Clockwork early morning insomnia, possibly from overtraining

Posted by sleepdealer @sleepdealer, Tue, Apr 7 4:51pm

Hi all! New to this great forum and hoping someone here can help me.

I’m a 38 year old guy, 6’4″, 178 pounds. I’ve been having incessant early morning insomnia for months, and am struggling to pinpoint the cause. I should clarify what I mean by early morning: I’m a night owl, and have gone to bed at around 2:30 AM for at least the last twenty years. (There was a period of a couple years when I was working on Asian time and had to go to bed even later (4:30 to 5:00 AM), but I’m back to my druthers of 2:30 AM.) My body seems to function best on about 7.5 hours of sleep, so if my circadian rhythms are in tune, I go to bed around 2:30 AM and wake up around 10 AM with a song in my heart and hope for the day, but I can function reasonably well on about 6.5-7 hours of sleep *provided that I wake up around 10*. (Waking up at my normal time seems to be more important than going to sleep at my normal time.) But since last summer, I’ve been waking up around 8 AM every morning, and with a BANG – not gradual, groggy wakeups, but with a surge of energy and a pounding heart that casts me impossibly out of sleep in an instant.

My initial self-diagnosis was that this was some consequence of overcardio and undernutrition. For most of my late 20s and early 30s I was pretty fit, doing HIIT cardio sessions for about 90 minutes a day, 4-5 days a week, and everything was dandy. Work and marriage kept me couchbound for my mid-30s, however, and I grew chubby, sulky, and TIRED – like the less I moved, the more worn out and depressed I got – and I couldn’t live with the person I was becoming. For New Year’s 2019 I resolved to get back into shape, so I resumed the HIIT and radically cleaned up my diet: no sugar, no caffeine, and no flour or refined grain. (I’m also a vegan of 15 years and a teetotaler who’s never had alcohol more than once or twice a year at any age.)

Anyway, I felt GREAT, and unfortunately started to overcook the training, letting my normal 90 minute sessions spiral outward into 180 and even 240 minute grindfests. I was obsessed with reclaiming a six pack, and underate, underhydrated, and overtrained, ignoring all the warning signs of system collapse. I stopped losing weight, even though I was eating less and working out more, and a few DexaScans revealed that I was putting on body fat in general and visceral fat in particular month after month despite a total lack of sugar intake and a mammoth calorie deficit. I also had what I’d call permanent dude PMS, getting irritated by seemingly everything and taking all sorts of trivial slights deeply to heart, and I was fantasizing about food, especially junk food, every night.

Sometime in the summer of 2019 I started to have the sleep disturbances, but they were intermittent at first: some mornings I’d wake up at 8 and struggle, but I often could get back to sleep, and even when I couldn’t, I’d be fine the next night. Then, in September, my beloved cat, who I’d had for a decade and was the last pet of mine from my bachelor days, was suddenly diagnosed with malignant lymphoma and given six weeks to live. From that day on, I was up at 8 AM every day, no matter what, and couldn’t get back to sleep under my own power no matter what I tried. Since then nothing has changed. If I go to bed at my normal time, I’m up at 8 AM with what feels like an adrenaline rush, and if I go to bed earlier I wake up earlier and *still* have the 8 AM adrenaline rush (or whatever it is) when I’m out and about in my morning routine. The morning wake up is so jarring that sleep vanishes completely, and the idea of just breathing and going back to bed is laughable. The insomnia feelings don’t kick in for several hours, but then inevitably hit me like a truck.

I tried doxepin for several months and it did help me sleep. I’d still wake up at 8 AM with the same horrible energy burst, but the doxepin would overpower it and drag me back down till my normal 10 AM wake up. Unfortunately the doxepin stopped working, but it was obviously treating the symptoms, not the cause, so it was always going to be a band aid and I kinda knew its day would come.

Two other notes:

* My testosterone is much lower than it used to be. In 2018 (before the overtraining) it was 493 ng/Dl, now it’s 290. My sex drive/libido is basically zero – the machinery still works, but I never want to turn it on. This has been the case since last summer – about when the insomnia started to creep in – and has not improved in any way. I’d love to get my testosterone back, and feel like the insomnia must be related somehow, but I can live without it if need be. The insomnia is a much more pressing issue.

* I’ve tried a lot of the holistic supplements (Seriphos, holy basil, kava, ashwaghanda), thinking that I was suffering from high cortisol, but none of these has worked, and if anything they’ve each had the OPPOSITE effect: they seem to give me heart palpitations and some physical unrest/agitation. Seriphos is particularly rough: if I take it before bed, as most naturopaths suggest, I wake up about three hours later and can’t fall back asleep for love or money. Kava used to be one of my favorite relaxants, and now it makes me feel like I’m one step closer to a heart attack – tight chest and shortness of breath. (Not nearly extreme enough to require a doctor, of course, but still bad.)

