Scary or normal? The eternal question
June 23, 2014 9:22 AM   Subscribe

For the past few months, I've found it very hard to run. Slowing down (a lot) helped the problem out but it still pops up occasionally. Lately I've been wondering if it's my heart. And yes, I want you to listen to a long recitation of my symptoms and problems.

Hi, YANMD! So, I had the best holiday season eva! And when it was over, I had gained 10 pounds in 2 months. I've never gained that much weight so quickly but I totally ate a ton and I also started having some pretty serious menopause symptoms around January - primarily hot flashes and insomnia.

I also started having a problem running. I was already the slowest runner on the planet (typically going on the treadmill at 5.0mph). I run with a heart rate monitor, so before this problem, I'd run until my heart rate went up to about 160 and then I'd walk until it went down to 120. In a typical session on the treadmill, this would happen maybe once or twice, depending on how regularly I'd been exercising.

I had slacked off during the holidays so when I started running again in January I expected it would be difficult. It was _extremely_ difficult. Running at my usual pace felt like I was running under water - like it took soooo much work to move my legs. My heart rate would go up very quickly and then I'd stop and walk. I was pretty much not running at all. I finally settled into a pace of 4mph (yep walking pace) and I'd stop running when my heart rate hit 150 and walk until it went down to 120. At this miserable pace, I finally got back up to running about 2 miles without stopping most days.

But every now and then - and the last time was this past Saturday - I'll go for a run and from the start it just seems like IT IS SO HARD. This Saturday, I'd run for a bit and my heart rate would go up to 150 and so I'd walk for a bit and it would go down and then I'd run for a bit and it would go right back up. I finally stopped after about 2.5 miles (had intended to go for 4). And then today - lovely run - my heart rate was right where it should be, I felt great, everything was awesome and then when I stopped running to cool down, my heart rate shot up to 170 and stayed there for at least 5 minutes. While I was walking!

Misc info - menopause symptoms now under control thanks to the addition of activella and welbutrin. My resting heart rate is typically around 48-50 and it pretty much always has been this rate - that's not new. However, I'm no Lance Armstrong - I'm in my early 50s and about 20 pounds overweight. And yes, I've called my doctor but I'd like to get a feel for whether this is a thing or just normal life - possibly caused by running with 20 extra pounds.

I saw my dr about this earlier this month and he tested me for blood clots in my legs. That was fine. He also did an EKG which was fine except for a note that I had unusually low heart rate. I've been running outside since this spring, but I run in the early morning so I don't think the heat would be a factor.

Thanks so much for your input - I want to be an educated, but not pushy and paranoid, patient about this.
posted by Lizlemondrop to Health & Fitness (13 answers total) 3 users marked this as a favorite
I don't think anybody here can begin to answer your question, because the symptoms you describe can be normal sometimes and indicative of potentially serious problems other times. Rapid weight gain can be a sign of fluid retention, such as that seen with congestive heart failure, or it can be a normal result of holiday eating and menopausal-related hormonal changes. Difficulty exercising and increased heart rate could be the result of deconditioning from holiday slacking plus carrying increased weight. Or it could be the result of heart disease. Any of this could be related to your new medications for menopause (this is probably what the doc was concerned about when he had you tested for blood clots).

I wouldn't feel comfortable guessing as to what's going on without knowing more about your symptoms, family history, physical exam, and test results. This is why your doctor needs to be the one helping you out with this. If you don't think he's taking your symptoms seriously and it's at all possible, get in to see another doctor for a second opinion. But 'should I be worried about heart problems' is really not a question that can be answered well on the internet.
posted by bookish at 9:54 AM on June 23, 2014

ASSUMING your doc eliminates any pathology, side effects from meds, etc.:

So, 160bpm is brushing against the upper limit of your target heart rate if you're in your mid-50's. If you were hitting that at 5mph (barely above a brisk walk, as you noted) before gaining the weight and taking time off - well, no offense, but you were never in that great of shape to begin with.

If I were you, I'd do the following:

1. Stop running. Stick to walking at a brisk pace for now. Stick some books or something in a backpack and walk with that for a little extra work if you want; if you can do this outside in a park so much the better.

2. Lose the weight, and by weight I mean fat. You don't need cardio to do this, this is all about diet. Extra fat doesn't help you any, creates needless extra work for your heart, and more wear and tear on your joints when you run.

3. Start weight training (I know... eponysterical). We all lose bone density and lean body mass at the rate of about 1% per year after the age of 30, this is reversible with weight training and IMHO is a much bigger concern than aerobic capacity at your age.

4. If you insist on running, pick it up again using a structured program like Couch to 5k, which many many people have used successfully.
posted by mrbigmuscles at 9:57 AM on June 23, 2014 [1 favorite]

Are you running outside during the day, when it's hot?
posted by oceanjesse at 10:06 AM on June 23, 2014

Are you running outside during the day, when it's hot?

Per OP: "I've been running outside since this spring, but I run in the early morning so I don't think the heat would be a factor."
posted by schroedingersgirl at 10:28 AM on June 23, 2014 [1 favorite]

I've been running for over fifteen years and have run at different body weights and overall fitness levels. To me it sounds like a combination of time off and weight gain. Weight gain, particularly quick weight gain when you don't have the strength to support it, will slow you down. A lot.

