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Please help me identify what is causing the tingles.

vrk3dsvrk3ds
in General Training Discussions

Sure hoping someone has ran across this problem before, because its about to drive me nuts.

So I had my Big Day (1hr swim, 4 hr bike, 1 hr run) yesterday, and everything seem to be going great. I felt that my nutrition was spot on, pacing was great (.71 IF for 4 hr ride), and overall the run felt fine as well. I finished up at our local YMCA, which is a 20 minute drive home, and stopped off at a Convenience store just around the corner to get my post race chocolate milk. Felt fine driving home, unloading bike, car, etc...

Then I sat down, put my legs up, and bam it started. The feeling can be described as all over numbness, and tingling. I sat in the chair for an hour trying not to puke, pass out, or basically move until the feeling stopped.

Any idea what the hell was going on with my body? This is not the first time this has happened to me either. When I was training for IMLT in 2013, I had the same sensation about 30 mins into my run on another Big Day, and had to struggle back to the YMCA, where I had to sit for about 30 mins until it quit.

I'm not sure if my blood sugar is crashing, I'm bonking, or what, but need to get to the bottom of it ASAP.

The best way I can describe the feeling, is if you have ever had a bad case of the flu, and end up vomiting, the feeling you have afterwards where your body is numb (Touch two fingers together and you can't feel the ends of your fingers, and or everything has a tingly sensation)

Thanks for any ideas on where to start, what to possibly test for, etc...

Comments

  • Chris DavisChris Davis
    Scott,

    What were some of the details on your nutrition? I suffered through something similar on my lead up to IMTX, and the rest of the team said it had to do with too many calories, especially on the run. I wasn't smart enough to ask about it until the week before IMTX, so I never really solved it, but want to hear what others have to say.
  • vrk3dsvrk3ds
    So breakfast was bulletproof coffee, steel cut oats, and my vitamins via nun all day.

    I had 6 bottles of water with nuun 3 servings of ucan, 2 honey stinger waffles, 2 chia bars, 3 margarita shot blocks per hour. Approx 400 cal/hr.

    Afterwards I had pint of chocolate milk think it was about 700 cals, and a liter of water.

    I didn't think it was crazy since I trained on approx 600 cals/hr for Tahoe in 2013. Only difference is I'm trying to cut out the sugar drip.
  • rlh2000rlh2000
    My first guess would be you need more salt?
  • Chris DavisChris Davis
    I know you may not think it, but you're in a GREAT position. You're picking up on the problem early in training and still have BOTH race rehearsals (and normal workouts too) to work out the kinks in nutrition and execution. So you have a chance to experiment with what people say here.

    Sounds like I may be re-hashing some stuff for you, but you might want to read through all the race nutrition stuff here:
    http://members.endurancenation.us/Resources/Wiki/tabid/91/Default.aspx?topic=Nutrition+Central

    And especially the nutrition calculator excel spreadsheet found here:
    http://members.endurancenation.us/Resources/Wiki/tabid/91/Default.aspx?topic=Ironman+Nutrition+Calculator

    I was 185 on race day, and the EN calculator had me taking in 465 cals/hr on the bike, and then kick back to 300 cals/hr on the run. When I got the same feeling that you're describing above, I was actually ingesting about 520 on the bike and 440 on the run (that was my second race rehearsal).

    If I were in your shoes, I'd keep doing what you're doing on the bike, but maybe look at dialing back calories on the run, based on what the EN nutrition calculator says for a guy your weight.
  • Ed EovinoEd Eovino
    Scott... I'd suggest you watch this... You might want to tweak your plan to be a little more in line with Jesse's recommendations. I know Coach P follow his advice pretty closely... and we all know what kind of beast he is!

    http://members.endurancenation.us/Resources/Wiki/tabid/91/Default.aspx?topic=Race+Fueling+Webinar+(Jesse+Kropelnicki)
  • William JenksWilliam Jenks
    I can't be specific with the symptoms you've had, but I am reasonably certain that virtually all of my related-sounding issues (not quite the same) have been related to dehydration or other gut-related problems.

