It was a beautiful October day in 1986. The air was fresh, the leaves were just starting to announce a new season, and the Mets were in the playoffs. It was a perfect day to go for a run. So I geared up and was off.
After finishing two miles, I noticed a strange feeling in my chest. It felt sort of like swallowing cold ice cream. The feeling soon passed, and I forgot about it until days later.
The following morning my alarm went off at the usual time. However, something was really wrong. My legs and arms felt as if they were made of lead. I was able to get out of the bed with difficulty, but I found I couldn’t stand up for more than 30 seconds at a time.
What was odd was that I had no other symptoms. I had no headache, no sore throat, no cough, and no sniffles. The only symptom I had was extreme fatigue.
Since my symptoms came on suddenly, I figured I had some kind of virus and was sure that in a few days I would be better. Why wouldn’t I? I had always healed from things before.
Well, after weeks I didn’t get better. All my blood tests were normal. The only diagnosis my doctors could come up with was that after acquiring a virus, I had developed chronic fatigue syndrome (CFS).
After a month, I regained some energy which gave me hope that I was getting better. However, after a day or two of feeling better, the fatigue returned.
My eventual symptoms included constant fatigue in varying degrees, exhaustion after activity, waking up tired, brain fog, a generalized aching throughout my arms and legs and headaches. Over the next thirty years of visiting numerous health practitioners, the diagnosis remained the same.
I eventually learned to deal with the fatigue by cutting back on activities and only doing what I thought I could do without putting myself in bed for a week. I did have to quit my podiatry practice because I just couldn’t stand up long enough to make it work.
During my whole ordeal, I didn’t get depressed. There was no time for that. I tried to focus on how to get better. It just wasn’t happening.
Why Did It Take Me So Long To Get Better?
I suspect there are two main reasons why I didn’t recover quickly. The first is that I probably should have rested more. Some chronic fatigue sufferers need months of bed rest to get well.
I started a new career that allowed me to do a lot of work from home, but then I got married, and Barbara and I had four children and homeschooled them all. I had a family to support. There was no rest for either of us.
I just remained fatigued.
Secondly, I’m not good at dealing with stress. Stress is a major contributor to CFS and a major factor preventing its cure. See here and here.
So add up a lack of rest and an inability to deal with stress, and it becomes difficult if not impossible to heal from CFS.
Eventually, a doctor found that my cortisol levels were abnormal. My adrenals were fatigued as well. Stress was probably more of a problem than I first thought.
85% Better But With Consequences
About 12 years ago I went on a gluten-free diet (GF). Considering my experiences with wheat it was highly suspected that I have non-celiac gluten sensitivity.
That seemed to give me a little more energy but not much. How much this contributed to the CFS I don’t know, but I’m sure it affected my immunity.
What really gave me a big boost in energy was the walking routine I started 10 years ago.
I started slow with a walk around the block and then built up to a brisk 1.75 miles. The improvement in my fatigue was significant. I became about 65% better within a month. I found walking to be one of the perfect activities to reduce my stress.
Then about 4 years ago, I improved my diet. I changed from a GF diet to a GF paleo type diet. I also juiced heavily. In four months, my energy levels improved again. I was now about 85% better.
Because I had been basically sedentary for about 30 years, I started suffering from muscle pulls and bursitis. I also noticed a decrease in muscle mass in my upper body (see my article about sarcopenia). This prompted me to want to start strength training.
The question was could I do it? Even though I was much improved from CFS, would the stress from lifting cause me to relapse into severe fatigue?
Remember that physical or psychological stress can be devastating to CFS sufferers. I decided to give it a go. But first I had to know what I was in for.
Strength training will cause extra stress on the body
The Danger Of Too Much Stress
Successful strength training is based on a process that includes physical stress, recovery from that stress, and the body’s subsequent adaptation to that stress.
