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


Stress and Autoimmune Disease and Exercise

In a recent blog post, I wrote all about stress and how it is linked to autoimmune disease flare-ups. Stress (which comes in many different shapes and sizes) has been medically proven to have an intense effect on the symptoms of chronic illness like autoimmune disease and fibromyalgia. Stress is a trigger to chronic illness symptom flare-ups. This is majorly important when understanding how our bodies process exercise. You can read that article here.

Exercise Intolerance and Autoimmune Disease

At it’s most basic definition, exercise can be defined as stress on the body. In fact, the stress that exercise puts on the body is what makes it work to create change. It is due to the stress of exercise that our bodies are able to adapt and become stronger, better, faster.

However, for those of us living with chronic illness like autoimmune disease, we are already living under so much stress, simply due to the activity of chronic illness within our bodies. And as I wrote in my article on stress, any additional stressor added to the body can aggravate this already overwhelmed system. And this is what leads to exercise intolerance.

Exercise intolerance is 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.

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.

So, 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 have in our head “what we think we should be able to do” or “what we used to be able to do”. We set our expectations accordingly, and when our bodies fight back and won’t let us do these things, we often respond with anger, frustration and negativity- and we direct those thoughts and feelings inward. We 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.

If you have exercise intolerance, it’s critical to take a moment and realize that no amount of willpower or determination will change the fact that your body is simply not capable of achieving that aggressive goal that you set for yourself- or at least not at this moment in time. So- by accepting that exercise intolerance is something that you are experiencing, you can release yourself from this cycle of picking the wrong exercises, pushing too hard, and having a bad experience by either not being able to finish, or having an exercise induced flare-up afterwards. Through the acknowledgement of exercise intolerance, you can begin setting your body up for success.

However, this does not mean that you should give up and 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.

This is where Autoimmune Strong comes in- it’s a workout designed for people living with exercise intolerance. It helps us build strength without overwhelming our systems. It’s designed to help us avoid exercise induced symptom flare ups. It’s designed to help us get back to living our life, loving our bodies, and feeling good every day.

Click here to join Autoimmune Strong’s workout program and see if it’s right for you.