Making it all Work

The Mystery Bug
Springtime this year was filled with a cautious optimism over the forthcoming road cycle racing season. Almost two years of a ketogenic diet and a full year practising exposure to cold temperatures – with no winter bugs or health setbacks – meant that it was perhaps time to see the fruits of all this effort. Naturally, the next thing that happened, immediately after the end of the ski season at the start of May was that out of nowhere a debilitating fever struck. Fifteen days of fever, involuntary fasting and hospitalization, plus another six weeks of recovery meant that there was now a considerable and unexpected setback.

Goals can sometimes be dynamic and shift. Summer’s goal would now be to climb back up that hill and try to get at least some athletic performance before the entire season was over. The problem was that for almost two years now, since stopping eating carbohydrates, performance was declining not improving and that was even without the debilitating fever thrown in. 2015 season had seen a change of plan where due to difficulty recovering from races I stopped participating early in the season and focused on a modified training program – the “Maffetone” approach. I wanted to be able to develop the capacity to work hard but at a lower and apparently more aerobic heart rate. Despite lots of nonsense on his website and from his forum moderator his logic appeared to be the best out there – so this meant avoiding any exercise classed as anaerobic so as to allow the underlying aerobic system to improve and grow properly. All the signs were that this was the right thing to do. My heart rate had been maxing out at 172 bpm (slowly declining with passing years) and yet I was often sustaining 165 or even 170 for an hour or so during training – obviously very anaerobic. According to Maffetone this would only be corrected by a long period of “pure aerobic” training due to any anaerobic work inhibiting aerobic development directly. In real terms this just meant endless plodding slowly on long bike trips or when running. To ease the boredom I got through some pretty heavy audio books that I’d never have the patience to sit down and actually read. By the end of Autumn 2015 this approach pretty much assured that any fitness that was there to begin with had gone. Moving forward to the May 2016 fever episode and putting on belly fat even on a ketogenic diet – things were really not looking good at all.
Maffetone also proposed a system of calculating an aerobic training heart rate for a threshold which he calls the “aerobic threshold”. Not only is it doubtful that such a thing exists but strict formulas are being used when we know there is a variation of up to 20% in heart rate between individuals. In this case I just used nasal breathing as a guide instead. Being able to breathe comfortably both in and out of the nose is a strong sign of aerobic function for several reasons,  plus the heart rate corresponding to it is not very far from Maffetone’s formula derived value. After about ten months of this pure boredom – winter included – not only was there no fitness remaining but all my enjoyment and enthusiasm had vanished. 

On top of all of the above I had totally changed technique – incorporating movement patterns taken from Chi Running. The goal was to develop more efficient movements, protecting the lower back and joints and using the core muscles and glutes more, instead of over-relying on the quads. Everything was counter intuitive but direct physical feedback made it clear that it was correct. Changing major movement patterns at my age after riding bicycles since being two years old definitely carries at least a temporary performance penalty.
To sum up  I had…  
  • lost  performance through major technique restructuring.
  • lost significant muscle and strength though fasting in 2014.
  • removed easy, fast energy from carbohydrates from August 2014 onwards.
  • lost all my fitness through Maffetone plodding from June 2015 through to March 2016.
  • been wiped out by an unknown bug in May 2016 that took months to recover from.

