Musings On Oxidative Stress, Hypoxia & Apoptosis...

[juliegee]

Forgive me for losing my place or misspellings. I'm working on this between little ghosts & goblins appearing at my door. Like most of us, I'm still trying to connect the dots. I have strange hematological findings that are getting stranger and stranger. Very appropriate for Halloween

Like many here, my son and I consistently have high hemogloblin, hematocrit, MCV, MCH- all typical in patients that are extremely dehydrated or living in a high altitude. Except that we are well hydrated (at the time of testing) and live slightly above sea level These finding are also consistent in patients suffering from hypoxia- oxygen deprivation. On top of this, my last several rounds of blood work are also showing leukopenia (low WBC's), neutropenia (low neutrophils), and hypogammaglobulinemia (low gammaglobulins). One theory bantered about in autonomic dysfunction is that we suffer from a lack of available nitric oxide, which in turn causes the oxidative stress and resulting hypoxia. I've read studies that indicate that severe and prolonged hypoxia can lead to apoptosis (cell death)- explaining my leukopenia, neutropenia & hypogammaglobulinanemia- which results in immunosuppression. Ding Dong- Never knew there was a Bumble Bee Transformer

I know that I'm not in good company with the immunosuppression- pretty rare here. BUT, I think I've figured out WHY that's happening & hope someone here can offer advice. A little over a year ago, I was 20 lbs heavier than I'd ever been- a result of my MCAD meds- and I began a pretty intensive exercise routine. Well, it's been a ton of work, but really beneficial in so many ways. I dropped all the weight and have maintained it. For the first time in my life, I am RUNNING and lifting light weights etc. My autonomic & MCAD stuff is so much better. in many ways, my health is much improved, EXCEPT for my compromised immune system

I have found lots of studies that confirm that a severe and prolonged exercise program can result in leukopenia, neutropenia, and hypogammaglobulinemia possibily as a result of hypoxia and the subsequent lack of nitric oxide....WELL we deal with that anyways in daily life. I suspect that my already compromised body perceives the stress of a fairly mild to moderate exercise program as extreme stress and my blood work is proof of that. It's getting bad. My WBC is at 3.0. My internist wants to send me to a hematologist for a bone marrow biopsy I think I know what's going on and want to figure out a way to fix it.

I know the easy answer is to stop exercising, but that's so hard as the benefits are amazing. My conditioning has helped to stabilize my HR and BP. My metabolism is fast enabling me to eat well & still maintain my weight (even with my appetite stimulating antihistamines.) My cholesterol is down 20 point to 160 and my MCAD symptoms are stabilizing. By pushing my boundaries in exercise I am showing my body how much it can handle. A shower used to wear me out. Now, on a really good day, I can run for an hour. I'm only running about 15 miles a week, lifting light weights, and doing other calisthenics, like push-ups, jumping jacks, squat thrusts, etc. I know many here became sick when they were in top physical shape. I don't want to crash, and I don't want to stop.

I'm considering supplements that body builders take to increase availability of nitric oxide. They're almost all geared towards men and promise to improve my sexual performance as a side effect I'm also considering glutamine or arginine or n-acetyl-l-cysteine. Dr. Weil's website says I need astragalus, echinacea, and Chinese mushrooms. Of course, I can't find any doctors that "get" how our bodies function, much less one familiar with suppressed immune systems in elite athletes. If i found one, I'm sure he'd raise his eyebrows and send this middle-aged woman running to a psychiatrist for lumping herself in the "elite" athlete category. I KNOW I'm not, but my body is working as hard as theirs... and I'm getting similar hematological results.

Any ideas? I need your collective wisdom. THANK YOU!

Julie

[firewatcher]

Julie, why not go straight to the heart of the problem and see if you can try a Rx for Oxygen therapy? I never had much luck with the body building supplements. If it is tissue hypoxia then O2 should help your numbers. You might also get a creatine kinase test to see if you are really shredding your muscles and the exercise is actually causing tissue damage. Just a thought.

[juliegee]

Julie, why not go straight to the heart of the problem and see if you can try a Rx for Oxygen therapy? I never had much luck with the body building supplements. If it is tissue hypoxia then O2 should help your numbers. You might also get a creatine kinase test to see if you are really shredding your muscles and the exercise is actually causing tissue damage. Just a thought.

How would Oxygen therapy work? Would I just spend some time every day hooked up, like before or after exercise?

I need your brains, Jennifer. I looked at my last blood work & all I have is serum creatinine and it's borderline high at 1.00. Does that show the same thing as a creatine kinase test? Would muscle breaking down be the ONLY thing that supports my theory? What about prolonged hypoxia from running? I'm certain I'm at 85% or more of my VO2 max as I run. Studies I've read said that causes the immunosuppression in athletes. Whatch'a think?

