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Neurology (Expert Forum)
Tolerance of intense exercise possible in mitochondrial disease?
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Tolerance of intense exercise possible in mitochondrial disease?
by pomg, Sep 10, 2001 12:00AM
Is it possible to have a mitochondrial myopathy and be tolerant to intense aerobic exercise such as running and playing sports?
Tolerance to walking and light exercise is low and brings about symptoms but heavy exercise seems to improve strength and symptoms. I actually get complete resolution of my weakness and visual problems.
Diagnosis was by a high (over 100) blood lactate/pyruvate ratio. Lupus, MS, MG, ALS, diabetes, heart problems, and vascular problems have been ruled out by testing.
Symptoms are intermittent left-sided weakness, blurry vision, double vision, confusion, gastrointestinal dysfunction, numbness, and pain. Symptoms are worse at night and when under stress. Response to CoQ10 and L-carnitine is somewhat effective, but so was Mestinon previously - my interpretation is that these things help but aren't addressing the real problem.
Any feedback on this issue would be highly appreciated.
Tolerance to walking and light exercise is low and brings about symptoms but heavy exercise seems to improve strength and symptoms. I actually get complete resolution of my weakness and visual problems.
Diagnosis was by a high (over 100) blood lactate/pyruvate ratio. Lupus, MS, MG, ALS, diabetes, heart problems, and vascular problems have been ruled out by testing.
Symptoms are intermittent left-sided weakness, blurry vision, double vision, confusion, gastrointestinal dysfunction, numbness, and pain. Symptoms are worse at night and when under stress. Response to CoQ10 and L-carnitine is somewhat effective, but so was Mestinon previously - my interpretation is that these things help but aren't addressing the real problem.
Any feedback on this issue would be highly appreciated.
Doctor's Answer
by CCF-Neuro-M.D.-JT, Sep 13, 2001 12:00AM
Exercise intolerance is a common symptom that over half of patients with mitochodrial disease report. So in answer to your question, yes you can have it without intolerance to exercise. However, I am wary of the diagnosis if it is based on your lactic acid alone. Genetic testing is available as well muscle biopsy and urine and serum amino acid studies which would be more definitive than lactic acid elevation by itself as this can be seen in other muscle diseases (which means other treatments). Also with vision changes and left sided weakness, I would make sure nothing is going on in the brain with an MRI. But if MS was "ruled out", I assume it has been done. Mitochondrial disease could very well be the cause of your symptoms, but before committing yourself to this diagnosis and lifetime treatment make sure it's the right diagnosis. Talk to your docs as they know you best. Dr. Bruce Cohen here at the Cleveland Clinic is a mitochondrial disease expert and if you are questioning the diagnosis or would like to be managed by an expert on the disease, then you are welcome to make an appointment. Good luck.
I am currently being evaluated by my PCP for an electrolyte problem, as it seems lately I am getting resolution of double vision, blurry vision, and weakness with Gatorade (plain water or juice doesn't work, sometimes caffienated soda seems to). I have some thoughts to a hypokalemic periodic paralysis, but I wonder if it is another component of the sports drink, even sugar or maybe an electrolyte other than potassium that is the problem. Also wonder if the Gatorade drinking is the important part of the heavy exercise that improves my symptoms.