[HN Gopher] Why thinking hard makes us feel tired
       ___________________________________________________________________
        
       Why thinking hard makes us feel tired
        
       Author : yamrzou
       Score  : 122 points
       Date   : 2023-11-16 20:05 UTC (2 hours ago)
        
 (HTM) web link (www.nature.com)
 (TXT) w3m dump (www.nature.com)
        
       | yamrzou wrote:
       | https://archive.ph/WJCMC
        
         | insanitybit wrote:
         | Should probably replace the link with this, since it's actually
         | readable.
        
           | theyinwhy wrote:
           | "Please submit the original source. If a post reports on
           | something found on another site, submit the latter."
           | 
           | https://news.ycombinator.com/newsguidelines.html
        
             | insanitybit wrote:
             | OK but the original source is not accessible?
        
       | progne wrote:
       | Is glutamate : neurons :: lactic acid : muscle?
        
         | andbberger wrote:
         | no
        
         | adpirz wrote:
         | The lactic acid thing is a myth.
         | https://www.bostonsportsmed.com/2013/08/the-lactic-acid-myth...
        
       | User23 wrote:
       | Because it takes energy? This is pretty well observed in high
       | level chess[1].
       | 
       | [1] https://www.espn.com/espn/story/_/id/27593253/why-
       | grandmaste...
        
         | insanitybit wrote:
         | That hardly seems conclusive. For example,
         | 
         | > Meanwhile, players also eat less during tournaments, simply
         | because they don't have the time or the appetite. "The simple
         | explanation is when they're thinking about chess, they're not
         | thinking about food," says Ewan C. McNay, assistant professor
         | of psychology in the behavioral neuroscience program at the
         | University of Albany.
         | 
         | That seems far more likely. I'm sure many of us can relate to
         | working through lunch when we have an intense deadline, and not
         | even realizing we're hungry until hours later.
         | 
         | > According to Ashley, India's first grandmaster, Viswanathan
         | Anand, does two hours of cardio each night to tire himself out
         | so he doesn't dream about chess; Kasimdzhanov drinks tea only
         | during tournaments and plays tennis and basketball every day.
         | Chirila does at least an hour of cardio and an hour of weights
         | to build muscle mass before tournaments.
         | 
         | And apparently they're exercising quite a lot as well.
         | 
         | This hardly seems to support that it's just brain power. And my
         | recollection is that focus does not significantly increase
         | glucose uptake in the brain - though _stress_ can obviously
         | increase heart rate, but that 's separate, one can focus
         | without being stressed.
        
         | pikma wrote:
         | If thinking hard required a lot of energy, wouldn't we expect
         | that thinking hard would cause an increased heart rate and
         | faster breathing?
        
       | tantalor wrote:
       | > watching letters appear on a computer screen every 1.6 seconds
       | and documenting when one matched a letter that had appeared three
       | letters ago. The other 16 participants were asked to perform a
       | similar, but easier task. Both teams worked for just over six
       | hours
       | 
       | This is torture
        
         | solardev wrote:
         | It's like guitar hero's evil twin.
         | 
         | After six hours, I wish the study would've differentiated
         | between "tired" and "murderously enraged"
        
         | sva_ wrote:
         | Probably got a chance to win a $20 Amazon gift card in return
        
         | mholm wrote:
         | This is fairly similar to an ADHD screening test I took. I was
         | mentally exhausted after about 20 minutes of it.
        
         | deegles wrote:
         | This is a working memory exercise called "n-back". For true
         | torture try "dual n-back" where you also have to match a tone,
         | shape or color.
         | 
         | https://en.m.wikipedia.org/wiki/N-back
        
         | TonyTrapp wrote:
         | Sounds like something coming straight out of The Stanley
         | Parable.
        
