The Four Factors You Need To Consider When Exercising With Autoimmune Disease

Finding the right type of exercise for your body is a nuanced and evolving process as we heal our autoimmune disease. As previously discussed exercise is a stressor on our bodies that we must manage alongside other physical and emotional stressors, including our chronic illness. 

People living with autoimmune disease need to approach exercise differently than “the standard american way”. We can not approach exercise with a “no pain no gain” mindset. Our mindset has to be flipped on its head: if there is pain, there is no gain. 

If we push our body past its limits we can experience an exercise induced symptom flare and the exercise progress and strength we built may be set back as we heal. These types of flares may not manifest directly after exercise so we must pay special attention and track activities, stressors and symptoms to determine the cause of a flare.

So how do we find the right exercise when facing exercise intolerance leading to symptom flare ups? As with many things in our healing journeys this is not one size fits all. There are four main factors to consider when approaching exercise:

1. Intensity

2. Duration

3. Frequency

4. Type

1. FREQUENCY
This refers to how often you exercise. Exercise doesn’t work when you do it sporadically, or if you do a lot of it in a one week period and then stop. 

In order to reap the optimal benefits of exercise, you must exercise consistently over time. Ideally, this should look like daily exercise with rest days incorporated- but if this is too much, in the beginning, you can work up to it. The most important thing is to be consistent, so if that means that you exercise one day and then take two days of rest, then you need to make sure you get back to exercise and repeat.

2. DURATION
This refers to how long each exercise session should be. If you are consistent with your exercise, it doesn’t need to be that long. Frequency is more important than duration when it comes to managing autoimmune symptoms, and exercising without flare-up. A lengthy workout session has more of a chance of overstimulating cortisol, so keeping it short is best. However, how you define short depends on your level of fitness. If you are someone who is newly diagnosed, or new to a fitness regiment, short should mean 10 to 15 minutes per session at the most. And many people need to start with even less, at 1 to 5 minutes. Remember- everyone needs to start somewhere. You need to start with what works for your body. 

3. INTENSITY
This refers to how hard your workout is for you. This means how much you push your body, how heavy your weights are, how far you run, how sweaty you get, how fast your heart beats, and how quickly you get out of breathe. 

Typically, when we think of exercise, we think we want it to be intense. But this does not hold true for people with autoimmune disease. Generally, the rule of thumb is that people living with autoimmune disease should keep the intensity low to moderate, especially when starting out. Exercise should not exhaust or deplete you- you should have enough gas left in the tank to be able to still get through your day. 

The right kind of exercise is one that is progressive, and builds in intensity just a little bit, slowly, over a long period of time. This slow building process of intensity helps our body adapt to the challenge without freaking out and shutting down with a flare-up. 

4. TYPE
This refers to the style of exercise. Generally, any style of exercise can be adapted to follow the rules listed above. However, a note of caution: exercises that really ramp up cortisol, such as HIIT training, spin class, and Crossfit WODs, as well as any kind of cardio such as running or elliptical should be done with extreme caution. These types of activities are significantly more likely to stimulate an exercise-induced flare-up.

We know autoimmune disease symptoms improve with exercise so with these factors in mind the approach to exercise, while different for every person, starts slowly. My recommended approach to use gentle strength training combined with flexibility and mobility training. Start with low-intensity and low duration and after a few successful weeks of consistency without flare-up, you can build intensity and duration over time. Cardio, such as walking, can use this same approach for building to a level you are comfortable with while staying healthy.

The Autoimmune Strong exercise program is built around these four factors- and is designed to help you exercise in a safe and effective way, without flare-up. So, if you are ready to start exercising in a way that works best for your body, but don’t know where to start, check out the Autoimmune Strong website

Top Five Tips To Help You Increase Your Energy Through Exercise

When living with autoimmune disease, exercise should not be considered in a vacuum- we need to think of our overall stress health and then figure out where exercise fits into that big picture. We must start thinking about our overall balance of stress and connect it to how our bodies ebb and flow with our autoimmune disease symptoms, it can help us to understand the full scope of our bodies’ needs, which leads to creating a better balance in our entire picture of health.

When we hear the word “stress” it instantly has a negative connotation in our minds. However, some stress can have a positive effect and, of course, some negative stress is unavoidable. As people living with autoimmune disease we have to understand individual stressors and their cumulative effect on our healing. So- what could possibly be a positive stressor? Exercise! Exercise puts stress on the body to create change--change we are seeking from exercise like increased mobility and strength!

Exercise has also shown to elevate mood, reduce anxiety and depression, improve blood flow, and boost heart and lung health. Benefits of exercise continue by improving posture and balance which is very important as we age. The symptoms of autoimmune disease have been proven to improve with exercise when done properly.  

This is the key- exercise must be done properly in order for us to reap the benefits. Here it  comes back to exercise as a stressor. If we push too hard and subscribe to the “no pain no gain” exercise philosophy we often hear our symptoms will actually get worse. If we continue to push we may even end up in an exercise induced symptom flare. We must consider all forms of stress in our lives--physical and emotional--then approach how much exercise we can handle. I encourage you to start slow, slower than you think you need to and slower than you probably want to. This is where we will truly feel the benefits of exercise; slowly build strength and mobility and soon you’ll feel energized, not exhausted, by exercise. It is not one size fits all, and it is not a linear path forward; we must keep a close eye on our stress, fatigue and disease symptoms and constantly adjust both exercise and other stressors as possible.

