Achieving the Healing Benefits of Exercise When Dealing With Chronic Illness

by Dr. Susan Tanner, MD

“Do you exercise regularly? If so, what type of exercise do you do?”

Okay, okay. I can hear the audible groans as those questions are launched! I am actually quite familiar with the response, as I encountered it often when I asked my patients about exercise for many years in my medical practice. My goal was never to shame anyone, though; rather, I wanted to gather key information about their routines, and life practices that could give me a better insight into their current health, mindsets, and overall wellbeing. You see, a person’s exercise regimen or lack thereof is truly every bit as important as any meds that they are taking, any illnesses they have had, and any symptoms they are currently experiencing.

Exercise is as important to our health and longevity as food and water. Our bodies are meant to move—it is true, if you don’t use it you lose it. Far more than that, however, are the huge positive impacts that regular exercise has on boosting and strengthening the immune system, increasing overall metabolism, mitigating stress and negative thinking, enhancing bone and muscle health, improving quality of life, and lengthening life span.

The is no one-size-fits-all exercise regimen. Recommendations for exercise depend on many things, and obviously will vary according to the basic health of the individual. Questions like whether or not they are already active, and if there are underlying medical conditions that require modifications must be taken into consideration. In one article I cannot tackle everything, but what I hope to lay out here is a “basic course of exercise” recommendation for most people. That being said, before starting any program, especially if you have been inactive, I would recommend that you do get medical clearance from your doctor to make sure no underlying issues are present.

Exercise BASICS

There are many iterations of exercise, but for the purposes of this article, I am going to divide exercise into 2 main categories:

  1. Aerobic exercise;
  2. And, Strength training.

Aerobic exercise and strength training are equally important, as they work together to improve/maintain internal health and regulation, to make bones strong, and to keep muscles and tendons supple. If you have access to and can afford a personal trainer, all the better, as they do help to keep you accountable and can customize a program for you to help you develop a well-balanced routine and to avoid injury. Also, always remember that of utmost importance is taking everything slow and steady. You can always add more, but you don’t want to overdo it when you are just starting out and set yourself back in your health goals or in your recovery from any health challenges you are facing.

(Note: For an article specifically about how a mold illness sufferer got back into exercise from sickness, click HERE.)

Aerobic Exercise

The American College of Cardiology states that running 5 minutes a day can reduce the risk of cardiovascular disease up to 45%. This is HUGE! I take that a step further and recommend something called high intensity interval training, or HIIT. This can be done walking, running, or on a bike, or on an elliptical machine.

What to do:

  1. Start with a moderate pace for 2 minutes. You should feel your blood flowing, and your body becoming active, but should not become breathless.
  2. Next, you are going to go for 5 rounds of a 30 seconds on, 60 seconds off interval. At the top of the first round, you will push yourself as hard as you are able until the 30 seconds is up. Then take 60 seconds to recover, working at a moderate level. You will repeat this 30 seconds hard push, and 60 seconds moderate effort until the 5 rounds are complete.
  3. Do a 2-minute cool down at a moderate pace.

(Note: The beauty of this type of HIIT training is that you can increase your intensity by upping your pace, upping the resistance on the machine, and/or upping the incline. Varying which machine you use and what variables you manipulate can also increase your fitness and aerobic capacity, because it prevents your body from adapting and plateauing.)

That’s it! As you become more fit, you can do more intervals, or you can incorporate these intervals into a longer overall workout session such as a longer walk, jog, biking or elliptical experience. But, if you just start here, with this minimal investment of time, the benefits can be noticeable in just a few weeks. These benefits may manifest as weight loss due to improved metabolism, better endurance as aerobic capacity is increased, better sleep, and better mood. Additionally, the metabolic changes AFTER you are done exercising stay with you for the next 8-12 hours.

If you can commit to 3 days a week of HIIT, that is ideal. The great thing about HIIT training is that if you suffer from fatigue or any illness, you can modify your maximal effort as needed.

