• Melanie Pigeon, RN, BSN

Autoimmune Disease and Exercise Intolerance

Have you ever been all ready to go, with your workout gear on, water bottle in hand, and now you find yourself too tired to go through with the workout itself? This is not uncommon for individuals with an autoimmune disease. If you have or even think you have symptoms related to an autoimmune disease it can be difficult to find the right way to keep active. An autoimmune disease is when your body becomes inflamed due to the overactive immune system attacking and damaging its own cells and tissue.


Now if you try to exercise with this scenario it can become very difficult and sometimes dangerous. With an autoimmune disease, it can be frustrating because we don’t have the leeway to push our bodies to be more productive, give too much, sleepless, to say yes too often or exercise in the way we would like. The danger we put ourselves in, if we are not careful and prepared for a healthy exercise routine with an autoimmune disease is called exercise intolerance. Exercise intolerance isn’t feeling sore the next day or tired from pushing yourself too hard. It is pain, vomiting, visual disturbances, trouble breathing, and not just feeling tired but such extreme fatigue you are tingling all over for days to weeks.


It definitely is a catch 22. Many people who manage their autoimmune disease maintain a consistent exercise schedule, however, getting there is the process we need to shed more light on. It comes down to balance and finding a way that won’t set us back. A setback or more commonly known for US autoimmune suffers is called a flare. A flare is all the unwanted symptoms making their way to the surface. For someone in this predicament, exercise causes even more inflammation and less ability to exercise in the first place. It becomes a vicious cycle until we follow a plan and listen to our bodies.


You see I say us because I too have a few autoimmune diseases, Systemic Lupus Erythematosus (SLE) being my primary diagnosis. I have exercise intolerance and had to come up with a plan to follow my body’s needs so I can fulfill my dreams. I want to be around for my children and my children’s children. At the beginning of my exercise journey, I would sign up for classes at the gym for the 50 and older crowd…I was in my 30’s at the time. I even would do the water aerobics classes. Before this journey, I was a dancer and at one time a competitive ice skater so for me it was difficult to slow down. I didn’t look like I belonged there and the instructors always wanted to push me.

It is hard to speak up and let me tell you those amazing men and women are strong. However, once I felt comfortable explaining my journey to the instructor and made some great friends along the way, I created this team of friends that would encourage me and make me feel accomplished. Find a partner or a group. Someone or a group of someones to encourage each other and make you accountable. Start to feel comfortable with your journey and your illness. You are trying to make the best with the hand you were dealt. You can make this illness take the backseat to your life! I would love to help in your journey…You are welcome to come to join our group and fellow accountability partners.


It is important to find your workout regimen and the best place for you. The way to do this is by listening to your body. You will find in time that learning what your body is telling you is the best tool you have in your journey with autoimmune diseases. It will help guide you throughout this process. Never ignore the signs of exercise intolerance. Pushing yourself too far can bring progress to a screeching halt just as if you had never begun the process to find an exercise routine in the first place. Progress is our mission. Progress in strength, ability to do more, quality of life, and dreams you once held. Get yourself up and moving. It won’t be easy but not doing anything is like lying down and taking it. Every little step toward finding a process with your autoimmune disease that can stop the progression and give you strength should be the goal!


When you begin to exercise and those pesky symptoms come to the surface, you must stop. It doesn’t mean it is over, just stops for now. Reset and try again the following day. I remember not too long ago I had a flare which had me starting back at square one. Although I had to start over again, I did bounce back sooner because I kept my body strong. It was a process and that first workout was only 3 minutes on a stationary bike before the exercise intolerance kicked in and I was symptomatic. I was able to recover and try again in a couple of days. I took a picture that day and posted it on my Instagram to prove looks can be deceiving and we all fall and have to dust ourselves off and get back up again. The plan and the goal to live and enjoy as long and as strong as we can is my message!


Keeping my strength up over the years helped me bounce back after a flare. My recovery was shorter and I was able to begin an exercise regime in a shorter duration rather than starting from scratch. It may get frustrating but the alternative is giving into your disease, the pain, and shorten life span. This should not be a question. You have to make yourself a priority. I have children, a husband, a house, dogs, farm animals, and a job and I understand that I had to put my health first. What is that analogy we have all heard… put your mask on first! It is so true.

Make the choice to become stronger one minute at a time if that is what it takes. You fall …start over and get up again, choose you, and don’t give up. Don’t let this illness win. You are still in there and you CAN make this happen. Find the new Rock-star you are. Someone who is going to beat all odds despite the challenges you face. We may or may not like it but we have to exercise…. let’s find a way to do just that with an autoimmune disease!


So where is the happy medium and how do we become those happy autoimmuner’s? How do we keep the heart-healthy activity of a stationary bike or a brisk walk from pushing us into an inflammatory mess and in bed for days? Exercise is by definition an activity requiring physical effort, carried out to sustain or improve health and fitness. Now “requires physical effort” is a red flag for many suffering with autoimmune disease. The part about improving health and the other functions exercise gives like a better mood or sleep, are the effects we are shooting for. Not suffering but adapting and living healthy and strong.

What is the routine to achieve improvement and health benefits as well as tolerate the exercise itself? Follow along in the infographic below

Click here for a free printable workout and symptom tracker. A good place to start and keep you on track during this process. Track how you tolerate your workout to see where you should begin and set your goals.


  • Low impact such as a brisk walk, stationary bike, or yoga. If all you can do is stretch that is still progress!

  • Fuel/ anti-inflammatory diet – Don’t run on an empty tank. You wouldn’t drive your car without the right gas or oil, so give your body the same respect. Give your body the healthy food it needs to run properly!

  • Hydration, Hydration, Hydration – water is essential for good health. You need to ensure an adequate fluid intake, especially with physical activity. Your body depends on water to survive and with a chronic illness, we can’t run with an empty tank. Keep yourself hydrated and don’t get to the point where you feel thirsty. If you are thirsty or have dark yellow urine you have already started showing signs of dehydration. This can cause more exercise intolerance symptoms to arise.

  • Limit frequency and start slow with 15-minute workouts… conserve those spoons!


Do all of this and find your body’s happy place. This is a journey, not a race. Not too much exercise but not too little. This is your life, and this condition is lifelong. It may require a little extra tender love and care, but it will pay off.

I truly want myself and others to find a way to accept the reality of their illness but that doesn’t mean you accept feeling horrible because of it!

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