My endocrinologist at Kaiser won’t run any tests on me beyond a catchall blood panel because “my testosterone is still in the normal range”, no matter how crazy the loss of libido is, and my “TSH level is normal so any thyroid-related insomnia is impossible”, a statement which seems flatly contradicted by a lot of the medical literature I’ve looked into. I need a better doctor and a place to start – can anyone help? At this point I’m ready to bestow half my kingdom – which amounts to a used car, a couch, and a medium sized TV, but hey 😀 – on anyone who can save me from this.

Hi @sleepdealer,
Welcome to Connect. I am so sorry you are struggling to pinpoint the cause of your early morning insomnia, but you have come to the right place to talk with people who have similar experiences. I’d like to introduce you to @lioness @johnhans @artscaping @januaryjane @128128terry11t @sandytoes14 @brucearoo @gloriajean who have all discussed insomnia in this group and may be able to offer support and help you to find the answers you seek.

I see that you said you initially thought it was due to over-cardio and under-nutrition, were you able to scale back on the over training and how did that effect your mood?

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@sleepdealer Thanks for the invite amandabutnett . to this discussion. Sleepdealer I think you need to see your Dr and ask these questions . I can answer to the exercise . You are wearing your body out . WOrking out 90 minutes a day is way to much. Your muscles need at least one day in-between to rest and build up again. Sounds like you have your adrenaline pumped up so high this maybe affecting your circadian rhythm . I would talk to a therapist and endocrinologist about you hormone,s . We can self diagnosis to a certain extent but I think you need more professional help here so start by talking to your Dr . he can advice you. Just tell him like you have told us here . I wish you the best in finding out answers .

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@sleepdealer – I would concur with @lioness. Jim@thankful

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@lioness

@sleepdealer Thanks for the invite amandabutnett . to this discussion. Sleepdealer I think you need to see your Dr and ask these questions . I can answer to the exercise . You are wearing your body out . WOrking out 90 minutes a day is way to much. Your muscles need at least one day in-between to rest and build up again. Sounds like you have your adrenaline pumped up so high this maybe affecting your circadian rhythm . I would talk to a therapist and endocrinologist about you hormone,s . We can self diagnosis to a certain extent but I think you need more professional help here so start by talking to your Dr . he can advice you. Just tell him like you have told us here . I wish you the best in finding out answers .

Jump to this post

Some doctors would know what to do and some would not, so they give you pills to slow you down and then you can't function. I have taught myself to slow down and enjoy everyday events because I was a work horse for so many years trying to please my husband who is now deceased. Today after lunch I sat in a sunny window because it is too windy to go outside, so I enjoyed the magnolia tree which is in full bloom in my back yard. The southern tree has acclimated to the north environment and it is such a pleasure to behold. I overdid the past two days digging daffodils that needed to be moved so now I must rest. We need to adjust our work load according to the need to keep the body happier. and it changes as we age. I am excited about planting seed and getting veggies growing. It is the best thing I can do right at the moment, but my body doesn't always keep up with my mind. Dorisena

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@dorisena

Some doctors would know what to do and some would not, so they give you pills to slow you down and then you can't function. I have taught myself to slow down and enjoy everyday events because I was a work horse for so many years trying to please my husband who is now deceased. Today after lunch I sat in a sunny window because it is too windy to go outside, so I enjoyed the magnolia tree which is in full bloom in my back yard. The southern tree has acclimated to the north environment and it is such a pleasure to behold. I overdid the past two days digging daffodils that needed to be moved so now I must rest. We need to adjust our work load according to the need to keep the body happier. and it changes as we age. I am excited about planting seed and getting veggies growing. It is the best thing I can do right at the moment, but my body doesn't always keep up with my mind. Dorisena

Jump to this post

Well said! More importantly. Well done! Thank you for your motivating testimony. I'm going out and plant some marigold seeds.

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Hello @sleepdealer,

It sounds like you are really struggling with sleep, energy, and nutrition. I'm wondering, do you keep track of food/liquid intake now?

You have told us about the over-exercise problem but I'm wondering if the lack of nutrition might also be an issue. It might be worthwhile to have some nutrition blood tests done, especially the levels of vitamins D, A and B. As @lioness said, an endocrinologist might be the best person to see right now. They usually check levels of important vitamins.

Have you told your doctors about your increased exercise and your decrease in food and liquids? Have you seen an endocrinologist?

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I want to be as supportive and helpful as possible: however, what I say may not feel good. Let me assure you I am aClinical Nurse Specialist with 3 degrees, one is a masters in nursing that focused solely on clinical adult psychotherapy and becoming knowledgeable about all primary theorists. I also have 33 years experience. Working in clinical settings and teaching at the university level. My longest tenure was at The Menninger Clinic, a hospital that had a school of psychiatry and provided psychoanalytical training. My direct work was on the Trauma Recovery Program and the Self-Harm program. I have seen patients who were addicted to exercise, as well as eating disorder and mutilating themselves. There is a diagnosis called “Body Dysmorphic Disorder”. A problem with accepting aspect (s) of one’s body. I would wonder with you about any unusual beliefs you have about your body, any past trauma? Have you ever seen a well qualified Psychiatrist, Psych CNS, or Psychologist. My thought is that you are struggling with this disorder, and perhaps, others. You would be caring a great deal for yourself if you would make an appointment with a professional I recommended and get on some meds and definitely get into a psychotherapy process that is interpersonally oriented. You probably have a psychiatric disorder. You can feel better.