But where to start? How to put this into action? 

Here are the Autoimmune Strong Top Tips for Exercising Safely When Living With Autoimmune Disease: 

Step 1: Brain Dump For Stress Awareness
Start by writing down all of the things that you know cause your body stress. Some typical ones are: lack of sleep, emotional relationships, a messy house, long demanding workdays, sitting in traffic, money issues, etc… Just making a list of everything that causes you stress can bring awareness to the reality of the situation. And while this may seem overwhelming and daunting, if you continue to take the steps forward that I am recommending, you will begin to see a reduction of stress over time, which will increase your health AND your ability to exercise! 

Step 2:  Make A Commitment To Exercise
Now that you have visibility of your stressors, the next step is to make a commitment to yourself to begin a consistent exercise routine- even if it’s just for a few minutes (or a few seconds) a day. This means that no matter what stressors life brings you- no matter what is on your brain dump list- that you are making a commitment to yourself to do something every day. This is habit building, and it will stay with you for life. 

Step 3: Keep A Daily Journal
At the top, write out your commitment. For example- I will practice my abdominal bracing technique (a foundation of the Autoimmune Strong program) for 1 minute today. Then, journal about the successes or challenges you faced to accomplish this goal. Did you do it? Then celebrate it! Or did something stop you from doing it? Try to figure out what that thing is that’s getting in the way, and see what you can do to change it. 

Step 4: Modify Your Exercise Routines Based on Stress Levels
Your body can only handle so much stress. Stress is the thing that aggravates autoimmune disease symptoms, so we must keep our stress in check! Exercise is a form of stress on the body, so you need to figure out where exercise fits in the big picture of your entire stress load. Having high stress in your life? Reduce your exercise. Keep doing it, but do less. One minute of standing on one leg (even if you are holding onto a wall) is still way more effective than doing nothing! And if it’s a lower stress time period for you, that’s great! You can incorporate a little more exercise into your life. It will fluctuate over time, and that’s okay.   

Step 5: Make Sure to Include Rest and Recovery Days!   
In order to keep your stress levels low, you need to incorporate rest days into your training. This will help your body recover faster and build the energy for those daily tasks. However, rest days can be a slippery slope. Some people take a rest day, and it becomes two rest days, then three, and then all of a sudden a week has gone by. So be intentional with your rest days. Make a plan for the next day, so you know you will return to your exercise. The rest days are an important part of your schedule- so consider them as part of your exercise routine and you will be less likely to let your exercise slide away…  

Autoimmune Strong is built with this approach in mind. We work slowly through movements and progress through several levels of programming, built for bodies just like yours. But here I will reiterate again-this is not a linear path-exercise is a stressor on our bodies. Take time each day to consider the stress you’re experiencing and the level of stress a particular exercise will add. With these two factors in mind you can decide what you can handle for that day. Don’t get discouraged if the answer is the exercise you had planned is too much. Just scale back! Do part of a video or stick to some gentle movements you are familiar with. Even doing a few minutes (or seconds!) will serve your healing by continuing to build strength without experiencing an exercise induced flare. 

Want to know even more? You can check out my previous posts on exercise intolerance here and exercise induced flare ups here. Also- check out the Autoimmune Strong website to get started with an exercise program designed for you and your body.

My Favorite Exercise to Relieve Neck Pain

Many of us live with neck and back pain. This is often due to the fact that our lifestyles are not conducive to correct posture. We sit all day, we type of the computer, we text often, we drive while holding onto the steering wheel, and these things cause postural distortions that that look like this: 

• Our necks jut forward

• Our shoulders curl forward

• Our upper back rounds

All of these posture issues combined propels our body to bend forward, so our spine doesn’t line up in one straight line. And this is what causes pain- when our spine is misaligned, our muscles are out of balance. Due to activities like computer work, driving and texting, our chest muscles (called pectorals) are overused and our upper back muscles are underused, too weak to counterbalance the overworked pectoral muscles… and our body doesn’t like it, so it sends pain signals to our brain. 

If you are experiencing this kind of pain (or even if you aren’t), try this exercise and let me know how it feels. It’s very simple, anyone can do it, and it feels oh so good. 

Training Your Body To Handle The Demands of Everyday Life

There is this really deep misunderstanding that people living with autoimmune disease have about exercise. They truly believe that exercise is not good for them, and that their life will be better without exercise. They believe that a sedentary life is the best option for them, in order to control their pain. They believe that not moving is the ONLY option.

Examples of things I have heard?

“I learned not to push myself physically ‘cause I end up in bed for 3 days paying for it”

“I feel better when I don’t exercise”

“I no longer work or do anything because any and all activity causes me fatigue and pain”.

Is this you??? If so, I totally get it, I understand 100% what it feels like to be in pain, exhausted all the time, where any little bit of movement causes disastrous effects. And I can totally understand how it seems easier to stay home on the couch, because the risk of movement causing pain is so high. I get it, because I have been there. 8 years ago, this was me. Stuck on the couch, exhausted, in pain, watching life pass me by.

