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Chronic fatigue: carb intolerance, sleep problems, sodium potassium imbalances.


since a knee operation in January 2013 where I suffered from a cardiac arrest and reanimation I suffer from chronic fatigue. The first months I was bedridden, sleeping for 22 hours of 24 hours, only leaving the bed for buying & eating food, showering etc. I was 28 years old at the time (male) and considered healthy by most medical standards (athletic / slim build, exercising, no smoker and limited alcohol consumption).

Okay, long story. Hope you will read.

I have mainly three big issues.

1. Non refreshing sleep
2. Carbohydrate intolerance
3. Sodium / potassium imbalances

I recently found out that my bad sleep is probably psychological, I am working on that (EMDR / journey) and it is slowly improving.

Problems 2 and 3 are more troublesome to treat.

First the carbohydrate intolerance. This problem started appearing during the recovery phase of my first knee accident / operation in February 2011. I had a tibia plateau fracture (shattered tibia). It is a miracle that I can walk again according to the doctors so I am really grateful for that.
During recovery physiotherapy I started to get night sweats, waking up, getting really hot and really awake and not being able to get back to sleep until I eat carbohydrates. Other foods, for example protein from a protein shake don't work. It got as worse as waking up 3 times a night and having to eat 3 times a night. I exercised five times a week back than, and started gaining weight. Also on the daytime I got hungry every two hours. I even needed to eat half way the training to get through the training - even if I eat quite a heavy carbohydrate rich meal 1,5 hour before training. Back than I eat a lot of whole grain wheat and what was considered mainstream healthy diet (low fat low sodium, dairy etc).

I started a low-carbohydrate, low grain diet which got rid of these symptoms and I finally could sleep through the night again. Problem is that 5 years later the carbohydrate intolerance is bigger than ever. If I eat more than 50 grams of carbs a day I would wake up at least twice a night. When I strictly eat less than this amounts of carbs I can sleep through the night at once (!).

But when I do some more physical activity like sailing with friends or vacuuming the whole house, traveling, etc I heat up in the moment and need to eat carbohydrates before I can even get to sleep. Sometimes I have to eat a lot like a full bowl of oatmeal.
If I eat fast glycemic index carbohydrates in the night, wake up & heating again is much faster. The same for eating not enough carbohydrates. If I eat fast glycemic index carbohydrates or just not enough, I get hot and really awake again before I even got to sleep. I measured cortisol by saliva and I have really high peaks at those nightly heat periods.

Second problem: the sodium potassium imbalances.

First signs of this problem where in 2012 where I was bedridden for two months that started like a flu that didn't want to go over. I urinated a lot, drank a lot. If I drank a cup of tea, within a half an hour I peed it out again. I started to note the amount of fluids I peed and drank and measured a 6 liters a day. Restricting the amount of fluids I drank to two liter a day didn't do anything for my health, only had a lot of thirst. I started to get arrhythmia's (very slow, bonking heart) and got completely out of breath for 5 minutes (no exaggeration) after walking up to one stair. I also was severely constipated, had severe headache, was bedridden all day, incredible thirsty, frequent muscle cramps and balancing troubles.

These symptoms I googled and I found out about hyponatremia. I started supplementation of sodium and within a few hours I was out of bed and easily walking around the house. The excessive peeing was over for a few hours after the first teaspoon of sodium chloride and my thirst went away(!). After starting peeing again, I took another teaspoon of salt. Peeing stopped again for a few hours. I felt a lot better already than. This I continued and three days later I was back on the university following courses. I did not have a blood test for sodium than. I would guess that was an episode of hyponatremia. The extensive medical tests I had later that week all showed up normal (echo of heart, ECG while on a bike, ECG while in rest etc).

After my surgery in 2013 these problems got quite worse but it took a while to find out. One thing I found out that after evening dinner with a lot of vegetables, I always felt better and could actually do some stuff. I tried sodium supplementation already and didn't do much. I tried potassium supplementation and that worked like a charm. I could lay in the bed all week, feeling sick and general malaise (heavy arms and legs), take a few grams of potassium chloride and get up, and clean the whole house without even thinking about it. It is a difference of night an day. I have repeated this for countless times - every time I think I can do without salt supplementation, or I have to do it for medical research, I quickly become bedridden for the whole day. The most difficult is when I think I am tired of something else (infection, done too much in the previous days). But almost all periods of extreme fatigue end with potassium supplementation (sometimes it is sodium supplementation). If I have sodium and potassium both under control, I can function normally, have a good condition etc. Problem is that this only lasts for an hour or two maximum. Then I need to take it again. The amount of being out of breath with some mild exercise (like walking up two stairs) is a test for me to know how much I am off.

If I drink diuretic stuff, like thee, coffee, beer this problem gets worse.

Problem is: this pattern is never shown in the blood by regular medical tests. Only weird thing was that my salt excretion (24 hour urine) was way too high on the end of a three week low sodium diet. That was bread free, whole food paleo diet with no salt added and no products with added salts (like commercial broths). So my salt intake was very, very low but excretion was still around 6 grams a day. This was still considered a normal excretion by the doctor but I don't think he knew how rigorous I was avoiding salt. Also, anti diuretic hormone and the other one (can't remember) where within normal ranges.

Thanks for reading so far! Please don't tell me stuff like: "it is in your head". I've heard that enough and worked a lot on the topic without improvement on complaints. I already know psychological development is important with chronic disease. I hope to find about my physical complaints. Thanks :)

Please share your thoughts, happy to answer questions.
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