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I personally understand this explanation of body dysmorphic disorder and thank you, engelee for your sharing some education about it. My husband had an eating disorder which he ignored and denied, he had obvious OCD which he never treated, had obesity and diabetes which he never treated, and died of metastatic prostate cancer which he refused to follow proper treatment and denied he had cancer until the very end when he was paralyzed and wouldn't eat at all for six weeks. Oh, and he had dementia which the family recognized but we could not control him at all, so we let him drive around town and eat and tell lies instead of managing the family business which was failing. He also picked scabs off his neck and ate them, chewed his nails and spit them out in the house or the car, and was a confirmed alcoholic. The last fifteen years of his life, he made me miserable, apparently wanting me to leave him so he would not have to share his income with me. I was a possession he wanted to discard. His grandmother raised him after his mother rejected him. Talk about trauma!
My fourteen years of doing my own mental rehab and healing has gone well but I still work on forgiveness and letting it all go. I have become a nutrition geek and work on my eating and exercise for good health but am physically limited due to surgeries. I study regularly and promote good habits to everyone I meet.
I have pretty good peace of mind despite 50 years of servitude and have a positive attitude which I love to share with others. It's what I can do. Dorisena

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Thanks everybody who's replied so far! I wanted to share an update, since I figure the people who will benefit most from this thread are others with similar symptoms who run across it via Google, and I've learned a lot these past few days.

This is going to be long, so first, the tl,dr!

:: It was overtraining
:: Stopped doing anything that made me break a sweat
:: Eating a lot a lot
:: HMO docs worse than useless, know nothing about this and are unwilling to learn even when you do your own research and try to share it with them
:: Got a good doc who is running a number of urine/saliva adrenal stress panels to see what's misfiring (epi, norepi, cortisol, cortisone, GABA)
:: Insomnia is still the bane of my life but is relenting a bit, and pray pray pray I might be out of the sleep ICU
:: Testosterone/libido not coming back and according to the doc will take an eternity to reboot unless I take scripts, so I'm taking scripts
:: Finding that OTC adrenal stress meds (kava kava, holy basil, Seriphos) really work, especially kava, which is a godsend
:: Low dose anti-depressants for insomnia (amitriptyline, trazodone) also worked once my system cooled off

While this could still be some freakishly rare affliction like an adrenal tumor, the odds seem about 99% that I'm suffering from the Exercise Hypogonadal Male Condition (EHMC), a number of excellent papers on which by AC Hackney can be found in on the NIH website. If you're familiar with the Female Athletic Triad, you can think of EHMC as its male counterpart, with roughly the same constellation of symptoms: disruption to the endocrine system, derangement of sex hormones, and damage to the body itself (often bone depletion or a weakened immune system, among others). I was pretty sure that overtraining and undereating caused all this, but reading those papers and talking to/reading blogs by runners and cyclists sealed it – I've got the same cause, the same symptoms, and the same initial response to the suggested treatments. @lioness is on the same page as I am in suspecting adrenal dysfunction, but what I still haven't figured out is precisely what kind of adrenal dysfunction this is and how to treat it. I did find a good doctor (finally) who ordered a panel to test my diurnal cortisol, cortisone, epinephrine, and norepinephrine, along with a neuro profile, the results of which should come in this week. He's also got me on some meds (Clomid) to try to reboot my testosterone and libido, which is still abysmal but flickering back to life.

I talked to a few endurance athletes I know and read a lot of blogs and threads by guys who've overtrained themselves into oblivion, and it seems like the symptoms of male overtraining come in stages: first some strange physical reactions here and there, then emotional and hormonal dysfunction, then major disruption, physical debilitation, injury, extreme fatigue, and malaise. I was lucky enough to catch this (or get caught by it) before I got to the scariest stage, and what I've heard from everybody who's been through this is that step one is STOPPING THE TRAINING COMPLETELY. (Step two, if you eventually start training again, is never again training anywhere near as maniacally as you were.) So I quit everything but a morning walk and 20 minutes of yoga, and am otherwise going to stay glued to my couch for at least a month. (I was also on a heavily reduced training regimen for the two months before taking the hiatus, and that helped.) Here's what I've noticed so far:

* Most of the little issues have gone away. I don't wake up with calf cramps, my knees don't hurt when I walk up the stairs, and the gob of phlegm that was forever lodged in my gullet is almost gone. (That phlegm was so bad a month ago that I couldn't bend over and talk at the same time without hacking up a wad.) The irritability has cleared up too, thank God – even when I'm on very short sleep for days in a row nothing really fazes me, even major major stuff, whereas two months ago I was so jacked up and triggered that I could barely handle my cat unplugging my laptop or the car in front of me not banging a right on red. I'm my mellow self again and I couldn't be more grateful for that.