         | frenchwhisker wrote:
         | Reminds me of a card game I played as a kid called Egyptian
         | Ratscrew, where one of the possible rules is to slap the deck
         | if a "sandwich" appeared (e.g. a 3, a J, then another 3), so
         | you always had to keep the card before the last one in your
         | head. I remember variations such as "double sandwiches"--which
         | made the 2-back into a 3-back--and many others.
         | 
         | https://en.wikipedia.org/wiki/Egyptian_Ratscrew
        
           | hx8 wrote:
           | I use to colloquially call this game "slap deck" as a kid.
           | The general approach taken was to add a ton of house rules,
           | such that it was a large test of working memory to keep all
           | rules in your head. We kept some simple rules to keep the
           | game approachable for younger children, and older
           | children/teens would continue to add house rules to make the
           | game more complex. In addition, game play would be very fast,
           | and often times patterns would be missed because no one
           | recognized it quick enough.
           | 
           | Some of the rules that would sometime appear that I can
           | recall
           | 
           | * Put 1 or 2 jokers in. Jokers are slappable
           | 
           | * Doubles are slappable (3, 3)
           | 
           | * Three (or four) face cards are slappable
           | 
           | * Three (or four) cards of the same suite are slappable
           | 
           | * Three (or four) consecutive cards are slappable (2, 3, 4,
           | 5) or (5, 4, 3, 2)
           | 
           | * A player without cards can 'slap in'
        
             | pradn wrote:
             | I've taught this game to 3 year olds and college students -
             | everyone has fun with it!
        
           | iamwpj wrote:
           | Ahh, thanks for the memories! If it weren't for my slow
           | reflexes, I would have been much better at that game.
        
         | irrational wrote:
         | How many minutes could you last before you lost focus said,
         | "Screw it" and stopped really trying? I think I'd last maybe 5
         | minutes.
        
         | Almondsetat wrote:
         | > This is torture
         | 
         | I would like to ask everyone to stop for a moment and think if
         | in their line of work they are required to perform tasks like
         | this. Your job might be even shittier than you currently feel
         | like it is
        
           | derekp7 wrote:
           | The difference is the reward afterward. Learning to play a
           | complex piece on an instrument is mentally taxing, but
           | getting it right gives you that sense of accomplishment that
           | can't really be matched with anything else. Same with
           | debugging a program you are writing, or solving other types
           | of problems.
           | 
           | Doing hours of arithmetic homework as a child didn't give me
           | that reward signal, so for me that was torture back then.
        
         | zulln wrote:
         | ChatGPT throw together that game in a few seconds if you want
         | to play it.
         | 
         | https://github.com/zulln/misc/tree/master/lettergame
         | https://zulln.se/misc/lettergame/
        
       | simonw wrote:
       | From https://www.npr.org/2019/09/18/762046422/the-chess-
       | grandmast...
       | 
       | > Chess grandmasters spend hours sitting over game boards. And
       | yet, high-level players lose 10 to 12 pounds on average over a
       | 10-day tournament.
        
         | insanitybit wrote:
         | I'm wondering if they're just on amphetamines.
         | 
         | > He taps his foot gently to keep his alertness on the highest
         | level while still not losing too much energy. He chews gum.
         | 
         | Sounds like the kind of behavior you'd expect when hopped up on
         | something tbh
        
           | BurningFrog wrote:
           | You have to assume anything not tested for (that helps) is
           | used at the top.
        
             | DarmokJalad1701 wrote:
             | > You have to assume anything not tested for (that helps)
             | is used at the top.
             | 
             | More like, at the bottom[1].
             | 
             | [1]: https://www.youtube.com/watch?v=11SdThUNgLo
        
               | ephbit wrote:
               | First, my apology that I am making this off-topic remark.
               | 
               | Remark: is it just me, or do other people too hesitate to
               | click a youtube link with no title given?
               | 
               | I feel like I at least want to know the title of the
               | linked video, even if it doesn't reveal much about the
               | video.
               | 
               | IMO it'd be very nice if people made a habit of
               | Ctrl+c/v'ing the title along with a yt link.
        
               | drivers99 wrote:
               | Good point. I think I've seen some subreddits with a bot
               | that does that for YouTube links.
               | 
               | Title: Making Beads That Vibrate To Cheat In Chess
               | 
               | Length: 18min, 54s
               | 
               | Channel: MixMorris (102k subscribers)
               | 
               | 17,364 views
               | 
               | Oct 23, 2022 #chess #engineering
               | 
               | Description: "This video speaks for itself." (sic)
        
               | klyrs wrote:
               | Thanks, I wasn't going to click and this confirms my
               | "never click a youtube" policy is sound.
        