Thanks so much for your input. I'm not looking forward to an unnecessary BMB. I want to fix this.

Julie

[firewatcher]

Julie, why not go straight to the heart of the problem and see if you can try a Rx for Oxygen therapy? I never had much luck with the body building supplements. If it is tissue hypoxia then O2 should help your numbers. You might also get a creatine kinase test to see if you are really shredding your muscles and the exercise is actually causing tissue damage. Just a thought.

How would Oxygen therapy work? Would I just spend some time every day hooked up, like before or after exercise?

I need your brains, Jennifer. I looked at my last blood work & all I have is serum creatinine and it's borderline high at 1.00. Does that show the same thing as a creatine kinase test? Would muscle breaking down be the ONLY thing that supports my theory? What about prolonged hypoxia from running? I'm certain I'm at 85% or more of my VO2 max as I run. Studies I've read said that causes the immunosuppression in athletes. Whatch'a think?

Thanks so much for your input. I'm not looking forward to an unnecessary BMB. I want to fix this.

Julie

Julie, O2 should correct the hypoxia if it is there. I'd probably do it while exercising. Creatine Kinase is a marker of muscle breakdown/damage. My cardiologist suggested that I have one drawn since I can't seem to make any gains with exercise and have such muscle pains after. My serum creatinine is 1.2+ and has been up to 1.34 so they are wondering how I'm managing to kill my kidneys. Hypoperfusion is the only answer they've suggested, but yours might actually be from increased muscle mass. This is that vague area that no one goes into because it is really sports medicine/nephrology but not in an athletic way, so you won't find a doc who really knows anything about it. Good luck and keep me posted.

[juliegee]

Julie, O2 should correct the hypoxia if it is there. I'd probably do it while exercising. Creatine Kinase is a marker of muscle breakdown/damage. My cardiologist suggested that I have one drawn since I can't seem to make any gains with exercise and have such muscle pains after. My serum creatinine is 1.2+ and has been up to 1.34 so they are wondering how I'm managing to kill my kidneys. Hypoperfusion is the only answer they've suggested, but yours might actually be from increased muscle mass. This is that vague area that no one goes into because it is really sports medicine/nephrology but not in an athletic way, so you won't find a doc who really knows anything about it. Good luck and keep me posted.

Can you see me now, running with my oxygen tank??? What a pair we are....I guess I need a sports medicine doc, who specializes in autonomic dysfunctions Tell me if you know a good one

I was thinking the same thing as your cardiologist, regarding your creatine kinase. I came across that somewhere in my reading & thought of you- might be telling and help explain your extreme post work-out pain & kidney stuff. Thank YOU for your help.

Julie

[firewatcher]

Julie,

One of the complicating factors to knowing if it is hypoxia is your RBC; a pulse-ox meter will also say max saturation because it is seeing all those red cells. What is your HR doing during exercise? Where does it land compared to your supine, resting value? I'm betting it is still pretty high. I wonder what part your MCAD plays as well, exercise can be a huge mast cell trigger. My PT has told me that I won't find a doc that will be able to help me: most Sports Medicine docs see athletes (normal, super fit/healthy) not rehabilitation cases. What if you cut back 1/2 way? Deconditioning occurs rapidly, so you'd know in a month if that was what was causing it.

[juliegee]

I just wanted to update this topic on the off chance that it will help someone else. Jennifer (Firewatcher) and I have been chatting & she convinced me to actually measure my HR when running. I did and it was way too high, around 160 (probably higher)- which is around 95% of my target HR. Apparently this hypoxic state, regularly repeated, CAN impair your immune system as I suspected. Here is a link describing the process:

http://www.livestrong.com/article/217150-what-are-the-dangers-of-going-above-your-maximum-heart-rate/

I plan to buy a good HR monitor to wear while I run and try to stay around 80% of my target HR. I'm hopeful that this will allow my immune system to repair itself and allow me to keep on exercising!

Huge thanks to our Jennifer for helping me figure this out!!!

Julie

[lieze]

Thank you for sharing that.

The thread was scaring me a bit but when you put that into perspective it makes sense.

I try to stay in normal heart rate zones most of the time so I am not causing any damage anywhere.

My rates do run high not that high often when I work or go places part of that I think I bring on with my own anxiety because once I relax I can hang out in that same place and be fine.

But I do try to limit that time that I allow my body to be in that state for my overall health and get plenty of rest after.

Your follow up post really helped to ease my mind.

[firewatcher]

Julie,

I'm betting your higher RBC count was what was allowing you to keep going with a HR that high. It is the only way that you'd be able to maintain the O2 demand. Now lets hope that backing off improves your immune function!