Headache After Walking
Q: I get a headache after I walk. What could be causing it?
A: Typically headaches that come on during or after exercise are the result of low blood sugar. If you do not normally suffer from migraines, then hyperventilation or exercise-induced asthma, stress, or muscle strain can also cause headaches.
One way to identify the cause behind chronic headaches is with VO2 testing. This is a test that monitors a patient’s oxygen and carbon dioxide exchange and heart rate during vigorous exercise. It is a precise test that generates results specific to the individual, not a generalized diagnosis based on age or other factors.
VO2 testing is useful in determining the heart rate at which an athlete switches from breaking down fat for energy to breaking down glycogen. In order to break down fat, oxygen is needed. If the athlete is not taking in enough oxygen to break down fat, they break down glycogen instead. Glycogen is glucose (sugar) stores located in the muscle and liver. If you are walking a long distance, hitting the treadmill in the gym, or lifting weights, glucose, unlike fat stores, does not maintain energy levels efficiently. If an athlete were to rely on glucose solely for energy he or she would burn out before the activity is over — something which could potentially result in injury and prolong recovery. This point of no return is called anaerobic threshold (AT).
VO2 testing is helpful for three reasons:
1 If a patient is trying to lose weight, then VO2 testing finds the target heart rate zone that utilizes pure fat for energy.
2 To amp performance, VO2 testing reveals at what heart rate a patient can burn fat for energy. Burning fat is a better source of energy. It doesn’t exhaust the patient, and he or she will be able to walk long distances without fatigue. The testing also reveals the heart rate at which they can push into their glucose-burning zone for the last few miles of an endurance event.
3 Knowing one’s anaerobic threshold helps the patient do interval training. Improving AT allows patients to walk faster, which in turn burns more fat and calories and improves performance.
Q: My heart sometimes feels like it is racing — is this a heart palpitation, and is it dangerous?
A: For the most part, heart palpitations, or an awareness of the heart beat, are a normal phenomenon. However, the feeling of your heart “missing a beat” may reflect a change in cardiac output. Many non-cardiac conditions such as exercise, anemia, anxiety, and thyroid disorders can cause an increase in ventricular output which gives the feeling of an abnormal or missing heartbeat. On the other hand more serious heart conditions, like an incompetent heart valve causing regurgitation, may lead to the ventricle having premature beats which we sense as an extra or a skipped beat.
Bradycardia, an abnormally slow heartbeat, and tachycardia, an abnormally fast heartbeat, are cardiac arrhythmias that generally are asymptomatic. When they are noticed, they feel like a slow skipping beat or a fluttering feeling. If these symptoms are associated with a decrease in arterial pressure and cardiac output, especially in an upright position or standing position, other symptoms like dizziness, blurring of vision, and loss of consciousness may occur.
If there is an occasional palpitation during a vigorous walk it is most likely nothing to worry about. Palpitations that start to occur more frequently with exertion or are associated with other symptoms like dizziness, blurring of vision, or a temporary loss of consciousness called syncope may be a clue that something more serious is occurring. You should check with your primary care physician or a cardiologist when any of the more serious symptoms are present, or if the frequency of palpitations increases.
— Jacob May
A2: First of all, anytime you have a new symptom associated with your heart or cardiovascular system, you should consult your doctor. Palpitations are defined as a sensation or awareness of the heartbeat. This could be feeling like the heart is racing, or that it is skipping beats. It is more common with increased body awareness during anxiety or with increased heart output during exercise. Women may also notice palpitations with hormone changes at menopause. If light-headedness or fainting occurs with the palpitations, seek medical attention, as this could indicate a serious problem.
Palpitations caused by anxiety can be calmed with herbs such as chamomile, passionflower, or lemon balm. Hawthorne is a wonderful heart tonic herb. Palpitations associated with menopause can be supported with Motherwort, black cohosh, or wild yam. The bottom line is this: While most of the time palpitations are harmless, it is important to find out the underlying cause.
— Arianna Staruch
This Issue’s Experts
Lindsey Nelson, ND, is a naturopathic primary care physician and can be reached at 503-279-0205 or firstname.lastname@example.org.
Jacob May, DC, brings careful thought and analytical thinking blended with a holistic approach to medicine and can be reached at 503-279-0205 or email@example.com.
Arianna Staruch, ND, is a naturopathic physician focused on women’s health issues and can be reached at 503-279-0205 or firstname.lastname@example.org.