    Have you done a trial long ride, just drinking a LOT of sports drink of choice and forgetting all those solids? On a warm day, I'm drinking up to 72 oz of fluids an hour. Doing that with normal sports drink (and a bit of straight water sometimes if I'm sick of the drink) ensures that there's no problem with hyponatremia. I would think that you could get very close to your calorie goals with minimal supplementation (a gel or two as needed).
  • Stephanie HartmannStephanie Hartmann

    If you use the UCAN properly, you don't really need all the other food, which in my case, sits in my gut. More liquids, maybe some salt? If I add salt to the gatorade it's not only tolerable but kind of tasty (think margarita). Just a thought, I certainly am no expert, just a beginner. Miami is a tough place to stay hydrated and food seems to just inhibit hydration for me. I get a tingly scalp and a sugar belly if I have anything other than a bite or two of a power bar.

  • rlh2000rlh2000
    Cubital tunnel causes very specific patterns of numbness, not the "all over" numbness and tingling. Sounds to me to be more systemic and related to nutrition rather than nerve entrapment.
  • morpheusmorpheus

    I'm on the same page as Jenks.

    Can you connect these episodes with Hi Volume or Hi Intensity Workouts with very hot / very humid days?


    N. Carolina isn't that far from here so I know you're cooking outside. 6 bottles of fluids isn't that much hydration for a 6 hr day. It's very tough to beat the inconvenience of a self supported 2-3 bottle per hour ride. Because of that, we tend to reduce the number of bottles we consume.



    This is why I dig 1-2 hr loops with a cooler stashed for reloads. I also try to bring 1 bottle of water that was frozen overnight. This is great for pouring over my head and swigging hydration that doesn't have that gunky feeling. I tend to overheat easily and this really helps me.



    Sounds, to me, like this might be something to at least consider. How to stay cool / Hydration in addition to number of cals and electrolytes.
  • Nate ParadyNate Parady
    sounds like dehydration to me. how many times did you pee during your training event? was there much time between the end of your swim and the start of your bike...were you drinking while transitioning?
    On a hot day above say 85, I'm right around 40oz of sports drink an hour just to maintain. especially if I'm going to run for an hour afterwards. Once the run stops I keep drinking...
  • vrk3dsvrk3ds

    Update after my last RR for IMChoo. 

    Conditions for the day was starting temp at 84 degrees, cloudy, very humid, temp dropped into the low 70's and then built back up to low 80's by start of run.

     So did my last RR on Saturday, and had a great ride, managed my nutrition with 48 oz of Gatorade Endurance /hr, 2 Margherita Cliff Blocks, and on S Cap. SO those numbers break down to:

    380 Cal/hr

    99.5 CHO

    1764 sodium/hr

    595 potassium/hr

    I pee'd 5 times on the bike, and once more in transition before running. Had a great run but about 40 mins into a 60 min run my fingertips started tingling, and by the end it was another full blown tingly episode. I feel that it wasn't dehydration causing it so wondering what else it could be? Coach P thought it might be Potassium, but it looks like I had plenty of that through my nutrition plan? Since it was cooler than what I have been training in could I have had to much Sodium/Potassium? Upon finishing my brick, I immediately drank about 4-6 oz of dill pickle juice, and that seemed to keep the tingles from getting really bad, but it still took about 30-45 mins to subside?

     

    Any suggestions, help would be greatly appreciated since I am now 2 weeks out from IMChoo, and don't want to experience this on race day?

