Expert: Suzan Jackson - 10/27/2009

Question
I have CFS and by the end of the day or the work week, I am too tired to exercise.  Should I push myself and exercise anyway?

Answer
Hi, Deborah -

First, I'd like to apologize for the delay in getting back to you.  I've been severely ill with a bad CFS flare-up that lasted over a month, so my computer time has been pretty limited.

I was actually kind of surprised by your question.  Most people with CFS can't exercise at all.  In fact, it's amazing that you're able to work (sounds like full-time?).  That's unusual in itself for someone with CFS, so I'm guessing your CFS is milder than most (though I'm not underplaying how hard this must be for you!).

One of the primary, defining characteristics of CFS is an intolerance to exercise or exertion.  It's one of the few symptoms of CFS that is unique and can help to diagnose whether symptoms are from CFS or from some other cause.  The CDC calls this exercise intolerance "post-exertional malaise."  It comes from dysfunction at the cellular level, with the way our bodies respond to exertion, resulting in something researchers call oxidative stress.  Generally, we are especially intolerant to aerobic exercise (the kind that raises your heart rate).

What this mean, in practical terms, is that exercise or exertion makes you sicker and makes your symptoms worsen.  It's a delayed reaction: often, exercise can even feel good when you're doing it, but within an hour to 24 hours afterward, all of your CFS symptoms will suddenly worsen dramatically, making it feel as if you have the flu.

Here are some articles and research papers explaining exercise intolerance:

http://www.prohealth.com//library/showarticle.cfm?libid=12921

http://www.prohealth.com/library/showarticle.cfm?id=8661&t=CFIDS_FM

An article that explains exercise intolerance in simpler terms:

http://www.prohealth.com//library/showArticle.cfm?libid=13119

And an article about whether people with CFS should exercise:

http://www.cfids.org/archives/1998/pre-1999-article11.asp

So, the short answer to your question is a resounding NO!  People with CFS should never force themselves to exercise; it will only make you worse.  Generally, having any symptoms at all is a sign that your body needs rest.  The more you rest, the better you'll feel.  You should only attempt light exercise (short walks, yoga, stretching, etc.) when you're feeling good and have few symptoms and, even then, you have to be very careful not to overdo or you'll end up sicker the next day.

Although there aren't a lot of effective treatments for CFS, a few things do help, including treating sleep dysfunction, treating Orthostatic Intolerance, treating underlying infections, and proactive rest.  Please let me know if you'd like more information on any of these aspects of CFS.  You can respond again here on AllExperts or contact me through my blog (see below).

Good luck and best regards -

Sue Jackson

www.livewithcfs.blogspot.com