* The bigger problems have cooled off but not resolved. My insomnia isn't as severe: I do still get the adrenaline (or whatever) surges waking me up in the middle of the night, but they aren't as primal as they were. A few weeks ago I would wake up at 4 AM feeling like masked men had dragged me out of bed by the hair: my heart would race and my legs felt a couple of live wires that'd been cut out of the wall and were spitting electricity all over the place. Those wakeups were so rough that none of my meds could get me back to sleep, let alone merely lying in bed. I'm still getting roused at 4 AM by that adrenal surge, but my heart rate isn't up and at least half the time I can fall back asleep with a smile, a little self-reassurance, and some deep breathing (and sometimes a Seriphos). I even managed to fall back asleep at 8 AM a couple of times, which hasn't happened (without prescription drugs) in over a year!

* I didn't realize how often my adrenaline (or whatever) was surging, but I was probably having flare ups a dozen times a day. Now it's more like two or three. When I was in the teeth of this thing earlier this year, I obviously noticed the attacks in the middle of the night because they were so badly ravaging my sleep, but I was shrugging off the ones that hit me when I did exhausting things like eat, walk to the corner store, or pick up an Amazon box that had fallen off the porch into the bushes. All this week when I've done everyday tasks I've noticed that I feel fine, and it hit me that I hadn't felt fine at all before and the reason I hadn't felt fine because my nervous system was lit up like a circuit breaker. I hadn't even noticed half the hormonal havoc I was subjecting my body to! I'd normalized it all.

* My legs are very, very sore, but in a different way, like they're finally getting a chance to repair at the roots. Of course I'd been sore during all the training, but I was able to push through it with caffeine, sports massages, yoga, ice compresses, and sleep meds. This soreness feels different and must've been something my body had to override to meet the demands I made on it; on some level I wonder if my adrenal system is so haywire because I was forcing my body to run on it, instead of normal, healthy energy like food and muscle glycogen. Maybe adrenaline was the only thing that allowed me to press through the deeper structural damage I was inflicting on myself. (Earlier this year I tried a Thai walk-on-your-back massage to see if it would help with my hamstrings, and the therapist was worried and told me I had the tightest leg muscles she'd seen in ages and that she was afraid to bend me in some typical stretches because she thought they might snap. I laughed at that at the time, but she must've been right.)

* A lot of the OTC treatments I thought were exacerbating my symptoms were actually lessening them! I tried stopping kava, tulsi, and Seriphos in various combinations this week, and every time I did my symptoms got worse. Kava works especially well: I tried a heavy strain on Friday and a light strain on Saturday and somehow had NO adrenaline surges either day, even at night! (Unfortunately kava does not prevent the short sleep 8 AM wakeups, but it keeps me asleep from 2 AM to 8 AM and chills out my adrenals the rest of the time.) I talked to a kava guy and he told me I had the scary tight chest after kava because I was taking it with amitriptyline fresh in my system (whoops, turns out amitriptyline has a 20 hour half life), apparently a common kava interaction. I cut that out and no more tight chest, hell yeah! As much as I love the kava and can attest to its power, I'm still trying not to take it more than once or twice a week because of the alcohol-esque toll it takes on the liver. After I stopped it, the surges returned Sunday and Monday (today), but aren't as bad, so here's hoping. Seriphos also works: it doesn't seem like to stop a surge that's coming – if I take it at bedtime, it doesn't prevent the 4 AM attack – but it does calm me down quickly if I take it immediately afterwards. I've also been taking one in the morning, as directed, to try to help balance out my system, but it's hard to know how much recovery, if any, is down to that.

* Diet and nutrition has helped a lot. @teresa, I think my commitment to nutrition backfired and actually masked my symptoms for a while. Healthy eating is a foundation of my life, absolutely bedrock – when I started doing it a few years back, I was a new man, and I've been devoted to it ever since – and I'm kinda convinced that eating as nutritious a diet as I do kept me able to train as foolishly as I was when my body should've just collapsed. I eat my take on the Joel Fuhrman food pyramid: 30% fresh veggies, 15% low-fructose fruits, 20% beans, 20% nuts/avocados/seeds/cacao/yogurt, 15% grains. I try to get all my nutrients (except B12, D, and DHA/EPA omegas, which I have to supplement) from food. I don't have any vitamin, mineral, or iron deficiencies, I have test results to vouch for that, and the most surprising thing is that not only do I not have low bone density (one of most common symptoms of overtraining in men and women), I actually still have really, really HIGH bone density, like in the 99th percentile of the population per my last Dexa. I have to imagine that's down to diet. That said, while I was eating healthy food, I was not eating nearly enough. Reading up on the Female Athletic Triad, I learned that to nourish themselves adequately for the stress of training, female athletes are supposed to eat 45 calories per kg of lean body mass IN ADDITION TO however many calories they burn working out. No standards have been established for men, but for me that would've been 45*72 + 2250ish on training days, or ~5500 calories. I was eating 3000! NO FUGGING WONDER my metabolism went to hell, I lost all muscle above my waist, and I was hungry enough to gaze at fast food billboards and dream of climbing up to gnaw the photos. Now I'm eating 3300 a day on zero exercise and I've actually lost fat this week for the first time in 2020. Go figure.