               | tysam_and wrote:
               | And if your sense of humor is similar to mine, then you
               | might just find this video by DougDoug riffing on the
               | topic hilarious:
               | 
               | Title: "I created the ultimate Chess Ai (it can cheat)"
               | 
               | https://www.youtube.com/watch?v=l_wOsSda3Us
        
               | anon_cow1111 wrote:
               | I don't think I've clicked a no-context youtube link in
               | years. Sometimes when it seems like it might be worth
               | clicking, I just throw the hash into a search engine.
        
             | slkdjfalzkdfj wrote:
             | There actually are regular drug tests for professional
             | chess.
             | 
             | The simple fact is that doing any kind of mindsport
             | intensely over an extended period is very draining.
        
           | tayo42 wrote:
           | I would think large swings like that are water weight.
           | They're probably really focused and not drinking or eating as
           | much as usual
        
             | insanitybit wrote:
             | I totally agree. My personal opinion here is:
             | 
             | 1. They're stressed and therefor eating less, especially if
             | they're spending the daytimes of the tournament playing
             | games - hardly conducive to appetite, and in fact I expect
             | many will avoid food purposefully to try to not get that
             | sleepy-full feeling.
             | 
             | 2. To a much lesser degree, increased stress == increased
             | heartrate == increased BMR.
             | 
             | 3. Maybe, and I hate to speculate because of the stigma
             | (personally I don't care if chess players are doing drugs),
             | some amphetamine use, or at least caffeine, all of which
             | can suppress appetate further.
             | 
             | I personally very much doubt that it's the thinking hard
             | that's actually burning calories.
             | 
             | Unfortunately, I can't even read the linked post! It's
             | paywall'd.
        
             | bluGill wrote:
             | A pound of fat is 3500 calories. If a chess player eats
             | nothing at all they are unlikely to burn that many calories
             | in a day. Chess players do eat during a tournament.
             | Therefore weight loss must be water.
        
               | dekhn wrote:
               | That's not how weight loss works- you don't lose a pound
               | by "burning" fat.
        
               | Detrytus wrote:
               | How else would it work? You burn fat (as in: you turn it
               | into energy, powering your own living cells), turning it
               | into CO2 and H2O, which are then breathed out or expelled
               | with urine.
        
               | devmor wrote:
               | What? Yes it is. Your fat cells are turned into ATP via
               | Beta-oxidation and used for cellular energy. The excess
               | carbon from the processes is then exhaled as CO2 during
               | normal respiration and the water is sweated or urinated.
               | 
               | When you lose about 3500 calories of energy via this
               | process, you have burned a pound of fat.
        
             | ergonaught wrote:
             | Absolutely water weight.
             | 
             | I can drop 10 pounds this week trivially by triggering a
             | water flush (change in diet), essentially at will. Wife
             | absolutely hates it, but that's water weight.
        
           | lordnacho wrote:
           | Does amphetamine help concentration?
        
             | calamari4065 wrote:
             | Adderall is basically amphetamine.
        
               | tysam_and wrote:
               | That's like saying 'gasoline is basically an oil
               | product'. It literally _is_ mixed amphetamines, it's not
               | basically it.
        
             | Pyxl101 wrote:
             | Yes, it can. It provides a feeling of excitement or
             | enthusiasm for whatever you're doing, and can be channeled
             | into working hard for long periods of time. Especially if
             | your job already brings you some satisfaction, then doing
             | your job on amphetamine will provide more. Pilots in the
             | airforce (and possibly other warfighters) are given
             | amphetamine to augment their performance.
             | 
             | I think of it as basically stealing energy or enthusiasm
             | from the future, though. You might feel energized and
             | focused now, but it comes at the expense of less energy and
             | focus when the drug wears off. The withdrawal effect is
             | pretty mild if you take prescription doses of it though,
             | e.g. Adderall (which is amphetamine). At normal moderate
             | doses, taken in the morning, almost all of that energy can
             | be recouped during sleep (though not all). I wouldn't want
             | to take it daily for a long period of time though,
             | otherwise you'll build up an 'energy deficit' that could
             | lead to a crash.
             | 
             | P.S. I know people who have essentially destroyed their
             | lives by becoming addicted to amphetamine or meth. It's a
             | dangerous drug.
        
