What is Exercise Intolerance, and How Can I Exercise if I Have It?? Part 1

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This is a great question, because there is actually very little information provided to the public about exercise intolerance- and yet it is a very really thing with very important consequences, particularly for the 23 million people and counting who have been diagnosed with an autoimmune disorder and want to exercise.

Wikipedia describes exercise intolerance well:

"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 is not a disease or syndrome in and of itself, but can result from various disorders."

As far as I can tell, there hasn’t been any specific medical research done to connect exercise intolerance to autoimmune disease (however, I am not a doctor, so I don’t have access to their depth of knowledge and research). In my search of the information available to the public, I found little information that helped me understand exercise intolerance as it applies to autoimmune disease.

However, after talking with hundreds of people all around the world living with autoimmune disease and chronic pain, I have seen firsthand how exercise intolerance is a side effect. When I describe the definition of exercise intolerance, their eyes light up and they say “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 always tell me that knowing that there is a term for this experience of theirs brings them some comfort, because it means that they aren’t just “weak” or “lazy” but that 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? Well, let’s think about the impact that both autoimmune disease and exercise have on the body, and what happens when you combine them.

Autoimmune disease happens when your immune system goes haywire and mistakenly attacks your own internal organs/systems as foreign invaders. So, that means that even at rest time, your body living with autoimmune disease 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, and therefore have less capacity to function properly. When you put added stress on your body through exercise, each of your body parts have to work together to help you perform the exercise and then recover. With a malfunctioning organ/internal system, it is more difficult for your body to actually perform the exercises and then recover properly so you can do it again.

All of this together makes exercising with an autoimmune disorder difficult. But, our bodies are designed to be able to push through tough situations, at least in the short term. So- we have the ability to overcompensate using our adrenaline. To get through the stress and effort of exercise, your body has to kick your adrenaline into gear to make you work harder, sweat more, and keep going. This can lead to an overexertion of your adrenal glands (that produce your 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 (often referred to as adrenal fatigue).   

So- it makes sense now why all of these people (including myself) have struggled with exercise intolerance, right? 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 exercise like lengthy cardio sessions, High Intensity Interval Training (HIIT), Cross Fit and Power Yoga. And for many people, it’s not just these intense workout programs that can exacerbate the exercise intolerance. Even walking or restorative yoga can be too much. And if we push though and do the exercises anyways, we often end up with an exercise induced symptom flare up, which puts us out for the count for days, perhaps 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.

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!