[defurr]

BACKGROUND: In May 2014, I experienced a mild but noticeable diffuse axonal concussion from excessive head shaking. Primary symptoms were extreme exhaustion and brain fog that lifted after about two weeks, but I continued to be unable to eat high glycemic foods (potatoes) without a headache, and any significant accidental jarring would produce temporary dizziness (<24 hours).

I was symptom-free (aside from avoiding potatoes) for about six months, and stopped taking curcumin, aminos, and green tea extract. Stayed on B, D, fish oil.

Two weeks ago, my hair dresser gave me an excessively vigorous head scrubbing. Light-headed sensation and brain fog ensued (along with sensitivity to loud noises), and unlike on previous occasions, did not relent after the first 24 hours. So I'm back on all of the usual supplements (plus creatine and pantethine), trying to sleep 7-8 hours/night, and doing 30 minutes of daily zen meditation.

My two questions are these:

ONE, MORNINGS: I have begun to notice some improvement, feeling pretty normal, but generally towards late afternoon and lasting until bedtime. Mornings are still light-headed fog, even with lots of sleep. Is this because my supplements are gradually kicking in? Why would mornings be worse? I've started doing green tea in afternoons. Caffeine (even a touch of coffee) seems to help.

TWO, EXERTION: I have historically been an exercise addict, lots of road cycling. I have stopped completely, so as to keep heart rate <100 BPM. Is this preferred until symptoms subside almost completely? I can ride a trainer in my house to minimize bumps/jarring and temperature, but if heart rate is a concern during the initial healing phase, then I will continue to hold off on that. (I rode trainer two times the first weekend this happened, before I realized that this one was going to stick around longer than normal.)

Any insights and wisdom are welcomed. Sorry for the long narrative, and I always feel a bit abashed writing on this forum, given how much more debilitating some of your symptoms are.

[Mark in Idaho]

The only reason to minimize exercise is when increased heart rate causes headaches. If exercise does not cause headaches, there is no reason to stop or reduce exercise.

You have your own supplements regimen. I don't have any response to that question. I doubt anyone will because some of your supplements are unique to you.

Originally Posted by defurr

BACKGROUND: In May 2014, I experienced a mild but noticeable diffuse axonal concussion from excessive head shaking. Primary symptoms were extreme exhaustion and brain fog that lifted after about two weeks, but I continued to be unable to eat high glycemic foods (potatoes) without a headache, and any significant accidental jarring would produce temporary dizziness (<24 hours).

I was symptom-free (aside from avoiding potatoes) for about six months, and stopped taking curcumin, aminos, and green tea. Stayed on B, D, fish oil.

Two weeks ago, my hair dresser gave me an excessively vigorous head scrubbing. Light-headed sensation and brain fog ensued (along with sensitivity to loud noises), and unlike on previous occasions, did not relent after the first 24 hours. So I'm back on all of the usual supplements (plus creatine and pantethine), trying to sleep 7-8 hours/night, and doing 30 minutes of daily zen meditation.

My two questions are these:

ONE, MORNINGS: I have begun to notice some improvement, feeling pretty normal, but generally towards late afternoon and lasting until bedtime. Mornings are still light-headed fog, even with lots of sleep. Is this because my supplements are gradually kicking in? Why would mornings be worse? I've started doing green tea in afternoons. Caffeine (even a touch of coffee) seems to help.

TWO, EXERTION: I have historically been an exercise addict, lots of road cycling. I have stopped completely, so as to keep heart rate <100 BPM. Is this preferred until symptoms subside almost completely? I can ride a trainer in my house to minimize bumps/jarring and temperature, but if heart rate is a concern during the initial healing phase, then I will continue to hold off on that. (I rode trainer two times the first weekend this happened, before I realized that this one was going to stick around longer than normal.)

Any insights and wisdom are welcomed. Sorry for the long narrative, and I always feel a bit abashed writing on this forum, given how much more debilitating some of your symptoms are.

[defurr]

Originally Posted by Mark in Idaho

You have your own supplements regimen. I don't have any response to that question. I doubt anyone will because some of your supplements are unique to you.

My second question is not about the suitability of my supplement regime, but rather if anyone has any ideas about why symptoms would be most intense in the morning, even after a good night's sleep, and then gradually fade throughout the day? The gradual absorption/assimilation of my morning pill pile was one of the only ideas I had.

Good to know about exercise. I will resume post-haste. Thanks for the response, Mark.