               | devmor wrote:
               | As someone who basically requires dextroamphetamine to
               | function, I've always found the notion of becoming
               | addicted to it crazy, nonetheless. If I don't set alarms
               | to take it, I will forget, for days at a time until I
               | suddenly realize why I haven't gotten much done and my
               | memory has been bad this week.
               | 
               | I wonder if there is something about the dopamine issues
               | of the ADHD brain that prevents an addiction to
               | substances that aid it.
        
             | hereme888 wrote:
             | It depends. Raising those neurotransmitters (dopamine >
             | norepinephrine > serotonin) is a matter of balance.
             | 
             | If a person already has good levels and healthy receptors,
             | and they suddenly raise them too much, it just makes people
             | obsessive and actually not focus well on the important task
             | at hand.
             | 
             | It's a double-edged sword, always with warnings and side-
             | effects.
        
               | mewpmewp2 wrote:
               | Although if you are playing chess, obsessiveness with the
               | game would probably be good. But of course it will vary
               | greatly from person to person.
        
               | hereme888 wrote:
               | Actually, the sort of obsessiveness it produces
               | diminishes the ability to switch attention, so people get
               | obsessed over a particular train of thought and are
               | unable to evaluate other strategies. Basically you end up
               | obsessed over that one strategy, and motivated to do it,
               | instead of taking a step back to re-assess.
        
             | groby_b wrote:
             | Only if you have ADHD.
             | 
             | If you don't, it's negatively impacting mental performance
             | - but it's really good at helping you to deliver slightly
             | subpar performance for grossly extended periods of time.
             | (Common uses: Crisis situations where you cannot step away.
             | Cramming for exams)
             | 
             | I suppose you could call this a different form of
             | concentration, but AIUI it's more energy than
             | concentration.
        
             | tysam_and wrote:
             | Yes, and sometimes people view it as a zero net drug, but
             | it's not always a 1:1 relationship of borrowing from the
             | future. It's significantly helped me, and there are some
             | downsides, but the benefits have been far greater than the
             | negatives (and having the extra motivation is...incredible
             | since my brain does not really do that all that much
             | naturally).
        
           | tambourine_man wrote:
           | I've been tapping my foot ferociously since I was a kid and
           | the most I've been "on" is caffeine. Lots of it, though, but
           | the taping helps me even when I'm not drinking coffee.
        
             | Obscurity4340 wrote:
             | Not that its representative necessarily but have you been
             | screened for AD(H)D, the leg and foot tapping/shaking was
             | always a big thing for me. And its not parkinsons lol,
             | otherwise I've had it my whole life ;)
        
             | djbusby wrote:
             | Tapping or that thing where you keep the ball of the foot
             | on the floor and then shake the leg like trying to double-
             | bass hit a-la John Bonham? That's the one I do. Annoys the
             | heck out of everyone around cause it shakes things. So they
             | say Stop! Then get frustrated with my too-loud typing or
             | humming or... whatever, gotta let that excess energy out
             | somehow.
             | 
             | Interrupting my focus state with "why are you doing that?"
             | - doing what?
        
         | pikma wrote:
         | There's another thread linking the same article, and it's very
         | unclear that this loss of weight is caused by the mental
         | effort.
         | 
         | If thinking hard required a lot of energy, wouldn't we expect
         | that thinking hard would cause an increased heart rate and
         | faster breathing?
        
           | sva_ wrote:
           | It is a bit confusing to me because it is often said that the
           | brain draws about the same amount of energy, no matter what.
           | Perhaps people also eat less during tournaments.
        
