I’m guessing a lot of folks out there are having a hard time recuperating from COVID, chronic stress, burnout, and the accumulated fatigue of years of coping through a pandemic. Maybe you feel like you’ve been resting a lot, but you don’t seem to be able to recover that last bit of your energy from the “before times.” Or maybe you were already burned out then!
I’ve just released my new course Self-Care for Restoration, where I teach concrete techniques for moving from total rest into active recovery without falling into a cycle of overdoing-and-crashing. Here’s a sample video, aimed right at all you go-getters who are at a loss when people tell you to “slow down” and “just rest”!
Launch special – I’m offering the course as a name-your-price offering starting at just $5.
I’m excited to announce that I will be sharing my new course, Self-Care for Restoration, as a name-your-price series beginning this week!
If you’ve had a viral illness or a prolonged bout of stress, it’s not unexpected to feel tired. But ongoing, crushing fatigue could be a sign of a more serious condition. We’re told to “rest a lot” and “don’t push yourself,” but figuring out how to care for yourself, and then following through, can feel like just another chore competing for your limited energy. This course will help you understand why rest is so important after illness or stress, how this bout of fatigue might be different from normal tiredness, how to measure your physical and mental energy expenditures, and how to pace yourself for complete recovery.
This self-paced online course may be right for you if you:
Are exhausted from months or years of chronic stress
Have mostly recovered from Covid and still don’t feel back to your usual levels of energy
Have a pattern of overdoing it, then crashing
Are trying to “take it easy” but can’t seem to get fully rested
Aren’t really sick anymore…but haven’t really gotten well
This course has practical advice for giving your body the space it needs to recover and will guide you to build a recuperation program that suits your unique needs. The program has three phases:
Radical rest
Active recovery
Reconditioning
In each phase, I quickly sum up the physiology of what’s happening in your body during that phase, the #1 thing to focus on in each phase, and practical tips for helping yourself progress to the next phase of restoration. Then I share activity recommendations and a physical practice video and go into more detail on the how-and-why behind my recommendations, if you have the interest and energy to explore deeper. I’ve even developed a week of deeply nourishing menus to reduce the work of feeding yourself well at this time!
There is no timeline for recovery – instead, I help you learn to follow your body’s cues for what it needs. Chances are, if you are experiencing the symptoms above, the old rules about what your body needs don’t apply right now. I’ll teach you what body signals you need to pay attention to, how to track them qualitatively and quantitatively, and how to know when it’s safe to increase your activity.
Because I feel strongly that this course material needs to be out in the world and accessible to as many people as possible, I am offering it on a pay-what-you-will basis – including “free.”
Ok – I’ll start off with the old standby: it depends. So let’s refine the question further: Is intermittent fasting and/or keto safe for people with adrenal fatigue, long Covid, thyroid malfunction, and other forms of autonomic dysregulation?
I’m going to argue “no, it is not.” I have both personal experience and science to back me up on this.
When I was recovering from post-viral fatigue, I made (very brief) attempts at both of these approaches to eating. It was a disaster. Both left me in a crashed-out, shaky, weak, fumbling pile within 24 hours. I know it can be hard to adjust to these programs, but this wasn’t simple discomfort. This was my body screaming toward physical collapse in a very obvious and profound way – and it all righted itself immediately on getting some carbs in my body.
So I started looking into why this might be. I dug through scads of pages, and it boils down to:
When your body is having a hard time self-regulating adrenaline, cortisol, and other stress-related hormones, low blood sugar is perceived as another stressor.
In addition, the particular kind of stress it exerts demands more of exactly the parts of your endocrine system that are most fried just now. Specifically, cortisol is released to increase blood sugar – and producing cortisol is super hard on your body when you have these conditions.
The first step to recovering from stress or illnesses that have thrown your endocrine system out of whack is to stop stressing out your endocrine system. Seemingly innocent things – like missing a meal – can have an outsized impact on your system. So I suggest:
Eat regularly, and avoid getting too hungry between meals. For many months, I had to get up in the middle of the night to eat. (Meatballs were great for this.)
Eat foods that will keep your blood sugar stable – lots of protein, fat, and fiber and a moderate amount of complex carbs. You don’t want a ton of sugar and refined flour, but you also don’t want to avoid carbs completely.
Add a pinch of salt to your water, and drink lots of it. Salty broth is another great option.
