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  Last updated: 8/1/2019

Miscellaneous Medical Questions


Q.I recently rode Paris Brest Paris, perhaps you know about this ultimate 1200k endurance cycling event. I did not make it to the finish but did make it 1100k, in about 82 hours (which meant I had 8 hours to do 100k...) I was not dehydrated nor was my blood sugar low. I rode 26 hours before sleeping for 5 hours (good sleep) and then 22 more before 3.5 hours of sleep. The third day I felt good, riding at dusk I became very fatigued, disoriented, even hallucinated. I made it to a control, got 4 hours of sleep, thought all would be well. Started riding at 6 am, could not stay awake, tried napping by the side of the road, and I guess did not look like I was doing so well as someone called an ambulance. My blood pressure was OK, pulse was 45, slightly low for me. As I plan to do this and make it in 2007, any advice for legally dealing with this sort of fatigue? I tried caffeine, amazing how little caffeine does once one reaches this level. Does what happened to me indicate any condition or syndrome or lack of some nutrient? Is there a quick fix when one gets this (I know sleep... other than that) low?

A. The short answer is "no". I doubt there are any supplements that would prevent this from happening. Even when you eat just right, there is a limit related to your own physiology that reflects metabolism at the cell level. On another day, it might be a breeze and yet you would have done nothing differently as far as training. Good luck in 2007.

Avoiding the Flu

Q. I bike about 100 miles a week. With the upcoming flu/cold season, will altering my diet in any way prevent or reduce my chances of catching a cold/flu? If I get a cold/flu, will altering my diet in any way reduce the length of time I have a cold or flu? Will regular moderate exercise during the time I have a cold/flu reduce the the length of time I have a cold or flu, make it worse, or do nothing at all?

A. There is no evidence that diet supplements will reduce your chances of getting a viral URI or upper respiratory infection ("the flu"), although a regular, moderate exercise program does appear to provide some protection. If you do get a viral URI, zinc lozenges will cut down the duration of symptoms. During the early phase - when you are having aches, chills, and perhaps a fever - it is best to back off on your training or riding program. There has been suggestive evidence that continuing to push during this time can lead to additional problems.

B12 Injections

Q.I am a competitive rider 46 Years old. Can you give any clarification on using large doses (3cc) at a time of B12. Are there proven benefits to this?

A.I believe any benefit would only be a placebo response. There is no physiology that would support this (unless you have pernicious anemia) not any scientific evidence.


Q.I have been told to exercise to avoid osteoporosis (which runs in my family). Will cycling do the trick?

A.We're discovering that cycling may contribute to bone loss in both men and women because it's not a weight-bearing activity. So cyclists should crosstrain for bone health. Weight training and jumping (like rope skipping) are helpful.

Saddle Sores

Q.I have been having problems with saddle sores, especially after long, and multiple day rides. Any ideas.?

A.Saddle sores are due to a combination of injury to the tissue from long saddle times which decreases tissue resistance to infection, and then infection with bacteria that are present in the area (the skin surface on the buttocks)which take advantage of this decrease in resistance to infection from the injury. If you minimize the concentration of bacteria on the skin, you can minimize the chances of an infection taking hold in the "fertile soil" of the injured tissue. Gradually increasing the length of training rides may "toughen" the skin of the area, and help to decrease the amount of tissue injury from future long rides as well. A few tips:

Take simple steps first:

Then consider topical agents:

Occasionally a rider will complain of saddle abrasions or sores on only one side of their crotch. This could indicate a leg length discrepancy. But unless it's several millimeters or more, chances are it doesn't need to be corrected (typically with a shim under the short leg's cleat).

And a related problem.

Q.I'm 50 years old. Male. Just did Cycle Oregon and came home OK.....One week later my groin area looks like hamburger. I used Chamios Butter, but I skin has several areas with huge bumps(cysts) that are very uncomfortable. Never had this problem.....Any thoughts? - CW

A.If I getting the location correct, it sounds as if you have either a fungal infection of perhaps a "folliculitis" (which is a bacterial infection much akin to a saddle sore) in the skin crease between your leg and abdomen. If so, you will need either an antifungal creme or an antibiotic. I'd suggest you go to a Walk in Clinic or call your physician.

