Did you know that exercise can actually reduce inflammation? Moving your body every day is a great way to feel better and improve your mood. In addition to those benefits, you can combat chronic inflammation with exercise. However, too much of a good thing can be harmful. Prolonged or very intense exercise may actually exacerbate inflammation. That being said, exercise is an essential part of the healing journey.
Exercise and anti-inflammatory benefits
Exercise has so many benefits, especially if you have an autoimmune disease. One of the best side effects of exercise is how it impacts inflammation. Why is this important? Because chronic inflammation affects or even causes almost every autoimmune disease. In fact, underlying symptoms of autoimmune diseases improve when we minimize inflammation and oxidative stress. Below are a few of the important benefits of exercise:
Exercise can influence the Th1/Th2 balance
Helper T cells are an essential part of our adaptive (or acquired) immune system. These cells activate other cells to produce antibodies, attack invaders and infections. There are 2 types of helper T cells – Th1 and Th2. Each of these types of cells release different chemical messengers (called cytokines) that perform a specific immune function (1).
Th1 and Th2 cells are balanced for most people. However, in autoimmune conditions, there is an imbalance where one type of helper T cell is dominant. Check out this blog for more detail about these cells and autoimmune diseases.
Now, how does this tie into exercise? Exercise can actually help shift the helper T cell balance to lower Th1 production. This is especially helpful for Th1 dominant diseases including multiple sclerosis, inflammatory bowel disease and rheumatoid arthritis (2). However, if you have a Th2 dominant disease like systemic lupus erythematosus (SLE) or Sjogren’s syndrome, exercise can still provide many benefits.
Muscles release anti-inflammatory agents during exercise
Exercise causes muscles to contract. Contracting muscles release interleukin 6 (IL-6). IL-6 is both an inflammatory cytokine and an anti-inflammatory messenger. However, the IL-6 released during exercise helps reduce inflammation (3). These anti-inflammatory benefits work for moderate exercise. When exercise becomes more prolonged and intense, IL-6 stimulates cortisol production. Cortisol is our stress hormone, so more cortisol puts more stress on the body (4).
Exercise can lower oxidative stress
Oxidative stress refers to the imbalance of free radicals and antioxidants in the body. Free radicals are these nasty little particles that float around in the body and damage cells, tissues and organs. Antioxidants capture these free radicals and stop them from harming our body. Our bodies get stressed when there are more free radicals than antioxidants. This is called oxidative stress. Low to moderate levels of exercise can actually lower oxidative stress. In a study of elderly people, simply walking 30-60 minutes twice a week lowered oxidative stress levels (5).
Do all forms of exercise benefit us?
The short answer is no. The above benefits are realized with a low to moderate amount of exercise. We start seeing these benefits disappear with longer and more intense activity. Researchers call this the J-curve of exercise (6). Being completely sedentary increases inflammation. As activity increases, inflammation drops and boosts the immune system. However, there is an inflection point. More intense exercise increases inflammation and suppresses the immune system. Here are some of the downsides of intense exercise:
Intense exercise may cause immune system dysfunction
The immune system can suffer from prolonged, continuous exercise. Any moderate to intense exercise over 1.5 hours starts to affect how efficiently the body attacks invading viruses or bacteria. In fact, several studies on marathon runners show that they are 2-6 times more likely to develop upper respiratory tract infections than non-marathon runners. While exercise has anti-inflammatory benefits, prolonged exercise depresses both the innate and adaptive immune systems (4).
Strenuous exercise can increase stress hormones
Intense and/or prolonged moderate exercise activates the stress hormones. Exercise increases epinephrine and cortisol, otherwise known as the fight or flight hormones. These hormones not only signal stress, but they lower macrophage and Th1 production. So when the numbers of these specific immune cells fall, the immune system is less robust and efficient (4).
Exercise may trigger leaky gut
Leaky gut is the common denominator of autoimmune disease. Healing the gut is typically the first step to healing inflammation. But, exercise can ruin all of that. Gut permeability increases with an increase in exercise intensity and duration. One study found that exercise at or above 2 hours at a 60% VO2max is when things start to go downhill (7). Check out my Instagram Friday Live for a deeper discussion on this topic.
How can I use exercise to improve my autoimmune disease?
There are clearly benefits from low to moderate exercise. And, incorporating movement into your daily routine can help reduce inflammation, improve joint mobility, and increase your quality of life. It is important to keep exercise comfortable and non-strenuous to avoid putting too much stress on the body. Some of my favorite ways to move the body include:
- Jogging at low intensities
- Strength training
If you are doing exercises that can go up in intensity (like jogging or cycling), be sure you are checking in with your body. You should be able to hold a conversation while doing these exercises. However, if you are out of breath, you are working too hard. Additionally, getting support from a local trainer or physical therapist can be lifesaving. They will be able to determine the appropriate exercise for you and your condition. Also, if you cannot find anyone local, check out the autoimmune strong online programs.
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