Anyway, sorry to any innocent passersby for the info dump, but I hope it helps anybody else who's dealing with this. I'll update the thread when I get my test results. With any luck I'll be able to report precisely which part of my poor abused endocrine system is revolting, and what treatment the doc advises.

REPLY
@sleepdealer

Thanks everybody who's replied so far! I wanted to share an update, since I figure the people who will benefit most from this thread are others with similar symptoms who run across it via Google, and I've learned a lot these past few days.

This is going to be long, so first, the tl,dr!

:: It was overtraining
:: Stopped doing anything that made me break a sweat
:: Eating a lot a lot
:: HMO docs worse than useless, know nothing about this and are unwilling to learn even when you do your own research and try to share it with them
:: Got a good doc who is running a number of urine/saliva adrenal stress panels to see what's misfiring (epi, norepi, cortisol, cortisone, GABA)
:: Insomnia is still the bane of my life but is relenting a bit, and pray pray pray I might be out of the sleep ICU
:: Testosterone/libido not coming back and according to the doc will take an eternity to reboot unless I take scripts, so I'm taking scripts
:: Finding that OTC adrenal stress meds (kava kava, holy basil, Seriphos) really work, especially kava, which is a godsend
:: Low dose anti-depressants for insomnia (amitriptyline, trazodone) also worked once my system cooled off

While this could still be some freakishly rare affliction like an adrenal tumor, the odds seem about 99% that I'm suffering from the Exercise Hypogonadal Male Condition (EHMC), a number of excellent papers on which by AC Hackney can be found in on the NIH website. If you're familiar with the Female Athletic Triad, you can think of EHMC as its male counterpart, with roughly the same constellation of symptoms: disruption to the endocrine system, derangement of sex hormones, and damage to the body itself (often bone depletion or a weakened immune system, among others). I was pretty sure that overtraining and undereating caused all this, but reading those papers and talking to/reading blogs by runners and cyclists sealed it – I've got the same cause, the same symptoms, and the same initial response to the suggested treatments. @lioness is on the same page as I am in suspecting adrenal dysfunction, but what I still haven't figured out is precisely what kind of adrenal dysfunction this is and how to treat it. I did find a good doctor (finally) who ordered a panel to test my diurnal cortisol, cortisone, epinephrine, and norepinephrine, along with a neuro profile, the results of which should come in this week. He's also got me on some meds (Clomid) to try to reboot my testosterone and libido, which is still abysmal but flickering back to life.

I talked to a few endurance athletes I know and read a lot of blogs and threads by guys who've overtrained themselves into oblivion, and it seems like the symptoms of male overtraining come in stages: first some strange physical reactions here and there, then emotional and hormonal dysfunction, then major disruption, physical debilitation, injury, extreme fatigue, and malaise. I was lucky enough to catch this (or get caught by it) before I got to the scariest stage, and what I've heard from everybody who's been through this is that step one is STOPPING THE TRAINING COMPLETELY. (Step two, if you eventually start training again, is never again training anywhere near as maniacally as you were.) So I quit everything but a morning walk and 20 minutes of yoga, and am otherwise going to stay glued to my couch for at least a month. (I was also on a heavily reduced training regimen for the two months before taking the hiatus, and that helped.) Here's what I've noticed so far:

* Most of the little issues have gone away. I don't wake up with calf cramps, my knees don't hurt when I walk up the stairs, and the gob of phlegm that was forever lodged in my gullet is almost gone. (That phlegm was so bad a month ago that I couldn't bend over and talk at the same time without hacking up a wad.) The irritability has cleared up too, thank God – even when I'm on very short sleep for days in a row nothing really fazes me, even major major stuff, whereas two months ago I was so jacked up and triggered that I could barely handle my cat unplugging my laptop or the car in front of me not banging a right on red. I'm my mellow self again and I couldn't be more grateful for that.

