Training for Century - Feeling Very Sick on the Bike - PCOS? HELP?

Hi Everyone ..... I thought I'd post here see if anyone has any advice.

I'm very new to cycling - have joined Team in Training and been training for 14 weeks for my first Century on August 23rd.

I have a problem of getting severely sick to my stomach when I've been on my bike for around 4.5 or 5 hours - so for me around mile 55 or 60. It has happened on the last 4 rides and last Saturday it came along with a pounding headache and no energy (I only finished 78 of the 82 miles scheduled). I have worked so hard with my coach and other teammates on my food - I've tried everything, energy bars, protein bars, granola bars, boiled potatoes, PB&J, fig newtons, Twinkies, Poptarts (my team likes the sugary things), crackers, pretzels, GU ... I've tried combos and nothing seems to help. My coach is at a loss as he sees me eating all along the route and at the stops. I'm drinking all my water - 1.5 to 2 bottles an hour.

One thing I'm not sure might be related is that I do have PCOS (Polycystic Ovarian Syndrome) - which means that I am insulin resistant because it takes higher levels of insulin to keep my blood sugar at a normal level. So I know that for me to lose weight (a whole other subject) I'm supposed to focus on a low-carb diet. So I don't know if there is a link to all the high carbs - if it makes the amount of sugar in my blood make me feel that ill. I just don't know. (Do have a call into the doc.)

Just thought I'd post for advice, stories, any guidance?? SO appreciated!

It could be you are just eating too much! Were you bonking before?
I'm no expert, others should chime in soon enough that know a lot more. It's been shown that you don't need to eat as much as you are burning while you are burning it; because your blood supply goes away from your digestive system and into your limbs... resulting in an overwhelmed gut, (nausea)

I was wondering that as well - I'll eat a banana between stops, or one PB&J every 25 miles. Maybe 2 granola bars. Some have said I might be eating too much. Other say they see me and I'm not eating enough. Just so totally confused. I'm always fine until around mile 55. On the shorter rides I felt fine. It really started when I hit the 50+ mile rides.

You can only absorb 250 - 300 calories per hour on the bike. All the rest just causes bloat and discomfort. Also, I really prefer people to eat on the bike, a small amount at a time, instead of waiting and eating a lot at the stop.

I don't know how hot it was, but 2 bottles per hour is a LOT. Again, you can only absorb so much water on the bike as well (and I generally push people to take an electrolyte beverage instead of water).

What TNT chapter are you training with? (I'm a long time TNT coach.)

Thanks Sara ... I'm with the Massachusetts Chapter.

I'm probably overestimating my water - its hard to tell because I fill up with the Sag and I'm rarely at the bottom of my bottle when I do fill up. But I would say at least a bottle an hour. SO I might have had that wrong.

I've tried eating less and I still feel sick - which is why my coach says the same thing - eat tiny bites every 15 minutes. Other mentors have thought that was insane. So I've tried it both ways and I still get so sick.

Actually, for me, if the weather is hot, 2 bottles an hour is just barely enough. If I'm not replacing electrolytes along with it, I will notice it on a single ride or immediately afterward. Headache and nausea sure sounds like dehydration and/or hyponatremia to me.

Do you sweat heavily? Is your coach in a car, where he could carry a scale? How about weighing yourself for fluid loss at each food stop?

You have tried the small bites every 15 minutes thing?

I don't know anything about PCOS, and it seems that perhaps you should consult with a doctor or nutritionist who specializes in the effect that may have on your system. However, if you do have a sugar tolerance issue, what about trying some lower glycemic index type foods? Whole wheat bagel with PB only, for example (instead of white bread with PB and jelly), or Turkey sandwich on wheat bread, eaten a bite at a time every 5 minutes or so. Also balancing things out with some other sources of protein and fat - nuts, for example. I see you've tried "protein bars", but I am talking protein in a more non-process version. Many bars have added ingredients in them which may be contributing to your symptoms - so start simple, with the basics to see if you can narrow it down to something that works.

Some of the items you listed as having from your SAG stops sound like WAY too much sugar even for someone who doesn't have an insulin issue (twinkies, poptarts, etc.) Even pretzels, while great for salt, are just quick absorbed white flour.

If I eat too many sweet things I get nauseous. Protein is what gets me through, have you tried to eat more protein rich foods?

I was thinking protein, too. I think there are a couple of protein drinks designed for drinking while exercising. These may still be too high in sugar, so experimenting with protein first, and if it seems to be better, it might be worth it to try these out.