(Note: In addition, there is a stellar recent scientific study to suggest that HIIT training can help with insulin resistance and a decreased ability for the body to use fat for fuel that come as a result of sleep deprivation. Since many mold illness patients specifically struggle with getting to sleep and staying asleep, insulin resistance and a poor ability to regulate blood glucose can become quite problematic. Instituting a few, even moderate, HIIT sessions per week could attenuate some of the deleterious effects on the body caused by the constant lack of sleep.)

Strength Training

These sessions can be incorporated in the days in between HIIT, or can be done the same day, but again, 3 days per week is ideal. Investing in some simple hand weights, resistance bands, or using machines at the gym or YMCA are all options. If you elect to use machines, receiving proper instruction on their utilization is a very good idea to avoid injury.   Start slow and light. While it is not in the scope of this article to demonstrate specific exercises, maintain proper form and full range of motion are more efficacious and beneficial than lifting heavy. Choose exercises that mimic functional movements, like lifting things from the floor or overhead, or sitting and standing back up. These exercises engage multiple muscle groups, help strengthen muscles in movement patterns most often used and needed in daily life, and burn more calories. Also, looking at exercises that involve specific muscles, like the thighs, (hamstrings and quadriceps), the “bottom” (gluteus)—strong glutes actually protect your lower back, shoulders and arms (biceps and triceps) are all good when properly executed. In general, begin with weight that you can easily lift, and begin with 8- 10 repetitions of the exercise. When weights are light, keep rest periods shorter, about 30 seconds or so. Then, repeat that exercise again, for a total of 3 sets.   You may prefer to do “circuit training”, in which you move from one exercise to the next to the next, and then repeat the course from the top. For example, you would do 10 shoulder presses, 10 bicep curls, and 10 triceps extensions, rest and repeat for 3 rounds, rather than doing 3 sets of each individual exercise. As you get stronger, you can increase the weight that you use, little by little. Using proper technique and form will prevent injury. Obviously, you can modify what you need to if you have underlying structural issues or are easily fatigued.

The overall benefits of resistance training include increased resting metabolic rate and better weight loss, improved bone health and increased muscle mass, improved body mechanics and coordination, improved insulin sensitivity and burning of more abdominal fat, and improved regulation of hormones including growth hormone and testosterone.

Measuring Exercise “Readiness” Using Heart Rate Variability

If you have been ill, or are new to exercise, then there is value in pacing yourself in how hard to push or when you may simply need a rest day. One of the best measures for this is something called heart rate variability (HRV). The topic of HRV is dense and worthy of an entire article but in the interest of brevity here, this measurement refers to the time interval between heartbeats. When we look at these intervals, there are patterns that evolve that show the balance in overall heart rate, respiration, blood pressure, body temperature and more–it is a non-invasive measure of the Autonomic Nervous System. An “exercise readiness score” can then be determined by the patterns that emerge. If you can measure and pay attention to your individual readiness scores, you can maximize your exercise efforts and know when to push harder and when to hold back. Usually, and in very simplified terms, high HRV is an indication of cardiovascular and overall health as well as general fitness. Generally speaking, it tells us how recovered and ready we are for the day. On the other hand, low HRV tends to indicate a heightened heart rate and stress response from the body, and can tell us that we need a rest day, or to take it a bit easy with the exercise, so that our bodies can recover.

There are several different devices that can be used to chart HRV. Personally, I like something called the Oura ring, which you wear like a normal ring during day and night to monitor your heartbeats. The information is linked to an app on your phone, and is fascinating—you can even see what happens to your HRV during sleep! Another similar device is called the Elite HRV, which involves wearing a chest strap and also sends the info to your smart phone. While you can surely make exercise decisions based on how you feel and energy level, having documented scores with these devices gives a great guideline as you progress more into the fitness world! Additionally, improvement in heart rate variability scores has been shown to indicate improvement in types of chronic illness in patients suffering from mold illness, chemical sensitivity and others. As a matter of fact, some environmentally-trained doctors see such value in HRV for charting a patient’s progress and response to treatment, that using an electrocardiogram (EKG) is part of each exam. Since HRV reacts to changes in the body earlier than heart rate, it is a powerful diagnostic tool.

Are you interested in implementing exercise into your life? If you are interested in learning more, or in proper supplementation for exercise, please visit and read my blog articles on this topic. If you have questions or comments on this or other articles, please write to us below or email us at