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Comment by MyFirstSass | Hacker News Reader

I've had this for some years but it seems to be getting a bit better for some unknown reason.

The worst part is not the fatigue but the PEM, or post exertional malaise.

Took me years to figure out my lifting made me feel like absolute garbage, almost suicidal if i went hard enough, but not right after, felt great the following day, but then, super crash and extreme doom and gloom 48 hours afterwards, so unfair and bizarre.

These days i workout in moderation. Such a weird condition, and i would love to know what goes on chemically as it feels very, very physical, like some hormone/mineral or whatever suddenly runs out and.

Tried all kinds of supplements but have a feeling it's related to the gut biome, inflammation levels and general stress / cortisol also pseudo scientifically known as adrenal fatigue.

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If you have too much inflammation and if you have a stressor that causes cortisol to go up, like lifting, the conversion of T4 to T3 may be disrupted and you have too much reverse T3 instead. This causes hypothyroidism two days later.

Easy test is to take T3 (liothyronine sodium) on such a day. See if you feel better.

https://pubmed.ncbi.nlm.nih.gov/8895357/

Thanks for writing this. I'm sorry you have to deal with it. I have something similar: once I lift hard enough when [re-]starting lifting, I get a big emotional hangover the next day or so as well. Feels like a truck hit me, basically. No amount of food, hydration, sleep, or anything stops it.

It might be comorbid with my hypermobility, but who knows. I basically expect it to happen at this point and just plan to lay low for 48 hrs.

Have you had your kidneys tested? This sounds incredibly similar to kidney disease.

I have this pretty bad, to the point where even climbing a few flights of stairs will leave me wasted and feeling like utter shit. It's taken 15 years and 10s of thousands of dollars (with insurance) to figure out that I have Hashimoto's. The treatments can help a little bit, but not much, and no doctor can tell me why. I've read a few books that give some plausible sounding examples, but anytime I've mentioned these to doctors they are dismissive yet can offer zero explanations themselves. There are no shortage of chiropractors and functional medicine practitioners that have very plausible sounding explanations, but no real solutions (I've tried every type of diet-based advice I could and it can sometimes feel like things are improving a little bit, but the super hard diets are not sustainable. I've restricted gluten and dairy as those are the two most suggested things that enflame, and I definitely feel better without those things, but it's really, really hard to eat like they tell you too unless you have a personal chef).

If you are having similar, try completely cutting caffeine for a little while. It can be extremely hard when you're already fatigued, but it is like gasoline on the fire for me now.

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