But what if I told you that there was a way to transition off that couch? And that it involves exercise? And that it involves an exercise training schedule- just like an athlete has? I know you will think I’m crazy… but keep reading.

Athletes use their time in the gym to train for their sport, right? An NFL player trains and practices before a game. An ice skater spends time on the ice, practicing her routines, building up her skill set so she can accomplish a beautiful feat.

Well- I urge you to think of yourself as an athlete. But instead of training for a game, a match, or a race… you are training for life! You are training to go to the market, to climb the stairs, to go to a bbq. You are training to have the energy, strength, and mobility to do the things you want to do, everyday.

An athlete doesn’t just wake up and do something spectacular on the field. And the same goes for you- you can’t just wake up and expect your body to do more than it’s capable of. You have to train it! And that requires a change in perspective.

1. Set your goals

What is it that you are training for? To play with your kids in the park? To be able to walk through Walmart? To be able to go out to dinner with your friends after a long day at work? To be able to travel with your spouse? To hike? To dance? Well, whatever you want to do, think of it as your “game day”.

2. Identify your limits.

This is the hard part. Be honest with yourself- how far of a reach is that goal? If it’s a really big goal, like if you want to go on a 10 mile hike but it’s hard for you to walk down your driveway right now- then you need to set smaller goals that build up to the big goal. The key is to pick goals that are achievable, so you get some wins along the way. A goal that’s too big will feel frustrating if you don’t have smaller goals along the way. The more honest you can be with yourself, the better you can train. Remember, these are your current limitations. If you train yourself like an athlete, these won’t be your limitations for much longer. The bar will be raised.

3. Define the type of training will achieve this goal

Now, you need to decide the how. How are you going to train for this?? Some people like to walk, others like to swim, others like yoga or zumba. Personally, I recommend going through the Autoimmune Strong program, because it is designed specifically to get your body in shape and adapted to exercise without causing a flare-up. Often, even these “gentle” types of exercise like walking, swimming, water aerobics, zumba and yoga can cause pain and flare-up, because your muscles aren’t prepared properly. That’s what Autoimmune Strong does- it meets you where you are and builds strength slowly through simple, at home exercises, to get you ready for “game day”. Building strength, mobility and flexibility in teeny tiny steps that are accomplishable in 5 minutes or less? That’s Autoimmune Strong’s specialty.

4. Commit to your goal--and how you will get there.

Finally, whatever exercise you select, you need to make a commitment to the process. Your mindset is important! Showing up and doing this work is hard, especially when you are in the midst of a flare-up cycle. You don’t need to do lots of exercise for exercise to be effective. Consistency is the key. The length of time spent every day is less important- in fact, 5 minutes might even be too long for you, depending on your level of exercise intolerance. So even if you can only handle 5 seconds of movement- start there, and do it consistently. Every day, or every other day, or even every three days- it doesn’t matter- as long as you don’t give it up. These things take time, change doesn’t happen quickly.

Follow these steps, and I promise that you will be ready for your game day. You will be prepared to show up and conquer that goal of dancing at your daughter’s wedding, or walking down the street to get a coffee, or simply walking up and down your stairs. You don’t need to live life on the couch. Life doesn’t have to pass you by. Train for it- and you will be surprised at what happens next.

Autoimmune Strong is an online exercise program designed specifically FOR people living with chronic illness, BY a personal trainer who lives with multiple autoimmune diseases herself. If you are ready to train like an athlete but don’t know where to start, click here to check out Autoimmune Strong.

Tips to Create a Morning Routine

Mornings can be tough…but they also set the tone for the day. So I’ve worked to create a morning routine that gets me started on the right foot. 

I know I feel so much better when I exercise so part of my morning routine includes exercise. But, it’s about more than just exercise. Your mornings can set you up to achieve goals big and small.  And when it comes to exercise keeping my intentions clear is so key to remaining successful.

Once I am in a consistent daily routine that includes exercise, my body craves it!. When I skip for too many days in a row I really feel the difference. I’m stiff and sore, and the pain that I used to feel all over starts creeping back in. My brain gets foggy, and I have a hard time concentrating on anything. 

Once I’m in the groove of it, it’s easier to be motivated. 

But the getting started part? The process of getting into that routine? Well, it’s hard. 

I made a quick video talking about how I approach my mornings.  

How I Use Music for Motivation

There are so many days where it becomes hard to motivate to get the exercise done. But I know exercise will ultimately make me feel better!

So on days when I’m distracted, want to prioritize other things or just don’t “feel like it” I use music to get myself going.

I’ve made myself a few playlists of music that inspires me, music that makes me want to move. And I made a promise to myself that for the length of the first song, I will try. I will do something. Even if it’s just dancing around like a silly person. Nobody’s watching, right?

And more often than not when the first song ends and the second one starts I’m already in it, feeling better and SO ready to keep going! The music lifts me up mentally when I know if I skipped the movement I’d end up in a downward slump of negativity.

You can try out my “one song” tactic with my playlists or make your own!

