Monday, January 12, 2009

Avoiding a Relapse

Those of you that read my training log know that some weeks are better than others but I avoid a major relapse into adrenal exhaustion. The most common question that I get is as follows: “How can you train at this level and manage to avoid a relapse?” I’ll do my best to answer that question in this post. First, I need to address the causes.

1.Weak adrenals from birth- I was not properly tested for adrenal disease until I was 25 years old but based on my results, my doctor feels that I was born with weak adrenals and based on my experiences, I tend to agree. Some of the symptoms, such as difficulty waking up in the morning were present from a very young age. However, the energy crash may have been avoided with a lower stress lifestyle. In any event, my capacity for stress was limited by weak adrenals. Plenty of people take on far more physical and emotional stress than I ever did yet never experience an energy crash.

2.Chronic emotional stress- From 9th grade, through 4 years of high school, 4 years of college and 2 years of graduate school, I pushed myself to excel in the classroom and sometimes took a course load that was too difficult to bear. One B per grade period was usually acceptable but I was upset with myself if I did any worse. There were periods in which I spent the bulk of my time outside of class studying in the library. Some semesters, the workload was concentrated within a few “hell weeks” then I would have it relatively easy for a while. Other times, the work was constant throughout the semester and I could never give myself time to recover. In undergrad, I usually felt decent during the semester but had a major let down after it was over, which is characteristic of fast oxidizers (hyper). In both high school and undergrad, I was a top student, graduating in the top ten percent of my class. When I got to Clemson for graduate school, the average student was as intelligent as I am and some could match my determination as well. As my health deteriorated, it became more difficult to focus and my grades slipped a bit, which never sat well with me.

3. Chronic physical stress- As I have posted before, I lack the talent to become an elite runner but do have enough to be pretty good when healthy. However, my capacity for workouts was limited by my weak adrenals. Even before the energy crash, there was no way that I could have trained at 70-80 MPW like most college athletes plus I studied so much that I didn’t have the time. My strongest events were the middle distances on the track (800-1500 meters) and I tailored my training accordingly with a steady diet of short and fast intervals. I usually topped out around 25-30 MPW on 5 training days per week but most of my runs were at tempo pace or faster. Long runs of 6-10 miles were also pushed hard. As my condition slowly worsened, I was unable to improve as much as I had hoped based on my intense training and was beaten by runners who skimped on their training. This frustrated me to no end.

4.Poor diet- I consumed a lot of sugared and caffeinated drinks while seeking more energy. What I got was a temporary hit of energy from the stimulants and ended up beating up my adrenals even more. Also, I consumed more than my share of simple carbohydrates and the garbage that is served at fast food restaurants.

5.Other environmental factors- I have read horror stories about people that have reported having “never been the same” after a certain event or taking a prescription drug. As a teenager, I was on an acne drug called Accutane that has been linked to chronic depression and adrenal disease. In some very rare cases, people have reported that the “side effects” are still present 20 years after stopping the drug. Accutane is just one of many drugs that have been linked to long-term ill-effects that are not limited to thyroid and adrenal disease. Obviously, there were other factors in play in my situation but feel that Accutane did play a role. Finally, adrenal disease can be caused by exposure to toxic metals which displace important minerals and prevent systems from doing their jobs. FYI: my toxic metals have never been shown to be a serious problem.

The solution:
1. Supplements- If you do have weak adrenals from birth, this is most important. Once I crashed, simply avoiding stress was not enough to restore health. The greatest determinant to how I feel is the pills You’ll need a hair and/or neurotransmitter test to determine what to take, what not to take and how much to take. My case was unusually complex in that one fewer or one more pill per day made all the difference in the world. Re-test every 3-6 months to track your progress. The test may reveal necessary changes that can be made before negative effects appear. I monitor my body’s reaction to the supplements very closely and take note of how my training goes. For example, if I am unsure about a formula at a particular time, I rest a day or 2 so I’ll be fresh then test myself in a time trial. On a good day, I can run 5 miles in less than 35:00 even without competition. If I’m under 35, I know that no changes are needed. If I’m closer to 36, it’s no big deal. It can be attributed to normal variability in performance. If I’m over 37 and going all out, I’m losing close to 30 seconds per mile and certainly don’t feel right. Something is clearly wrong so I try another formula and run it again. Sometimes I consult my doctor but it’s happened so often that I usually know what the problem is on my own. For example, if my legs don’t hurt but I can’t breathe, it’s almost always hyperthyroidism. If my legs do hurt but I’m not out of breath, it’s something else, often low neurotransmitters. Often, after a couple of “C” or “D” workouts, I make the needed adjustment before I get to the point in which I cannot do a workout, which is the only time that I give myself an “F.” If I do not change my formula when it is necessary to do so, every scheduled hard workout would be an “F” even if I am well rested.

