Blog changes

Thanks to everyone who followed Training Because I Can! over the last nine years. This blog started with Addison's Disease, hypothyroidism and a crazy idea of doing an Ironman distance triathlon. My life has changed and so has this blog. I am using this blog strictly for Addison's Support topics from here on out. I hope to continue providing people with hints for living life well with adrenal insufficiency.

Thursday, June 23, 2011

Addison's and exercise, getting started

Disclaimer:  This entire post is OPINION and not based on studies or anything other than personal experience and observation.  Do not start an exercise program without the permission of your physician.

I seem to be getting a lot of questions lately about getting started with exercising when one has Addison's.  (Thanks R and MDJunction friends!! and B).  My answer to how to get started is not usually well received!  Most people want to jump right back in to where they were at their peak physical form prior to diagnosis.  My opinion is, that's a terrible idea!  You're setting yourself up for injury and despising exercise. 

FYI, I do not consider myself an expert on exercise by any means.  I DO have experience with Addison's and exercise.

As I'm thinking about this, it's going to be a long one.  As usual, I'll put bold subheadings so you can skip stuff you don't want to read.

  • Are you diagnosed?  If no and you think you have Addison's, don't freaking exercise.  Your glycogen stores are depleted and you're prone to hypoglycemia, low blood pressure and you will lower your immunity.  One of the hallmarks of Addison's is fatigue that's worsened by exercise.
  • Are you diagnosed?  If yes, are you stable?  Do you feel well for most of a day?  A week?  If you can't answer yes to those questions, do you feel better with a short bout of exercise?  Get clearance from your doctor to exercise.  If you don't feel well for most of a day, 
    • Have you had your thyroid properly evaluated?  Pernicious anemia?  Iron deficiency anemia?  Parathyroid?  Diabetes?  Celiac?  Lupus?  Etc.
    • Do you replace deficient hormones like testosterone (yes ladies, that means you!), DHEA, progesterone, estrogen, sodium/potassium balanced with florinef?
  • OK, so you're diagnosed, stable and you have your doctor's permission to start exercising!  Yahoo!
  • Set a goal.  Research it, Evaluate it, write it down, announce it.  Know what it involves.  For example, want to go windsurfing in Mexico for a week.  Do you know how to swim?  What time of year is best to do this?  So, you need swimming lessons, money, plane tickets and you'll need to rent gear.  When's the next round of swimming lessons offered?
  • Evaluate your current condition.  BE REALISTIC.  Can't walk to the mail box?  Recently suffered from a huge crisis?  Feel ok?  IT DOESN'T MATTER, START SLOW.  Here's where you're going to start hating my advice.
  • Create a REALISTIC time line.  Jumping in full bore after a period of longer than three weeks of inactivity is, well, plain old dumb.  You are risking getting very sore (UNNECESSARY IN MY OPINION!!!)  and risking injury (ALSO UNNECESSARY).  Consider this, if you haven't done much for months and then you start slowly increasing exercise and intensity, you're doing much more than you've done for months.  Getting sore is not necessary in my opinion.  How can it be beneficial to do too much and get sore and not be able to do anything for days?  Doesn't it seem more reasonable to do a little bit every day?
  • SLOW DOWN.  Do less than you think you ought to and more often than you think you should.  For example, do you want to run a marathon?  Haven't run at all for months or years?  Start out walking every day.  Make your walking intentional, not like walking from your car to the mall and back. Current government guidelines.  
  • MAKE A PLAN  Find a good exercise plan for the activity you want to achieve.  Do you fit the minimum requirements.  Let's say no.  Let's say it's a marathon training program and the minimum requirement is a 15 mile training week prior to starting the program.   You can easily get there slowly!!
  • WALK, WALK, WALK  I'm a huge proponent of WALKING.  There's no shame to walking and it's GREAT exercise.  It's aerobic (if you're doing it right) and can be challenging.  Let's say you haven't been exercising at all and one mile is a reasonable distance for you.  
    • Plan to walk a mile a day for a week.
    • The next week, walk a mile a day but faster.
    • The third week, walk alternately a mile a day and two miles a day.
    • The forth week, walk two miles a day.
    • Week 5, you'll be way ahead of what you were doing a month ago!!!  You can start Hal Higdon's 18 week novice marathon training program as a power walker!!
    • Week 6, run one minute and walk four minutes.  Slowly, slowly increase the amount of running you do over weeks and months.
  • MEDS
    • I increase my hydrocortisone 5 mg for the first three exercises sessions of something I'm out of practice or have never done.
    • For long runs, I increase my hydrocortisone 1 mg for every mile.  For example, I would increase hydrocortsione by 5 mg for a 5 mile run.  Eventually, you may not need to increase for some runs.  You'll have to determine for yourself if it's necessary.
    • I used to increase my florinef.  Now, I do not.  With the increase of hydrocortisone, you get more mineralocorticoid properties of florinef.  
    • I use SaltStick when it's hot.  Admittedly, I don't have much experience with heat as it rarely gets warm enough to wear short sleeves here in Teton Valley.  This spring when I was running in Morocco, I took 2 SaltStick with my morning meds, 2 SaltStick prior to exercise and 2 SaltStick every hour I was running, 2 SaltStick or a high sodium dinner.  It worked well.
    • Hydrate.  Yep, drink water but not  too much.  Pee once an hour.  
  • Weight lifting and alternate exercises
    • I currently love the programs for squat, situps, pushups and dips.  It's very reasonable and slowly but surely increases reps.  No weights needed.  The goal is set for you so you don't have to research.
    • Use good form if you decide to lift weights.  START SLOWLY so you don't damage ligaments and tendons.  My opinion is the same for men as women.  Start slow and light, really.  Get a trainer if you really want to lift and don't know GOOD FORM.  
    • Yoga, I started doing Anusara yoga last fall and I think it's the greatest exercise EVER.
Crap, this is too long.  I doubt anyone even read this far down.  Use common sense!  Do less at the start of your exercise program!  Get a doctor's permission before you begin!