Autoimmune Strong Pop Playlist

All About Cardio

Facebook Live May 20, 2019

Andrea discusses how to approach cardio while healing your chronic illness

• Finding the right type and amount of exercise  [2:39]

• Risks and benefits of cardio [9:05]

• Muscle imbalances and their effect on successful cardio [11:19]

• Rules for approaching cardio [15:24]

• Steps for introducing or getting back to cardio [19:55]

• Describing an exercise induced flare [28:55]

• Walking as cardio while healing [33:00]

Recovering after you overdo it

Facebook Live May 13, 2019

Andrea discusses recovering after you have pushed too far or faced a set back. Topics covered (with timestamps) are:

• Building slowly after a big set back [3:40]

• Approaching cardio after a flare [8:11]

• Dealing with consequences and adjusting expectations for yourself and explaining that to others [9:40]

• Making conscious choices about exercise [14:48]

• Planning time to recover [18:10]

• Helping others to understand [22:30]

• Building a routine and dealing with guilt [26:13]

• Getting back to the gym after proper recovery [30:35]

• Navigating life choices and choosing when to say no [34:11]

Caring for Others while Healing your Chronic Illness

Facebook Live May 6, 2019

Andrea discusses managing autoimmune symptoms and self care while caring for others.  Topics covered (with timestamps) are:

• Andrea’s story of caring for two young children while undergoing diagnosis [2:30]

• Exploring diet changes [12:00]

• Learning your needs and managing with loved ones [18:00]

• Feeling lost and confused when attempting to heal [24:37]

• The start of Autoimmune Strong and filling a need for a new kind of exercise [31:35]

Exercising While Healing Autoimmune Disease

Facebook Live April 29, 2019

Andrea discusses exercising while healing autoimmune disease.

Topics covered (with timestamps) are:

• Extended flares and being “in the thick of it” [2:40]

• Diagnoses and speaking with doctors doctors about exercise intolerance [8:49]

• Exercise and exhaustion cycles preventing progress [14:22]

• The healing journey and continuing as a work in progress [18:57]

• Physically demanding jobs and training to support activity [20:00]

Weight Loss, Stress, and Chronic Illness

Facebook Live March 18, 2019

Andrea discusses her approach to healthy weight loss. Topics (with timestamps) covered are:

• Strategies for preparing for a big event [3:00]

• Handling Negative self-talk [8:00]

• Making successful and lasting change [11:10]

• Tips for prioritizing Health [20:28]

• How stress affects autoimmune disease[21:31]

• Anxiety as a symptom of a flare [35:57]

• Exercise with chronic illness [38:07]

Exercise Motivation

Facebook Live March 25, 2019

Andrea discusses motivation and exercise. Topics covered (with timestamps) are:

• Identifying what is holding you back [2:40}

• Learning to reframe what exercise means [6:35]

• Understanding your current health state and proper exercise for it [9:27]

• Navigating a exercise during a flare [15:24]

• Tips for starting small and staring now [25:00]

• Finding ways to fit exercise into your day [29:33]

Overcoming the Fear of Exercise

Facebook Live March 11, 2019

Andrea dives into tackling fear of exercise after a setback or flare. Topics (with timestamps) covered are:

• The mental toll that exercise-induced flares and setback can take [4:20]

• How dehydration affects recovery and strategies to rehydrate appropriately [7:20]

• Sugar cravings and recovering from a flare [12:41]

• Stress and recovery [16:56]

• The process of mourning for past life and abilities [21:31]

• Tactics for explaining flares and your needs to friends and family [32:05]

Identifying an Exercise Induced Symptom Flare

Facebook Live February 25, 2019

In this video Andrea discusses how to identify an exercise-induced symptom flare-up.
Andrea will break down how to identify an autoimmune disease flare vs. other illness and how to track your symptoms over time. You’ll learn how to be honest with yourself about the symptoms and the causes and how your body speaks to you through these symptoms. She’ll then help you to understand the steps you can take to heal when in a flare and prevent future flares.

And if you want to learn more about stress, exercise and autoimmune disease visit here:

https://www.getautoimmunestrong.com/b...

The Goldilocks Principle

Facebook Live February 11, 2019

In this video Andrea teaches you all about finding that sweet spot of exercising in a way that feels good and doesn't cause a flare-up. This means slowing down your exercise ambitions and working smarter not harder to achieve real long-term results. Hear about her recent experience and challenge in the gym- stopping, even though she felt great! There is no one size fits all approach- and in this video, Andrea teaches you how to tune in and listen to what your body really needs. Here you will learn about the Autoimmune Strong “rule of one quarter” to find your baseline to begin your exercise plan safely and effectively. Andrea will help guide you to understand how you can meet yourself where you are and build on a solid foundation. Five seconds of the right exercise is better than five minutes of the wrong exercise that will lead to a flare up.

Explaining the Connection Between Stress, Exercise and Autoimmune Disease

Facebook Live, Monday Jan 28, 2019

In this video, Andrea talks about the relationship between stress, exercise and autoimmune disease. You’ll learn about different types of stress and how to manage stress and exercise when living with autoimmune disease.

Andrea will explain exercise intolerance which stems from a lower tolerance from exercise, stress and raising cortisol levels than those not living with chronic illness. This can lead to an exercise-induced symptom flare of an autoimmune disease. You’ll hear more about symptoms of this type of flare and how to detect and prevent it.

Exercise as been medically proven to reduce the symptoms of Autoimmune disease. But many trainers and doctors do not understand the concept of exercise intolerance for those living with chronic illness. The key is to make sure your exercise is just enough that you get the benefits of exercise but you don’t put too much stress on you body that your body can’t handle it.