* The bigger problems have cooled off but not resolved. My insomnia isn't as severe: I do still get the adrenaline (or whatever) surges waking me up in the middle of the night, but they aren't as primal as they were. A few weeks ago I would wake up at 4 AM feeling like masked men had dragged me out of bed by the hair: my heart would race and my legs felt a couple of live wires that'd been cut out of the wall and were spitting electricity all over the place. Those wakeups were so rough that none of my meds could get me back to sleep, let alone merely lying in bed. I'm still getting roused at 4 AM by that adrenal surge, but my heart rate isn't up and at least half the time I can fall back asleep with a smile, a little self-reassurance, and some deep breathing (and sometimes a Seriphos). I even managed to fall back asleep at 8 AM a couple of times, which hasn't happened (without prescription drugs) in over a year!

* I didn't realize how often my adrenaline (or whatever) was surging, but I was probably having flare ups a dozen times a day. Now it's more like two or three. When I was in the teeth of this thing earlier this year, I obviously noticed the attacks in the middle of the night because they were so badly ravaging my sleep, but I was shrugging off the ones that hit me when I did exhausting things like eat, walk to the corner store, or pick up an Amazon box that had fallen off the porch into the bushes. All this week when I've done everyday tasks I've noticed that I feel fine, and it hit me that I hadn't felt fine at all before and the reason I hadn't felt fine because my nervous system was lit up like a circuit breaker. I hadn't even noticed half the hormonal havoc I was subjecting my body to! I'd normalized it all.

* My legs are very, very sore, but in a different way, like they're finally getting a chance to repair at the roots. Of course I'd been sore during all the training, but I was able to push through it with caffeine, sports massages, yoga, ice compresses, and sleep meds. This soreness feels different and must've been something my body had to override to meet the demands I made on it; on some level I wonder if my adrenal system is so haywire because I was forcing my body to run on it, instead of normal, healthy energy like food and muscle glycogen. Maybe adrenaline was the only thing that allowed me to press through the deeper structural damage I was inflicting on myself. (Earlier this year I tried a Thai walk-on-your-back massage to see if it would help with my hamstrings, and the therapist was worried and told me I had the tightest leg muscles she'd seen in ages and that she was afraid to bend me in some typical stretches because she thought they might snap. I laughed at that at the time, but she must've been right.)

* A lot of the OTC treatments I thought were exacerbating my symptoms were actually lessening them! I tried stopping kava, tulsi, and Seriphos in various combinations this week, and every time I did my symptoms got worse. Kava works especially well: I tried a heavy strain on Friday and a light strain on Saturday and somehow had NO adrenaline surges either day, even at night! (Unfortunately kava does not prevent the short sleep 8 AM wakeups, but it keeps me asleep from 2 AM to 8 AM and chills out my adrenals the rest of the time.) I talked to a kava guy and he told me I had the scary tight chest after kava because I was taking it with amitriptyline fresh in my system (whoops, turns out amitriptyline has a 20 hour half life), apparently a common kava interaction. I cut that out and no more tight chest, hell yeah! As much as I love the kava and can attest to its power, I'm still trying not to take it more than once or twice a week because of the alcohol-esque toll it takes on the liver. After I stopped it, the surges returned Sunday and Monday (today), but aren't as bad, so here's hoping. Seriphos also works: it doesn't seem like to stop a surge that's coming – if I take it at bedtime, it doesn't prevent the 4 AM attack – but it does calm me down quickly if I take it immediately afterwards. I've also been taking one in the morning, as directed, to try to help balance out my system, but it's hard to know how much recovery, if any, is down to that.

* Diet and nutrition has helped a lot. @teresa, I think my commitment to nutrition backfired and actually masked my symptoms for a while. Healthy eating is a foundation of my life, absolutely bedrock – when I started doing it a few years back, I was a new man, and I've been devoted to it ever since – and I'm kinda convinced that eating as nutritious a diet as I do kept me able to train as foolishly as I was when my body should've just collapsed. I eat my take on the Joel Fuhrman food pyramid: 30% fresh veggies, 15% low-fructose fruits, 20% beans, 20% nuts/avocados/seeds/cacao/yogurt, 15% grains. I try to get all my nutrients (except B12, D, and DHA/EPA omegas, which I have to supplement) from food. I don't have any vitamin, mineral, or iron deficiencies, I have test results to vouch for that, and the most surprising thing is that not only do I not have low bone density (one of most common symptoms of overtraining in men and women), I actually still have really, really HIGH bone density, like in the 99th percentile of the population per my last Dexa. I have to imagine that's down to diet. That said, while I was eating healthy food, I was not eating nearly enough. Reading up on the Female Athletic Triad, I learned that to nourish themselves adequately for the stress of training, female athletes are supposed to eat 45 calories per kg of lean body mass IN ADDITION TO however many calories they burn working out. No standards have been established for men, but for me that would've been 45*72 + 2250ish on training days, or ~5500 calories. I was eating 3000! NO FUGGING WONDER my metabolism went to hell, I lost all muscle above my waist, and I was hungry enough to gaze at fast food billboards and dream of climbing up to gnaw the photos. Now I'm eating 3300 a day on zero exercise and I've actually lost fat this week for the first time in 2020. Go figure.