This concept of stress/recovery /adaptation is based on a theory proposed by Dr. Hans Selye in 1936. Selye, a pioneer is stress research, was the first to identify the effects stress has on an organism. Interestingly, Selye was the first researcher to use the word stress in a biologic context. He also coined the word “stressor”.
In his theory, the General Adaptation Syndrome (GAS), Selye explained that an event that threatens an organism’s well-being, a stressor, leads to a three-stage bodily response:
Stage 1: Alarm or Shock
In this stage of the GAS, the body recognizes that there is a threat or a stress present. In response, the sympathetic nervous system is activated and adrenaline is released. This produces the classic fight or flight response.
Further, the hypothalamus-pituitary- adrenal (HPA) axis stimulates the adrenal glands to secrete cortisol. Cortisol (known as the stress hormone) stimulates the release of glucose, fats, and amino acids into the bloodstream to meet the demand for more energy.
Stage 2: Resistance or Adaptation
Here the body attempts to recover from the stress and return to homeostasis (the normal physiological environment that exists within the organism). If the stressor remains or reoccurs, the body will attempt to adapt to the particular kind of stress involved.
This adaptation to the stress is the body’s way of ensuring survival in a world full of stressors.
During this process, certain hormonal, nervous system, and tissue adaptations take place that will lessen the effect of the stressor. If the body repeats this process too often with little or no recovery, it will ultimately move into a final stage.
Stage 3: Exhaustion
This stage occurs when long-term stress is not removed. The body’s resistance to the stress may gradually reduce or collapse altogether.
Eventually, all of the body’s resources are eventually depleted and the body is unable to maintain normal function.
During this stage, the adrenal glands can become extremely fatigued and may even fail. The immune system and the body’s ability to resist disease is severely compromised.
If this stage lasts too long, severe illness such as high blood pressure, heart disease, stroke, rheumatoid arthritis, G.I. ailments, diabetes, and other stress-related illnesses can result.
From looking at this scenario, it’s not too hard to see why constant physical or psychological stress is deadly.
As I mentioned before, people who are healing from CFS or adrenal fatigue or even those healed from those diseases are extremely sensitive to stress. Extra stress can worsen their condition or even create a relapse.
I believed I had healed enough and had learned enough about my body that I could strength train with certain parameters. In order not to relapse, I had to stay within those parameters. I also received permission from my doctors.
How To Strength Train Without Entering Selye’s Exhaustion Stage
When someone lifts a weight that disrupts homeostasis, it becomes a stressor and the body has to deal with it.
In the initial stage, there is an immediate shock to the muscles. The body responds as above and also with an inflammatory process. This is why some people feel sore after a workout.
During the adaptation phase, the body responds to strength training by attempting to equip itself with the tools necessary to survive exposure to stress. In training, this can include hormonal adaptations, nervous system adaptations, and increases in structural and metabolic proteins.
Selye suggested that the body’s adaptation to stress takes place within 48 hours. It is during the adaptation phase when muscle growth takes place.
As the body adapts to the stress, it becomes more efficient to deal with the same stress in the future. Strength and performance are thereby enhanced. Selye made this point in 1975. When stress enhances mental or physical function such as through strength training or challenging work, it may be considered not distress but eustress.
If training is not done properly, meaning if the adaptation phase is not allowed to proceed properly, then it is possible for the trainee to enter the exhaustion phase. This is known as training overload and can result in:
- poor performance
- sleep disturbances
- increased chronic pain
- abnormal mood swings
- chronically elevated heart rate
- depressed appetite
- weight loss
- other physical and mental abnormalities
These symptoms are extremely similar to those of severe depression resulting from ongoing stress. People who have CFS or adrenal fatigue are familiar with these symptoms.
If I didn’t train wisely, though, I would experience them long before I faced classic training overload.
In order not to get exhausted I had to all the more diligently observe the factors affecting recovery and adaptation.
Factors Affecting Recovery and Adaptation
1. Time
Selye proposed that adaptation occurs within the first 48 hours of the initial stress. This means that I couldn’t train the same muscle group within 48 hours.
