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About the fatigue and activity level thing

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    About the fatigue and activity level thing

    I wanted to post in Jules A's thread on this, but couldn't find a way to do it without derailing the topic, so decided to start a new one.

    I've discussed this with my doc to find out what sort of conditions can cause the type of fatigue that comes on by overexertion. Mine lasts a few days, but when I overdo things, I overdo it BIG. I like to finish a project once started and push until I get as close to that as I can on my good days. It can and has caused flare ups for me. Why? Nobody has an answer to that.

    My doc's response to the fatigue question was they typically only see this type of exercise intolerance in autoimmune conditions like fibromyalgia, lupus, MS, all of those. He says it's difficult because they always counsel people to be more active, but for those with these health issues it can be counterproductive and take someone back two steps for every attempt at making gains in fitness.

    He also said they don't know why this happens or how to resolve it. The best a person can do is to slowly build up their stamina and physical condition to not cause another episode of fatigue and a backslide.

    In searching for an answer to this problem, awhile back I ran across this position statement on how exercise affects the immune system. It's long and goes into some depth, so for those who enjoy a meaty scientific read, it satisfies. Grab some snacks, something to drink and set aside a couple of hours to mentally digest this one.

    In a nutshell, one of the things they're finding in the studies on athletes is that marathon sessions tend to stimulate pro-inflammatory cytokines in the body, whereas lesser exercise sessions tend to stimulated anti-inflammatory cytokines. Some of this may have to do with damage to the muscle and it's subsequent repair. Another interesting thing some studies have found is that massage after a marathon helps to tone down this pro-inflammatory state.

    That's just one small part of this. The 2011 position statement is based on 2200 research studies that have been published on exercise immunology to date. It's very long, thorough and comes in two parts. Here are the links:

    Part I: http://www.medizin.uni-tuebingen.de/.../6/article.pdf

    Part II: http://www.medizin.uni-tuebingen.de/...64/article.pdf

    There are some admitted weaknesses to these studies, mostly they've only studied well-conditioned athletes like marathon runners. They haven't studied this in people with autoimmune conditions. So the effects might not be the same.

    However, when one considers the signals their own body sends out after a "marathon" day (whatever that means for you individually), typically feeling ill and body going into 'rest or else mode,' these are signals that can indicate inflammatory activity of the defensive kind like what you'd get with a case of contagious illnesses.

    Yes, I'm extrapolating, but in a way that makes sense. I found that the slow, gradual building of physical fitness the PT taught me helped in increasing my endurance and strength, but not in a way that set me back and made me feel unwell. And it definitely never caused a flare up, unlike my own unsupervised attempts at home were.

    It was a very, very gradual increase, starting with exercises lying on my back for a few weeks, then taking them vertical for a few weeks, then adding in some light strength conditioning for a few weeks, then adding in brief sessions of cardio.

    We built up this way slowly over the course of months, twice a week and she took me from 15 minutes of light exercise to 45 to 60 minutes of light to moderate exercise. It was successful and only threw me off if I had some physical work to do at home above my typical level of fitness, which happened to be lower than I had ever imagined it was.

    I'm going off track here, but I wanted to share this in case someone else out there might be confused on how to go about getting more fit and gain endurance without experiencing a setback or flare up. As part of adopting an anti-inflammatory lifestyle, exercise is at the top of the list for it's many benefits along with its potential to shift one's immune system from predominantly pro-inflammatory to predominantly anti-inflammatory.

    These studies demonstrate there is a connection between exercise and the immune system, and that the connection can shift between pro-inflammatory and anti-inflammatory based on ones level of fitness and intensity of the workout session. I would imagine that could include household activities as well. The body doesn't know the difference. It just knows that there is extra stress being placed on it and responds according to the level of stress it endures.

    Exercise immunology -> such a fascinating subject. It gets me all excited.
    It's not fatigue. It's a Superwoman hangover.
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