         | MichaelDickens wrote:
         | ~~This is not true.~~ (edited to clarify, see [2]) Robert
         | Sapolsky's research approximated calorie expenditure using a
         | highly inaccurate methodology. Troubat et al. 2008[1] estimated
         | calorie expenditure by measuring chess players' respiration and
         | found that they only burned 10% more calories than normal.
         | 
         | And anyway, the claim that chess players lose 1 pound per day
         | does not pass a basic sanity check. 1 pound of fat = 3500
         | calories. If you raised all that energy instantaneously in the
         | brain, it would raise brain temperature by around 2500 C (the
         | average brain weighs ~1.5 kg and the brain is mostly water so I
         | figure 1 Calorie ~= 1 degree C per kg). Obviously the energy
         | doesn't release all at once and it wouldn't all be released by
         | the brain, but that's still an implausibly high energy
         | expenditure.
         | 
         | [1] https://pubmed.ncbi.nlm.nih.gov/18987876/
         | 
         | [2] When I said "this is not true", I was thinking of the claim
         | from the linked article that chess players burn 6000 calories
         | per day, which is definitely false. Upon re-reading, I realized
         | the parent comment did not actually make this claim. I am
         | agnostic as to whether chess players lose 1 pound per day
         | during tournaments, but if they do, it's definitely not because
         | they're burning 1 extra pound of fat. It's plausible that
         | they're eating much less and/or losing water weight.
        
           | cactusplant7374 wrote:
           | Thanks for the write up. I always wondered about this.
        
       | mtrees_io wrote:
       | Water is wet. I think we need a scientific analysis of "duh"
        
         | esalman wrote:
         | Water wouldn't be so wet if you were cognitively challenged.
        
         | rzzzt wrote:
         | That's another rabbit hole altogether: is water wet or does it
         | merely make other things wet?
        
           | stillbourne wrote:
           | Is water the only wet thing? Because when I'm drying my
           | liquid solvents I'm only removing the water. Is 100% ethanol
           | still "wet?"
        
             | mtrees_io wrote:
             | Ladies and gentlemen, gather 'round as we reflect upon the
             | profound wisdom imparted by the Log from Ren and Stimpy. In
             | the sacred realm of the animated, behold the Log -- a
             | symbol, a metaphor, a wooden beacon lighting the path to
             | enlightenment.
             | 
             | Just as the Log rolls through the whimsical landscapes of
             | Ren and Stimpy's world, so too must we navigate the terrain
             | of job applications. The Log teaches us perseverance, for
             | even when faced with absurd challenges, it continues its
             | journey with stoic determination.
             | 
             | Applying to jobs, my friends, is akin to riding the Log of
             | life. We must embrace the twists and turns, the
             | uncertainties of the job market, with the same unyielding
             | spirit. For just as the Log is steadfast in its purpose, so
             | should we be in our pursuit of meaningful employment.
             | 
             | And lo, let us draw inspiration from the Log Song itself --
             | a melodic reminder that sometimes, in the chaos of job
             | hunting, it's crucial to find joy in the simplicity of the
             | process. Whether it's singing about our resumes or crafting
             | cover letters, let the Log be our guide to finding humor
             | and joy in the journey.
             | 
             | In conclusion, my dear congregation, as we face the job
             | market, let the Log's unwavering resolve inspire us to roll
             | forward with resilience and a sprinkle of absurdity. For in
             | the grand tapestry of employment, each of us is but a log
             | on the river of life, floating toward new opportunities and
             | adventures. Amen.
        
             | telios wrote:
             | A dry bar lacks water, not ethanol, and dry cleaning still
             | uses liquids, so I'd argue even the colloquial definition
             | is water.
        
       | mesarvagya wrote:
       | There was a discussion sometime back in reddit [1]:
       | 
       | The conclusion: Pushing brain to its limit requires a lot of
       | energy.
       | 
       | https://www.reddit.com/r/todayilearned/comments/17ms04d/til_...
        
       | nullhole wrote:
       | What's the difference between feeling tired and being tired?
       | 
       | (I'm not going to pay 30 bucks to read the article, so it may
       | answer that question)
        
       | wouldbecouldbe wrote:
       | https://archive.li/WJCMC
        
       | b33j0r wrote:
       | So, ATP is a thing. The chemical bonds store the energy, then we
       | waste that on puns and being mad at our birth.
       | 
       | Just don't tell Steve Lukather, somehow he never stops touring.
       | Totolly badass.
        
       | djokkataja wrote:
       | Previous discussion:
       | https://news.ycombinator.com/item?id=32430395
        
       | anonymousDan wrote:
       | So is there any proven way to train yourself to have more
       | endurance wrt your ability to think hard? Would be an interesting
       | line of research...
        
