Training has important therapeutic effects. An easy aerobic activity is essential component of training. The effect of aerobic exercise can easily demonstrated: in a client with a good aerobic function any muscle inhibition is temporarily normalized following slow repetitive movements that stimulate aerobic fiber activity (as naturally occurs during aerobic exercise). This procedure is used to determine 6 different states:

  • Normal Aerobic or Anaerobic function;
  • Deficient Aerobic or Anaerobic function;
  • Excessive Aerobic or Anaerobic function.

For more information on aerobic and anaerobic muscle fibers see Skeletal/Striated/Voluntary Muscle and Muscle.


Aerobic Challenge procedure

Client supine, find an Hypotonic Muscle and a Normotonic Muscle. The muscles can be related to the sport practiced by the person or any other muscle. The client alternately rises and lowers the lower limbs slowly as in a walking movement. Retest the muscles:

  • Both are Normotonic Muscle: normal aerobic function;
  • No changes (first is still inhibited, second is normal): deficient aerobic system, under-active (Aerobic deficiency);
  • Both are Hypotonic Muscle: Aerobic excess

Anaerobic Challenge procedure

Find a Hypotonic Muscle and a Normotonic Muscle. It is better if the muscles are related to the sport practiced by the person but any muscle can be used. Client stimulates anaerobic activity: he clenches the fists and rapidly alternates left and right forearms (bending and straightening elbows) for approximately 6-8 seconds. Retest the muscles:

  • No changes: this is the normal response;
  • Both muscles are inhibited: Aerobic excess, this is the most common imbalance;
  • Rarely they are both normal: Anaerobic deficiency.


The Aerobic and Anaerobic function of a muscle are complementary. It is useful to consider the balance of these two functions from the perspective of [[TCM]]. If too little Aerobic or Anaerobic energy exists, adding more improves muscle function (and inhibited muscles become normal). If too much Aerobic or Anaerobic energy exists, adding more will cause decreased muscle function (and normal muscles become inhibited). In the following paragraphs you can find the description and treatment of the 4 unbalanced conditions that can emerge from the 2 challenges:

Aerobic deficiency

Symptoms associated with aerobic deficiency:

  • Elevated respiratory quotient (RQ)
  • Lower oral pH
  • Declining endurance performance
  • Fatigue: this can be associated with blood sugar-handling stress (especially to carbohydrate intolerance)
  • Recurrent structural injuries: due to Adrenal Fatigue low back, knee and ankle are the most vulnerable joints.
  • Excess body fat
  • Excess hunger
  • Depression (mental and emotional stress is a frequent association)
  • Insomnia
  • Hormonal imbalance: especially high levels of cortisol and low of DHEA(S) (dehydroepiandrosterone) (that can cause sexual disfunction).
  • Often associated with Adrenal Fatigue
  • Other symptoms: orthostatic hypotension, lowered body temperature, low vital capacity.

Causes of aerobic deficiency:

  • Increased structural, biochemical, emotional/mental stress;
  • Dietary or nutritional excess or deficiency: often excess of carbohydrates and low fat and protein intakes. See also the paragraph Dietary Supplements at the end of this description.
  • Excess of aerobic training: overtraining causes the diminishing of aerobic and excess anaerobic muscle fibers.
  • Lack of training in the aerobic system: inactive people or people that trains strictly with anaerobic training (weight lifters).
  • Adrenal dysfunction

Treatments of Aerobic Deficiency:

  • According to the cause.

Anaerobic excess

This condition can be by itself or in conjunction with the Aerobic deficiency. In case they are both present the treatment is: removing all Anaerobic training for a time period while maintaining the Aerobic training to allow the rebuild of the aerobic system.

Anaerobic deficiency

This is not a frequent condition. It is often associated with aerobic excess. The condition is caused by the body’s need for anaerobic training as a mean to balance the aerobic and anaerobic systems. Treatment: light anaerobic training 3 times per week for 1-3 weeks.

Aerobic excess

This condition occurs only in rare occasions. It may be associated with Anaerobic deficiency. Many of these cases are due to neurological disorganization. Otherwise the person has developed an excessive aerobic function and needs an anaerobic training to restore the balance (light anaerobic training 3 times per week for 1-3 weeks).

For the treatment of the 4 unbalanced states, it can be necessary to: 

  • Build Aerobic Function: To effectively build aerobic function (at the beginning of training: building the aerobic basis), the athlete must not exceed the optimum aerobic training earth rate (measured with MAF test). At the beginning the training pace may seem easy and too slow, but it is the best way to build the aerobic function. The pace will quicken while the person maintain the same heart rate. It is important periodically recheck the heart rate with the MAF test: the test should not show any regressions (that indicate a problem). Walking is the easiest form of aerobic exercise.
  • Build Anaerobic Function: Anaerobic training should not be added to an athlete’s training program until aerobic function is significantly improved. In endurance athletes anaerobic training may lead to overtraining. Cortisol levels increase is the primary marker of overtraining. Power athletes should make every effort to maintain a balanced aerobic function to maximize their results. Power can be reduced and recovery delayed if the function of aerobic fibers is diminished. Aerobic fibers help remove circulating blood lactate improving power.
  • Use the appropriate Dietary Supplement: if the cause rely on a nutritional deficiency. See paragraph Dietary Supplements.

Dietary Supplements

Test if some of the following supplements can be of help (remember to check for priority):

  • Anaerobic function (glycolysis cofactors):Pantothenic acid
  • Magnesium
  • Potassium
  • B3 Niacin: the coenzyme NADH is made from Niacin.
  • Aerobic function (Citric acid/Krebs Cycle cofactors):Fatty acid: test different fatty acid combinations/products. This is very useful when different muscles have an unbalanced response to aerobic function test.
  • Coenzyme Q10: Statins inhibit Coenzyme Q10 production.
  • Electrons carriers: Glutathione.
  • B1 Thiamine: in excessive alcohol consumption, this inhibits pyruvate dehydrogenase (PDC) that is activated by Thiamine.
  • B3 Niacin: the coenzyme NADH is made from Niacin.
  • B2 Riboflavin: the coenzyme FADH2 is made from Riboflavin.
  • B5 Pantothenic Acid: Coenzyme A, part of the Acetyl-CoA, is made from Pantothenic Acid.
  • Lipoic Acid: useful in type 2 diabetes, where pyruvate dehydrogenase (PDC) is inhibited.
  • Magnesium
  • Iron
  • Copper
  • Manganese
  • Cysteine
  • Carnitine: helps convert fats in pyruvate. If deficient fatty acids cannot be used for energy (beta-oxidation) and accumulates in liver (omega-oxidation).
  • Aerobic function blockers (test them, if present should be corrected):Heavy metals toxicity (In particular: As, Hg, Sb, Fl, Al): they block several enzymes of the Citric Acid cycle.
  • Lack of oxygen: anemia, lung disorders: without oxygen the “aerobic” process (the electron transporting chain) cannot obviously work.