powder in hot water with a little milk several times a day. Theobromine, which is found at high levels in cocoa powder, relaxes smooth muscles, which causes the bronchi to dilate, allowing more air to enter the lungs. This could help me a little in maintaining a higher level of oxygen intake.
There is nothing i can do to increase the number of alveoli in my lungs, the little sacs where air exchange between the blood stream and the atmosphere takes place. Once the lungs finish developing, you are never going to have more of those.
Bummer...
*For reasons i won't get into here, i was very sedentary as a small infant, so much so that i became obese and did not learn to walk until i was 2 1/2.
*When i was 10, i tested positive for tuberculosis and was put on medication for it for several months, but we had never traveled. When there seemed no reason to believe i actually had tuberculosis, and my mom complained the medicine was making me tire (i think the truth is that's just when she noticed i tended to always be tired), i was taken off the pills, and the matter was simply set aside. (We moved a lot.)
*As an adult, there are shadows near the bottoms of my lungs on xrays, that are not due to smoking. Okay, i did smoke in my early 20's for 6 months, never more than a few cigarettes a day, but i first saw those shadows on my lungs years before that, when i had a standard medical exam before college. (The doctor paid no attention to them, probably thinking i was trying to hide the fact i was smoking - which i wasn't. Not tobacco, or pot, or anything.)
*When i was growing up, i couldn't blow up a balloon, no matter how much i tried. I couldn't even get it started.
I take this all together and conclude that my fatigue may be mostly due to a chronically inadequate oxygen supply, because my lungs never developed properly in my first 3 years of life due to my high level of inactivity. As an adult, my fatigue issue seems to be more complex, but maybe it all goes back to that one root cause.
How much can i do about this as an adult? I am now going to pursue breathing exercises in a way i never have before. They have always been more difficult for me than for other people, and so i have always given up on them - but now they seem an awful lot more important than i ever thought in the past.
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brillig, is there a way that you can have some kind of test to identify exactly what is causing this problem?
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Not at the moment, and past efforts to figure out what it is haven't yielded any answers. I am in a small town in central Mexico. I have seen local doctors, but gotten nowhere. In fairness, i saw a doctor in Canada about this too, with the same result. When you go to a doctor and complain of general fatigue, there are a huge number of possible explanations, and most of the time when a patient's main complaint is fatigue, a satisfactory explanation is never found. I have looked into hypothyroidism, chronic fatigue syndrome, and depression or anxiety conditions as possible causes - it is none of these things.
The best name i have found for my condition (working on my own at this point, i have exhausted my doctor options for the moment) is idiopathic hypersomnia. That is greek for 'sleeps too much and nobody knows why', literally. The only symptom for that, is that you sleep for at least 10 hours a night, and you have done so for at least 3 weeks. I have slept for 11 or 12 hours a night, whenever i can, for many years, and still i am usually tired during the day. In places where this is considered acceptable grounds for medicating, they give you modafinil. I now take that daily.
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*When i was 10, i tested positive for tuberculosis
TB can cause permanent lung damage ...
If left untreated, tuberculosis can lead to severe lung damage
http://www.cts.usc.edu/zglossary-tuberculosis.html
Lung function tests exist ... http://en.wikipedia.org/wiki/Pulmonary_Function_Test
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Just a thought, but perhaps you could run an experiment. If you can get hold of an oxygen generator or medical bottled oxygen, and it makes you feel as good as you do at low altitudes, then I would think it's telling you something about your lungs, or perhaps just your ability to handle high altitudes.
I know that when I get to 7,000 feet or above, it really slows me down, a lot!
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RD - I tested positive to the standard skin test for tuberculosis, which shows my immune system responded to the bacterium involved. I assume the pills i took were antibiotics for that. I admit i never checked before what that test actually is... dumb of me, i had this idea it reflected some aspect of lung function. I had never been outside of Canada at that age and nobody had any idea how it could be possible i had come in contact with tuberculosis. When the doctor took me off the pills, his comment was i was probably the last person who would come down with tuberculosis, which i am guessing reflected an assessment my immune system had responded to the bacterium despite having actually never had contact with it. It's been 24 years now since that doctor before college pointed out the shadows on my lungs, so i think if i had an untreated tuberculosis infection, that would have manifested by now. My parents were also both heavy smokers. I spent lots of time in the car with them on long winter trips while they both smoked. The shadows could be the result of having weak lungs in the first place and growing up with smokers.
There is a city an hour from here where i could possibly get my lungs tested. I could ask our doctor about that. There is a quick and dirty home version where you blow up a balloon and submerge it in water to roughly calculate volume. Of course, i've never been able to blow up a balloon. I'll go get one and see what happens... If i still can't blow one up - i haven't tried in many years - that is awfully damning in itself, no? I could get another chest x-ray done here in town to check up on those shadows. I imagine they are still just sitting there, but it could be good to take another look at them and get an opinion from our doctor. The doctors here listened to my lungs when i went in about the shortness of breath, and they sounded fine, once i was taking the pills for that. (That time i just went to the doctors that do consultations at the pharmacy - that is common here. They do simple assessments for simple things, then you go fill your prescription - $2.50.)
Geezer - i'm sure a bottle of oxygen would make any healthy person feel pretty happy. The normal thing when a person moves to high altitude is that it takes their body two or three weeks to adjust. I also had to adjust to a new language and a completely different diet, i had a hard time of it. At this point i don't think my energy level is any lower than it was when i lived in Toronto. But really i have had fatigue issues for most of my life - maybe all of it, since i can't remember an onset.
If the simple steps above show my lung volume is low, further steps may be warranted. I'll get on that.
Oh - i also had asthmatic bronchitis as an infant, at the age of about 3. Maybe the shadows could be scarring from that? No doctor has ever had much to say about why i get so tired, i think i've tossed out all these things to them over the years and never gotten any reaction.