By Rory Linehan

Key messages:
  • Exercise is important as a hormone regulation tool
  • People with active autoimmune disease should avoid high-intensity workouts such as long distance running
  • Low-moderate intensity cardio training has been shown to reduce pain, fatigue and physical function in Multiple Sclerosis patients
  • Strength training has been shown to decrease fat percentage and improve hormone regulation in patients with polycystic ovary syndrome
  • Low-moderate intensity cardio or strength training is best for those with active chronic inflammatory and autoimmune disease.

My health has been on a roll recently. I’ve increased the amount of food in my diet, I’ve been sleeping well and I have been far more productive than ever before. With all of these positive changes, I felt I was ready to increase my exercise frequency and intensity.

Anyone who knows me well, knows I love exercise. I was a cross-country runner in high school, played Australian Rules Football and had a regular weight lifting routine. Once I fell ill, I was unable to continue running or playing football. It was too much stress on my body. I was however very grateful to be able to maintain the weight-lifting.

My improved health provided an opportunity to try running again, to reclaim the that endorphin rush I had been missing for years. Unfortunately, things didn’t quite go according to plan…. After my first run I felt great but I noticed that the next day I was lethargic getting out of bed and my mental clarity was poor at work. I tried again the next day and again, I had the same symptoms. I knew my body wasn’t quite ready yet.


My first run past the White House. It felt great in the moment, but not so great the next day…

I’m determined to learn from my setbacks and this experience got me asking myself, what are the best types of exercise for those with autoimmune and chronic inflammatory diseases?

Why exercise?

Regular movement and exercise is critical for good health. Despite what you may have been told, exercise isn’t nearly as important for calorie burning as it is for hormone regulation[1]. All forms of exercise have a profound impact on our ability to adequately regulate our hormones, which is crucial for those with chronic illness.

Which type(s) exercise is best?

There is raft of exercises which we can chose from including;

  • cardio-intensive
  • strength training
  • low-intensity
  • high-intensity

With all of these choices, it can be difficult to determine which is beneficial and which may be harmful. According to integrative health expert Dr. Jim Nicolai, for people with autoimmune disease “mild to moderate exercise is best for boosting your mood without overtaxing your body[2]”. Further to this, ancestral health practitioner Chris Kresser states that “excessively intense exercise can cause a variety of health problems, especially for those dealing with other concurrent stressors such as autoimmune disease[3]”. This is especially so if you are one of the 20 million Americans who have a form of thyroid disease. The stress caused by intense exercise has been shown exacerbate the symptoms of hypothyroidism.

Unless your autoimmune symptoms are in remission or very well managed, it is best to stick a moderate or low-intensity work out.

So now you know how intense your workout should be, let’s see examine cardio-intensive and strength training.


A 2015 study[4] looked at the influence of regular walking on fatigue and pain in patients with the autoimmune disease Multiple Sclerosis. The results showed that after three sessions of 40 minutes per week for 12 weeks, patients improved not only their pain and fatigue over base line measures, they improved their physical function and mental health too.

While the results of one study alone aren’t enough to make sweeping generalisations, these results are encouraging enough for you to incorporate regular low-moderate intensity cardio-activity into your exercise regime.


The best documented effects of strength training on overall health are on hormone regulation. Hormones are the chemical signals that connect virtually every cell in your body and effect everything from weight control, to insulin sensitivity, bone density and maybe most importantly for those with autoimmune disease, stress management[5].

Handsome young man training biceps lifting barbell on bench in a gym

In another 2015 study[6], a group of patients with polycystic ovary syndrome (a disease which often precipitates or accompanies autoimmune disease) undertook strength training for three times a week over 10 weeks. At the end of the study, the group not only improved hormone regulation compared to the control group, their fat percentage decrease significantly too.


And the winner is?

There is convincing evidence that both low-moderate intensity strength and cardio training have beneficial effects on chronic inflammatory disease. In terms of which type of training has the greatest benefit, the answer will vary according to the individual. It’s a case of n=1!

Your own self-experimentation and personal preference will help you decide which type of exercise, cardio, strength (or both) works best for you. To make sure the exercise is beneficial and not detrimental, people with autoimmune or chronic disease need to make sure you don’t over-train and you keep and exercise to low-moderate intensity.

I’d love to hear about your exercise regimes! Do you exercise? Have you changed the type and/or frequency because of chronic illness? What has exercise works and what doesn’t? Let me know in the comments section below

* This information is advice based on research conducted across medical journals, clinicians’ websites and online newspapers.  I am not a medical professional and as such, please consult with your doctor before incorporating any new exercise regime into your life.