2. Proper sleep
Experts believe that at least 8 hours of sleep is necessary to support proper recovery. It is during this time that repair of the body takes place. The longer the period of sleep, the better the quality of recovery. This is one of the hardest parameters for me to follow.
3. Proper protein intake
The Recommended Dietary Allowance (RDA) for protein is 0.8 g/kg of body weight per day for the average adult. This could rise to 1.2 to 1.7 g/kg of body weight for strength and power athletes.
Strength training includes the breakdown and synthesis of protein. In order for the body to repair damaged muscle and build more muscle, it needs extra protein. If protein is not available from dietary sources, the body will take them from its own protein stores.
Also, some researchers argue that people over 50 may need to double the RDA of protein to prevent sarcopenia (age-related muscle loss).
4. Increased calorie intake
To get stronger, the conventional literature advises the consumption of around 200 to 400 calories more energy than we expend.
Strength training burns calories. Calories are vitally needed for energy and tissue repair. Besides protein, you can get these calories from carbohydrates or fats. The question is which are best.
Some athletes, like Lebron James, thrive on a low carbohydrate diet.
In my case, I like to get most of my calories from fats. However, I’ve found that I also need carb calories to maintain good energy. I find these in sweet potatoes.
Remember the main hormone that gets dysregulated in adrenal fatigue is cortisol, and cortisol has been shown to dysregulate on a low carb diet. I did try a low carb diet a few years back, but it made me weaker.
5. Omega 3 Fatty Acids
Omega-3 fatty acids are important for recovery. They support anabolic processes and assist in the management of post-exercise inflammation and pain. This means eat more salmon.
6. Hydration
We’ve all heard the mantra to “drink 8 glasses of water 8 times a day.” Surprisingly, there is not hard scientific evidence behind drinking 1.9 liters of water a day. It seems a good rule to follow; however, volumes may differ according to the intensity of training and location (hot climate).
7. De-loading
Those who have been training for some time might have to go through a de-loading (training weight is reduced for a time) process to facilitate muscle recovery
These are factors that facilitate recovery in healthy adults. Being that I was recovering from severe fatigue I had to be careful to stay within these parameters and be prepared to go the extra mile.
How I Modified My Training To Deal With My CFS
Since I was recovering from CFS and adrenal fatigue I had to be aware of what I could do. I was also 58 years old.
1. I couldn’t do high reps or high-intensity training. I simply knew that I wouldn’t recover sufficiently. The Starting Strength Model seemed the most reasonable.
2. I started out lifting three times a week. This worked okay while the weights were light. But, eventually, recovery became difficult. I switched to two times a week schedule. This worked well for about a year.
I suffered very little fatigue, little to no soreness, and had good gains.
3. About 3 months ago, I reached a plateau on my bench press so I switched my entire routine to one major lift 4 days a week (see below). This has worked even better. I’m lifting with practically no fatigue at all.
While making me stronger, strength training has also become a major stress reliever. When I lift, I’m in a bubble, and nothing can enter except what I want. My training and cardio time provide a major respite from the stress of the day.
I’m not suggesting people with CFS or adrenal fatigue should strength train. That’s up to you and your doctor. Fortunately, I was able to recover enough to train, and it has changed my life.
Ten years ago, I thought the only thing I had to look forward to was a life of worsening fatigue and a dissolving quality of life. Now I’m getting stronger and healthier day by day.