       | mdaniel wrote:
       | previous commentary:
       | https://news.ycombinator.com/item?id=32430395 (2022; 189
       | comments)
        
       | CapitalistCartr wrote:
       | I learned the real meaning of the word "thinking" the first time
       | I was at 4400m and had to pitch my tent. Thinking really does use
       | oxygen and effort.
        
       | blastro wrote:
       | Brain requires 12x the amount of oxygen per cell as a muscle
       | does. Brain is most expensive organ in body.
        
         | m3kw9 wrote:
         | Actually cheap because it does the most
        
           | fnordpiglet wrote:
           | Mine just sits around and worries all day.
        
       | tysam_and wrote:
       | I have chronic fatigue issues that go in and out of remission,
       | and the buildup of glutamate seems to by far be the biggest
       | factor for me.
       | 
       | N-acetyl Cysteine and other blood glutamate scavengers (BGS) like
       | malic acid and pyruvate are indispensable in these scenarios.
       | They don't solve the issue but dampen it a bit.
       | 
       | Additionally, a ketogenic diet helped me a lot.
       | 
       | Most of all, high dose niacinamide holds it in remission at
       | times, though I have a theory it's caused by a well-set-in,
       | chronic infection as the reduction in symptoms with niacinamide
       | correlates with the symptoms of fighting off an infection (very
       | swollen lymph nodes, histamine release, sometimes nausea &etc,
       | headaches, some other clear indicators, etc). I've been on it for
       | about 7-8 weeks or so and we're still going!
       | 
       | That said, having energy is a gift that is hard to quantify.
       | Chronic fatigue takes away your ability to think about anything,
       | so you have to have discipline to not think about anything
       | sometimes...which also takes mental energy. It's a bit of a
       | living hell, for suresies.
       | 
       | Here's hoping I get to stay in remission. <3 :')))))
        
         | rpmisms wrote:
         | Have you been tested for Lyme? This is textbook Lyme disease.
        
           | ryeights wrote:
           | If you don't live in a Lyme-prone area, Lyme is unlikely and
           | your risk of a false positive is high
        
             | rpmisms wrote:
             | It's spreading rapidly. Worth a shot. Undiagnosed Lyme is
             | horrible and can cause serious long-term damage.
        
