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Exertional Headache After Exercise: Low Brain Circulation and O2

Athlete with exertional headache after exerciseHeadaches after exercise (or so called exertional headaches or headaches on exertion) are very common in modern athletes and people who exercise (Turner, 2003). The cause of the headache may sometimes relate to allergic triggers in the air or some other environmental effects on the human body. However, most of the cases of headaches after exercise are due to reduced oxygen levels in the brain during and after exercise. Over 180 Russian MDs tested hundreds of their patients and found that such headaches exist only in people who have less than 30 seconds for the body oxygen test.

Why could brain oxygenation get reduced? It is all in the way we breathe during exercise. Once we start to lose carbon dioxide (via overbreathing), brain-oxygen levels immediately drop. Later, breathing remains heavy (after exercise), and it also causes pain in muscles and slow recovery rates.

Hyperventilation causes low O2 and headachesThis image on the left (done with PET scan) shows the effects of one minute of hyperventilation on oxygen availability in the brain. (PET scans reflect oxygen content in cross-sections of the brain). The cause of low oxygen levels in the brain is low arterial CO2 (hypocapnia), which leads to constriction of blood vessels (arteries and arterioles) and reduced blood and oxygen supply to the nerve cells.

Have you done running, cycling or cross country skiing together with very fit athletes? What is their noticeable difference? Their breathing patterns are lighter and easier. They do not gasp for air. Many of them have no problems talking and exercising at the same time. Lighter breathing increases CO2 and O2 levels in the brain. Really healthy people have light and easy breathing at rest too.

Key factor for headache after workout

Girl runingFor most people mouth breathing during exercise reduces arterial CO2. Only very fit athletes are able to keep high CO2 in the blood during exercise due to their lighter and easier breathing even at high intensities. Therefore, oral breathing has the same effect on brain oxygenation as hyperventilation (or overbreathing). It causes reduced CO2 and O2 levels in the brain cells. Since oxygen and carbon dioxide are fundamental for normal nerve cell functions, headaches on exertion are body cries for more oxygen and breathing retraining or breathing normalization.

In order to test these ideas, go for a lighter form of exercise, but with nose breathing only. Most people can eliminate these headaches if they use strictly nasal breathing (in and out) and slightly reduced intensity of physical exercise. With over 30 seconds for the body-oxygen test, it is very unlikely that one can get headache after exercise.

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Reference pages: Breathing norms and medical facts:
- Breathing norms: Parameters, graph, and description of the normal breathing pattern
- 6 breathing myths: Myths and superstitions about breathing and body oxygenation (prevalence: over 90%)
- Hyperventilation: Definitions of hyperventilation: their advantages and weak points
- Hyperventilation syndrome: Western scientific evidence about prevalence of chronic hyperventilation in patients with chronic conditions (37 medical studies)
- Normal minute ventilation: Small and slow breathing at rest is enjoyed by healthy subjects (14 studies)
- Hyperventilation prevalence: Present in over 90% of normal people (24 medical studies)
- HV and hypoxia: How and why deep breathing reduces oxygenation of cells and tissues of all vital organs
- Body-oxygen test (CP test) : How to measure your own breathing and body oxygenation (two in one) using a simple DIY test
- Body oxygen in healthy: Results for the body-oxygen test for healthy people (27 medical studies)
- Body oxygen in sick : Results for the body-oxygen test for sick people (14 medical studies)
- Buteyko Table of Health Zones: Clinical description and ranges for breathing zones: from the critically ill (severely sick) up to super healthy people with maximum possible body oxygenation
- Morning hyperventilation: Why people feel worse and critically ill people are most likely to die during early morning hours

References: pages about CO2 effect:
- Vasodilation: CO2 expands arteries and arterioles facilitating perfusion (or blood supply) to all vital organs
- The Bohr effect: How and why oxygen is released by red blood cells in tissues
- Cell oxygen levels: How alveolar CO2 influences oxygen transport
- Oxygen transport: O2 transport is controlled by vasoconstriction-vasodilation and the Bohr effects, both of which rely on CO2
- Free radical generation: Reactive oxygen species are produced within cells due to anaerobic cell respiration caused by cell hypoxia
- Inflammatory response: Chronic inflammation in fueled by the hypoxia-inducible factor 1, while normal breathing reduces and eliminates inflammation
- Nerve stabilization: People remain calm due to calmative or sedative effects of carbon dioxide in neurons or nerve cells
- Muscle relaxation: Relaxation of muscle cells is normal at high CO2, while hypocapnia causes muscular tension, poor posture and, sometimes, aggression and violence
- Bronchodilation: Dilation of airways (bronchi and bronchioles) is caused by carbon dioxide, and their constriction by hypocapnia (low CO2)
- Blood pH: Regulation of blood pH due to breathing and regulation of other bodily fluids
- CO2: lung damage: Elevated carbon dioxide prevents lung injury and promotes healing of lung tissues
- CO2: Topical carbon dioxide can heal skin and tissues
- Synthesis of glutamine in the brain, CO2 fixation, and other chemical reactions
- Deep breathing myth: Ignorant and naive people promote the idea that deep breathing and breathing more air at rest is beneficial for health
- Breathing control: How is our breathing regulated? Why hypocapnia makes breathing uneven, irregular and erratic.

References
Turner J, Exercise-related headache, Curr Sports Med Rep. 2003 Feb;2(1):15-7.
Indiana University Center for Sports Medicine, Indianapolis, IN 46202, USA.

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