     

    Thanks,

     

     

  • Leslie KnightLeslie Knight
    Scott, which fingers is it? Thumb, index, middle are innervated by one nerve and ring/pinkie by another. Is it all of them or does it fit one of these patterns? I wonder if you are having some swelling that is causing a nerve to be compressed. I have had this very mildly and couple of times. Pregnant ladies and obese people occasionally get it. It could also be the way you are holding your arms or neck that could pinch something. Is it both sides or just one? I'd be surprised if this were electrolytes, considering it sounds like you have plenty of them on board.
  • vrk3dsvrk3ds
    starts in all of the fingertips, but ends up pretty much all over, most noticeably in my hands and feet. Best way to describe it is the sensation you get after puking from the flu, where the room is spinning, entire body is having the pins and needles feeling. I was able to stop it from getting that bad this time, but the last time it happened it was that bad!
  • morpheusmorpheus
    That's alot of sodium, even for us.

    2 bottles/hr and peeing 6x does make it easy to move past dehydration.

    I expect you've nailed the sweat test. But, 1.7g Na per hour is very aggressive. Just based on this thread, that amount of sodium is the biggest outlier (sp?...like that's ever mattered to me.) in the bunch.

    Maybe someone else sees something differently.



  • Chris DavisChris Davis
    Just as a smell test, I looked at how much salt sweat has in it. I just read that sweat has 2.25 to 3.4 grams of salt per liter. That means your sweat has 632 to 956 mg of sodium per 24 oz of sweat. If you did the sweat test right, and really do require 48 oz of sports drink per hour, then you would need to be replacing between 1264 and 1912 mg of sodium per hour. Your 1764 mg of sodium passes that test, but is on the higher end of the range.

    Is it possible you're getting TOO MUCH salt? I just read the symptoms section of this page on hypernatremia:

    http://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypernatremia

    In a few words, it says when you get too much sodium a few things occur:
    1. neuromuscular excitability (tingling?)
    2. Your body will try to get rid of the extra salt via excessive peeing and/or vomiting (6 times?!?!)

    I'm not a doctor, and I didn't sleep at holiday inn last night, so there is a ton in that article that I dont understand. Maybe a doctor type will chime in about what it says...
  • jalesliejaleslie

    Well, I am a doctor and so feel obliged to say something.   That said, I honestly have no idea what to tell you.  Perhaps it's because I too did not sleep at a Holiday Inn last night.  

    I doubt it was true hypernatremia, as normal kidneys SHOULD be able to handle pretty much anything you throw at them.  That being said, we do "test the limits" on these days.  Most cases of hypernatremia occur with dehydration at the same time, and it does not sound like that was going on for you with 5 voids on the bike.  My GUESS would be too much sodium though, given that nothing else makes sense.  Do you really need the Salt capsule?  Or, I think you could back off on your fluids in similar weather (not particularly hot) as 5 voids is almost one an hour which suggests "overhydration".  

    For what it's worth, I had the same symptoms (although hands only) at IMTX last year towards the end of the run.  I didn't know why or what to, so I just continued my routine and it went away within 10-20minutes.  That's the only time I've experienced it.  Interestingly, I also voided about 5x on the bike that day, which was more than I ever have in any other race or RR.  

    Sorry I can't be more helpful.  

  • gurjsdgurjsd
    I just thought i'd drop in my opinion on this - as I had experienced something VERY similar about a month back.
    After a 6am morning brick session, everything was fine. Got home, showered, grabbed some fruit and off to work I went.

    However, when I got to work, sat down on my seat - started to get a 'tingly' sensation. Felt mildly sick (in the stomach) but the sensation soon passed. Now, the only difference that morning was that I 'may' have put too much BCAA and High5 powder in to my drinks bottle. I've read somewhere that a high level of nitrates can cause some dysfunction.

    I decided to test this theory a few days later, incase I thought it was a bad batch of either the BCAA or High5 tablets. And after self experiment, I found that I got the same feeling as I did that morning.

    So, the question I ask you - what did you drink that morning? Could you have mildly overdosed on nitrates.
    Its also interesting to note, that I felt fine during both workouts. It was only after that the feeling stepped in.

    G
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