This took us to the start of July 2016 – so clearly much progress was being made!
Obviously any sensible person would call a halt to this nonsense by now – but being sensible is not one of my strongest traits. (My strength lies mainly in postponing things!) There were some clearly positive things happening too that just couldn’t be ignored. In fact one huge and completely unexpected thing had happened through the ketosis. Within months of removing most carbs from the diet my maximum measured heart rate had gone up from 172 to 192 bpm. Is that even possible? I’ve never heard of this happening to anyone – but that’s what happened. Despite all the formulas out there for calculating age related maximum heart rate (so that you can then deduce heart rate training zones) I happen to know that when people are not sedentary throughout their lives that their maximum heart rate remains the same at all ages – and in my late 20s it used to be 198 bpm. The heart is also supposed to work 28% more efficiently on ketones than on carbs so this is all quite interesting. Prior to sinking into terminal decline a few good races had shown that performances were apparently not impaired by ketosis – yet training was definitely rendered unappealing and sluggish. It seemed that only either adrenaline or carbs could get things started. When on carbs (all my life up to this point) I never needed to warm up – but now it felt like unless there was the adrenaline of competition (which causes glucose production) then a 40 minute warm up was needed – by which time I’d rather by 2/3rds through the entire workout. At least I now knew why people do warm ups – and why elite cyclists warm up for 40 minutes before a time trial.
In 2014 I’d done a lot of fasting – each week for 2 to 3 days and then intermittent fasting as well. Body weight dropped off but so did power so I was no faster cycling uphill when skinny as when fat. However the second positive aspect of ketosis was that there were no energy swings – no bonking – even on one race of almost 8 hours with no food.
Those positives plus the new found ability to cycle comfortably for an hour or two in sub zero temperatures in just a cycling shirt and shorts (part of the cold exposure effort to produce brown fat – linked into ketosis) meant that despite hitting rock bottom in May 2016 there was no serious option of returning to consuming carbohydrates.
To sum up the positives…
  • Maximum heart rate up from 172 (and slowly declining) to 192
  • No more energy swings or bonking
  • Cold Thermogenesis and Adaptation working extremely well (no pain even in freezing water)
Reset Button
Despite the determination to continue the rejection of carbohydrate consumption – which is difficult as they are thrown at us from all directions in modern society and especially in sports education – there was no obvious solution to the contradictory and mixed results. The necessary reset however wasn’t too complicated in the end. The bug was gone so it was also time to get rid of Maffetone and fasting – the things that were not proving productive in any way.
Maffetone turns out to be wrong for a fundamental reason – he totally ignores the “lactate shuttle” mechanism. This mechanism is a direct channel by which the mitochondria consumes lactic acid – which is produced by the anaerobic system.
Utterly Simplistic Explanation of the Anaerobic System
Anaerobic respiration is called glycolysis and it produces energy very rapidly – from glucose – but in small quantities. For a while the body can handle that so it’s used for running away from tigers. Obviously that won’t get you very far but it works if it gets you quickly to safety. When you do this you breathe very rapidly and in doing so expel lots of CO2. What this does is block oxygen supply to muscle tissues as it reduces carbonic acid levels in the blood practically instantly. Anerobic respiration doesn’t use oxygen and you go into anaerobic overdrive to escape that tiger. There are many other aspects but we’ll stick to the relevant ones here. The energy molecules produced are called ATP (Adenosine Triphosphate) and each glucose molecule gives us two ATP.  There is a byproduct called “pyruvate” and when in tiger evasion mode we really aren’t interested in it. However this very fast production of both ATP (burned up fast) and pyruvate (not burned up) ends up in a few minutes with a huge pile of pyruvate – which converts to Lactic Acid and then – to over simplify everything – clogs the system and brings us to a halt – probably resulting in a tasty tiger snack. This is what happens to you towards the end of a 400m sprint when the legs just seize. All of the above takes place in muscle cells.
Utterly Simplistic Explanation of the Aerobic System
Inside each muscle cell there are many thousands of much smaller cells – called “mitochondria” which have their own separate DNA. Way back billions of years ago they were actually separate bacteria – but that’s another story. The mitochondria are not interested in tigers – they are the nuclear reactors of the body. The ATP quantity produced by mitochondria is 15 times greater than by glycolysis. More impressively – per gram of weight mitochondria produces 10,000 times more energy than the sun. For fuel it uses the waste products of glycolysis – pyruvate and also fatty acids, ketones, protein and alcohol and the burning process is called aerobic – because it uses oxygen as a catalyst. As long as we don’t see a tiger the pyruvate is gobbled up fast enough that everything is processed in harmony and there is no conversion to lactic acid – so the anaerobic system just acts like a top up to the other fuels going into the mitochondria.
Utterly Simplistic Error of Maffetone
Maffetone’s claim is that any tiger based training stresses the system so much that the mitochondrial system cannot develop. However he misses one really big issue. The mitochondria are clever little critters and they can learn to love eating lactic acid directly. This is called the “lactate shuttle”. Instead of lactic acid clogging everything up it becomes dinner for the mitochondria. This means the body can operate at anaerobic heart rates and yet the mitochondria are not impaired at all – they love it and develop even faster. They don’t blow up either – provided your main source of energy in the first instance is fat. Considering the average untrained body has about 160,000 Calories of stored fat to use and only about 400 Calories of stored carbohydrates – the sensible choice is quite obvious.
In simple terms the training to maximise aerobic potential should involve intervals – but not super fast then super slow. The interval should consist of about 80% max for a few minutes followed by around 40% for a few minutes – repeated. Training occurs during the slow 40% phase due to the mitochondria eating up the lactic acid that was produced. If you go too slowly at this point they just go to sleep instead. Group cycling is great for this because you can pull like crazy in front for a while and then fall back and wheel suck to recover – boosting your mitochondrial nuclear reactor. Goodbye Maffetone!
Where else did Maffetone go wrong?
The simplistic “age based” formula for aerobic heart rate threshold covers up a huge issue which is even more significant than the one already discussed. The problem is hidden in the “WHY” age matters…
The Missing Link