This type of a skin infection usually occurs because the area stays moist(making the area a great breeding ground for bacteria which then more get a toe hold in the macerated tissue). These infections are more likely if you don't wear clean shorts each day - which facilitates a higher bacterial count on the skin surface.

(For a nice summary article take a look at How to Solve Saddle Sores from Road Bike Rider.)


Q. I'm preparing for a mountain bike competition (2 days with 100 Km/day). I began a training program in February with gym exercises and spinning sessions (3-to-4 times each week). Since early June I replaced spinning sessions with outdoor bicycle rides (both road and mountain rides).During spinning sessions I train in the zone (152-165 bpm) for 45 minutes/hour. My MHR is 185 bpm. I use a HRM to monitor my progress.

During the 5 months or so since I began to train (an average of 8 to 10 hours/week) I noticed a resting heart rate passing from 59 bpm (February) to 50 bpm (end of June). At the end of June, during a outdoor road ride I experienced two episodes of palpitations with my HRM reading 200 bpm, no symptoms, everything normal. I stopped and after 2 minutes my heart rate abruptly dropped to 110 bpm. My RHR has not changed. I am a male, 43 years old in good health, my effort ECG is perfectly normal so is the cardiac echography. San these short episodes of tachyarrythmia be caused by overtraining?

A. Palpitations can be caused from many things - including genetic predisposition. A recent article suggested that runners had more atrial fibrillation as they aged than non runners - even though running is felt to be a "healthy" activity. Electrolyte imbalance is another cause - be sure you are replacing potassium and magnesium (supplements are not harmful and any excess is lost through the urine). And caffeine and lack of sleep can aggravate a tendency toward palpitations as well. Since you have had an echo, I presume you have talked to a physician - an arrhythmia can be the first sign of ischemia or coronary artery disease. With that said, the answer is possibly due to overtraining, although unlikely with your RHR going down. I notice that your trainer had you at about 80-85% max ht rate when spinning. A big mistake is training too hard every day - you really only need to ride at this level for 3 days a week. then add in a day or two of intervals and work on getting one or two slow spinning days per week.

Eye glasses and using your cycle computer

Q.I wear reading glasses and find that I have trouble reading my cycle computer with my sunglasses. Thoughts?

A.I have the same problem and finally broke downj and got a pair of subscription sunglasses. You can get bifocals or varilux (variable refracted) lenses (which I find the easiest for myself),

Here is another idea I found on - "There is a low-cost alternative for seeing up close -- stick-on bifocal lenses. These are simply thin pieces of vinyl that you attach inside the lenses of your normal glasses or sunglasses. They come in six different prescription strengths from 1.25 to 3.00 and are extremely easy to install and use. Buying sunglasses is expensive enough without adding on a bifocal prescription. For about $20 I was able to apply these lenses to a cheap pair of sunglasses that I already owned to see if they worked. They did, much better than ever expected. They aren't a solution if you need distance correction, but if you normally require help to read up close (i.e., you wear reading glasses or bifocals), stick-ons are worth a try. There are several online sources, including www.stickon and

Statins and physical performance

Q. My physician suggested I take a statin for my elevated cholesterol. I know statins can cause muscle aches. Is it possible they could impact my on-the-bike performance?

A Statins are one of the more commonly prescribed medications and have there own set of side effects - mainly muscle aches in 1 out of 5 users, occasionally severe enough to stop the medication.

I always wondered if there were performance changes in those who were taking statins but did NOT have myalgias (muscle aches). The answer is now in. Statin users in primary prevention experiencing myalgia do not have impaired aerobic exercise performance or muscle strength compared to

So when you are making that decision with your physician as to whether statins have a place in your medical care, concern about an impact on your cycling performance should not be a worry.

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