Anyway, sorry to any innocent passersby for the info dump, but I hope it helps anybody else who's dealing with this. I'll update the thread when I get my test results. With any luck I'll be able to report precisely which part of my poor abused endocrine system is revolting, and what treatment the doc advises.

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I am impressed with all of the research you must have done, @sleepdealer. You seem to be heading in the right direction, what a good feeling that must be for you.
I hope your success continues and that you will be back to normal as soon as possible. Of course that will probably not be overnight but you seem to be well aware of that.
I hope you keep us up to date on your success.
JK

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@sleepdealer

Thanks everybody who's replied so far! I wanted to share an update, since I figure the people who will benefit most from this thread are others with similar symptoms who run across it via Google, and I've learned a lot these past few days.

This is going to be long, so first, the tl,dr!

:: It was overtraining
:: Stopped doing anything that made me break a sweat
:: Eating a lot a lot
:: HMO docs worse than useless, know nothing about this and are unwilling to learn even when you do your own research and try to share it with them
:: Got a good doc who is running a number of urine/saliva adrenal stress panels to see what's misfiring (epi, norepi, cortisol, cortisone, GABA)
:: Insomnia is still the bane of my life but is relenting a bit, and pray pray pray I might be out of the sleep ICU
:: Testosterone/libido not coming back and according to the doc will take an eternity to reboot unless I take scripts, so I'm taking scripts
:: Finding that OTC adrenal stress meds (kava kava, holy basil, Seriphos) really work, especially kava, which is a godsend
:: Low dose anti-depressants for insomnia (amitriptyline, trazodone) also worked once my system cooled off

While this could still be some freakishly rare affliction like an adrenal tumor, the odds seem about 99% that I'm suffering from the Exercise Hypogonadal Male Condition (EHMC), a number of excellent papers on which by AC Hackney can be found in on the NIH website. If you're familiar with the Female Athletic Triad, you can think of EHMC as its male counterpart, with roughly the same constellation of symptoms: disruption to the endocrine system, derangement of sex hormones, and damage to the body itself (often bone depletion or a weakened immune system, among others). I was pretty sure that overtraining and undereating caused all this, but reading those papers and talking to/reading blogs by runners and cyclists sealed it – I've got the same cause, the same symptoms, and the same initial response to the suggested treatments. @lioness is on the same page as I am in suspecting adrenal dysfunction, but what I still haven't figured out is precisely what kind of adrenal dysfunction this is and how to treat it. I did find a good doctor (finally) who ordered a panel to test my diurnal cortisol, cortisone, epinephrine, and norepinephrine, along with a neuro profile, the results of which should come in this week. He's also got me on some meds (Clomid) to try to reboot my testosterone and libido, which is still abysmal but flickering back to life.

I talked to a few endurance athletes I know and read a lot of blogs and threads by guys who've overtrained themselves into oblivion, and it seems like the symptoms of male overtraining come in stages: first some strange physical reactions here and there, then emotional and hormonal dysfunction, then major disruption, physical debilitation, injury, extreme fatigue, and malaise. I was lucky enough to catch this (or get caught by it) before I got to the scariest stage, and what I've heard from everybody who's been through this is that step one is STOPPING THE TRAINING COMPLETELY. (Step two, if you eventually start training again, is never again training anywhere near as maniacally as you were.) So I quit everything but a morning walk and 20 minutes of yoga, and am otherwise going to stay glued to my couch for at least a month. (I was also on a heavily reduced training regimen for the two months before taking the hiatus, and that helped.) Here's what I've noticed so far:

* Most of the little issues have gone away. I don't wake up with calf cramps, my knees don't hurt when I walk up the stairs, and the gob of phlegm that was forever lodged in my gullet is almost gone. (That phlegm was so bad a month ago that I couldn't bend over and talk at the same time without hacking up a wad.) The irritability has cleared up too, thank God – even when I'm on very short sleep for days in a row nothing really fazes me, even major major stuff, whereas two months ago I was so jacked up and triggered that I could barely handle my cat unplugging my laptop or the car in front of me not banging a right on red. I'm my mellow self again and I couldn't be more grateful for that.

* The bigger problems have cooled off but not resolved. My insomnia isn't as severe: I do still get the adrenaline (or whatever) surges waking me up in the middle of the night, but they aren't as primal as they were. A few weeks ago I would wake up at 4 AM feeling like masked men had dragged me out of bed by the hair: my heart would race and my legs felt a couple of live wires that'd been cut out of the wall and were spitting electricity all over the place. Those wakeups were so rough that none of my meds could get me back to sleep, let alone merely lying in bed. I'm still getting roused at 4 AM by that adrenal surge, but my heart rate isn't up and at least half the time I can fall back asleep with a smile, a little self-reassurance, and some deep breathing (and sometimes a Seriphos). I even managed to fall back asleep at 8 AM a couple of times, which hasn't happened (without prescription drugs) in over a year!

