Extra intense nausea & a full 5 - 15 mins vomiting from riding hard?

Training
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Can pushing 110 - 150% FTP for a few mins near the end of a ride cause intense vomiting from overheating when you suddenly stop and lose wind cooling?

I’ve had a couple very new-to-me, quite bad episodes recently, and asking for the groups help to quell my concerns. Quite worried after this last one.

I’ve had a couple handfulls of “normal” exercise nausea during or just after hard pushes over my life. It’s normal for many, others never get it, no matter how hard they go it seems. Genetic, I guess. I say “normal” exercise nausea, bc it seems to mostly be similar; mild to intense nausea, you either back off in time and it subsides or you don’t, and you dry heave and / or actually vom once or twice, HR drops, nausea falls away pretty damn fast.

Seems from what I’ve read they think it’s from low blood sugar, low blood oxygen, buildup of lactate, or a mix of them. Not important, and please keep on topic; I am really hoping for some help w this important question. :slightly_smiling_face::heart:

This ain’t about that!

Important intro note: I think I have noticed that heat generation has gone way up since I’ve got more powerful. Like if power is up 20%, I’m prob generating near 20% more heat, right? But not going 20% faster, so not getting 20% more cooling? Not sure. Will close this loop below.

Anyhow, 2-3 times in the past year after a TR WO I’ve had pretty extra intense nausea and some dry heaving, and twice some intense vomiting for just 1 - 5 mins after a ride. I have noticed my heat suddenly spikes after I get off the bike, out of the fan. But the voms were only a LITTLE more intense than normal exercise voms, so I thought it was due to the normal stuff, didn’t make the heat connection.

Last weekend I had a Sprint Swim Bike. My A event, and was feeling great. Had a super strong, powerful and draining swim, and a super powerful bike. Super happy coming into end of the bike, decided in the last 1/4 = 5km to utterly roast myself; leave it AAALLLL out there. Last race of the season! HR chart shows REALLY maxxxed out (for me) finish. Was super hot the last 5-8 mins of the ride & run-in to T2, but feeling great.

As soon as I stopped, heat spiked, big time. Sweat started absolutely pouring off my head, and nausea spiked, real quick, started dry heaving & voming, really hard. Super intense, way worse than ever before, dry heaving now causing more heavy full body sweats, dry heaving went on for a good 10 ish mins. Hardly anything came up, bit of water & stomach acid, just dry heaving my ribs to bits and lots of spit. Paramedics called over by event staff. Grateful, and super embarrassed, for that. Sorry I wasted your valuable time, guys!! :confused:

I chalked it up to absolutely blasting myself. I think it was a PR for how hard I pushed, for how long. It felt like it. So just thought it was that.

But then yesterday I had a hard 46 min 22.6 km country ride. Did def push very hard, must have been hovering near or just above thresh for quite a bit of the first half (no on-bike PM yet, all TR WOs indoor). Got quite nauseated around kms 12-15 ish, had to back it off for a bit, recovered, then spun it back up for the last 2-3 kms. Nausea zero. But was quite warm; sweat pouring off my nose and chin for the last 5-7 km… #foreshadowing :roll_eyes: Gosh I can be thick sometimes! :slightly_smiling_face::laughing:

Jumped off bike, heat spikes huge, sweat waterfalling, nausea skyrockets, voms get just ridiculous. Like 15 mins of rib crushing dry heaving and trying to keep it down. In the first 5 mins I actually did fully productively vom part of lunch, twice. Miserable.

Way worse than the race. And I pushed waaaay harder, for longer, in the race.

So now I’m a bit worried. That I have something off under the hood that is causing voms to increase suddenly during hard pushes.

Two events, way more extreme than any before, suddenly, one week apart.

But: It was pretty chilly and a bit breezy on race day. I was outside. So I prob cooled quicker. I was inside yesterday trying to hide my voms from the neighbours! :laughing:Took about 40 - 50 mins before I fully stopped sweating.

So:
Question 1: Has anyone else noticed that heat generation increases a lot as you get stronger, and so having exactly proper kit for the weather, and then cooling off with the wind on you, instead of stopping while still hot, has become critical? Otherwise you overheat? Or nah, not much change in heat generation as you get much stronger? Like is heat generation an even bigger issue for tour pros, or it’s the same if you’re a 100 W rider or you’re laying down 5 w/kg for 20 mins?

Question 2: Has anyone else experienced this kind of intense nausea and extended period of vomiting specifically from overheating at the end of a ride, when you suddenly stop wind cooling? Ever happened to anyone before?

Thanks in advance for your time, and for keeping the discussion on-subject, focused on answering the two questions.

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Hey @AJS914 , thanks, ya, I did read that thread actually.

It seems to be addressing what I’m calling “normal” exercise nausea vs. this much more extreme prolonged voming I experienced for the first time twice just recently that I thiiiiink is brought on by sudden and super strong overheating. (Explained in my post in detail.)

Unless I missed something! Please let me know!

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Nothing of the sort, and I ride in pretty high temperatures. What temps we talking about? If I’m reading this right, you had this after what sounds similar to 2x20 threshold intevals? How do you fuel? I’d talk to a doctor.

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I am of course no doctor, but my first thought would be heat exhaustion. Exercise induced nausea tends to subside/improve when you stop or reduce the intensity as you’ve said, but overheating in a clinical sense (i.e. core temperature getting too high) can cause more extreme vomiting. It’s also pretty stressful on the body and can progress to more serious effects a la heat stroke, so I’d definitely get it checked out if it’s a repeat issue.

With that said, a few preventative things;

  • Make sure you’re getting enough electrolytes. (sodium in particular, since that’s the bulk of what you’re losing in sweat and it sounds like there’s a fair bit of that going on!) Electrolyte depletion will make things a lot worse and you’ll lose even more with vomiting, so It might be worth looking into your salt intake and/or getting a blood test to make sure there’s no underlying imbalances.

  • Get your core temp down as quickly as possible after finishing, and during the ride where feasible. If you’re indoors more fans are usually a good idea, as well as staying in front of the fan for 5-10 mins or getting into a cold shower immediately after. Outdoors can be a bit tougher, but dumping some water over your head during the effort or having some frozen bottles on the bike/at the finish line can help. (if you can get into some shade or a body of water, all the better)

  • Heavy sweating, high HR, headaches, cramps and dizziness are generally warning signs- these are of course sometimes expected during a hard effort, but can be something to pay attention to/track against the times you experience symptoms so you can get a bit of a heads up- especially in a training context, it’ll do your recovery no favours.

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