Generally speaking, I eat a lot of protein off the bike, and on the bike have really only found on thing that sits well for me. cliff shot blocks. yes, mostly sugar, but I find I need something on any ride that is more than an hour. I tend to fuel lightly once during a window of 30-50 minutes. the blocks say a serving is 3, I usually have 1, sometimes 2. I drink only water as the electrolyte drinks are awful for me. Plain electrolyte drops would be an alternative, and I'd use them if the blocks weren't working.

I hope you find a solution! Your goal is great, but it's no fun to be out there and feeling nauseous! I've been there plenty of times, and it really does take the shine off the experience!

Hugs and butterflies,
~T~

Hi,

I use to have the same problem, horrific pain in my lower belly, if I did not get off the bike immediately, it got worse to the point of immediate diarrhea and womiting (yeah, fun if you are in the Central Park).

I tried everything and then I discovered that it happens always when my guts are not completely empty and aggrevate them with continues pounding of my legs going up and down. So, I have moved my handlebars up just about 1 in. My belly has more space, and all the problems disappeared.

I am not sure if that will work for you, but you can try. I sacrificed a bit of the aerodynamics but I am not throwing up on the trail anymore :)

Martina

Quote:

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Originally Posted by gabriellesca

....I am insulin resistant because it takes higher levels of insulin to keep my blood sugar at a normal level.

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I bought a Gel Bot last year and filled it with natural peanut butter with a dash of raw honey and lemon juice. I nursed on that bottle and I never had a problem with spiking glucose levels and felt it really helped me with endurance rides. I also use Accel Gel as there is protein in it and for a pre-ride meal I eat an egg on wheat toast. I avoid anything sugary as it causes my blood levels to spike too much. Perhaps sticking with protein sources will help your performance.

Thanks everyone so much! It sounds like consensus is that I need to really focus on more natural protein while on the bike. So PB, turkey sandwich on a bagle maybe, PB&J on a bagel? Nuts is a great idea.

I love all the ideas and will pack alot of these foods for the Century. I don't have a long ride now before the 23rd - but will try these suggestions. I also might visit my doctor's walk in clinic - I've been sick to my stomach since Saturday. Argh.

Thank you all so much!

Any more thoughts advice - keep them coming ...

Is this only happening in the heat? No symptoms when it's cooler?

My sister has PCOS. She has all the classic symptoms and challenges. Over the last 2 years, she has lost a lot of weight, has walked two marathons, and has done multiple sprint length triathalons. I think that her experience has been that her body has just taken a lot longer than most to adjust to all the exercise. She started much slower than other people might. For example, walking two marathons and not feeling the need to run and being really happy about it. I think when she pushed too hard, her body just couldn't take it. So, she has found her own rhythmn. (And I'm so proud!)

PCOS can be a very subtle thing and the state of gynocological medicine is substandard at best, so getting clear information can be hard.

I exhibited signs of PCOS for years as well. Although my symptoms were all the exact opposite from my sister. And I never had the full endocrine workup because I chose the homeopathic route. For me, I've noticed that my body still needs a lot longer recovery time than others, and I need to listen to my own rhythmn. I build up slowly and carefully. As long as I listen to my body and am honest with what I hear, I'm ok.

My sister has long term plans for an ironman. And I think she'll do it. But she plans to build herself up over the next 5+ years. (She trains year round.) Slow and steady wins the race (or at least let's you finish it).

I have a lot of opinions and ideas about PCOS and complementary healing. If you're interested, feel free to message me. I can help more with that than training info. :)

Good luck.

I know I'm the only one that's said anything about hydration/hyponatremia... but if you're still sick, that sounds EXACTLY like I get, and it does sound like the one thing you haven't tried.

Ask your doctor or dietitian what hydration solutions are safe for you with your diabetes. Chug three liters as soon as you get off the phone with them and get to the store. I'm not exaggerating. See if you feel better within two hours after doing that.

Thanks OL - I'm not diabetic but do have PCOS so I am insulin resistant. I'm not really sure what you mean about my hydration - I've been drinking, what I'm told and what seems to be the right amount.

CL - No, its happening hot or cool.

Amy - Thanks very much. This is very interesting to me about your sister - she clearly is very motivated. I've been doing a bit of on-line research and if I could get in with my doctor I might try to see her (although she's booked).

I have a tendency to get hypoglycemic so I've had my share of blood sugar crashes too, but mostly off-bike, thank goodness. I second everyone's advice about protein, though I'd caution against cutting out carbs entirely - your muscles need the glycogen. (A friend on Atkins tried to eat protein-only on-bike and couldn't last past 50 miles.) But, according to my endocrinologist, by adding protein to your intake, you establish a base of slower-releasing energy going on underneath the quick-release simple sugars, and that helps keep the insulin levels more consistent. You might try a sports drink with protein in it. I use the PowerBar "Recovery" mix (marketed for use after rides) while riding because has protein in it. It's never made me feel sick to my stomach, doesn't taste too sweet, and I don't get crashes. I start with a bottle of it, and bring a baggie with enough powder to mix a second bottle half-way, instead of drinking the Gatoraide offered at most rest stops.