Keep your exercise below your aerobic threshold as much as possible – a maximum heart rate of about 120 is a good rule of thumb for most middle-aged adults. More on this in a future post.
I’ve hesitated on posting this for a long time, because it’s my own experience (n=1) of one very ill-defined health issue. I don’t want others to think if they follow this formula, they will automatically be well. There are too many variables. I did get better – very much better – but it took over 3 years. I also know people who have had similar ill-defined fatigue issues who have never gotten better. So I don’t want to sugar-coat this or make any promises.
I’ve decided to finally post it because I’ve heard from half a dozen friends in the last week who are still suffering long Covid symptoms. I didn’t have Covid – I originally got sick in 2016 – but I had some of the same symptoms, specifically crushing fatigue and exercise intolerance that lasted in different severities for over three years. I also had really whacked blood sugar and cortisol issues. So who knows. Maybe some of this will be useful to others who are still struggling months after being sick, and maybe it won’t. But I wanted to share this just in case. I’ve also expanded on it, and added videos of some exercises that worked for me, in my Self-Care for Restoration online course.
I’ll also add: having gone through this once, I am doing everything I possibly can to avoid anything like it ever again. Long Covid scares the shit out of me, because it sounds, if anything, worse than what I went through. So I’m all about vaccinations, avoiding being indoors with others, and masking pretty much all the time I’m around other people. I miss being with family and friends. I hate disappointing them by staying away. I’d be losing my mind if I didn’t have my sweetie and my house and my garden. But since I have those things, in my estimation, avoidance is FAR preferable than recovery. I would encourage you to do as many layers of avoidance as you can, too.
How I recovered from post-viral fatigue (aka adrenal fatigue)
In February, 2016, I had a bad case of pneumonia. I was knocked flat for two weeks, and it was two more before I could go to work five days a week. A couple weeks of asthma (steroid inhalers helped), then another bout of something viral in mid-March. Finally, around the beginning of May, I finally felt like I wasn’t actively fighting disease.
But I wasn’t ok. For months – then years – even small amounts of exercise or stress would knock me on my butt for days. I did get well enough to go back to work full-time, but for weeks, all I could do was go to work and sleep. Many nights, I couldn’t stand up and chop a couple carrots to go into dinner. Twenty minutes of light garden work on Saturday morning meant I needed to stay on the couch until Monday morning. I did make progress, but it was agonizingly slow. In fact, I wouldn’t be back to my starting levels of energy and ability to do daily tasks until 2019. And I wouldn’t feel good until 2021.
If any of this resonates with you, do what makes sense to you. Don’t do anything that runs counter to what a medical professional has told you. But in these days of long Covid, we’re all shooting in the dark. Maybe this flashlight will point out something useful for you.
My post-viral protocol – the short version
Slept more than usual (10+ hours/day in the beginning). Laying down for 15 mins mid-morning and afternoon was astonishingly helpful.
Figured out my safe activity limit and didn’t overdo it.
Reduced cortisol responses – stress and blood sugar fluctuations.
Ate plenty of salt.
Took taurine to help balance electrolytes and repair damaged tissues.
The details
Sleep and rest
The first thing that helped immensely was to lie down around 10 and 3 every day for at least 15 minutes – especially during the work day. I was really lucky that my office had an unused sound-room-turned-storage-area and they let me throw a mat and pillow on the floor for my daily rests. I don’t know what it was about being horizontal, but that’s what really helped me make big strides in being able to work full work days in the early months. I did 2x/day for several weeks, then 1x/day, and after a couple months, I didn’t need to do this any more.
I also slept a ton. I’ve always slept a lot compared to most people, like 8-9 hours/night. But when this hit, I slept even more. The best I felt in 2016 was when were were on vacation in Europe. No work, little stress, and between sleeping in and taking a long nap every day, I was sleeping close to 14 hours a day. Paired with several miles of very slow walking each day, I actually felt pretty good and thought I was on the mend. But once I went back to work, I faded. I finally had to make myself head for bed around 9pm every night. Many nights, I would fall asleep on the couch after work, too. It all helped. And if I then found I couldn’t fall asleep at night, I just reminded myself that rest is nearly as good as sleep, and just zoned out for hours until I’d fall asleep.
