Exercise

[clivealive]

A stupid question I know but does anyone out there manage to do any exercise?

I've had P.A. for over 43 years so I'm well acquainted with the weakness, fatigue, breathlessness etc. associated with it and up until now I have happily led a sedentary life.

However, in May this year I was diagnosed with Type 2 Diabetes and "told" that I must exercise....

So I bought a "mini exercise bike" which I programme to give me 20-25 minutes peddling a day whilst I can still sit in my armchair.

The problem is that I now feel more exhausted than ever before and am wondering whether the exercise is depleting my B12 levels too much - especially in the run up to my next four weekly injection.

I realize that tiredness is a symptom of both P.A. and diabetes so it's a bit of a double whammy and maybe at the age of 74 I should "expect" to be tired, but if there are any "fitness experts" on this forum who can give me some advice I would be most grateful.

[Gambit62 Administrator]

Clive,

I manage to jog between 0.6 and 2.5 miles twice a day (depends on whether working or not). Also cycling to and from work but I also take ridiculous amounts of B12

You might also find this post interesting - gives you someone to contact at least.

healthunlocked.com/pasoc/po...

[clivealive Forum Support in reply to Gambit62]

Thanks Gambit62,

I read through the links you posted but couldn't find anything of much help to me.

Meanwhile I received the following from Diabetes.UK which has led me to the decision to scale down my exercises in the hope of regaining my energy levels. Hopefully my next Blood/Glucose test in February will still show the diabetes to be in control.

The message read:_

"Hi Clive, an HbA1c of over 48 is considered to be in the diabetic range, so this is why you received your diagnosis. However, you have since improved to 40, which is nicely within the non-diabetic range, most likely due to the modifications you may have made to your diet and activity levels. The HbA1c would not be affected at all by the fact you hadn't fasted, however the the 'plasma fasting glucose level' would have been - anything over 7.0 for a 'true' FBG would also indicate diabetes, so for the doctors this would have been seen as confirmation.

You sound as though you are managing your diabetes well, so as the others have said, perhaps the tiredness is related to the B12 and not your blood glucose levels "

*****************************

Thanks again for all your help.

[daphninia in reply to Gambit62]

Clive my doctor said that one can overdose on b12 and motto go beyond 1 every 2 months. What do you think?

[fbirder in reply to daphninia]

That's total nonsense. It is virtually impossible to overdose on B12. It is water soluble, so anything the body doesn't use gets eliminated in the urine.

In cyanide poisoning B12 is given intravenously - up to 10,000 ug.

stichtingb12tekort.nl/weten...

[engels in reply to fbirder]

I think you'll find that's 10,000mg not ug. In simple terms, the initial treatment for cyanide poisoning is 5g of hydroxocobalamin (the equivalent of 5,000 standard NHS injections) given intravenously over a 15 minute period and this dose can be repeated if necessary.

[fbirder in reply to engels]

Yup, I made a boo-boo.

[Gambit62 Administrator in reply to daphninia]

As others say your doctor is incorrect. The treatment for cyanide poisoning is with hydroxocobalamin - as it binds very strongly with cyanide to produce cyanocobalamin.

There are no known downsides to having artificially high levels of B12 - there is a CORELATION between B12 treatment and cancer/larger tumours but no causal link has ever been established and as low B12 will lead to cancer the most likely causal factor is a period of B12 deficiency before supplementation ... and the larger tumours are probably B12 promoting reproduction of cancerous cells as well as healthy cells.

The EFSA (European Food standards agency) have recommended daily upper limits for vitamins - B12 doesn't have an upper limit for the reasons above.

efsa.europa.eu/sites/defaul...

It is true that hydroxocobalamin is only licensed in the UK to be administered once every 2 months - for reasons that nobody has been able to fathom. In other parts of the world where it is used - eg Germany - recommended treatment is once a month.

[clivealive Forum Support in reply to daphninia]

Hi daphninia,

I think others have responded to you question before me but my understanding is that any excess of B12 is "flushed out" through your urine. Initial "loading doses" are done every few days and I've been on 4 weekly injections for 43 years sometimes reduced to 3 weeks when I feel the need.

I wish you well for the future.

[MariLiz]

Well I only do gentle exercise, walking, and Yoga, anything else is just too exhausting. Some people find swimming is good, but I have an allergic reaction to chlorinated water. MariLiz

[clivealive Forum Support in reply to MariLiz]

Thanks MariLiz and well done with your exercises!

I'm fast coming to the conclusion that I've been "overdoing" mine for

the diabetes and will scale it down a bit hoping that my energy levels will climb back again. Hopefully if my next Blood/Glucose in February still show the diabetes to still be under control on the reduced exercise I can do even less.