I also carry a little baggie of Snyder's of Hanover peanut-butter pretzel sandwiches on longer rides. They're super-yummy, bite-size (more convenient to nibble on on-bike), and a good mix of protein with carbs.

Hope this helps - and good luck on the century!

Jennifer

Thanks Jennifer - I'll try to find the 'Recovery' Drink and the pretzels with peanut butter is a great idea.

I love the advice guys - I think the protein will really help me as I haven't had any protein on my rides at all (except for the bananas - which I think are a source of some protein). Any other protein suggestions - keep em' coming.

On top of this ... I slipped and fell this morning going into work and my ankle, foot, and knee are bruised and swollen! Argh!

Anyways, on rides I do best with a mix of protein and carbs. Subway brand sandwiches are a perfect blend, just don't eat all the sandwich at once. No veggies or roughage except olives on the sandwich, the time for that stuff is off the bike. Or, leftover steak rolled up in a tortilla is *****in'. Energy bars are a waste of time for me, I don't digest soy very well so feel no energy when I eat one. And (shudder) no bananas on the ride, I am "sensitive" so they give me the gastric symptoms described by other riders.

I love the shot blocks, I get the margarita ones with extra salt, or the orange with caffeine, when I can find them.

Sorry to hear about your ankle :( - I hope it heals up quickly!

Quote:

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Originally Posted by gabriellesca

Just thought I'd post for advice, stories, any guidance?? SO appreciated!

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Hang in there...you'll get this figured out! I basically lose my appetite on longer rides, but it doesn't sound as severe as what you're experiencing. I don't really get nauseous, but a lot of foods I'd normally love are impossible for me to eat.

I've experimented with different things and I've found that Gatorade, black cherry Cliff Shot Bloks, and a few select flavors of gels work great for me. But getting solid foods down that I actually have to chew is quite difficult. Sandwiches, for example, are not something I can eat while riding. I can't make myself swallow the bread. But turkey cold cuts go down easily. I've can also tolerate cashews and almonds, but peanuts make me gag. And Red Vines and chewey cookies work for me too (but crunchy cookies would be gag-worthy). I think it's really an individual thing. A friend of mine can eat anything while riding. I am surprised by how little I eat during a long ride. But believe me, I make up for after the ride when I'm a bottomless pit!

Good luck figuring this out...I have found it frustrating and it sounds like you're frustrated too!

Sorry to hijack..

Amy: I wanted to contact you about pcos, but i can't find a way to contact you through here. If you can email me, I'd love to chat! Thanks! adsnoop@mchsi.com

Hello!
I have PCOS as well and have been diagnosed as borderline on insulin resistance. I have it under control with diet and exercise. I have never felt better once I started eating right and exercising.

I second what Amy said about having to work harder to get to the goal and that recovery might take a little longer. That just makes the victory sweeter!

One thing that I am wondering as I read through your posts... are you taking Metformin? There is a possibility that medication is causing the problem.
http://www.medicinenet.com/metformin/article.htm
I took it for two days b/c a Dr. recommended it. I threw it away and haven't looked back. I am assuming that during exercise, the body becomes more efficient in it's use of insulin and if you throw a medication in the works, it could really cause some havoc. Might be a good question for a Dr. that is knowledgeable as both a physician and an athlete. Or a pharmacist that is an athlete.

As an aside, I have found that I can eat pretty much any amount of carbs that I want while I ride as long as I have some protein to go with them or if I alternate a snack with carbs and one with protein. I tend to reach for a protein bar b/c they are easy to put in a jersey.

Good luck!

Thanks Flyby - I don't take Metformin. I tried it for a while but the side effects were harsh for me.

I think that making sure I have some protein while I ride - although not too much (from what I'm reading) - is going to be really key next weekend.

Today is our last training ride - a very easy and flat 15 mile ride to lunch and then 15 miles back. I'm looking forward to something flat for once!

Thanks everyone for your help! My fears about next weekend and my first (and maybe only) Century are mounting. But my ankle, knee, and foot got the okay from my ortho which is great!

I'm trying to get to Wichita Falls next weekend for my century, Hotter'n'Hell!! While I don't have any medical issues (diagnosed anyways) It will be my first and I am nervous. Since it is the same date you posted, I was just wondering if it is the same ride.

In any case, listen to your body!! It will tell you when you've had enough. Take a lot of breaks and be safe. Most important, HAVE FUN!!!!