Maffetone is basically saying to people that if you are old and slow then get used to it. You are not going to get much faster. Well think again! He might have had success with Ironman athletes in their prime but what happens when you take hardened couch potatoes and try to turn them into performance athletes? Likewise what happens when you remove sugar from lifelong carb addicts?
Utterly Simplistic Explanation of Ageing
The bottom line is that the nuclear reactors – the mitochondria – are the key – not carbs and not even specifically the training. Mitochondria use electrical charges from chemical sources. There are five engines in a chain in each mitochondria and each one of them can have blockages. Blockages cause electrons to spill out and they in turn create “free radicals” which wreak havoc on DNA and everything else. The mitochondria end up damaged, mutated and inefficient. This damage accumulates so that by your mid nineties as much a 95% of your mitochondria may be mutated and practically useless. Some animals have fairly electrically leaky mitochondria – rats being an example. The rat lives for about 4 years. Pigeons have a similar metabolism but with very non-leaky mitochondria so they can live for 35 years. However we do have some flexibility and so you can choose to some extent the path of the rat or the path of the pigeon.
The Path of the Pigeon:
  • Avoid overeating as it causes major electron leaks as there is too much ATP and so the engines are blocked while waiting for you to use up that ATP. Loads of free radicals are produced.
  • Avoid excessive carbohydrate consumption (considered normal levels today) which prevents fat metabolism and so deprives the mitochondria of its main fuel – forcing glycolysis to take over and producing high levels of free radicals.
  • Damaged, mutated mitochondria can be purged. The best way to purge them is through exercise. Exercise also stimulates biogenesis of new mitochondria.
  • PQQ (Pyrroloquinoline quinone) – literally found in stardust – stimulates mitochondrial biogenesis. Fortunately it is also found in dark chocolate and can be supplemented!
  • CoQ10 stops the engines from blocking – by age 40 we already lose half of our natural production – so take a supplement – 100mg to 200mg. This also acts directly as an antioxidant as well as stopping the electron leak.
  • L-Carnitine takes fatty acids into the mitochondria and empties the garbage. Like CoQ10 it diminishes significantly with age – supplement Acetyl-L-Carnitine 2 to 3 grams per day. This stops free radical production too.
  • ATP once used up leaves ADP behind and a difficult to produce sugar called D-Ribose is needed to provide the resources to turn this back into ATP. We lose D-Ribose with age so supplement 2 to 3 grams per day.
  • Brown fat does not lose electrons as they are simply turned into heat – which is what pigeons do and is why they live so long. Human babies do this too. We increase brown fat levels through Irisin (hormone – discovered June 2012) production from both endurance exercise and from adaptive exposure to cold. Take cold baths or showers regularly.

