What Is Exercise Intolerance and How Does It Impact Those Living With An Autoimmune Disease

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Exercise Intolerance and Autoimmune Disease

Exercise intolerance has been medically linked to chronic diastolic heart failure and metabolic disorders, yet not much has been published on its connection to autoimmune disease. However, after talking with hundreds of people living with autoimmune disease and chronic pain, I have heard firsthand how exercise intolerance impacts their life.

After explaining exercise intolerance to people living with autoimmune disease, they’ve always responded with, “Yes, that describes me! No matter how hard I try to exercise, I am always exhausted, weak and debilitated. I can barely do the things I want to do.”

And they’re comforted in knowing there is a term for this experience, and understanding that this experience doesn’t mean they are “weak” or “lazy.” Because they aren’t -- there is a real reason for why their bodies won’t do what they want their bodies to do.  

So, why does exercise intolerance happen when you have autoimmune disease?

In order to understand the connection between exercise intolerance and autoimmune disease, you first have to look at the impact that both autoimmune disease and exercise have on the body -- and what happens when you combine them.

Autoimmune disease is a condition in which your immune system goes haywire and mistakenly attacks your own internal organs/systems as foreign invaders. That means that even at rest time, your body is working overtime both to attack and protect you from these “foreign” invaders. This is exhausting to your system, even before you add on any extra exertion like daily activity and exercise.

Additionally, when you live with autoimmune disease, it means that you have systems in your body that don’t function in a normal capacity. These body parts have been under attack by your immune system for a long time and have experienced malfunction and deterioration. Therefore, they have less capacity to function properly. With a malfunctioning organ/internal system, it is more difficult for your body to not only do exercise, but also to recover properly from it so you can do it all again.

All of this together makes exercising with an autoimmune disorder difficult. But bodies are designed to be able to push through tough situations -- at least in the short term. They have the ability to overcompensate using adrenaline. To get through the stress and effort of exercise, your body kicks your adrenaline into gear so you can work harder, sweat more, and keep going. This can lead to an overexertion of your adrenal glands (which produces adrenaline), causing more fatigue and exhaustion. Over time, these little glands become overworked and stop producing the adrenaline as needed, and your body loses the ability to push through.

That’s why those of us living with an autoimmune disease have struggled with exercise intolerance -- it’s just too hard for our bodies to power through in this “no pain, no gain” fitness society. We quickly burn ourselves out when we try to overexert ourselves with traditionally-designed exercises like lengthy cardio sessions, High Intensity Interval Training (HIIT), Cross Fit and Power Yoga. And for many people, even just walking or restorative yoga can be too much. If we push through and do the exercises anyway, we often end up with an exercise-induced symptom flare-up, which puts us out for days, if not weeks on end.

The first step to dealing with exercise intolerance.

If you think that exercise intolerance is something you have, the first and most important step is to acknowledge it and accept it.

This is a very hard thing for people to do. When it comes to exercise, we often expect to be able to do “what we used to be able to do.”  So we set our expectations too high. And when our bodies fight back and won’t let us do these things, we respond with anger, frustration and negativity which just causes us to feel badly about ourselves. We tell ourselves that we just need to “get it together,” that we are lacking in determination, effort, or willpower, and we fill ourselves with negative self-talk around this issue.

It’s time to let go of that vicious cycle.

The next step to dealing with exercise intolerance.

If you have exercise intolerance, it’s critical to accept that no amount of willpower or determination will change the fact that your body is simply not capable of achieving the aggressive goal that you set for yourself -- at least not at this moment in time.

This does not mean that you should stop exercising. It also does not mean that you should use your exercise intolerance as a reason not to start exercising. It just means that you need to create a modified exercise program to work in tune with your body.

By accepting that exercise intolerance is something you are experiencing, you can release yourself from the cycle of picking the wrong exercises, pushing too hard, and having a bad experience (by not being able to finish or having an exercise-induced flare-up afterward). And you can finally stop setting your body up for failure, and begin setting your body up for success.

In Part 2, I am going to tell you all about how to create this modified exercise program, and how to start in tune with your body so that you can properly use exercise to help -- not harm -- you. Stay tuned!