[MicroMan]

G'day Daffur,

It seems to me that you're pretty thoughtful in taking care of yourself. My only comment would relate to exercise. Regardless of what expert you speak to, exercise will always be one of the recommended components of your recovery. The extent to which you should do this depends on the nature of your concussion (physiologic, cervicogenic, or other comorbidities [i.e. depression, etc.]).

I'd recommend you look up some of J. Leddy's research at the Univ. of Buffalo (http://www.ubortho.buffalo.edu/concussion/leddy.html). His group has established an exercise regimen for the recovery and return to play for student athletes. It involves progressively increasing your exercise/HR without causing increased symptoms; if symptoms increase/return, that level of activity is deemed too much and the student must recover from the event before exercising again.

Anyway, the point is that exercise is considered important to recovery. Unfortunately for me, I seem to be very intolerant to physical activity but am working at improving this. Hopefully you're more tolerant and will be able to exercise without symptom exacerbation in the near future!

Originally Posted by defurr

My second question is not about the suitability of my supplement regime, but rather if anyone has any ideas about why symptoms would be most intense in the morning, even after a good night's sleep, and then gradually fade throughout the day? The gradual absorption/assimilation of my morning pill pile was one of the only ideas I had.

Good to know about exercise. I will resume post-haste. Thanks for the response, Mark.

You could be having a blood sugar issue. Since you are not eating for 8-12 hours when you are sleeping, your blood sugar can become unstable. The fact it gets better throughout the day gives me the idea it could be that as well since it could be related to the fact it stabilizes once you start eating.

Could be something to look into.

[Mark in Idaho]

I should have thought of the blood sugar idea. My wife used to take my son a glass of orange juice when she woke him for school. Otherwise, he was grumpy until after he ate.

Fasting hypoglycemia is not uncommon. 7 to 8 hours after a meal, the body often needs to start relying on the liver for energy. For some, this is not adequate.

I need to eat before going to bed or I struggle to sleep through the night as I hit that fasting hypoglycemia by early in the morning.

MM, I was alluding to Leddy's concepts when I mentioned heart rate and headaches. His primary indicator for lowering exercise pulse rate is headaches.

btw, Many use caffeine to force through this low blood sugar issue. This can cause even worse problems over the long run.

[defurr]

This is an interesting idea, but I think I've got blood sugar covered. See below and feel free to disagree... My sleep/meal schedule is as follows:

• Sleep 11PM to 6AM, eat at 7AM.
• I have a big breakfast: veggie shake, oatmeal (peanut butter and bananas), and an omelette with sausage.
• Snack at 11AM: nuts and flax seed crackers
• Lunch at 2PM: Chipotle burrito bowl
• Snack at 6PM: pizza and chicken leg
• Dinner right before bedtime: various

It's almost as if it has to do with me relaxing as the day goes along. I'm more of a night person, anyway. It's like I stop worrying about my condition, and it rewards me by dissipating. I would fear psychosomatic illusion, were it not for the loud noise sensitivity, which seems too spontaneous to be imagined.

[donniedarko]

I haven't been able to find an answer to the reason behind this but I also feel the worst in the morning, and a lot better in the evening hours. I have seen other people mention it in this forum as well, so it's not uncommon. I'm going to an endocrinologist this week to get tested to see if it may be a hormonal issue.

[defurr]

That's an interesting angle... I can well imagine that hormones shift throughout the day, according to stress levels, etc. I got a blood test about five years ago wherein I was flagged as having low testosterone-- which was odd because I don't suffer from low libido or motivation.

I've been pondering DHEA but haven't yet researched potential side effects. WebMD cites potential hair loss... not good. I am hyper-vigilant about not consuming products with phthalates, BPA, or other xenoestrogens (no bottled water of any kind, etc.).

Donnie, keep us posted on your endocrinologist visit.

[Mark in Idaho]

DHEA is the quarterback of hormones. It can be tested with a blood test.

I take 12.5 mgs of DHEA daily. My T is low but T cream makes my face break out. If I take 25 mgs of DHEA, my face gets really oily. T can cause hair loss. DHEA does not appear to effect my hair. It got thin before I started the T or DHEA.

Sleeping 7 hours does not mean good restorative sleep. Not a comment on your sleep, just a comment about sleep. Eating right before bed can effect quality of sleep. Digestion takes a lot of energy. That energy could be taken from the energy your brain needs. You might consider a lighter meal before bed.