Energy management and balancing expenditure versus conservation is an important issue for even the most healthy among us. For those suffering from autoimmune disease, for whom fatigue is often a major factor and symptom, proper management is crucial, as both a means of alleviating overall fatigue and ensuring that one has enough energy for the most significant daily activities. Here we consider some aspects of energy management and conservation for those dealing with autoimmune conditions.
Yes, there has been a decent amount of research and reporting dedicated to energy management, and even some that focuses exclusively on such conservation in autoimmune patients and populations. Since fatigue and energy loss is such a prominent symptom is so many conditions, the available studies tend to cover fatigue over a broad range of scenarios and diseases. One such investigation examined whether those suffering from COPD (emphysema or chronic bronchitis) could be helped in this regard by using specific energy conservation techniques (ECTs). While they don’t specify what these measures were, the researchers concluded that ECTs – which involved different body positions – did indeed lower the energy costs associated with activities of daily living, and also reduced patients’ perception of shortness of breath, a common symptom found alongside fatigue.
There are also several studies and reviews, similar to the first mentioned above, that examined energy expenditure and conservation during daily activities, without regard to autoimmune disease specifically. One particularly fascinating study reported on the energy expenditures made by all of us during non-exercise activity, meaning various “fidgeting” motions while standing or seated. While individually these movements don’t seem like they would make a big difference, the researchers found that collectively such movements do indeed contribute to energy expenditures great enough to affect one’s energy balance over the course of a day. The implication is that especially for those with autoimmune conditions, we must be mindful of even seemingly minor motions and how they may affect our overall energy balance and needs. Another study looked at daily energy costs and spending as it relates to mortality in older adults. Unsurprisingly, the investigators found a correlation between moderate energy expenditures and reduced mortality.
Two separate research reports focused exclusively on energy conservation for those diagnosed with autoimmune conditions, and seemed to rely heavily on intervention by occupational therapists (OTs), who play a major role in examining this issue and helping patients overcome or manage their fatigue levels. Each review centered on slightly different parameters.
One review discussed several non-pharmaceutical measures – such as different forms and levels of exercise, occupational therapy and even cognitive behavioral therapy – as treatments that have proven helpful to those dealing with autoimmune disease. The other was more concerned with the educational aspect and keeping the patient knowledgeable about best practices, as well as planning for the future (in terms of hours and days and “saving up” energy for the times you really need it). Both are excellent articles that offer practical advice for the autoimmune patient looking for relief from fatigue and ways to conserve energy for when it is most needed – the first is a PubMed article about fatigue and non-drug treatments and the second is specifically about energy conservation for those with autoimmune challenges.
Whether we’re considering healthy people or those with autoimmune conditions, there are always certain activities, such as strenuous exercise or standing for long periods, which tend to drain us more than others. There is no hard and fast rule as to which exercises or daily activities are acceptable, and this differs considerably among patients. In addition to the disease state, other variables include age, obesity, sedentary lifestyle and having additional limitations. In general, the name of the game is balance between choosing or performing activities that help keep you fit and those that (while providing exercise) result in more harm than good.
One of the main points made in the literature seems to be the idea of those with fatigue (from autoimmune issues or otherwise), learning to manage their energy reserves by making things easier on themselves whenever possible. One example of this is establishing “stations” at which to perform activities, where the person can sit and perform various tasks. Another is learning to inform others of one’s needs, and then allowing them to assist in activities of daily living and other more strenuous tasks, thus making life more tolerable and navigable.
While the limits on activity and exercise depend very much on the individual, certainly anything that leaves one absolutely exhausted and unable to participate in normal daily life and other endeavors should probably be avoided, since this goes counter to the idea of maintaining energy balance. It is also important to remember that depending on certain variables, performing the same activity may result in very different amounts of energy expenditure for two different people. That is, high-intensity exercise is not necessarily required for large energy expenditures, especially if the person is obese or otherwise unfit. Thus, different people will have very different experiences in terms of what exhausts them and what is tolerable.
Unless one has a specific physical limitation that prevents activity and exercise, mild to moderate exercise is almost always a good idea, regardless of autoimmune status. People of all ages, sizes and disabilities generally benefit from low levels of exercise, both in terms of general health and the ability to cope with disease flares or setbacks. When in good condition, the body is usually more able to absorb and deal with minor injuries and fatigue, rebounding more quickly than in those who remain inactive.
However, it is once again a matter of balance and personalization. Some people with autoimmune diseases report significant energy boosts with moderate exercise, while others claim it makes them even more tired. And some autoimmune sufferers are more able to handle intense, weight-bearing exercise than others. Finding the appropriate middle ground is the key, and this area differs quite a bit among patients. A bit of trial and error is often required for patients to determine their specific thresholds; this should be done in consultation with one’s clinician and any supporting therapists.
About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians. After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time. He may be reached at [email protected].
This blog post was originally published by AutoimmuneMom.com, written by Dr. Rothbard, and first published on Oct 4, 2013.