If You Enjoyed Chronic Fatigue And Strength Training, You Might Also Like
How To Start Strength Training Over 40
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The 10 Most Important Strategies I Used To Beat Chronic Fatigue Syndrome: Part 1
The 10 Most Important Strategies I Used To Beat Chronic Fatigue Syndrome: Part 2
Weekly Workouts
John’s Workout
Height: 5’11”
Weight: 180.0#
Sunday
Rest Day
Cardio: 33 min. walk outside
Monday
Barbell Bench Press Dumbell Rows
45.0# 1 x 5 (warm up) 20.0# 1 x 8
65.0# 1 x 5 (warm up) 30.0# 1 x 15 x 3
85.0# 1 x 5 (warm up)
100.0# 1 x 3 (warm up)
112.5# 1 x 5
130.0# 1 x 5
147.5# 1 x 5 +3= 8
No Cardio
Tuesday
Barbell Back Squats
45.0# 1 x 5 (warm up)
75.0# 1 x 5 (warm up)
95.0# 1 x 3 (warm up)
130.0# 1 x 5 x 3
Cardio: 33 min. walk outside
Wednesday
Rest Day
Thursday
Over Head Dumbbell Press Narrow Grip Bench Press
20.0# 1 x 8 (warm up) 45.0# 1 x 8 (warm up)
30.0# 1 x 12 x 3 70.0# 1 x 3
90.0# 1 x 8 x 3
Cardio: 30 min. treadmill 3.5 mph
Friday
Deadlift
100.0# 1 x 5
145.0# 1 x 5
195.0# 1 x 2
247.5# 1 x 5
Cardio: 30 min. treadmill 3.5 mph
Saturday
Rest Day
Barbara’s Workout
Sunday
Rest Day
Cardio: 33 min. walk outside
Monday
Barbell Bench Press Dumbell Rows
45.0# 1 x 3 (warm up) 10.0# 1 x 8 (warm up)
65.0# 1 x 3 x 3 20.0# 1 x 8 x 3
Tuesday
Barbell Back Squats
45.0# 1 x 5 (warm up)
65.0# 1 x 5 x 3
Cardio: 33 min. walk outside
Wednesday
No Workout
Cardio: 20 min. treadmill 3.0 mph
Thursday
Over Head Dumbbell Press
10.0# 1 x 8 (warm up)
15.0# 1 x 8 x 3
Cardio: 20 min. treadmill 3.0 mph
Friday
Deadlift
65.0# 1 x 5
90.0# 1 x 2
110.0# 1 x 5
No Cardio
Saturday
Rest Day
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Nicole says
I don’t think I have this but it is a constant fatigue because I have small children. Two toddlers that wear me out and still wake up at night. Its a tough life
Barbara says
Hello Nicole,
By the way, that’s my daughter’s name. It’s a lovely name. I can identify with toddler fatigue. We had two sets of two. Toddlers can wear out new moms pretty quickly. It’s not uncommon for mom’s to suffer from adrenal fatigue and that’s not a good thing. Stress and a lack of sleep are major causes. Health practitioners can easily identify this through cortisol levels. 🙂
Janet says
Very Informative.
John says
Thank you Janet, for your kind comment.
Joseyphina says
Very determined, I can see. Inspiring.
John says
Hello, Joseyphina. Thank you for your kind comments.
Alexis Bledel says
I have the hardest time keeping my energy up. I think I sleep more than anyone I know. I have more energy when I workout, which I do 3 times a week although not at this level. Maybe I missed it but how much cardio do you fit in?
John says
Hi, Alexis. I try to do at least 20 – 30 min of cardio 4 -5 times a week. It’s usually walking at 3.5 mph. Sometimes I’ll split it up into two sessions. Studies have shown that 3 – 10 minute sessions gave the same result as one 30 min session. Same here on energy. I’m constantly trying to maximize mine. Sleep is so important.
Paige strand says
Good for you! Stress is such a big contributor in negative health situations, I learned myself that being able to take the time for self care can make all the difference sometimes.
John says
Hi Paige. Thanks for commenting. I agree, self care is so important. In our busy lives, it’s so easy to forget this.
Rebecca says
Thank you so much for this article! I started weight training last September and, following on from glandular fever, I developed CFS around Christmas time. Everything has been affected: my work (I drive 2 hours to and from work), my social life and my training. My lifts have plateaued and I’m getting really frustrated 🙁
I really need to educate myself further and be sensible about my weight training/any other strenuous activities while I have CFS – so this has helped tremendously. I hope my symptoms get better, I feel like half the person I used to be.