* I didn't realize how often my adrenaline (or whatever) was surging, but I was probably having flare ups a dozen times a day. Now it's more like two or three. When I was in the teeth of this thing earlier this year, I obviously noticed the attacks in the middle of the night because they were so badly ravaging my sleep, but I was shrugging off the ones that hit me when I did exhausting things like eat, walk to the corner store, or pick up an Amazon box that had fallen off the porch into the bushes. All this week when I've done everyday tasks I've noticed that I feel fine, and it hit me that I hadn't felt fine at all before and the reason I hadn't felt fine because my nervous system was lit up like a circuit breaker. I hadn't even noticed half the hormonal havoc I was subjecting my body to! I'd normalized it all.

* My legs are very, very sore, but in a different way, like they're finally getting a chance to repair at the roots. Of course I'd been sore during all the training, but I was able to push through it with caffeine, sports massages, yoga, ice compresses, and sleep meds. This soreness feels different and must've been something my body had to override to meet the demands I made on it; on some level I wonder if my adrenal system is so haywire because I was forcing my body to run on it, instead of normal, healthy energy like food and muscle glycogen. Maybe adrenaline was the only thing that allowed me to press through the deeper structural damage I was inflicting on myself. (Earlier this year I tried a Thai walk-on-your-back massage to see if it would help with my hamstrings, and the therapist was worried and told me I had the tightest leg muscles she'd seen in ages and that she was afraid to bend me in some typical stretches because she thought they might snap. I laughed at that at the time, but she must've been right.)

* A lot of the OTC treatments I thought were exacerbating my symptoms were actually lessening them! I tried stopping kava, tulsi, and Seriphos in various combinations this week, and every time I did my symptoms got worse. Kava works especially well: I tried a heavy strain on Friday and a light strain on Saturday and somehow had NO adrenaline surges either day, even at night! (Unfortunately kava does not prevent the short sleep 8 AM wakeups, but it keeps me asleep from 2 AM to 8 AM and chills out my adrenals the rest of the time.) I talked to a kava guy and he told me I had the scary tight chest after kava because I was taking it with amitriptyline fresh in my system (whoops, turns out amitriptyline has a 20 hour half life), apparently a common kava interaction. I cut that out and no more tight chest, hell yeah! As much as I love the kava and can attest to its power, I'm still trying not to take it more than once or twice a week because of the alcohol-esque toll it takes on the liver. After I stopped it, the surges returned Sunday and Monday (today), but aren't as bad, so here's hoping. Seriphos also works: it doesn't seem like to stop a surge that's coming – if I take it at bedtime, it doesn't prevent the 4 AM attack – but it does calm me down quickly if I take it immediately afterwards. I've also been taking one in the morning, as directed, to try to help balance out my system, but it's hard to know how much recovery, if any, is down to that.

* Diet and nutrition has helped a lot. @teresa, I think my commitment to nutrition backfired and actually masked my symptoms for a while. Healthy eating is a foundation of my life, absolutely bedrock – when I started doing it a few years back, I was a new man, and I've been devoted to it ever since – and I'm kinda convinced that eating as nutritious a diet as I do kept me able to train as foolishly as I was when my body should've just collapsed. I eat my take on the Joel Fuhrman food pyramid: 30% fresh veggies, 15% low-fructose fruits, 20% beans, 20% nuts/avocados/seeds/cacao/yogurt, 15% grains. I try to get all my nutrients (except B12, D, and DHA/EPA omegas, which I have to supplement) from food. I don't have any vitamin, mineral, or iron deficiencies, I have test results to vouch for that, and the most surprising thing is that not only do I not have low bone density (one of most common symptoms of overtraining in men and women), I actually still have really, really HIGH bone density, like in the 99th percentile of the population per my last Dexa. I have to imagine that's down to diet. That said, while I was eating healthy food, I was not eating nearly enough. Reading up on the Female Athletic Triad, I learned that to nourish themselves adequately for the stress of training, female athletes are supposed to eat 45 calories per kg of lean body mass IN ADDITION TO however many calories they burn working out. No standards have been established for men, but for me that would've been 45*72 + 2250ish on training days, or ~5500 calories. I was eating 3000! NO FUGGING WONDER my metabolism went to hell, I lost all muscle above my waist, and I was hungry enough to gaze at fast food billboards and dream of climbing up to gnaw the photos. Now I'm eating 3300 a day on zero exercise and I've actually lost fat this week for the first time in 2020. Go figure.

Anyway, sorry to any innocent passersby for the info dump, but I hope it helps anybody else who's dealing with this. I'll update the thread when I get my test results. With any luck I'll be able to report precisely which part of my poor abused endocrine system is revolting, and what treatment the doc advises.

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Hello @sleepdealer, As @contentandwell said, I'm also glad that you are getting a handle on these various health problems. It sounds as if your research has led you to some new insights.

You are right that it will take a while for your body to recalibrate and get back to more normal functioning.

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