Dr Rob Andrews, Consultant Senior Lecturer in Diabetes and Endocrinology has conducted detailed research into exercise and diet for those with Pituitary Conditions and Addison's Disease. While basic principles of exercise participation should be followed, some extra precautions need to be taken. Factors such as temperature, duration and intensity are considered*.
Exercise is an essential part of everyday living. The basic principles of any participation should include warm-ups, stretching, cool-downs, increased fluid intake and nutrition. A combination of aerobic activity, and strength work. Some flexibility and relaxation are to be included. Gradually increasing time and level.
So why is it important to consider additional precautions?
Exercise puts the body under stress. This requires cortisol. When you have pituitary insufficiency or Addison's disease the body cannot produce enough (or no longer produces). Then an adrenal crisis can occur. The signs of which are shown in the chart below from The Pituitary Foundation. This can be life-threatening.
Different levels of intensity
It's important to apply the principles of caution and management of your condition daily to your exercise. How much, if any extra medication will be determined by the actual activity, what is causing the additional stress and the symptoms you experience. Dr Andrews gives guidance to his patients using the chart below. Based on the intensity, duration, level and type of participation. Considering external factors such as extreme heat, extended lengths of exercise and competitive sports.
He comments that swimming should be considered high intensity. Due to the additional demand required to maintain body temperature in the water. Another recommendation is that if you feel unwell during or after exercise a small top-up may be required. If concerned talk to your Endocrinologist. Especially after a diagnosis or if your exercise participation increases. If you enter competitive events you may need to consider its impact and react accordingly.
Individual plans
Your consultant will work out your daily doses of medication with you depending on your specific schedule. Exercise will be a consideration. Inform them if you are involved in a lot of sport and a personalised plan can be created. Dr Andrews How to stay on top of exercise blog gives three timed examples, for medium and high-intensity exercise on a typical medication regime. These are for an athlete, taking a standard adrenal replacement regime.
Competitive Sport
Becoming fitter, stronger and faster with Addison's disease follows Mark’s Story. Diagnosed as a child he had a successful football career. He encourages people to have fun with exercise and not be scared. Carry snacks, drinks and medication. On a walk or run? Then set a tracker on your phone and send it to someone.
Summary
In the beginning focus on getting your everyday medication correct. Adjust medication as necessary. Think of the key points: duration, intensity, weather conditions and choice of exercise. Just being nervous or the pressure of being around more people. Changes in the ventilation of a room or new environments could make a difference. Even a change of coach or instructor. Use The Pituitary Foundation chart above as a reminder of the key symptoms to watch for. Listen to your body. Take your time. Build your confidence. If concerned take action. Then talk to your medical team.
*Please remember that these blogs are very real to us. We are on the same journey. It’s tough, slow and frustrating. Most of the Scenarios we face ourselves. Sometimes we find what we print useful. Other times we don’t. It’s included because everyone's journey is different. We have passionate perseverance to help others. To dispose of all content would be a waste and a disservice to our readers.
Links
Addison's Disease - Stay on top of exercise
Adams Story
Twitter Q&A answer session summary