John Bianchi says
Hi Rebecca, thanks for stopping by. I had CFS for 28 years. I wasn’t able to start weight training until I was significantly better. Remember, over-stressing your body is one of the worst things for CFS sufferers. I hope you get well soon.
Tom berthold says
I found your article very interesting and still very relevant today. Thank you! It was fascinating that from all the things you tried in order to to address CFS, walking made the biggest difference – I can see how that worked, because you connect with nature, it forces you to slow down, and you experience low cardio activity for a long period of time. I have a few questions:
1. Did you try increasing protein intake during your workouts and was there any benefit?
2. You did not mention any supplements which I found interesting – just quality food, sleep, cardio, etc. Anything one can learn from that?
3. Over the past 5 years since this article was published, have you learned anything more?
Thanks,
Tom B
Dr. John Bianchi says
Hi Tom,
I now believe that my CFS resulted from a combination of two main factors. There was definitely some kind of viral component. The second component was a dysregulated autonomic nervous system (ANS). My sympathetic branch was constantly dominating my parasympathetic branch. The reason for this was probably a combination of chronic stress and POTS syndrome. Daily walking was the means to bring better regulation to my ANS. As for the viral component a radical change in diet seemed to help tremendously.
I started strength training seven years ago at 57 years old. That was about 27 years after coming down with CFS. I could have started two years earlier but shoulder bursitis prevented it. My impetus to start lifting was a noticeable loss of muscle mass in my arms.
At that time I was on a paleo diet. I wasn’t tracking macros closely, so I didn’t really know how much protein I was consuming. When I went keto about 4 years ago my protein was around 90 – 100 grams/day.
About two and a half years ago I went on a 95% carnivore diet. After reading studies by Stuart Phillips and other protein researchers I realized that for my age and training I had to increase my protein intake. Now I’m at a minimum 140 g/d (BW 165). The result is an improved body composition and significant improvement in lift total. Bench press increased by 10 pounds (max 190), press increased by 20 pounds (118), squat increased by 25 pounds (210). Deadlift is still at around 300 max. My body weight did not increase.
I don’t increase protein during workouts but try to get at least 50 grams within 30 minutes directly following.
During the years of severe CFS, which lasted at least 20 years, supplements had little effect. I think the GF and paleo diet were providing nutrients for future healing. The paleo diet seemed to increase my energy levels and then the keto diet provided another big boost.
You stated, You did not mention any supplements which I found interesting – just quality food, sleep, cardio, etc. Anything one can learn from that?
These practices gradually got me to a place where I was about 90% functional. Like I said that was about 9 – 10 years ago. I was around 54. However, I would still have days when the fatigue was quite apparent. I noticed that the fatigue was correlated to stress and the resultant disruption of my ANS. About 5 years ago I started to investigate deep breathing techniques to regulate my ANS. They worked really well and I still do them today, especially when I feel the fatigue coming on. I also use them every evening before falling to sleep. I now think that chronic stress was a major contributor to my CFS. Of course, there was also that viral component. In that case I had to optimize my diet to improve my immune system.
Because I’m on a very low carb diet I do supplement. I take magnesium daily and make sure I get enough sodium. I also take vit D3 and K.
Over the past 5 years since this article was published, have you learned anything more?
I no longer get that kind of fatigue that disables one from doing any meaningful activity. However, when I lift I cannot do high volume so I limit my training to one heavy lift per day (5 d/wk). For example, on squats I limit lifting to 4 heavy sets at 3-5 reps per set. That’s it. If I go over that I’ll get pretty fatigued and wasted for the rest of the day. Higher volume (8-12 reps) with lower weight will have the same effect. I don’t think this is a result of age but rather too much stress on my ANS. However, with 4 heavy sets I feel great afterwards.
So in retrospect what got me to 90% healed (I doubt anyone gets 100% healed) was optimizing diet and controlling chronic stress. For me, the former was easy and the latter difficult.
Blessings,
John