2. Low stress in personal life- Find a low stress job without heavy overtime. True, the money will not be as good but you can’t put a price tag on health and happiness. Americans are now working longer hours and sleeping less than they were even 10 years ago. Half of all white collar workers log more than 50 hours per week. Many of these workers are under chronic stress during the day and feel nothing like getting any type of exercise when they finally get off work. They pick up fast food for dinner, eat late night snacks and end up overweight. Weekends are spent on maintenance of the home or watching television. If the trend of more work/less sleep continues, the problem of adrenal disease will only worsen and mainstream medicine offers little hope of recovery. If you are a university student unsure whether or not you can handle a course load, don’t take all of them or drop one early in the semester. It’s better to be slightly bored (slightly is a key word) than overwhelmed by stress. If you are in a situation in which high stress in unavoidable, you are not doomed even if you have a history of adrenal disease. However, your supplement program may have to be modified and monitored more closely than usual.

3. Smarter training- I almost never run all 7 days a week or do 2 a day workouts. Also, I do not see myself ever going over 60 MPW even if I feel that I could handle it. As of now, 50-55 is my upper limit. If I feel that I need it, I am not afraid to take a second rest day during the week. Also, my style of training is very much different than before the crash. I do a lot more LSD (long slow distance) and rarely run short, fast intervals unless I am specifically training for a 5K. Because of this training, I am unlikely to come close to my PR for the 1 Mile but my racing is at distances 5K and longer. I have already set PRs at every distance 5 miles and up and feel that a 5K PR is within reach down the road. Whether it is as a result of too much distance or too much intensity, overtraining presents a risk of a relapse and I must remain wary of it. However, proper supplementation leads to more balanced chemistry, which will increase my workout capacity and mitigate the risk of overtraining. Soreness from intense training feels different from soreness as a result of a chemical imbalances and I know that difference very well. If I am sore as result of chemical imbalances, I don't push it. If I do try in that state, I'll fade early, get slower with every step and do myself no good by staying out there. When I know that it's not my day, I cut the workout short. The payoff is that I am fresh when I get back in balance. I've run some fast times just a few days after an adjustment.
*One very important point, I was a competitive runner from ’92-‘99 and was good enough for Division II teams. Even when I was no longer competitive, I still ran off and on when my relative lack of symptoms allowed. I was still in decent running shape up until early 2005. If not for this background, there was no way that I could progress to a 2008 marathon after my second running life began as 2006 came to an end. Also, it is a big mistake to jump right back into training at the first sign of improvement. Despite my competitive background, I was a walker as recently as the Fall of 2006 then progressed to walk/jog then followed a program similar to a “Couch to 5K.” Even elite performers would do best to follow a similar program.

4. Better food and drink choices- My doctor has told me that sugars and simple carbohydrates are “poison” for someone with my body chemistry. I rarely consume soda now but when I do, I drink something caffeine free and/or something sweetened with pure cane sugar rather than high fructose corn syrup. Drinking more water has also been helpful. I have also reduced my fast food consumption and increased my servings of vegetables. Lean meats and proteins make up the bulk of my diet.

5. No prescription drugs- I have not taken any drug since I came off the anti-depressants in the Fall of 2006 and unless my life is in danger and there is no alternative, I will not take another as long as I live. That said however, I do not advocate quitting meds cold turkey and admit that they can be beneficial for some people. I continue to test for toxic metals and would take pills with a chelating effect if a test showed toxicity.

I have a friend from California who is currently recovering from adrenal fatigue. He told me that when he shares my story with others with the disease, the most common reaction to seeing my running times is disbelief. True, if you had told me back in 2005-06 that I would be running marathons, I would not have believed it. However, that reaction is more indicative of a lack of faith than anything else. Yes, my recovery was improbable and even my doctor said that my early progress was “way ahead of schedule” but nothing is impossible with God (Matthew 19:26). If you accept defeat, then that’s what you will get. See Part 2 of the Mission section of my main website ( As for the disbelief, I don’t see how anyone without a medical background could know so much about this disease and the treatment without actually going through it. My picture is posted at the finish line of my first marathon in Oregon, which proves that I really did it in less than 4 hours.

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