We don’t have fixed energy levels depending on age – they are dependent on how we take care of and feed our mitochondria. Treat the mitochondria right and your training will be able to safely follow – but no amount or type of training will sort out energy levels and performance without attending to this directly. Carbohydrate dependence masks this underlying issue (by ramping up glycolysis) and although it works for a while it will lead to trouble somewhere down the line. Those who have developed a solid aerobic system since youth appear to have an advantage which can be sustained throughout their lifetime – but this always appears to have its roots in very intense work – not in slow Maffetone style aerobic plodding.
The Test – Racing
Applying all of the above eventually I was ready to put it to the test in the Dromoise bike race in late September. The race was 119km long with around 1800m vertical of climbing. There is the race for the winner here of course but each competitor is also in a personal race constituted from all of those cyclists at a similar level. I must admit that the race was great for the first 70km, stimulating and exciting whether climbing or descending. Then at around 70km – after the descent from the second of three major climbs, my right leg went into complete cramp. The left leg was pretty close to doing the same but just managed to avoid locking up. That was the end of the race really. From this point onwards the battle was against myself more than against anyone else. Pushing on the pedals to accelerate was impossible so people who overtook couldn’t be chased and that leads to isolation. Holding a steady pace was possible but it was against the wind now for 50km and one big climb involved too. Several attacks of severe cramps eventually left the right upper quads in a bit of a mess by the end of the race. On the positive side the time was still good and within the so called “gold standard” for the age group and about 90th out of 144 in the age category – which was respectable considering most participants were keen club racers.
Since “feeding the mitochondria” my training had switched from being a tiring plod and difficult to recover from to being a stimulating pleasure with fairly fast recovery. This race felt the same – but now it was without carbs – not even eating during the 4hrs 36 minutes. The limit had simply been fitness. It takes more ATP to relax a muscle than to contract it – so when you overdo it the muscle just locks up in contraction. However, I had a plan for where to go from here. Two days of rest and the legs had fully recovered despite the cramps and energy levels were already high again. This ensured that both running and cycling training could be done and still provide a complete two day rest before the next race in exactly one week’s time.
Race 2 – Last Chance
This was actually my 3rd race of the season but not with all the right procedure in place. I was properly following “The Path of the Pigeon” now!
The “La Scott-Cimes du lac d’Annecy” is the last mountain race on the French calendar and would be my last chance to get things right this year. I didn’t expect to be ready as it was only one week after the Dromoise race but it seemed that recovery was good and there was no residual fatigue – though it rained hard during the night before the race and motivation was not strong.
Only two modifications were made to the huge pile of supplements for this race (BCAA – Branched Chain Amino Acids and stuff). Sodium bicarbonate and magnesium chloride were added. The baking soda is to stop cramps – just a teaspoonful in a water bottle. Some was taken before the race too with supplements – but one 700ml bottle to be used in the race had 500ml of mixed fruit juice with a huge pile of supplements and the bicarbonate added. The juice was only 10% sugars and when in ketosis the tolerable level of carbs is dynamic in relation to how many calories are burned in exercise – and it would be a lot on this day. The main reason for the juice was to make the horrible magnesium, sodium bicarbonate and all the rest of the supplements including Acetyl-L-Carnitine easier to swallow. Magnesium is used to relax muscle contraction. The “Rozana” mineral water I use has a high magnesium content already and magnesium chloride does cause diarrhea so only a small amount was added. You have to be careful because the mixture is explosive and I did have a significant eruption even through a supposed one way valve.
The “Scott” race is only 100km but with at least 2500m vertical. Being the final race of the season most competitors are at their fittest and the field is very strong. My only goal was to hopefully avoid another 50km of cramps. Quite stunningly I was able to maintain a high level of output from start to finish of the race – 4hrs 14mins. (I do my own timing for complete accuracy). What do I mean by “high level” of output? Over two and a half hours were spent with a heart rate between 165 and 175 bpm – with no drop off (Remember, 2 years ago my Hr max was only 172 bpm). During the final push to maintain position in the last 10km my heart was back up to 172 bpm – but a group of six working together annoyingly caught and overtook me just 100m from the finish line. During the race there were no stops and I only drank from the supplement bottle and one other 700ml bottle of water – no food. Breakfast had been high fat and protein – eggs, cheese and ham. This time I came 17th out of 30 in the age group in a significantly tougher race and was able to enjoy racing the whole way and not get dropped on the climbs. There were no energy dips, no cramps (thanks to the bicarbonate!) and it just felt good – better even than when being a carbohydrate addict and masking the mitochondrial issues by carb loading then guzzling gels and sugar during the race. With the carbs previously there were always energy swings and a need for more carbs. Heart rate would progressively lower during a race and by the end it would be impossible to raise it significantly. The carb dependent metabolism leans towards glycolysis and shuts down fat burning significantly. However, it appears that you can’t remove the carbs and hope to have energy unless you feed the mitochondria appropriately for your age and health.