           | tysam_and wrote:
           | The world is much more complex than this, unfortunately,
           | there are a significant number of etiologies which result in
           | CFS-like symptoms, it's one of the less studied umbrellas out
           | there.
           | 
           | Lyme, babesiosis, rocky mountain spotted fever, etc, all
           | negative. I also did a urine Lyme DNA test a while back but
           | looking back on it, apparently that was not an extremely
           | reliable test (though the western blot has a decent amount of
           | false negatives as well).
           | 
           | I believe it's a chronic yeast infection that's slowly
           | traveled up under the skin of my left leg for the last 7
           | years or so. It started out as athletes foot in college, and
           | then when I got past the point of being too overwhelmed to
           | treat it, it had set in pretty well.
           | 
           | I wondered if the two were correlated, but over the past few
           | years I've had increasing leg pain in that area, and the same
           | pain in my toe where the infection was. Of course, the nature
           | of this infection is that seems to be resistant to many OTC
           | classes of antifungals, so it did not budge. The most
           | effective agent was carvacrol/thymol, which is extremely
           | broad range (even against MRSA), but it macerated the skin to
           | a point of strong pain, bleeding, etc, all that jazz. Even
           | when it cleared up on the outside, there was a deep white
           | patch under the skin that you could see under the (healthy-
           | seeming) skin, which, of course, is its own unique class of
           | horror.
           | 
           | About a year ago or so, I finally broke and decided to get
           | rid of the skin infection no matter what. I basically mixed
           | isopropyl alcohol and table vinegar and put it in the skin
           | after removing the top layer of dead skin, which as it was an
           | open wound was extremely painful. I used the reasoning that I
           | could temporarily damage the nerves with overexcitation via
           | the isopropyl alcohol stimulation, and that reasoning panned
           | out after an excruciating several days, after which my nerves
           | were damaged enough to no longer hurt under the raw vinegar
           | and alcohol combination.
           | 
           | That at least cleared up the surface infection until I was on
           | the Appalachian Trail this year (which, yes, I did my two
           | months on it with chronic fatigue + post exertional malaise
           | (!!!!) !), where, more than a year later, the infection
           | inexplicably came back again.
           | 
           | I found niacinamide in my search for treatment-resistant
           | infections, and it cleared up the surface infection within an
           | astounding 2-3 days. I started taking it orally, and became
           | extremely sick, it felt like I was being poisoned and doing a
           | mini-chemotherapy of sorts, so I slowed down and began taking
           | silymarin and NAC to help preserve liver and kidney function
           | (which seems to still remain okay so far).
           | 
           | The process of treating it has been painful, as the initial
           | days caused a huge flare in leg pain in my left leg
           | corresponding with swelling of the lymph nodes almost
           | exclusively on the left side of my body, oddly enough (though
           | it seems to have balanced out, a bit). I was in the emergency
           | room on my birthday last year due to the leg pain, and they
           | couldn't figure it out so they offered a potential umbrella
           | diagnosis of complex regional pain syndrome.
           | 
           | It's hard to keep up with dosing as I do have a bit of an
           | aversion to feeling sick -- it quite literally feels like I'm
           | being poisoned! -- but, my CMP from even this week came back
           | okay, and I'm getting a feeling of underlying 'rightness'
           | despite the transient negative symptoms (including having to
           | pee every 2-3 hours...not fun).
           | 
           | I've had maybe two dozen doctors, both in and out of the ER
           | (6 visits in the last year or so), or so give me that look of
           | not quite being able to know what to do. I applied to the
           | internal medicine program at the Mayo Clinic a few months ago
           | and got a form letter turning me down. It's not due to
           | incompetence, it's just that there is a long tail of
           | extremely complicated conditions that categorically fit an
           | umbrella of symptoms, but are extremely hard to actually
           | track down (and the semi-binarization of medical specialties
           | makes cross-disciplinary diagnosis extremely difficult for
           | these vague kinds of conditions).
           | 
           | I'm sitting here now and can feel the leg pain when I focus
           | on it, for example. But I think treating it is worth it --
           | especially as one has to work to live in many circumstances!
           | That said, this does not underpin how grateful I am to at
           | least have one avenue -- whether it's temporary or not --
           | where I can have energy.
           | 
           | This also doesn't cover things like the mast cell sensitivity
           | (diagnosed as not MCAS by _two_ separate immunologists,
           | though they both fall in the tryptase-test-philosophy camp).
           | I react to everything, including All Free and Clear
           | detergent, for example, and with food and such sometimes it's
           | just eating tons of meat (it's pure muscle protein and fat
           | and doesn't have things I can react to like lots of plants
           | do) and multivitamins to cover the nutritional gaps.
           | 
           | I wish it were as simple as just having Lyme disease, as I
           | think that would be much, much easier for me personally. But,
           | I suppose to keep living we have to accept the limitations
           | that we have (and unfortunately this is not the only journey
           | of limitation I'm on -- I also have autism to a mild-moderate
           | degree!), and I had a number of years where I really
           | struggled (like, really really struggled). But all of that
           | said, I think although it's taken a few years, I've come
           | around the bend in accepting the challenges I've been given,
           | and am on that upward walk of learning to enjoy the life that
           | I do have access to in the meantime. It's not perfect, and I
           | have a lot of big bumps in the road, for sure, but the slope
           | for me is pointed up, and that's what I wished for for years.
           | And I'm enjoying life a lot more than I have in the past, on
           | average! :')))) <3 <3 <3 <3 :'))))
           | 
           | Hope that answers your question.
        
             | rpmisms wrote:
             | Whoa, thank you for the comprehensive answer. I reach for
             | Lyme since it's one of the most common and under-diagnosed
             | diseases in this category, but you are definitely in your
             | own category here. Good luck, having something outside the
             | reach of standard antibiotics already makes doctors afraid,
             | and this would probably give an immunologist nightmares.
        
         | jonhohle wrote:
         | It sounds like you've looked into it thoroughly, but have you
         | had a blood iron test as well? My iron levels were not below
         | the normal range, but taking an iron supplement (Proferrin) was
         | profoundly impactful for me. I went from needing daily 1-2hr
         | naps back to a normal sleep cycle (and can even go on <7hrs
         | without feeling fatigue during the day).
        