I wish you well for the future,

[MariLiz in reply to clivealive]

Good luck with it all, and definitely don't overdo it! If we do it catches up with us eventually. Usually the next day for me. Best wishes MariLiz

[clivealive Forum Support in reply to MariLiz]

Thanks MariLiz for your good advice. I mentioned how I was feeling to my nurse this morning as she gave me my B12 injection and she basically said the same thing. I've definitely been pushing myself too hard and will scale back.

Please keep well yourself.

[fbirder]

Gentle, regular exercise is what one should aim for I've heard. I try to walk our dogs at least once a day (about 1.2 to 2 km) when I feel up to it. I keep a journal of how fatigued I am and when I have my injections and apply a patch.

It looks as if I can do quite a bit between 2 and 6 days after an injection. Days 7 and 8 I get quite knackered after a short walk and days 9-12 I'm too tired to do anything.

I'm going to use my journal as evidence to persuade my GP that I really do need weekly injections rather than fortnightly.

With the diabetes exercise is an important habit to break the cycle of

[clivealive Forum Support in reply to fbirder]

Thanks fbirder,

I have just received the following from Diabetes.UK which has led me to the decision to scale down (but not eradicate altogether) my exercise in the hope of regaining my energy levels.

The message read:-

"Hi Clive, an HbA1c of over 48 is considered to be in the diabetic range, so this is why you received your diagnosis. However, you have since improved to 40, which is nicely within the non-diabetic range, most likely due to the medication and modifications you may have made to your diet and activity levels.

You sound as though you are managing your diabetes well, so as the others have said, perhaps the tiredness is related to the B12 and not your blood glucose levels "

*****************************

Hopefully my next Blood/Glucose test in February will still show the diabetes to be in control.

Thanks again for your comments.

[JanD236]

I don't have diabetes so can only comment on the PA side of things. I have monthly B12 injections from my GP and am a 55 year old woman.

I regularly exercise...gym, bike rides (longest ride this year 132 miles), hiking (hiked up Mt Toubkal, the highest Atlas Mountain, in May this year).

Despite being able to do these big events I do know when my B12 is low. For example, I've had to turn round exhausted after 10 miles on my bike and spend the day recovering in bed which shouldn't happen on my level of fitness. Or I'll come home from work and that's it, day over, am too exhausted to do anything other than crawl to bed.

I had been having B12 injections every 2 months but definitely ran out of steam by 6 weeks. Happily my GP suggested we increase the frequency to monthly so I now feel more on an even keel most of the time. Having said that I do take methyl sublingual lozenges before & after a heavy exercise session (and also on the infrequent occasion I drink alcohol).

[clivealive Forum Support in reply to JanD236]

Hi JanD236

WOW! I think that's fantastic that you are able to maintain that level of fitness and am so pleased that your GP is proactive with your injection frequency.

My surgeon told me in 1959 after he'd removed two thirds of my stomach, that I'd have to give up my apprenticeship and "get a sedentary job", but being a callow youth of 17 I ignored his "advice" (warning?) finished training and qualified as an electrician.

It was only in my early twenties that finding the physical exertion at work beginning to tell on my health that I got a job as a buyer for an electrical wholesaler and got married in 1965 aged 24. Sadly my wife was taken ill with a heart defect (following rheumatic fever)12 weeks after the wedding and spent several months in hospital. The worry and stress this caused me led to a downturn in my own health eventually causing me to lose my "sedentary" job in 1966 and I was signed off sick.

I became very depressed (a symptom of P.A.?) was given a cocktail of drugs including Librium, Tofranil but eventually got a temporary job as a builder's labourer. After six months down went my health again and I was "on the sick again" only this time I was sent to an assessment centre to determine what kind of job I was going to be capable of doing. It was deemed I could do office work and was sent on a book-keeping and accounts course in London for 5 months between September 1969 and February 1970 on my completion of which I was registered "Disabled" and started work for a local multinational company in my home town.

All this while my physical health had stabilized and I had coped well with the re-training course. However, the new job was intensive and the stress began to tell and I started walking around like a Zombie. My doctor did a number of blood tests and eventually in 1972 after two Schillings Tests determined it was P.A. and I was started on cyanocobamalin every 4 weeks - which I am still "on" 43 years later.

All down through the years I've been careful to eke out my energy between the injections and have mostly coped OK but with the exercise I'm now doing for the diabetes I'm going back to my "Zombie" state again.

If only my surgeon of 57 years ago had explained why I needed a sedentary job then maybe the P.A. would have been diagnosed earlier and I'd have been spared the worst of the symptoms.

I guess it's all a bit academic now and perhaps I should be grateful that I'm still "clivealive" at 74.

I wish you well JanD236