Please ask me questions in the comments section.  I probably didn't make sense in the above babble.  Remember, this is entirely based on opinion and experience, not fact.  Also, remember, I stink at running.  I'm a back of the pack "runner", mountain biker and pretty much any other physical activity.  I like lots of sports that I'm not good at and I do them regardless of how bad I am at them because I enjoy exercise despite my physical inability to do any of them well.


Pip said...

I agree with the starting slow. Before Addisons I used to do a lot of weights and a lot of spin classes and was fairly fit. After Addisons I spent a year at a sports rehab clinic before really getting back into the gym, running and cycling. I built myself back up again first.

Anonymous said...

This post is PERFECT. Very helpful. Keep talking!

Thank you!

Unknown said...

Pip and Anon, thanks for the comments. Anon, I will try to post more like this!


Eric P said...

I agree with slow start. start should be slow for doing exercises..

DFarias said...

Hello. Thanks for your posts.
I'm Adrenal Insufficient(Addisons) and love doing Yoga as an exercise. I think one of the reasons it works for me, in relation to my adrenals, is because instead of the heartbeat accelerating quickly, which can use up a lot of adrenal output or hydrocortisone, the heart rate is controlled somewhat and gradually increases because of the gradual increase in movement coupled with the deep, rhythmic breathing that goes along with all of the Yoga movements.
Diana Farias, Concord, CA

Tara said...

I am really still learning how to live with Addison's & Hashimotos. I have been a runner my whole life and then started training for a marathon and was also working with trainer and swimming - I was in incredible shape then everything just changed - my body wouldn't respond, and I started to become really ill. Well it is almost two years later. I have been on steroids for a year but it is only just recently that I have gotten the definitive - yes you have Addison's as well as Hashimotos. I am so grateful for your blog - I have been afraid to run again but last week I went and ran for the first time in over 18 months!

Rebecca said...

After more than 2 years, I finally feel good enough to run again! I have tried to run a few times during this journey, but I now know I wasn't ready yet. I have been walking at least a mile everyday for a few months now. On my better days, I have tried to incorporate some short jogs into my walk. Today was my best day yet. I walked/jogged 2.6 miles on my hilly driveway, .6 miles was running (6 x .1 mile jogs). I have walked farther, but this was the most I've run. I am focusing on building up slowly and it has been paying off. My first "race" will be in 3 weeks. My whole family will be walking a 5k trail race with me. I'm hoping to run a full 5k for the Easter race. (These are the only trail races near me. ) However, I have already accepted the fact that I may not be able to run a full 5k by then. For the first time in a few years, I'm okay with that. Thanks to this post and blog I know I will get it back, and that is what counts. I will run another marathon, backpack/camp with my family (this summer), and participate in my life again!

Thank you!

Unknown said...

Rebecca, thanks! It makes me so happy to hear that you are doing well. Thank you for sharing!

Good luck in your 5K!!


Maple Tree Girl said...

Thank you so much for this! I am recently diagnosed secondary adrenal insufficient and my doctor wants me to stop running long distances and start meditating instead.

That is so not going to work!

It is very encouraging to read through your blog and see someone who keeps lacing up and heading for the trails. I'm going to ask my doc to read your blog.

(I also just contacted my county EMS office to ask if they carry Solu-Cortef. My doc is writing me a script to have my own on hand at all times. Again - thank you for the excellent advice!)

Unknown said...

Maple Tree Girl,

Tell your doctor he's crazy! Don't let AI stop you from doing anything.

I ran across a portion of the Sahara in March and will run across much of Tennessee in July of 2012. I've done 100 miles in one go. Next weekend I'll be doing my 3rd 50 mile race in 3 months.