           | tysam_and wrote:
           | Yes I tend to consume half a pound to a pound of red meat per
           | day (calories in -- rather extreme food sensitivities
           | unfortunately), so my iron levels are good.
        
         | rcfox wrote:
         | I'm curious how you came to start taking these supplements?
         | Were they prescribed by a doctor? Several of these appear to be
         | abundant in food (according to quick search results) so I
         | wonder if it's more of a digestion/absorption issue for you?
        
           | tysam_and wrote:
           | It took a reading a few thousand pages of ncbi.nlm.nih.gov
           | papers over a number of years (I made it a habit just to try
           | to crack this thing), this is one of those traditional 'fall
           | through the cracks' kinds of things. My PCP admitted to me
           | that she felt ashamed at not being able to help any further
           | and not knowing what to do, and she's internal medicine.
           | 
           | I have reactions to nearly every food group out there, even
           | things traditionally safe for many (minus the ultra safe
           | things like rice, lamb, etc).
           | 
           | It's definitely not a digestion/absorption issue, in fact I
           | have a reasonable belief that have barrier permeability
           | issues as things like taking GABA will result in respiratory
           | depression + temporary oxygen starvation for a few seconds -
           | half a minute or so (yay) followed by that emergency
           | contraction of blood vessels that the body does when trying
           | to get oxygen to muscles. That's one good indicator of
           | systemic barrier dysfunction, for example, as that is
           | certainly not supposed to happen in healthy people since GABA
           | is not supposed to cross the intestinal barrier (or the BBB
           | barrier for that matter) in healthy individuals (though I
           | wonder if one tiny benefit is making GABA slightly more
           | effective for me for anxiety over, say, the average person
           | due to potentially-increased BBB permeability). Additionally,
           | things like P-glycoprotein inhibitors (like piperine, etc)
           | cause me to react much more strongly to food/environmental
           | things.
           | 
           | Apples would contain, say, the most pyruvate and malic acid
           | (though I react to apples pretty badly, sadly, I'll get
           | arthritis-like symptoms (which makes typing and manipulating
           | objects difficult, for example), though I take an OTC 5-LOX
           | inhibitor nowadays that is actually surprisingly quite
           | effective at preventing things like that from happening in
           | accidental food exposures. Still not enough to have apples
           | straight though, lol).
           | 
           | So it's things like that. Most of this is things like looking
           | at the Krebs cycle, finding upstream things to targets that I
           | want that seem to perform well (like oxaloacetate, which is
           | sold at an outrageous price), and then putting them through
           | the empirical test pipeline to see if they hold up.
           | 
           | Things like niacinamide for example I'm taking 1.5-2. grams a
           | day which would be hard to get from food, pyruvate is also
           | hard to get from food as well. I love the idea of food as
           | medicine, but unfortunately it's mostly calories in (and
           | thankfully I don't seem to react to multivitamins, thank
           | God).
           | 
           | I've tried several thousands of dollars worth of supplements
           | over the last several years trying to find combinations that
           | work. This is most certainly harder than most of the machine
           | learning problems that I work on, as the loss signal is not
           | all that clear, really (unfortunately)!
           | 
           | I am glad to have found something that seems to have a
           | positive impact, however!
        
         | andai wrote:
         | >I have a theory it's caused by a well-set-in, chronic
         | infection
         | 
         | Have you looked into fungal overgrowth / candidiasis? Keto
         | seems to work for that too
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9583754/
        
       | willsmith72 wrote:
       | i'm glad studies like these exist, and hope we'll see more and
       | more like it in future. But as the article mentioned, the more
       | interesting part is the follow-up. How do you improve your
       | decision-making and reduce tiredness?
        
         | trealira wrote:
         | I've found that exercise helps. I try to jog and lift weights
         | regularly, but usually I exercise for a few months and stop for
         | a few months. When I don't exercise, I notice I'm a lot more
         | tired and feel significantly colder than when I work out.
         | 
         | Also, if I don't eat enough food, I feel tired throughout the
         | day as well. It makes me feel like I can't focus or think, but
         | then I'm fine after I eat. Maybe it's because I'm skinny.
        
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