My nutrition story...

One of the things I get asked about most often is my own personal nutrition. Everyone wants to know what I eat! And that makes sense, nutrition was (and is) a very big part of my healing journey. So here is my nutrition story.

In the years of 2012 through 2014, things were really bad for my health. I was in incredible pain, totally exhausted, constant flare-ups. I couldn’t get an accurate diagnosis and I had never even heard of the word autoimmune.

I had though, heard of the word gluten and at the time, I was eating a lot of it. Bagels, Cheerios and Mac & Cheese were my staples, because I had toddlers at home.  I decided that I would try going gluten free for a bit and see if it helped. I began to focus on organic foods, primarily vegetables and protein instead. I found out much later that I have Celiac, so going gluten free was really essential for me.

I didn’t know it at the time, but I had basically created the Paleo diet for myself. I eliminated coffee, alcohol, dairy, gluten, grains and sugar (mostly- this has always been the hardest part for me). And then, as I started to feel some improvement, I went a little deeper into the eliminations by removing eggs, nightshades, and beans (oh how I missed eggs, peppers and tomatoes). I essentially created the Autoimmune Protocol Diet for myself.

And here is the thing- I did feel better. It was gradual and it didn’t totally eliminate my flares, but it most certainly made them fewer and farther between. And over time, I began feeling really good. But it took time.

What I know now is that my gut was really destroyed, and it has taken a long time living on a healing diet to repair it. Over the years, I have done many food re-introductions, some successful, but many not. The good news is that now, many years later, I have been able to re-introduce some foods that I really enjoy- like eggs, tomatoes, peppers, rice and oatmeal. I can even include alcohol, cheese and sugar on a very limited basis.

At the time, I was going through this elimination diet all on my own. And it was hard. My family was supportive but it was a big change for us. I didn’t really know why I was doing what I was doing- I just had an instinct that this is what I needed to do. And my friends thought I was crazy. I struggled going out to eat and nobody could cook for me. I often felt lost and like giving up. It required so much thought and so much food prep. It was a far cry from the easy bagel and cream cheese lunch I used to love. It was a challenge, and I slogged my way through it. Looking back, I am so glad I did it. It changed my life. And now, all that thought and food prep- it feels like nothing. It’s just part of my everyday life.

For those of you just beginning your food journey, I applaud you. It’s not easy, and it can be really scary. But it’s important- dare I say essential- for you to gain strength and control back over your body. And to guide you I am going to share some of my favorite resources here to help you on your way.

First, I encourage you to give the Autoimmune Strong Food Guide a good read through. It’s a free resource included in your Autoimmune Strong membership (you also get access to it when you sign up for a free trial). It is a comprehensive e-book filled with educational information about what you should eat and what you should avoid. It is a very general overview and it does not promote any particular diet. It’s a great place for those of you who are just starting to think about how food makes you feel, and how you could use food to help you feel better.

For those of you looking for something a little more specific and in-depth I encourage you to learn a little more about the Paleo Diet and the Autoimmune Protocol. The internet is filled with great resources, how to guides and millions of recipes that can help you stick to this healing diet. Here are links to my two favorite resources on how to get started. For information about Paleo, read this and for information on the Autoimmune Protocol, read this.

For those of you already doing the Autoimmune Protocol Diet and want some extra help and support, or for those of you just starting and are feeling overwhelmed, I encourage you to check out the program SAD To AIP in 6. It is a small group coaching class which gives you specific guidance and support with the Autoimmune Protocol Elimination Diet. You can learn about it here. AND… If you decide to sign up, here’s a discount code just for Autoimmune Strong members! Enter the code autoimmunestrong15 at checkout to receive 15% off the program price.

And as always, I am here to answer any questions that you might have. Nutrition is a big, important and sometimes scary topic. So if you are struggling- lee me know! I want to help. And if you have had a great experience with an elimination, or a food/lifestyle change- tell me about that too! You can comment on the blog, or send me an email at info@getautoimmunestrong.com.

With Love,

Andrea

The Mechanism of Stress and Its Impact on Our Bodies When We Live With Autoimmune Disease

Living with chronic illness means living with constant pain and exhaustion. All. The. Time. This is what people who don’t have chronic illness don’t understand. Basic daily activities can be difficult, like climbing stairs, going to the grocery store, and playing with your kids or grandkids. We aren’t exaggerating our pain and exhaustion, it’s our real life experience. And exercise? It seems impossible. Even if you used to do tons of exercise in your past. Today, exercise can seem daunting, just too much.

And so- we sit. We rest. And we talk to ourselves in a negative, self-defeating way. We wonder what’s wrong with us, why other people can move around the world without this kind of pain. We wonder if something is wrong with us, and then we start to think, maybe we are just lazy??? Maybe those doctors who tell me my pain is all in my head- maybe they are right?

Is this you? A few years ago, before I learned about the relationship between stress, autoimmune disease, and exercise intolerance, it was definitely me. 100%. But here’s the thing. We aren’t lazy. And it's NOT just in our head. And there IS something wrong with us. We live with autoimmune disease, fibromyalgia, lyme disease, or some other type of chronic illness. Our bodies are not like other people’s bodies- so how should we be expected to do what their bodies do?!