Figuring out safe activity levels
This was a huge part of actually getting better. I’m convinced if I had figured out how very little exercise was “too much,” I could have cut my recovery time by a year or more. After several months, and the vacation I mentioned where I could actually walk several miles a day, I thought I should be able to get back to my regular activity levels. But I kept taking 2 steps forward and 3 steps back. I learned to be especially wary of days when I felt good – because I’d work in the garden, and go to yoga class, and maybe even more…and the next day, I’d be a wreck and it would take me a week to get back to where I’d started. I finally got a fitness tracker, and used it to track the maximum activity I should be doing in a day. I don’t think I could have figured it out without the gadget – things that I thought were easy, like puttering in the garden – showed up as being extremely taxing on my heart rate.
I’ve put together a PDF with details and some ways for you to figure out a good level of activity. You need some movement to heal, but you can’t overdo it. And if your experience is like mine, you will be shocked how little activity is “safe” at first. You’ll want to push yourself to get back to normal. You’ll be bored and frustrated and annoyed and you’ll want to “do more.” But what I found was that the #1 thing that kept me from healing was to keep pushing myself.
So, I focused on doing exactly the right amount of exercise, because healing is “doing something.” For me, it started with 15 minutes of seated yoga every morning and 15 minutes of exceptionally light gardening (like, harvesting pole beans) per weekend. I did breathing exercises while lying in bed. And I kept my daily activity generally around 50% of what my activity tracker said my goal should be for a sedentary person my age. If I felt good, I’d go as high as 75%, but never two days in a row. Over about 18 months I was able to increase my activity to the point where I didn’t feel limited or like I had to ration my activity.
It’s very important to note that you can’t just set arbitrary goals for improvement, like “I’ll do 10 minutes of walking every day this week, and next week I’ll increase it to 15 minutes a day.” That’s pushing yourself, and it will keep you sicker, longer, than anything else. Absolutely the hardest part of recovering, for me, was adjusting my activity levels only after I’d shown improvement instead of making a plan for improvement.
Keep cortisol steady
My doc explained that my endocrine system was completely fried from a combination of work stress and then the pneumonia. (I think the OBC I was on to regulate my cycles also played a part, though he disagreed.) So, it was important to keep my cortisol levels working normally. That largely meant reducing stress and keeping my blood sugar steady.
Stress reduction was hard, but it happened partly automatically because I just didn’t have the energy to worry about a lot of crap. One thing that was very useful, though, was to find something to laugh about every day. Wait Wait, Don’t Tell Me was very therapeutic. I also saw my reflexologist, chiropractor, and (to a lesser degree) massage therapist regularly, which helped a lot.
I also found ways to make cooking be less work. My sweetie did more kitchen stuff, and we had a lot of meals that were practically zero work – like a rotisserie chicken, frozen sweet potato fries, and green beans. It was super important to eat densely nutritious foods, because I had to keep my blood sugar steady. One blood sugar crash would set me back for days. I could only go about 6 hours without eating, so I kept a couple pounds of homemade meatballs in the freezer at all times. I’d wake up around 4am, eat a couple meatballs, and go back to bed. I remember when I finally slept through the night every night for a month. It felt like a triumph.
Pasta and white rice…were not good choices. I needed lots of protein, too, but I quickly learned a keto diet was also right out. Drastically reducing carbs might help for a lot of things, but that was definitely not the case for me. Two days of keto sent me into a serious tailspin, which ended almost instantly when I ate some carbs.
I wrote a whole blog post about this, with recipes. Go take a look there for details.
Salt
This was a weird suggestion from my doc, but it really seemed to work. Eat a lot of salt. In fact, every time you have a glass of water, put a pinch of non-iodized salt in it. Soup in salty broth is great, too. Apparently, in adrenal fatigue, you need extra salt. Not sure of the exact mechanism (here’s a quick overview), but it helped a lot.
Taurine
I didn’t figure this one out until 2021, and honestly, I’m not sure it would have helped me earlier. In the early years, I had “paradoxical reactions” to any kind of supplement. Most notable was that the magnesium drink called CALM made me very jittery, like caffeine. Anyway – by 2021, I was basically back to my pre-pneumonia state. I knew I could probably be better, but I didn’t really have any limitations on my activity, I was sleeping through the night, and nothing was really “wrong.”
