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How Exercise Intolerance Affects Autoimmune Disease

You’ve made radical lifestyle changes – addressed your diet, your sleep and your stress and you’re feeling better. You are drinking enough water to float away. You are exercising. But you are still having setbacks and flare-ups. Believe it or not, it could actually be your exercise that is hurting rather than helping you. We’ve always been told that exercise is healthy and good for us, especially for healing and recovery as well as for preventative measures. What nobody talks about is a common side effect of autoimmune disease that has a huge effect on our health and our ability to exercise. It’s called exercise intolerance.

So what is it? Exercise intolerance is defined as “a condition of inability or decreased ability to perform physical exercise at what would be considered to be the normally expected level or duration. It also includes experiences of unusually severe post-exercise pain, fatigue, nausea, vomiting or other negative effects.” Basically, this means that people with exercise intolerance have a lowered capacity to tolerate exercise. And there is a very good reason as to why people with autoimmune disease experience exercise intolerance. It has to do with our bodies ability to process and handle stress. People living with autoimmune disease are constantly bombarded with stress, simply due to their overactive immune systems. As we’ve previously talked about, autoimmune disease is defined as “an illness that causes the immune system to produce antibodies that attack normal body tissues.”

This autoimmune attack, along with the inflammation caused by the immune system activity, creates a very large stress load for our body to handle and process. This internal stress activates the sympathetic nervous system, otherwise known as the “fight or flight” mechanism of the central nervous system. This fight or flight mode plays a significant role in depleting the body of its energy, which is why so many of us living with autoimmune disease experience consistent exhaustion and fatigue. Our bodies are constantly trying to manage the stress from within, which makes it harder to manage when we add on external pressures from daily life. Then add in exercise and it’s a LOT of stress for our bodies to handle. This is how exercise can overwhelm our already compromised system.

Exercise is defined as “a physical stressor”. That’s how exercise creates change within the body. When we place stress on the body through activity, the body responses with adaptation. This is how we get stronger by lifting weights or we get faster by practicing running. If exercise is done properly, it becomes a positive stress because it creates positive improvement on the body. Exercise can elevate mood, reduce anxiety and depression, improve blood flow, heart and lung health. Exercise can fix postural problems, can make daily physical activities easier, more fun and less prone to injury. Exercise can develop strength and improve balance, which has long term benefits as we age. AND if done properly, exercise can actually have an effect of reducing the symptoms of autoimmune disease.

The key here is that phrase “if done properly”. When exercise is too aggressive or intense, it can flip from positive to negative stress. This is where it becomes a problem for people living with autoimmune disease. Too much exercise can cause symptom aggravation rather than symptom management. This is exercise intolerance, where our bodies can’t handle as aggressive and intense exercise in the way we think it should.And what happens when we have a stress overload due to our exercise intolerance? We end up with an exercise induced autoimmune symptom flare-up.These flare-ups are easily mistaken for something else. That’s why it’s so hard to connect the dots here. Exercise induced symptom flare ups don’t always happen immediately after exercise, sometimes they can happen 1-2 weeks later! And they can take many different forms. Some people experience exhaustion, others experience flu like symptoms, and others have incredible aches and pains in their bodies and it becomes painful to move around.

If you are experiencing exercise induced symptom flare ups, then this is an indication that your current exercise routine is not working well for you. It means that your body is over-worked, over-stressed and highly inflamed. And that means that you are preventing healing from happening. This does not mean that exercise is bad for you! In fact, it’s just the opposite. As I mentioned, exercise is indeed really good for you and does have a very important place in the autoimmune healing journey. However, it means that you do have to examine the type of exercise you are doing and evaluate- is this exercise routine really what my body needs? Is this what suits me best? And we need to be very careful to make sure that our exercise routine is not causing setbacks and symptom flares.

Just like with diet, people living with autoimmune disorders need to exercise differently than the standard American way. We need to exercise in a way that builds strength and endurance, but that keeps the physical on our bodies stress low. This does not often match with traditional fitness messaging. We are often told that intense exercise is best. No pain, no gain right? Wrong. We need to listen to our bodies and not push them to the limits. We need to get over our ego and our need to do the same exercise routine we used to do before we got sick. We need to be careful of adding too much stress to our bodies, especially if we have high stress in other areas of our lives. Give yourself grace and recognize that a particular form of exercise may need to be switched up from time to time depending on your needs.

The rule of thumb is this: take a good hard look at how you are feeling and if you are having discomfort, exhaustion and/or flare-ups (journaling your routine is a good way to track your symptoms). Do you find that after a week or two of intense exercise you have a flare-up? Does exercise make you feel worse rather than better? Do you feel exhausted or angry or irritable after your workouts? If so, this is an indication that you need to back off your current exercise routine and make some modifications.

So, how should I exercise if I have exercise intolerance? Here’s where it gets complicated. The answer is that it is different for different people. The best style of exercise for you depends on a lot of different things, like your age, the level of fitness you have had in the past, what kind of autoimmune disease you have, the degree to which your disease affects your exhaustion levels, the amount of undernourishment your muscles have experienced from years of poor digestion, the amount of stress you experience in your life from things besides exercise… and many more.

Four factors to consider when trying to find the best exercise for you: