Exercise Intolerance and POTS

It's the dreaded advice you know your physician is going to eventually bring up.  Exercise.  But, it's been way. too. long. since you last exercised.  You're not even sure if you can do a sit up without passing out.  

Maybe you were a marathon runner before your diagnosis.  Or, maybe you were the average couch potato who enjoyed reading books more than running down the street.  The fact remains that you are not tolerating exercise well.

WHAT IS EXERCISE INTOLERANCE

Exercise intolerance is a condition in which a person experiences symptoms such as shortness of breath, fatigue, or chest pain when they exercise. These symptoms can occur even when the person is exercising at a level that is normally expected for their age and size.

There are many causes of exercise intolerance, including heart disease, lung disease, anemia, and even some chronic illnesses such as POTS, or postural orthostatic tachycardia syndrome.

As someone with chronic illness, have you found yourself sucking in air by going up a flight of stairs?  What about just going to the mailbox in the heat?  You may have exercise intolerance.  Let's look at the symptoms.

SYMPTOMS OF EXERCISE INTOLERANCE

• Shortness of breath
• Fatigue
• Chest pain
• Lightheadedness
• Dizziness
• Nausea
• Vomiting
• Muscle cramps

Right.  Okay, so those symptoms are basically your life.  UGH.

If you experience any of these symptoms during or after exercise, it is important to stop exercising and rest. We know, we know.  If you stop you might never start again.  That's okay.  If you find it difficult today, try again tomorrow.  The point is consistency. 

If the symptoms are severe or do not improve with rest, you should see a doctor.

POTS AND EXERCISE INTOLERANCE 

Postural orthostatic tachycardia syndrome (POTS) is a condition that affects the autonomic nervous system, which controls involuntary body functions like heart rate, blood pressure, and breathing. People with POTS often experience a rapid increase in heart rate when they stand up, which can lead to symptoms like lightheadedness, dizziness, and fatigue.

One of the most common symptoms of POTS is exercise intolerance. This means that people with POTS may have difficulty exercising or may experience worsening symptoms after exercising. There are a few reasons why exercise intolerance can occur in people with POTS.

• Reduced blood volume: People with POTS often have a lower blood volume than people without POTS. This can make it difficult for the heart to pump enough blood to the brain and other organs when they are upright, which can lead to lightheadedness and dizziness.
• Improper blood distribution: The autonomic nervous system is responsible for distributing blood throughout the body. In people with POTS, the autonomic nervous system may not be working properly, which can lead to improper blood distribution. This can cause symptoms like lightheadedness, dizziness, and fatigue.
• Muscle weakness: People with POTS may also experience muscle weakness. This can make it difficult to exercise and can lead to worsening symptoms after exercising.

HOW TO EXERCISE WITH POTS

Your doctor finally said it to you, didn't he?  He said that the next step to managing symptoms of POTS is exercise.  Or, maybe you are simply desperate enough to try anything even if it means borrowing from tomorrow's energy levels (hello, spoonies!).

Here's some great tips on how to manage starting an exercise routine:

• Start slowly: It is important to start exercising slowly and gradually increase the intensity and duration of exercise over time.
• Listen to your body: It is important to listen to your body and stop exercising if you start to feel lightheaded or dizzy.
• Stay hydrated: It is important to stay hydrated before, during, and after exercising.  We recommend drinking a NormaLyte before and after an exercise routine.  Not sure how much NormaLyte to drink?  It's best to ask your physician.
• Elevate your legs: If you start to feel lightheaded or dizzy, elevate your legs to help improve blood flow to your brain.
• Take breaks: What's the saying?  Rome wasn't built in a day (wiki it here).  If you need to take a break during exercise, do so. It is better to take a break and continue exercising later than to push yourself too hard and worsen your symptoms.

If you have POTS and are experiencing exercise intolerance, talk to your doctor. They can help you develop a personalized exercise plan that is safe and effective for you.

Here are some additional tips for managing exercise intolerance with POTS:

• Choose exercises that are low-impact and do not require a lot of standing.
• Exercise in a cool, well-ventilated environment.
• Wear compression stockings or garments to help improve blood flow.
• Stay hydrated before, during, and after exercising.
• Gradually increase the intensity and duration of exercise over time.
• Listen to your body and stop exercising if you start to feel lightheaded or dizzy.

What kind of exercise program worked best for you?  Give us your best POTS exercise tips below!