Health & Wellness

How to exercise if you have an autoimmune disease

Dr. Marc Bubbs

Movement is medicine. Unfortunately, too many people today don’t get enough movement in their day. Physical inactivity is the most impactful modifiable risk factor for chronic disease worldwide. It is also the fourth leading risk factor for global mortality.(1) The benefits of movement are truly profound, impacting virtually every aspect of health. This can include improving blood glucose control and heart health, slowing cognitive decline, dementias and low mood, and can assist with certain types of cancer and many forms of autoimmune disease.(2) However, there is some nuance in how best to apply exercise if you’re already suffering from a pre-existing condition. In particular, forms of autoimmune disease require a strategic application of exercise to yield the greatest benefits. Autoimmunity is defined as a condition arising from an abnormal immune response to a normal body part.(3) There are over 80 different types of autoimmune conditions. However, some of the most common are celiac disease, diabetes (type-1), lupus, rheumatoid arthritis, inflammatory bowel disease, and Graves’ disease, to name just a few. Approximately 7% of the population struggle with an autoimmune condition, which often start in early adulthood and impact women much more frequently than men.(4)

autoimmune disease

Exercise & Autoimmunity

If you have an autoimmune disease, you’ll know that struggling with periods of fatigue (sometimes intense fatigue) is a reality that must be managed carefully. These ‘flare-ups’ and increased inflammation can make exercise difficult, often feeling almost impossible. They can crop up periodically (and randomly) throughout the year.
  • Should you exercise during a period of pronounced fatigue?
  • What type of exercise may be most supportive to your health?
  • How do things change when you’re feeling great?
It’s important to have a strategic approach depending on how your autoimmune disease is affecting you. Supporting recovery during periods of fatigue and accelerating your progress when your health is on point. How does an autoimmune disease potentially affect your exercise? Exercise triggers inflammation, the process which stimulates the adaptations from which you get stronger, faster and fitter. During a period of pronounced fatigue and autoimmune symptoms, the inflammatory terrain in your body will be quite high. This means too much exercise or training too intensely (or worse, both!) can be problematic.

How Should You Exercise During Periods of Fatigue?

Exercise can be helpful during periods of fatigue, but you need to apply the right dose and type. In general, when struggling with low energy you want to do light intensity aerobic exercise. This type of ‘steady-state’ aerobic training (at 75% max heart rate or below) stimulates the flow of blood and lymph and supports the health of mitochondria in the body. Steady-state aerobic training at light ‘conversational’ intensity is also a great way to recharge your nervous system. It is often overlooked by many clients who want to train hard every time they step in the gym or out for a run. Light stretching or mobility exercise is another helpful way to stimulate blood flow to reduce muscle soreness and achy-ness as well as support superior cognition to fight off ‘brain fog’, a common symptom of autoimmune disease. Train smart during an autoimmune flare or periods of fatigue. The goal of exercise and movement when you feel ‘low’ is to support your nervous system and recovery to minimize the duration and intensity of the autoimmune symptoms.

When should I train intensely with an autoimmune disease?

When your energy is robust and you feel strong, it’s time to push the intensity and to engage in more resistance training. If you lift weights, steadily increase your training volume or the intensity (i.e. the amount of weight you’re lifting) to progressively overload your muscles and grow stronger. For aerobic training, during periods where your energy levels are high you can challenge yourself with more HIIT type sessions. Once again, you can build up to more high intensity HIIT sessions, just make sure you do it in a slow and steady pace. What you need to be mindful of is how taxing the intense training will be for you and your nervous system. For some, you’ll only be able to cope with small doses of intense training, spread intermittently throughout the week and month. For others, you may be able to train in this manner more frequently. Regardless, be mindful of symptoms of ‘over-reaching’ (the earlier form of over training) such as an inability to maintain your workout intensity, taking longer to recover between sets, impacts on sleep quality, lower mood, etc. Once you get a better understanding of how your body responds to stress, you can gauge the intensity at which to work.

Why does exercise work for autoimmunity?

Physical activity is important for managing autoimmune conditions and limiting the intensity and severity of flare-ups. How does it work? Exercise triggers a significant elevation in T-regulatory immune cells, which can help to prevent autoimmune disease. As well, it decreases immunoglobulin (antibody) output and produces a shift in the Th1/Th2 balance that favours a more beneficial effect on autoimmunity.(5) Your Th1 and Th2 cells both promote different anti-inflammatory reactions, with one responding to intracellular parasites, the other acts on the external parasites. Physical activity also promotes the release of special cytokines from muscles called myokine (i.e. IL-6) that have been shown to induce an anti-inflammatory response in the body.(6) These are powerful chemical messages to your immune system from exercise! In the long run, this also helps to support more robust health and resiliency. Of course, too much exercise or exercising too intensely (or worse yet, both!) can exacerbate your condition. That’s why it’s key to take things slowly and see how your body responds to guide the progress.

To sum it up... 

Light intensity, steady-state cardio and mobility work can help during periods of autoimmune flare-ups. More intense training is absolutely fine when you feel good, just be mindful to monitor your recovery. Movement really is medicine. Strategically apply the right dose and timing and you’ll be well on your way to feeling your best, more often, throughout the year!   marc bubbs Dr. Marc Bubbs ND, CISSN, CSCS