Hello doctors, I’ve been struggling with exhaustion for quite a long time (>decade!). And still I have no idea how to deal with it or what the real cause is. I’m always tired.
I’ve had sleep apnea for years, but bimaxillary osteotomy surgery fixed this. So this shouldn’t be an issue anymore.
I have sarcoidosis, but also here I haven’t had any symptoms for years now. (other than constant fatigue, which my pulmonologist does not attribute to the sarcoidosis)
The thing is that when I do no physical activity, I start to feel much better quite quickly. Within days I start to feel better already. But when I stay inactive for longer than a few weeks I start to feel sluggish and tired again.
I lay in bed for ~8 hours every weekday. On Saturday and Sunday it can even be 9 to 9 1/2 hours. So I try to get as much sleep as possible. I’ve tried sleeping less, but that certainly didn’t help.
I can train with low intensity (not above rpe@6) for a reasonable amount of time and not get too fatigued, although I still notice a big difference from when I do no sport whatsoever.
It gets real bad when I start to increase intensity (like adding a 1@8 primer set).
I noticed that training disrupts my sleep, even when I train early in the day. The more I add intensity to the training, the worse it disrupts my nightrest. (sleep is interrupted frequently,I have to go to the toilet more during the night, I lay awake longer)
It’s so bad that it influences my performance at work noticeably. My superiors are very understanding, but do urge me to try to find a solution. (they very well see the advantages of physically active employees => desk jobs)
Also performance during training drops significantly during times I’m extremely fatigued. It can drop by more than 20% (e1rm on all lifts) from one week to the next and doesn’t return to the previous level. (at least not within a month)
To indicate a bit what amount of training is too much for me to handle: I couldn’t finish any of your templates without getting over exhausted and being forced to take a huge deload to be able to recover. (yes, I tend not to give up even when I know I push myself too far) Not even the time crunch template.
I’ve tested it a bit and I would conclude that my MEV sits higher than my MRV.
Also when I feel extremely fatigued, my blood pressure drops. I feel dizzy and a bit nauseous. (which happens quite frequently lately: a few days every few weeks)
I’m OK with training at lower intensities for the major part of the year. But I also would like to compete in PL a few times each year. So I have to add some intensity for short periods before a competition.
I’m not looking for an immediate fix. But some indication of what could be wrong would already help a lot.
The list of causes for things that can contribute to fatigue is quite extensive, and is probably beyond the scope of what can feasibly be addressed via the forum.
We do typically look at lifestyle factors, sleep habits, and frequently check for sleep apnea up front, but there are many other contributors as well that would require medical consultation and potentially some lab work to sort out (for example, evaluating for anemia, hypothyroidism, hypogonadism, adrenal insufficiency, diabetes, and a long list of other possibilities).
In the meantime, I applaud your efforts to find ways to remain active – much like we describe for managing pain in training (see here: https://www.barbellmedicine.com/blog…ining-what-do/ ), the same approach could apply for managing fatigue, particularly when it is exacerbated post-training. The idea is to find a tolerable dose of volume, frequency, and intensity, and progress gradually from there with the understanding that ongoing symptoms may be part of the process, since fatigue - like pain - is a part of life as well.
Hello doctor Baraki,
Thank you for the answer.
I am aware that it is nearly impossible to pinpoint the main cause of my fatigue via a conversation on a forum. So I do appreciate the examples you are giving. I do not think I have anemia but in previous bloodsamples it stood out that I have smaller and fewer red blood cells than average. Testosteron levels were normal. Blood-sugar levels are also normal.
I don’t think I have ever been checked for hypothyroidism or adrenal insufficiency.
Maybe I should have my blood checked again. It has been a few years. (I didn’t see a reason the have it checked)
In the meantime I’ll keep experimenting with volume and intensity. I will eventually find that sweet spot where I enjoy training and not get over-exhausted too often. 