Why am I so sore after I exercise? Why do I feel tired after exercise when my heart and lungs are fine?
If you are too tired to exercise or feel wiped out for a day or so after exercising or "overdoing it" with normal activities such as house cleaning, there is a reason for it, and it is NOT that you are out of shape.
From time to time, I encounter people who won't exercise no matter how I encourage them. They seem to detest exercise completely but tend to be open to occasional movement activities. At most, I can get them to go for a casual walk a couple of days of the week, but never a brisk powerwalk and never daily. It is easy to assume nonexercisers are only out-of-shape, lazy, depressed, or lack motivation. It is best to ask the reason why they don't want to exercise and further ask how they feel the day after exercising.
Many non-exercisers don't have limiting heart, breathing, neurologic, or specific musculoskeletal pain problems. They will have good days in which they can get a lot done, whether around the house or in activities with their families. Then, after the good day, they will have bad days in which they are exhausted, sore, and trying to recover from "doing too much." If you have an autoimmune condition, you know what I'm talking about. So, what is actually going on here? This phenomenon has several names. The CDC calls it "post-exertional malaise," which is odd because getting stuff done should not be considered an exertional activity. Some doctors prefer to call it "delayed recovery from normal activity" or simply "push crash."
TGF β-1
One mechanism of "push crash" is an elevated TGF β-1 (transforming growth factor beta 1). TGF β-1 is a growth factor cytokine. Think of cytokines as particles in the blood that regulate the immune system. We need TGF β-1, as it is anti-inflammatory, however, at high levels, it is inflammatory. The key is determining the reason for the elevated level and working to reverse the root cause. Any significant
Autoimmune conditions and any unchecked inflammation (think dental problems), unfortunately, result in elevated TGF β-1. Biotoxin illness (think chronic Lyme, water-damaged building exposure, ciguatera - all produce inflammation and immune dysregulation) also results in high TGF β-1.
VEGF
People who experience push crashes suffer from a lack of oxygen delivery to the capillary beds. VEGF (vascular endothelial growth factor) is a signaling protein that stimulates blood vessel formation. When levels are too low, the capillaries already suffering from low oxygen shrink more. Not only is oxygen not delivered adequately, but wastes are not removed adequately. Lactate builds up and causes significant soreness.
VEGF levels are stimulated by exercise and by early hypoxia (low oxygen). Like TGF β-1 , levels can be affected by biotoxin illness. Further if VEGF levels are high, it will stimulate an increase in TGF β-1.
ATP, Leptin Resistance & Low Adiponectin
When oxygen is present, each molecule of glucose produces 38 ATP particles. When oxygen is not adequate, the anaerobic threshold is met, and only 2 ATP particles are generated from each molecule of glucose. The body burns glucose immediately, followed by glycogen (stored glucose). Normally, after the body uses up glycogen, it should move to fat stores as the next source of energy. Without enough oxygen in the capillary beds and if Leptin Resistance (LR) is present, the body reaches for protein (specifically, alanine and glutamine) as an energy source. This is bad! The body should be mobilizing fat stores for energy, not breaking down muscle. You want low leptin levels and appropriate increases in leptin when eating to tell you it is time to stop.
So why does it take two days to recover? Once the glycogen is used up, the body needs two days to replenish stores. This is why tiredness may occur for two days after you "overdo it."
Adiponectin is produced by healthy adipocytes (fat cells) and makes their fat stores more accessible. You want high adiponectin levels.
Mitochondria
When there is not enough oxygen to capillary beds, mitochondria struggle to do their job. As a result of low oxygen, they will "self-preserve" and further lower their metabolism. This will result in less mitochondria and less ATP (energy), making it physically difficult to exercise or get things done.
What to do?
You may increase your stamina and ability to exercise by doing sequential progressive daily exercises. To solve the problem of push-crash, you should find out what is causing it. This may mean working with a functional medicine physician to uncover sources of inflammation or immune dysregulation.
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