In order to figure out how to help our bodies feel better, the first step is for us to understand why we are different in the first place. And that means understanding how stress impacts the body when we live with chronic illness.

STRESS AS A POTENTIAL TRIGGER OF AUTOIMMUNE DISEASE

There have been many medical studies that suggest the possibility of stress as being a trigger of the onset of autoimmune disease (1,2, 3,4). While there is not a definitive link, many studies have indicated that stress may play a part in the development of autoimmunity. Here is a quote from one such study:

Physical and psychological stresses have been suggested in the development of autoimmune disease, since numerous animal and human studies demonstrated the effect of stressors on immune function. Moreover, many retrospective studies had found that a high proportion (up to 80%) of patients reported uncommon emotional stress before disease onset. This, however, is not surprising as the disease itself causes significant stress in the patient. 1

This means that, while the researchers cannot yet prove that stress is one possible trigger to the onset of autoimmune disease, the indication of a large percentage of retrospective interviews describing uncommon emotional events before disease onset is a compelling one. And in my own personal experience, in talking to so many people every day living with autoimmune disease, the links between personal trauma and autoimmunity are certainly observed.

For example, one event I hear about often as a possible trigger to autoimmune disease is the experience of labor and delivery of a child. Personally, this is part of my story- my autoimmune disorders came on soon after I had given birth. And while my son’s birth was a glorious moment and I love my son with all my heart- the stress and trauma it inflicted on my body perhaps was too much to handle.

So, while there is no definitive proof about the relationship to stress and the onset of autoimmune disease, it is very likely that stress plays a role here. So- as we continue to unpack the role that stress plays within our bodies while living with autoimmune disease, I think it’s an important piece of information to keep in the back of our minds as we continue to dig in deeper to the mechanism of stress and how it impacts our daily experience of managing our chronic illness. **

THE MECHANISM OF AUTOIMMUNE DISEASE & CHRONIC ILLNESS AS A STRESSOR ON THE BODY

So, now that we have discussed the possibility that stress could have contributed to the onset of diease within our bodies, let’s look at what type of impact chronic illness has on the body after it has been triggered.

Autoimmune disease is defined as “an illness that causes the immune system to produce antibodies that attack normal body tissues. Autoimmune is when your body attacks itself. It sees a part of your body or a process as a disease and tries to combat it.” 5

As we read above, the autoimmune disease basically causes our own immune system to attack our internal body systems as if they were an outside intruder, like the flu. Our immune system is built to protect our bodies from illnesses, virus’s and bacteria. However, in layperson’s terms, when we live with autoimmune disease, our immune system goes haywire, gets confused, and begins a constant stream of attack within our own system. It’s a constant stream of attack, because unlike the flu, which can be destroyed, your internal organs, your thyroid for example (in the case of Hashimoto’s disease, Graves Disease, and other autoimmune disorders)- weill, your thyroid can’t be easily killed off. So if the body considers the thyroid to be the outside intruder, it’s going to spend an intense amount of time trying to protect your body from it’s own thyroid.

This constant barrage of attack, as well as the constant inflammation caused by the immune system activity, creates a very large stress load for our body to handle and process. This internal stress activates the sympathetic nervous system, otherwise known as the “fight or flight” mechanism of the central nervous system. 6 And then, this fight or flight mode remains active indefinitely, which has a major effect- depleting the body of its energy. This is a significant contributing factor to the exhaustion and pain that we feel when we live with autoimmune disease. 7, 8

THE CYCLE OF ADDITIONAL STRESS AS AN AUTOIMMUNE SYMPTOM TRIGGER

Now that we understand how our body is under constant physical stress and duress from our autoimmune disease, it perhaps becomes more clear why our bodies, living with this chronic illness, as less able to handle additional outside sources of stress. As our nervous system is already overloaded from this constant barrage of internal abnormal activity, any additional outside stress will cause our already maxed out systems to go into overdrive.

So then let’s think of the many additional types of stress that we encounter every day. These everyday stressors can have a big impact on our ability to manage (or not manage) our disease.

External Stressors: These are stressors on our systems that we don’t often think about. When we eat chemically processed foods, like fast food or colas or sugary sweets, our body has difficulty processing it. For those of us with an already overloaded system, this type of stressor can aggravate our symptoms further and make us feel worse rather than better. Other types of external stressors are things like the ding of a cell phone (which stimulates the sympathetic nervous system), lack of sleep, or dehydration, when we don’t drink enough water. All of these things make our systems overloaded without us even knowing it.

Physical Stressors: These are the stressors that cause us physical difficulties and aggravate our physical pain. Things like poor posture, under-active and tight muscles, cause pain for all people- but when you are someone who lives with the additional stressor of autoimmune disease, this pain (like lower back pain, neck pain, and joint pain) is excruciating. Other more extreme types of physical stress are things like broken bones, surgery, and other types of physical trauma.

Emotional Stressors: We all have emotional stress on a day to day basis. Emotional stress can be triggered by things like traffic, or our interactions with other people. Relationship stress, family stress, work stress, all of this takes a toll on our bodies, triggering an even more overactive fight or flight response. Emotional stress can also be from trauma that occurred long ago.