Except for some heart palpitations. My heart would feel like it was skipping a beat a few times a day…then a few times and hour. I saw a cardiologist, who ran tests and confirmed it was benign, but if it really bugged me, he could give me medication. I passed on the meds, but I’d read that taurine can help palpitations, so I started taking 1000mg/day.
Holy. Mackerel. Not only did the palpitations go away completely in about 4 months, my energy went through the roof. Not in a sketchy caffeinated sort of way, but more like my body could actually heal and recover from exertion and damage. Our bodies are supposed to make taurine, but sometimes we don’t. Why not? Stress. Estrogen wackiness. Past infections. Yeah.
I’m wondering if this was what was missing all along. Taurine basically regulates electrolytes and fluids in and out of cells. So, you can eat or drink all kinds of good things, but if that can’t get where it needs to be, your body doesn’t have the materials to rebuild.
If you’re going to try it, take it in capsule form – not in an energy drink that has sugar, caffeine, and other garbage in it. Start slowly, too. I found I could handle one 1000mg capsule every other day at first. Any more than that had digestive side effects – I assume because it was changing how I metabolized magnesium, which is a known laxative.
After about 7 months of 1000mg/day, I felt amazing. I could work for hours in the garden and feel tired or sore. I could recover from any amount of exertion I cared to do with a good night’s sleep. Eventually, I was so energetic I was feeling a bit hyper at times, so I started staging down my doses.
Then my grandmother died, which was really stressful. It still seems like emotional stress still takes a harder toll on me than physical labor. I’m guessing that’s a cortisol thing. So I’m back to a full dose again. Maybe I won’t need it daily at some point, but for now, I’m still doing 1000mg/day. The good news is, I feel better than I’ve felt in…I dunno, 10 years? WAY better than I felt at the beginning of 2016, that’s for sure.
So that’s been my journey. Like I said, I don’t know how much of it applies to your situation. But I do dearly hope you find something that works as well for you.
Note: This is an archived post from 2019. In the end, I decided that the Morpheus (in its configuration at that time) wasn’t useful enough to warrant keeping it. I’m still (2023) searching for the “best in show” wearable for recovery tracking – they all seem to have some inaccuracies. What has proved most effective over time is simply tracking my heart rate all day (mostly using Polar products) and learning what activities cause my heart rate to spike. Then I could devise a recovery plan that stayed within the proper zone at different stages of recovery. I’ve put these findings together in a name-your-price online course, if you’d like the full details.
Yesterday, I reviewed the Morpheus Recovery Band. Today, I’ll talk about a suite of Polar devices/apps.
I’ve been using the Polar H10 chest strap the longest, both for morning heart rate variability (HRV) readings and for tracking exercise. I started using the Polar A360 in October for wrist-based heart rate tracking. The A360 isn’t made anymore, but the A370 is very similar and has nice new features like all-day heart rate monitoring and GPS. Then I also need two free apps: Polar Beat (for the H10) and Polar Flow (for the A360 and bringing all the data together). I know it sounds kinda clunky, but in practice, it’s pretty simple. Here’s how I use all of this to guide my active recovery.
Goals
My current goal is to recondition after a long illness. One of the problems with adrenal fatigue is that if you overdo physical or emotional stress, you can knock your recovery back days or weeks. It took me a year to figure out that 20 minutes of gardening, sweeping the deck, or moderate exercises like a few pushups and situps constituted “entirely too much exercise.” I would wake up feeling good, overdo it, and get knocked back to the couch for several days. It was incredibly frustrating because I rarely felt good two days in a row. For, like, two years.
So I wanted a way to quantify how much work I was doing and have some data to help me understand how much was too much. The key data I needed were my morning heart rate variability (HRV) scores, and some way to measure how much energy I was actually expending not just during workouts, but during daily activities, chores, walking to meetings, etc.
Polar H10
For HRV
I’ve already talked about measuring my HRV. I largely did that with the H10, though Welltory also let me measure it with my finger on my phone. (I ended up abandoning Welltory – it seemed less accurate over time and didn’t give me much uniquely useful info.)
For exercise tracking
Use with the Polar Beats app. Start the app, tell it what kind of exercise you are doing, and press “Start.”
If you leave the app open, you can see your heart rate moment-to-moment on your phone – if you can put your phone someplace visible while you exercise.
