Exercise may seem like a bad idea when you feel run down, in pain, or fatigued from an autoimmune disease. Autoimmunity, a disease in which the immune system attacks and destroys body tissue, can make exercise feel like an impossible feat when you’re not feeling good. However, studies show daily physical activity improves outcomes and helps manage symptoms compared to not exercising at all. This even extends to patients who may stop exercising due to pain, such as in the case of rheumatoid arthritis. No matter how small the effort, something is better than nothing when it comes to regular physical activity and autoimmunity.
Exercise guidelines for autoimmunity
Exercise has many general benefits, the best perhaps being that it simply makes you feel better. People who engage in regular physical activity report less depression and better self-esteem, and are happier. These benefits alone support autoimmune management as a positive mindset is more anti-inflammatory compared to a negative one.
However, when it comes to autoimmunity, exercise delivers specific immune benefits. In fact, you’ll never reach your full potential at managing an autoimmune condition unless regular physical activity is part of your protocol.
In studies, regular exercise has been shown to help dampen autoimmunity in patients with lupus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease, and other conditions. Studies have also shown that sedentary patients have higher incidences of autoimmune diseases than more active patients.
Research also shows that as a trend, patients with autoimmune disease tend to be more sedentary. This is understandable — autoimmune disease can make you feel poorly much of the time and our cultural depictions of exercise make it seem unattainable. The pressure to be a hard-bodied athlete who flips tractor tires and runs up stadium stairs can lead to resignation instead of physical activity.
But the benefits of physical activity for autoimmunity don’t have to come from intense workouts at a CrossFit gym, long runs, or two-hour weightlifting sessions to deliver benefits. Your fitness level, symptoms, and energy levels will determine what is appropriate for you.
To be effective in managing autoimmunity, exercise can be as simple as a short walk around the block if you’re just getting started. If chronic pain is an issue, exercising in water or on a recumbent stationary cycle may be more appropriate. If you’re feeling good and have been building your fitness, daily high-intensity interval training (HIIT), which activates a wide number of anti-inflammatory and immune-modulating mechanisms, can super charge the autoimmune-dampening benefits of your workouts.
While it’s important to exercise regularly, equally important is to not overdo it. Overtraining increases inflammation and can and lead to exercise intolerance, a condition in which exercise makes you feel worse, takes an unusual amount of time to recover from, or triggers a relapse or flare.
Exercise intolerance stems from compromised mitochondria related to chronic inflammation associated with autoimmunity.
Also, for some people with autoimmunity, there are days where they are bedridden with flu-like symptoms and barely able to function, much less exercise. Approach your physical activity habit with common sense and self-compassion — some days it just won’t be appropriate and that’s ok. Ease back into it when you feel better.
Why exercise is good for autoimmunity
The primary benefit of exercise with autoimmunity is that it lowers inflammation and stabilizes immune function. Because inflammatory flare ups provoke autoimmune relapses and tissue destruction, keeping inflammation down and immune function stable is paramount.
Physical activity increases the activity of regulatory T cells. These cells are critical when it comes to managing autoimmunity. As their name implies, they help regulate the immune system when it comes to increasing or dampening inflammation. Exercise has a profound impact on regulatory T cells.
Exercise also shifts the balance between the pro-inflammatory Th1 system and the anti-inflammatory Th2 system to be less inflammatory and more balanced.
It also promotes the release of messenger immune cells called IL-6, which help dampen inflammation.
A study on the effects of exercise on women with lupus showed that three months of regular aerobic exercise modulated immunity and did not trigger inflammation.
Patients with rheumatoid arthritis show milder symptoms and improved joint mobility with regular exercise.
In patients with multiple sclerosis, physical activity enhanced mood and mobility. Exercise lowers the risk of neuropathy in type 1 diabetes patients.
Many people feel they can’t exercise due to pain, but research has shown it reduces pain in patients with fibromyalgia and other chronic conditions that cause pain.
If you feel too unwell to exercise, ask yourself what you feel you can reasonably do and start there. Ask my office for more advice on using physical activity to address autoimmunity.
Board Certified in Integrative Medicine
Certified Functional Medicine Practitioner
Institute for Functional Medicine Certified Practitioner