It’s extremely important that we examine these stressors in our lives and that we make sure find ways to limit and balance out the intensity of these stressors in our everyday life. This is essential for disease management. The more we can control our own personal stressors, the more likely it will be that you can keep your autoimmune disease from flaring-up.

There are a multitude of options for stress management. Therapy, meditation, nature, art, play, love, hugs and snuggles- these are just a few. What works best is different for everyone- but as long as you find joy in your life, the joy will outweigh the stress, and you will benefit.

EXERCISE AND THE BENEFITS OF POSITIVE STRESS

And of course, since this IS Autoimmune Strong, I would be remiss if I didn’t mention exercise as a method for managing and reducing stress.

You see, while we most often think of stress as a negative, there is such a thing as positive stress. This is called eustress.

Eustress is the type of stress that actually improves our life in a positive way, and actually has the ability to help us manage and reduce our symptoms of autoimmune disease. 8 And exercise is a perfect example of eustress.

Exercise is defined as a stress on the body. That’s how exercise creates change within the body- by putting a certain kind of stress on the body- the body responses with adaptation. So- if exercise is done properly, it becomes a positive stress- because it creates positive improvement on the body. Exercise can elevate mood, reduce anxiety and depression, improve blood flow, heart and lung health. Exercise can fix postural problems, can make daily physical activities easier, more fun and less prone to injury. Exercise can tone muscle and develop strength and improve balance, which has long term benefits as we age. AND- exercise can actually have an effect of reducing the symptoms of autoimmune disease 9

The key here is that phrase “if done properly”. When exercise is too aggressive or intense, it can flip from eustress to distress. And then it becomes a problem for people living with autoimmune disease, because it can cause symptom aggravation, rather than symptom management.

This is why Autoimmune Strong is so important- it’s the only exercise program out there designed to help you find this sweet spot of eustress and exercise. Every person’s body is different and reacts differently to exercise. And every person’s body is dealing with a different amount of stress overload in their system. So- with a self-paced program, designed to go gently and slowly and progress over time- this will allow the body to access that place of positive, healing stress that will help repair and nourish the body, rather than deplete it.

Stress, Autoimmune Disease and Exercise- How This Creates Exercise Intolerance

Keep reading my next article here on exercise intolerance- to learn about how stress and autoimmune disease work together to make to make exercise difficult for you and your body. This article will tell you all about exercise intolerance- what it is, how to know if you have it, and what to do to overcome it. Click here to read.

**Please note here that I do not believe, nor am I implicating that researchers believe that stress is the only factor that causes autoimmune disease. There are many factors at play with autoimmune disease, stress is simply one possibility in this complicated matrix of disease.

1. Stress and autoimmunity.
   https://www.ncbi.nlm.nih.gov/pubmed/19931651
   

2. Stress as a trigger of autoimmune disease.
   https://www.ncbi.nlm.nih.gov/pubmed/18190880
   

3. The role of stress in the mosaic of autoimmunity: An overlooked association.
   https://www.ncbi.nlm.nih.gov/pubmed/30118900
   

4. Association between stressful life events and autoimmune diseases: A systematic review and meta-analysis of retrospective case-control studies.
   https://www.ncbi.nlm.nih.gov/pubmed/26708168
   

5. https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/autoimmune-disease
   

6. Current Directions in Stress and Human Immune Function

   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/
   

7. Restoring the Balance of the Autonomic Nervous System as an Innovative Approach to the Treatment of Rheumatoid Arthritis

   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188868/
   

8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911881/

   The role of stress in rheumatic diseases
   

9. Physical activity and autoimmune diseases: Get moving and manage the disease.

   https://www.ncbi.nlm.nih.gov/pubmed/29108826

Update! New Years Resolution 6 Months Later...

Back in January, I wrote to you with a confessional. I had recently made some HUGE changes in my life- I had moved my family to a new state, I had started full time building a business, and I was in a new town, away from all of the resources and routines I had relied on to stay healthy. It was overwhelming, to say the least. And I wrote to you then about how, in this time of intense transition, I was so busy taking care of everyone else, that I stopped taking care of myself. I let fear and overwhelm take over, and I stopped doing so many of the things I need to do to manage my health. 

You see, living with an autoimmune disorder or any kind of chronic illness requires constant vigilance in order to feel good. And I learned this the hard way. I stopped exercising every day because I told myself I didn't have time, that I had more important things to do. I stopped focusing on eating healthy, and instead, I focused on what was easily available, even though I knew it didn't serve me. I stopped carving out time for important self-care techniques, like foam rolling, because it felt hard and like it was an unnecessary use of my time. Instead, I just wanted to plop on the couch and watch tv before bed. I told myself that I deserved to relax because life was so stressful.

But I was wrong. I didn't "deserve" to relax and loosen up the reins. Because what happened was that, without staying on top of my healthy lifestyle, my health quickly deteriorated. I started having more frequent flare-ups. My pain and fatigue was back. I felt sore and uncomfortable all the time. So- by giving myself the space to take my eye off the ball, I actually paid a very big price.

I have learned my lesson, and I have spent the last 6 months working hard to get my health back. As I committed to you in January, this was not just a new years resolution, this was a lifestyle resolution. Never again can I take my eye off the prize of health.

And let me tell you- it was hard work to get it back.

Making time in my daily life for self-care was hard, especially when I always felt there were so many other demands on my time.