The following link shows the Scott route through the Bauges Massif –  elevation profile, speed and heart rate data are included:
During the race there were five women who were at a similar level to me – which is great to see. Of course they were considerably younger but only one was still behind me at the end. Often I’d be surprised to catch up with people during the race. During the first climb from the start I overtook a lot of people and expected it to all end badly – but it didn’t. The second long climb was the hardest for me and I started to lose ground – but only by about 12 seconds behind the guys I’d been climbing with and easily recovered this on the following descent. It was after the second climb about 2 hours into the race that I started to drink from the supplement bottle. The third big climb – the Col de Prés – back up from Chambery into the Bauges Massif was scary because if it’s all going to turn pear shaped that’s where it will happen. I noticed that by switching off and just looking at the road in front of my wheel, concentrating only on the body, then I’d unexpectedly catch up with people. Looking ahead at the climb is just morally discouraging so it’s better to just focus in the moment instead. There was still a lot of climbing on the way back to the finish line but seeing that I couldn’t be dropped from the group that had formed was encouraging. In fact the last hour was the fastest by far, averaging almost 30 kph. On the flats against the wind there were always people to work with. My legs were starting to run out of steam during the last long gradual climb but heart level was still great and there were no cramps – so this was just a fitness issue being only the 3rd race of the year for me. The long descent to the finish found me isolated so I had to defend my position alone and the flats at the end are long, winding and interminable so it allowed a group working together to overtake me right before the finish line and there was nothing left in the legs to do anything about it.
After the race everything was good – but about 20 minutes later when talking to someone I found that talking caused a slight post-exercise asthma. I just had to relax the breathing – through the nose – for a few seconds and that disappeared.
Persistence and Information – Making it all work
Giving up the low carb diet would have been very easy when performance was just not really forthcoming and training tedious. However, performance has not been the goal – health has been the goal. Racing is just a testing ground and motivator – as well as a lot of fun. Nobody at age 58 races to win a race – they race to beat the negative forces that would otherwise turn them into useless, comfort dependent couch potatoes and junk food degenerates on multiple prescription drugs for chronic disease. They race to feel good – and it works. Without serious persistence and good information this just doesn’t happen. 
There are as many different metabolisms as there are people – each one being different just as their fingerprints are different so this can’t be ignored. Some people thrive on carbohydrates and others thrive on fat or protein – some in between. What we all have in common is a programmed decline in enzymatic support for the mitochondria. Some fight that off from a good base established in youth almost regardless of dietary abuse. It’s best however to find out what is genuinely right for you and to optimise health by having it all work harmoniously. The fact that there is a huge problem existing in general is seen by looking at the overall health of the population. In the US (which all other developed countries are usually not far behind) about 76% of the population is overweight with 36% of adults obese. Most people die from chronic sickness such a cardiovascular disease and cancer – despite a $3.75 Trillion medical industry. The third leading single cause of death is “Medical Errors” and depending on how it is rendered the information easily puts “Medicine” as the number one cause of death – in fact it’s a struggle to avoid representing it this way. The common denominator here is that doctors have practically zero training in nutrition – they are toxic drug dispensers.

