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Comment by thewizardofaus | Hacker News Reader

Covid fatigue is no joke.

As an Elite Athlete I'm training 20-30 hours a week. I got covid last year (triple vaxed) and it wiped me out for a good 6 months. It took me 3 weeks to be able to walk longer than a minute without needing to lay down for the rest of the day and sleep.

I have dealt with fatigue problems for 6 months and only just now, do I feel like I'm getting "back to normal".

The most frustrating thing is alot of people are dismissive of the symptoms and generally say, "Oh yeah, I get tired too" but fail to understand the severity of it as they haven't experienced it.

I have a fairly good understanding of my body and the associated symptoms of overtraining/fatigue in a heavy training cycle but covid fatigue was soemthing completely different.

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Similar experience — and interestingly it can be seen in my resting heart rate over time and VO2 inference on my watch. The acute fatigue was quite bad (and is what people seem to talk about) but the milder lingering fatigue reduced my running and lifting performance across the board and left me tired in the late afternoon rather than the evening. It’s not life altering per se, but it impacted my routines and productivity noticeably.

Thankfully after 5 months I seem to have kicked it fully, and am ripe for another infection. Needless to say I got the bivalent booster before the holidays

Resting heart rate and HRV are super useful. In my case, I knew I was going to be sick before I felt symptoms just from the sleep data.

On Garmin you can indicate you are sick and it will stop your poor training from disrupting your VO2 inference.

I had very mild COVID in September and I totally have this problem . I have a constant urge to just go to sleep and have been afternoon napping fairly often, compared to my previous habits of never napping ever. I'm hopeful that most people talk about it lifting after six months

That sucks. My experience was to get back to training fairly soon (2 weeks after fever went away). After that training session I knew I should rest more and took an additional 2 weeks off. Then built back up my regular training starting at 10% volume and increasing at 10% increases each week. After 3 months I was back to regular volume. My suggestion is that everyone take at least two weeks off, and build up volume very conservatively. I’ve had lots of conversations with other people that love to train. It’s hard to take it easy and do less because we love training, but this protocol seems to work for many. Maybe it’s too conservative and everyone is different.

That's a very smart approach, and one my cyclist friend used when recovering from COVID in June of 2020. Took it easy for the rest of the year and put up some good numbers in 2021 and had his best year in 2022.

It's kind if important whether you develop long covid or not. If you don't then you don't need a long break, if you do, you could be out for months or forever.

And, exercise makes it worse for some people. So "push through" is a possibly terrible idea.

Seems like long COVID and CFS are being conflated here.

Not really, they're basically the same thing. Except hopefully you (eventually) recover from long covid. If you don't recover, it's medically indistinguishable.

Like CFS, "pushing through" can worsen symptoms - permanently.

One very troublesome aspect of that stats is that changes to sense of smell are tracked as long COVID.

It quite invalidates the figures

It's been 4 weeks since I got sick and I still feel tired and unwell, but it's not anything as extreme as not being able to take a short walk, I even did some lightweight cardio-type exercise and there are days where I can be working almost all day (pushing through). I'm not sure what I should do and I will try to research it, but I feel like I have to push as much as I can while allowing more rest (i.e. 10h/day sleep, 1h nap in the mid day) until I'm well and trying do some lightweight cardio every day and a short walk. Reading the comments I have some fears that I could make worse / permanent though.

If you were "training" 2 weeks after the fever went away, congratulations - you didn't have long covid.

You cannot exercise your way out of Long Covid, or other postviral fatigue syndromes - it presents identically to Chronic Fatigue Syndrome. Any attempt to exercise - even something as small as a short walk, or in severe cases merely taking a shower - results in a hard crash that feels completely unlike exercise fatigue, and can effectively confine you to bed for days. And every time you provoke a crash, you set back your recovery, potentially permanently. And you can't really tell by feel what your limits are, you just have to work it out analytically and be conservative. And the whole time, your brain feels like mush.

It's really no joke.

I think there's something in-between though.

I have been sick for 1.5 weeks (which is an extreme time for me by itself), afterwards I did not feel quite normal and got right back to being sick just after a few days, progressively getting worse. After another 1.5 weeks, I almost felt normal, only super-tired, I got to rest all day, only to wake up in the night feeling sick again. Another 5 days went by, to get back to the point where I feel tired but not sick and again, I went back to feeling generally unwell, although it may be better than the last time. It goes for 4 weeks now.

Most recently, I woke up, felt sick right there in the morning, feeling like I should rest rather than work but with great mental exertion I overrode it and carried a full day, with little to no rest, every minute pushing against that feeling and doing some light exercise too. At the end of the day, I felt like I did not sleep the entire night and as I went to sleep, I slept like a stone. The day after I got that tiredness feeling without feeling sick I wrote about earlier - which felt like progress.