Pip, who commented above has run a marathon and various other distances. Linda A had a goal of running 50 marathons in 50 states and completed a lot of that goal. Sue is a swimmer. Heather is an amazing bike rider. Ashley is an avid surfer girl.

I feel better with exercise and AI.

You can do it!

I've got a forum too where there are many HEALTHY people with AI and some trying to stabilize and get diagnosed. Join us if you have any questions.

You go girl!

:) Dusty

Juanita said...

This is great. It is exactly what I needed. I was diagnosed with Addison's 2 years ago and I have been fighting with the condition since then. It is finally stable and I am feeling more like my old self than I have in a very long time.
I have never been an athlete, but I have been in much better shape than I am now. I have wanted to start exercising just to be able to do something positive for myself, but I couldn't figure out where to start. The plan is a fantastic idea. I am the type of person that needs a goal and a path to reach it. This will work great for me.
I'll let you know how it goes.

FlyingPigsRule said...

Dusty-- thanks for a great site and all the info! I've been athletic my entire life and am a relative newbie to AD/AI. I'm finally set for competitions again but am both scared and excited. In training, I'm always having issues about 45 minutes into my workout, even w/stress dosing. My docs are clueless, but as an athlete, have you ever run into this or do you have any thoughts on what else may be making me symptomatic? I want to be safe but don't want to let any of the diseases I have limit my life-- or sports. Appreciate all you're doing!!

Unknown said...


Come join us at the forum!

The forum has lots of healthy Addisonian's who exercise and can give their opinions on why you can't go longer than 45 minutes.



Anonymous said...

I have been living with Addison's for 17 years. I have kayaked 26 miles in a day. Over the past year I have taken up cycling. I have moved up 3 levels and am starting to ride one more level up. I biked 100 miles this past weekend. The first 30 miles I averaged close to 19 mph. I will say that Addison's makes hill climbing tough. My theory is that conditioning can compensate for AD. I also prepared by eating complex carbs the night before. Also eat them during the ride. Many herbs are beneficial for energy. Many herbs are beneficial for energy and testerone. I also take B complexes a aminos. I am considering bringing cortisone on the longer rides. GU packets help too. I do lift weights as well. I will be 50 this year and I plan on doing this when I am 75. Just to recap. Prepare, condition, medicate, train, hydrate, electrolytes.

Unknown said...

Hi Anonymous,

I hope you DO bring a pill or two of HC with you on your longer rides as well as an emergency injection kit!

I've rock climbed, downhill mountain biked and regular mountain biked. When i did a road bike tour of the Finger Lakes in upstate NY, I hung out with a bunch of experienced road bike ladies. OMG, they had incurred worse and more severe injuries than I'd ever heard of in all of the other sports I've done combined. Please protect yourself and wear a medic alert bracelet and carry an emergency injection kit! Ambulances DO NOT carry Solu-Cortef nor are they allowed to administer. Unfortunately, when you road bike, you are at the mercy of texting drivers and motor home mirrors...

Come join us at the forum I'd love to hear some of your Addison's sports techniques. I don't have any in particular and would love to hear more about yours.


Anonymous said...

Thank you so much for posting this. I so needed to read stuff like this. It has been years since I was fit, and I have been scared to try, but to see others who actually don't give up, gives me hope. With addisons, asthma, and hyposthyroid, I thought I was doing pretty good until I went into addison's crisis last Christmas. I don't want to give up either just because I am 57. I was finally diagnosed with addison's disease in 2009. So thank you for sharing. Keep up that great work.
My name is Janet but I choose anonymous below because I didn't understand some of it.

Unknown said...

Janet, come join us at the forum

You will be much healthier if you exercise. There are lots of active people at the Addison's Support forum!

I look forward to meeting you there.

:) Dusty

Anonymous said...


Thannks for perfect information. I have been diagonesed with addison past 8years and am 31 now.Exercise was never part of my lifestyle. May be because I had addison sympotms since I was 6, and It was undigaoned untill 24. But now I am thinking of starting hot yoga, Could anyone let me know whether It is good for addison patient and also for hypothroid patient( As I am hypo thyroid patient also ). Considering I am only 48 Kg. and never put on much weight in my entire life. I always been skinny. Please need suggestion thanx

Unknown said...

Hi anonymous!

Come join us at where I have a forum. Hot yoga is possible! We have an Addisonian on the forum who is amazing at it. As a matter of fact, she took me to my first hot yoga class.

I look forward to seeing you on the forum!


Anonymous said...

My skin getting dark pigmentation ..... do I need to increase the dose??

Unknown said...

Hi Anonymous, increasing your dose of HC is a decision that should be made based on all of your symptoms, not just an isolated one. It's also something that should be discussed with your physician. Please join is at the forum if you want more information so that you can know what to talk to your doctor about. Www.addisonssupport. com