Exercise is hard work, especially if you are starting from scratch like I was. It's uncomfortable and difficult, and really challenges you both mentally and physically.

Eating healthy is a struggle- having to say no to things I love (like chocolate chip cookies and ice cream) is hard, especially when everyone around me says yes.

Taking time to foam roll at night, to breathe deeply during the day, to go to bed early- none of this is for the faint of heart.

But it is oh so worth it. Every second of the hard work is paying off. It's not perfect, I still face daily challenges, but I have come so far. 

I have lost weight, gained muscle, and I can feel my strength daily as I carry my groceries or throw my kids around in the pool.

I have gained confidence again- knowing that I can stick to a resolution and not give up halfway, even when it got really difficult.

I have gained true insight into myself and I have learned to say yes only to the things that are truly healthy for me.

I have more energy to get through my day, with a happy cheerful mood.

And most of all, I am proud of myself for finding my inner north star again.

These types of realizations don't happen quickly. They have come from 6 months of starting, failing, starting again, failing again... but not giving up. Sacrifices were made, tears were shed, but somehow, I made it through 6 months, and I am so much better for it.

In the next post, I will be talking to you about the 6 components of healthy living that I practice everyday (and hint hint- exercise is the first one!!!) So stay tuned!

What is Exercise Intolerance, and How Can I Exercise if I Have It?? Part 2: Exercise Induced Symptom Flare Ups

Have you ever done more than you thought you could during a workout, just to find that the next day you feel exhausted, perhaps even feverish and flu-like? This is an example of an exercise induced symptom flare up. In it’s simplest terms, exercise induced Symptom Flare-Ups are what happens when someone with exercise intolerance pushes too hard in the gym. When exercise is too much for us, our system gets aggravated and over-taxed, and the body’s way of responding is to go into a flare 1, 2, 3

What is a flare-up? People who live with autoimmune disease, fibromyalgia and other chronic illness know it well, they are intimately connected with the concept of a flare-up. A flare-up looks like this: when you have been feeling ok, perhaps even feeling good, and then all of a sudden you feel awful, you can’t get out of bed, your body is in pain and you can’t even move? That awful, indescribable but totally debilitating feeling is a flare-up. 

Flare-ups look a little different for each person, depending on the individual disease (for example, a Crohn’s flare-up has some symptoms like diarrhea that are different from a Hashimotos flare-up, which may be more flu-like) but generally, a flare looks like this: exhaustion, muscle aches, brain fog, painful body that is tender to the touch, lack of ability to function normally, along with heightened anxiety, depression and/or sadness.

Flare-ups can be caused by a wide variety of factors that can range from the change in seasons, to eating certain foods. Basically, anything that puts stress on the body can cause a symptom flare up. Stress has been documented as a trigger of an autoimmune disease and of a symptom flare-up (you can read my blog on stress here). And while there is a limited amount of research linking exercise directly to the experience of an autoimmune flare, the connection is obvious.

If stress causes a flare-up, then exercise causes a flare-up, because- exercise IS defined as a physical stressor on the body. At its most basic, that is actually the goal and purpose of exercise- to put the body under stress, so the body can adapt to the stress. In this adaptation, change happens- our muscles get stronger, our heart and lungs work more easily and efficiently, our body is better able to regulate hormones, and on and on. All of these adaptations are wonderful- these are the things our doctors want us to experience, to increase our healthfulness.

However, to get these benefits of exercise, we have to actually perform exercise, which causes a temporary increase in cortisol in our system. And for people with autoimmune conditions, that increase in cortisol (otherwise known as our stress hormone) can be too much for our system to handle. As I said before, stress (otherwise known as cortisol increases) can trigger autoimmune symptoms. This is how exercise induced symptom flare-ups happen to people with low tolerance to stress- i.e. people living with autoimmune disease and exercise intolerance. 

However, just because your exercise intolerance puts you at risk for an exercise induced symptom flare-up, it does not mean you should avoid exercise.

Exercise has significant health benefits, especially for people living with autoimmune disease and chronic illness.

It simply means that we need to modify our exercise plan to stay in line with the actual needs of our body.

As I have said before, exercise has been medically proven to be beneficial for those of us living with autoimmune disease. If done properly, not only can exercise provide long term overall health benefits, but it can also help us manage our specific autoimmune symptoms and flare-ups. Chronic pain and autoimmune conditions are exacerbated by inflammation, and, if done properly, exercise can help to reduce inflammation and pain caused by inflammation.

Additionally, the right exercises can teach our bodies adapt to a pain response, which can help us get through the pain and exhaustion of our daily activities. Our bodies need to learn to be comfortable being uncomfortable in a safe, protected way, so that when we are exposed to surprise, challenge and discomfort in our daily lives, our bodies are prepared to handle it.

Without exercise and movement, our physical aches and pains will actually increase over time. The goal here is to exercise daily, doing the right kind of exercise, to help your body reduce the pain experience and increase healthfulness. 

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.

1. Severity of symptom flare after moderate exercise is linked to cytokine activity in chronic fatigue syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378647/

2. Exercise and fatigue
https://www.ncbi.nlm.nih.gov/pubmed/19402743

3. Post-Exertional Malaise in Patients with ME and CFS with Comorbid Fibromyalgia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464757/