I don't have extreme tiredness like you describe, but something is clearly wrong and it cut my weekly work capacity by half. I never had something like. I also have been hearing about friends of friends also feeling unwell for 1 month or 2 months.

Actually, I have long covid. The sick feeling / malaise were some sort of early PEMs I think. Soon afterward, after I pushed it a bit too much with no awareness on the issue, I had a huge crash that did not feel like being sick, more like beign drained from all energy. I used to work a bit and play a video game when I was sick previously, now I am not able to watch more than 1h of a movie without resting.

My whole life is suspended. I hope I will get to recover. I will try to rest as much as I can. I believe I got this because I was working while being sick. Who the fuck know something like this was possible. They should fucking teach about this in school... don't work while you are sick or risk ending up disabled. Instead most doctors don't even know such illness exist.

I feel for you. This is such a strange virus.

My whole family got covid so I expected to be next. But I only needed to take 2 days off at work and I paused my training for just 3 days and was almost back to my normal HR/pace in less than a week since I got first symptoms. It took me 3 more weeks before I started getting negative test results.

> This is such a strange virus.

This effect was previously known as post-viral fatigue. It's not unique to covid.

What is unusual is how long it lasts and, to some extent, how severe it can be.

Not really it's just got various names. chronic fatigue syndrome, postural orthostatic tachycardia syndrome, post viral fatigue...

Even straight up depression. When billions of people catch the same virus unintuitive things happen.

Maybe it's a strange virus (by what metric?) But it was definitely psychologically a very strange time.

I find it so bizarre that in almost every discussion of long COVID, an athlete who can no longer make it up a flight of stairs is invariably referenced or partakes in the discussion. I'm amazed how many people know athletes.

And it's never just extra fatigue. It's can't walk for 60 seconds, or up a flight of stairs, or open a jar.

N.B. I'm not denying post-viral fatigue. I've experienced it myself multiple times

From my experience, this stuff isn’t limited to COVID-19, and I don’t mean that to minimize your experience with it. I just want to note that I had the flu in 2013; my temperature got up to 104F, and I was sub-par for about that same amount of time; it was about 6 months before I felt back to 100%.

Similar situation. Did a 70.3 in June and then was laid out flat like I had never been before. My watch was telling me numbers that looked like I did a full Ironman every day. For months.

I found that liver support supplements made a measurable impact.

What are liver supper supplements? Is there any research on this?

I found popular ones on Amazon.

I tried it because of doing research on my high numbers for Epstein-Barr (aka mono). I found via NIH papers that liver issues are common with mono patients so I figured I could be having that since there were no other obvious blood results.

I had Covid beforehand and when I had extreme fatigue I had the mono tests done. The EBV numbers were off the charts and then I found some NIH paper talking about how it’s thought Covid can reactivate EBV.

My biometrics jumped almost immediately up on my Garmin and stayed there. It was a life changer.

It's funny you mention that—I had Mono over a decade ago and it was a long ordeal for me. Multiple weeks of fatigue and feeling like crap. Mono was way worse than Covid in my instance—but they felt very similar.

What is the active ingredient of that supplement?

Liver Cleanse Detox & Repair Formula - Herbal Liver Support Supplement with Milk Thistle Dandelion Root Organic Turmeric and Artichoke Extract for Liver Health - Silymarin Milk Thistle Detox Capsules https://a.co/d/i9QCiCV

> Pure zinc oxide - Choline -Silymarin Milk Thistle Extract - Beet powder - Artichoke Extract - Chanca Piedra Extract - Dandelion root extract

I imagine it's a typo and probably should say:

liver support supplements

Whoops. Thanks!

Ouch that's a really serious and painful setback to your training! Sorry to hear about your struggles. Are you back to normal now? Any lingering issues eg cardio/breathing

Are you back to training? Or do you still need to be careful? Could you share some tips about pacing / not triggerring PEMs?

My friend is in his 50s, pudgy and kinda athletic but not elite, and he just had mild symptoms for a week. I wonder if "athlete's heart" could be compounding effects in some way?

> walk longer than a minute without needing to lay down for the rest of the day and sleep

I'm sorry, do you mean it literally?

Not OP but yes, literally. A friend of mine has long covid, used to run marathons. For a time he was unable to go up the stairs without crashing hard.

I was asking beacause a friend of a friend has the similar condition after catastrophic motorbike crash. He spent a month on a medical bed and then had to learn walking again. During that, he had to rest a lot after a minute of walking. I can't believe that COVID can make the same near-death effect on a body.

Note: I had mild-to-serious COVID myself with severe fever and 12% of lungs damaged, and was literally one day from rushing to the hospital. 0/10 will not recommend, had to fight with after effects, but nothing even near what you or OP described.

Have you been tested for Epstein Barr by any chance?

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