Having said that, it sounds like you definitely need to keep your doctor in the loop.
posted by TORunner at 10:35 AM on June 23, 2014 [1 favorite]

Response by poster: Thanks for all the good comments. I do plan to see my Dr. just to make sure but I think mrbigmuscles is on track with his recommendations - scale back the running, lose the weight (working on it!) and start weight training. Keeping up the hydration couldn't hurt either which might explain why sometimes it's fairly easy to run and sometimes it feels so hard. That is the thing that I want to check out - why sometimes it happens and sometimes it doesn't.
posted by Lizlemondrop at 10:42 AM on June 23, 2014

Unfortunately no one but your doctor can probably answer the 'scary or normal' part of the question, but I will throw in my 2 cents as a runner.

Where are you located? Even if the heat isn't as much a factor, humidity is at its highest in the early morning. I am in the northeast and my paces are around 30 seconds/mile slower than they are when the weather is cooler. You can add humidity + dewpoint to get a good idea of how much the heat/humidity combination should affect you. Less than 100 shouldn't affect you at all (50 degrees/50 dewpoint); at 130 I definitely feel the effects of humidity (70 degrees +60 dewpoint, for example) at 150 (80 with 70 dewpoint) I have trouble completing workouts, either I have to do them slower or I'm forced to stop partway through.

The fact that your heart rate shot up and stayed there is a bit concerning to me-- are you sure that is not a glitch with your HR monitor? I have wacky readings sometimes on mine-- did you confirm by measuring your pulse with your fingertips?

Also, sometimes you will just have a bad run. It might be something or it might be nothing. When I am diligent about checking my HR, sometimes I will have a run where my HR is much higher than I would expect for the pace, and it turns out that I'm coming down with something. Other times I will just have been dehydrated, or over-tired... Or nothing at all. Sometimes the next day I'm back to normal, with no apparent cause for the bad run at all.

It can be helpful to keep a running log, if you don't already, so you can make notes of how you felt, note your average/peak HR, etc. This can be helpful to show to a doctor, or you can just look at it yourself to make note of trends.
posted by matcha action at 10:44 AM on June 23, 2014

It looks like you just hit that spot where your hormones have dipped enough so that they no longer give you the protection they used to. Sudden menopausal weight gain without changing your diet or exercise is common. What used to burn off no longer does. Similarly your metabolism is on its way to that of a senior from that of a young woman and just took the biggest step in that direction. That can be frustrating and deeply dismaying, but it's not dangerous.

But I would also check for a couple of other factors. If you normally were exercising half an hour or so after having something to eat or drink and are now exercising four hours after that iced cap you can find a big difference in your stamina. Exercising when your blood sugar is low and you are hungry instead of exercising when your blood sugar is high could be a factor.

Another factor could be yo-yoing hormones. One day you can be brisk and effective, the next day when the hormones are out of whack, puffy, lethargic and grim.

Ten extra pounds is a lot for some people. There is a tipping point where suddenly you are running with weights instead of just running. You may have reached that spot where you feel the extra weight you are carrying.

And then there is humidity. Humidity can make running really hard so that you can't handle a hill, or a distance or a speed that you used to be able to manage, no problem.

That said, it's still up to your doctor to decide if this is scary or not and if there is any problem. But it could be perfectly normal, and not indicate anything but that it's just going to take more patience and more effort to gain and maintain your cardiac fitness.

You might want to try a non-weight bearing exercise, such as stationary biking to see if it makes a difference.
posted by Jane the Brown at 11:44 AM on June 23, 2014 [2 favorites]

Just throwing this out there, but menopause is not always the culprit. Working on losing the weight and doing weight training is always good advice, but note that weight gain can also be a warning sign of the start of a thyroid issue. Low heart rate can also be a symptom of low thyroid. I am assuming when you see your doctor, he will do blood work (fasting bloodwork) along with checking other things, so he can test thyroid levels, as well as iron, Vitamin B12, vitamin D, and other things that should be routinely checked as part of bloodwork.
posted by gudrun at 11:47 AM on June 23, 2014 [5 favorites]

Do you have seasonal allergies? I find running much more difficult in the spring and early summer because of tree pollen allergies. Also, I'm younger than you but I can't keep my bpm below 160 and maintain anything close to a running pace. Do you know your actual max bpm? Mine is way, way, way higher than the charts say it should be - there's a lot of range.
posted by mskyle at 12:40 PM on June 23, 2014

A thyroid issue was the first thing that came to my mind, too. See if your doctor can do a blood test of your TSH levels.
posted by stripesandplaid at 5:07 PM on June 23, 2014 [1 favorite]

10lbs is actually a lot of weight to add to a runner. Think if you had a 10-lb backpack.
posted by fshgrl at 8:36 PM on June 23, 2014 [1 favorite]

The amount of effort I have to put into the same workout can vary wildly based on what I've had to eat before--are you having a snack before working out some days and not others? Just one thought.
posted by whitewall at 11:16 PM on June 23, 2014

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