Five “zones” are color-coded from 1-5 based on your maximum recommended heart rate (220 minus your age).
For me, Zone 1 (50-60% of max HR) is 88-105 bpm because my max HR should be 176.
Zone 5 is 90-100% of your max (158+ for me), and I avoid it like the plague at this stage of my reconditioning.
Building on what I learned from the Morpheus band, Polar Zones 1-3 are recovery, Zone 4 is conditioning, and Zone 5 is overreaching. In practice, I aim a little lower – I think my conditioning zone probably starts around 130 bmp, which is 75% max or “Zone 2.5” and I don’t like to go above 150/Zone 3.5/85% max right now.
Polar A360/370
The 360 and 370 work basically the same way. You can use them as a wrist-based HR tracker for exercise, though it is not sensitive enough to track HRV (use the H10 for that). It is supposedly very accurate for walking and jogging, but less good for weightlifting and cycling. It also has an all-day activity monitor, and a sleep monitoring feature I’ve not used much at all.
The reason I got it is because I wanted to see my HR during exercise on my wrist, not my phone – I often use my phone to play workout videos and can’t see both apps at once. I also wanted to be able to track exercise on the fly during the day – e.g., walking to a meeting, or giving a presentation – because I suspected that many of my daily activities were more strenuous than I’d realized. It works great for this – I can see the same fitness zones on my wrist that I had been getting from the H10, and I regularly set it to record my activity while I’m at work.
You track day-long activity on the Polar Flow app. This will also take in info from Polar Beats, so if you do use the H10 for certain exercises, all the data gets collected into one place and count toward your daily activity. What’s slightly confusing is that “activity” is broken into different “zones” than training. Here’s a table…
Polar Training Zone
Morpheus Recovery Zone
HR range (BPM are for age 44)
Polar Flow Activity Level
0
Total rest
<88bpm
·Resting + sitting
1
Recovery
50-60% max
88-104bpm
·Low
2
Recovery
60-70% max
105-122
·Low-Medium intensity (breakpoint around 65%)
3
Recovery
70-80% max
123-139
·Medium-High intensity (breakpoint around 75%)
4
Conditioning
80-90% max
140-157
·High intensity
5
Overreaching
90-100% max
158-176
·Very high intensity
Danger
Galloping heart
177+
·Dangerous during recovery from adrenal fatigue
To keep things simple, I mostly just look at the Polar Activity chart during the day. On “good” days, when my morning HRV reading is 8-10 on Elite HRV and 7.5 or above on HRV4Training, I go for 15 minutes of “high intensity” activity (HR above about 130). On days my HRV reading is around 6.5-7.5, I avoid high-intensity activity entirely but generally try to get in some low-medium intensity activity around Zone 2/HR 105-120. On days when my HRV says I’m overtaxed, I really try to rest as much as possible, including having my husband drop me off in front of my building at work, always taking the elevator, and going to bed an hour early.
I improved steadily through 2018, and I am MUCH better able to handle physical activity now! In Feb. 2018, I was pleased that that my edge was to do 20 minutes of gardening on Saturday AND Sunday, and feel fine on Monday. In September 2018, my edge was 3.5 hours a day of vigorous t’ai chi, on a Thursday, Saturday, and Sunday, and though I was a little tired the following week, it wasn’t a real setback. I don’t think I’ve come close to pushing past my physical boundaries since then (3 months), though I am learning the toll stress and allergies take on my HRV scores. But that’s another post. 🙂
The 360 and 370 work basically the same way. You can use them as a wrist-based HR tracker for exercise, though it is not sensitive enough to track HRV (use the H10 for that). It is supposedly very accurate for walking and jogging, but less good for weightlifting and cycling. It also has an all-day activity monitor, and a sleep monitoring feature I’ve not used much at all.
To keep things simple, I mostly just look at the Polar Activity chart during the day. On “good” days, when my morning HRV reading is 8-10 on Elite HRV and 7.5 or above on HRV4Training, I go for 15 minutes of “high intensity” activity (HR above about 130). On days my HRV reading is around 6.5-7.5, I avoid high-intensity activity entirely but generally try to get in some low-medium intensity activity around Zone 2/HR 105-120. On days when my HRV says I’m overtaxed, I really try to rest as much as possible, including having my husband drop me off in front of my building at work, always taking the elevator, and going to bed an hour early.