What’s clear here is that 50 years of the general population being told to eat low fat and focus on fruit, grains and veg and to trust in doctors and government advice is totally wrong. The basis of good health should begin with ketosis – fat burning and flexible metabolism and expand out from that base. If the mitochondria is properly supported then if it doesn’t work well for you – then and only then might carbohydrates be the answer – otherwise most carbohydrates are extremely unnatural in our diet. Your body makes all the glucose it needs from fat and protein – it is NOT an essential nutrient and too much of it (as in the modern industrial diet) destroys the health of the majority of people – and limits sports performance in many.
Regarding competition there appears to be a sliding scale between…
  1. consciously doping and sacrificing health for results.
  2. unconsciously gorging on sugars with a closed down fat burning capacity.
  3. overcoming the sugar issue by overly intense and eventually destructive levels of training.
  4. a fat based diet with mitochondrial support and good long term health prospects.
It takes from 6 to 12 weeks to fully adapt the body to ketosis (fat burning) during which time there is an increase in uric acid. When properly adapted uric acid levels are lower than before starting the diet. Other than measuring breath ketones this is the best way to determine adaptation. Once adapted carbs can be eaten and processed without losing the fat burning capacity – as the metabolism is now “flexible”. The unadapted person cannot burn fat properly which is why they are subject to energy swings and bonking in competition. Excessive eating of carbs would kick someone out of ketosis but as long as it’s a “one off” the body returns to ketosis in a few hours and no re-adaption is necessary. During sports the best macronutrient supplements are Medium Chain Triglyceride oils like coconut oil as they are converted directly into ketones in the liver, simple carbohydrates as they won’t affect ketosis during exercise and the scale of consumption is dynamic – allowing more for greater or longer efforts and BCAAs (Branched Chain Amino Acids) which are broken down into glucose if required or used to repair and spare muscle tissue protein. However it’s the micro nutrients supporting the mitochondria (The Path of the Pigeon) which are the key as you start to age or just need a boost.
The motion pattern in Chi Cycling is different in that the hip moves backwards when the foot moves forwards on the pedal. This is the opposite of what people tend to do spontaneously. What this does is engage the core muscles in the recovery of the other leg. When sprinting or pushing really hard on a climb this connects the left and right through the core and the upper body can still remain relaxed and light on the handlebars if desired. It’s an amazing feeling. Part of the process concerns the timing of certain muscle use – everything starting at the centre – in front of the spine between the navel and the pelvis – the core, glutes and hamstrings engaging first to extend the hip then the quads and finally the calf muscles. Weight training is very similar in that you always work the big muscles first and end up with the little ones because otherwise if you tire out the little ones first then your session is already over. There’s a lot of awareness that gradually builds up with coordination and timing so that eventually the quads can once again be used at full power, body weight included in the pedal stroke and even pulling hard on the handlebars – but in an efficient manner that is in harmony with the body.
When all the other problems were mixed together it was impossible to know if the chi-cycling was working or not. It’s now becoming clear that it is great and works. It allows intelligent, dynamic alignment of the bone structure and access to undoubtedly a lifelong development potential that is just not present otherwise.
On the whole it’s unclear whether or not cold water immersion helps the body to recover from exercise. Personally I find that it certainly has a positive impact on stress and there is nothing better as a pick-me-up especially when it’s the day after a competition. Cold adaptation develops brown fat which is the safety valve for ATP that the pigeon uses and so helps overall mitochondrial health – so there will certainly be long term benefits of cold exposure at the mitochondrial level. Cold adaptation also re-wires the nervous system – especially the hypothalamus which controls body temperature regulation. The stimulation of pain (or temperature or both) receptors in the skin appears to be what triggers the adaptations – so there is no need to lower the body’s core temperature. It only takes about five sessions of cold exposure for pain to disappear in contact with cold water (from 0°C up to about 13°C ). The day after the Scott race Christiane and I swam for about 20 minutes in 12.5°C water and the feeling was excellent. Although shivering to warm up initially (sun was already down) later in the evening my body felt like someone suddenly turned a thermostat on – and that’s the famous Cold Thermogenesis kicking in – ATP being converted directly into heat without the need for mechanical action. 
Christiane getting into the lake 12.5°C still  looking great at 61 years old – must be doing something right!

Heart Rate Variability (HRV) 

Measuring HRV is a great way to independently gauge what is happening with your training. It is recognised as a clear way to spot over-training. All you need is a good heart rate monitor and a phone or tablet that will connect with it. There are several good apps but I like “Cardiomood” on Android best of all. My Mio Global Fuse LED wrist HRM is excellent too – far better and more reliable than any chest strap I ever used – and I’ve quite a collection of those. 
Last year all the indications I had were of over-training despite not doing a great deal. The HRV indicated that the Parasympathetic Autonomic Nervous System (ANS) was suppressing my resting heart rate at 36 bpm and body stress was constantly relatively high. I do have “athletes heart” which is fairly common – being an enlargement of the heart muscles. However I hadn’t until then considered this as a problem – other than knowing someone who had trouble getting insurance specifically because of that. It turns out though that the heart depends very heavily on mitochondria – so that also means it depends on CoQ10 and L-Carnitine. It is so dependent that someone with a debilitating heart blockage getting only 10% of normal oxygen to the heart can be returned to normal activity with just those compounds alone – the heart works so much more efficiently at the mitochondrial level when those nutrients are available. Needless to say it appears now – as with Maffetone’s hypotheses – that the ANS was not the issue at all – but low CoQ10, L-Carnitine and D-Ribose. Since supplementing my stress levels the day following a competition have been astonishingly low – around 24 on a scale that goes over 800 (850 being seen when training after the fever in May) – with a resting heart rate now around 46 instead of bottoming out at 36 and blood pressure averaging around 115/65.

Perhaps not only sports issues are being represented incorrectly due to unawareness of mitochondrial health – but also excess weight. It’s certainly a significant part of that puzzle too.

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