Extra cardio exercise w/Hep C, good thing, or a bad thing?

[susan400]

I am just curious if anybody knows whether or not doing high intensity cardiovascular exercise is good or bad when you have Hep C.  For any newbies who don't know my history...., I am NOT SVR and I am currently NOT treating.  I have done in the past, 10 different tries at treatment w/o obtaining viral clearance.  Currently, I've been off of treatment for the past 7 mon.  My last doctor's advice to me when I had my final follow-up appt. after a clinical trial was, "Stay thin, stay skinny".   So, since I like to eat and don't have any desire to go on a starvation diet...., I've been exercising a bunch.  It's making me really, really tired when I do it, but I'd like to think that I'm doing some good for the rest of my body at the same time.  I've done the spinning class now, 3 times.  I've always done the treadmill at home anyway, even before I started at the gym for exercise.  I tried some yoga for the first time yesterday.  At the gym I've been doing the cross-country program on the treadmill where it goes fairly high up on the incline, to where I get pretty winded and really work up a good heartrate and sweat.  I've done the eliptical a few times, but I find it hard to do it for longer than about 10 min.  I've added in the arm exercise 'bike' now and the stretching machine.  And I've been gradually increasing the weigh on the nautilus/free weight equipment.  My question is, have you read anything that says if this is good or bad?

Susan400

[CoWriter]

Co,,, you ok,
hope you don't have a fever or something

what happened to the co/jm tango ?

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New strategy!

Co

[CoWriter]

No, it wasn't during treatment.  It was untreated people.  I'll look for it.  

Co

[jmjm530]

what happened to the co/jm tango ?
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Sometimes we waltz. Hope this will not disappoint since I know Sunday is a slow night LOL

[apache1]

Co,,, you ok,
hope you don't have a fever or something

what happened to the co/jm tango ?

lol
apache

[jmjm530]

I posted a study a while back about how long periods of intense exercise could cause relapses for people with Hep C, especially if you were not used to exercising.
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I'm assuming you're talking about long periods of intense exercise during treatment?  If so, I kind of  agree that there could be a problem with immune suppresion increasing the chance of relapse.

That said, I don't think the same can be said for long periods of intense exercise post SVR or perhaps even post EOT although the later may be trickier. SVR has been demonstrated to be quite durable -- close to 100% after 1 year -- so if intense exercise caused relapse then, we would be seeing many, many more relapses.

On the other end of the spectrum -- pre treatment, I can say from both personal experience (as well as consultation with hepatologists) that it is possible to "relapse" (probably a bad choice of words) from the chronic asymptomatic stage to what might be likened to a symptomatic acute stage -- sky high enzymes, dark urine, etc. This happened to me at least three times in the 3-5 years after infection. I had a very symptomatic acute stage which turned asymptomatic, only to turn acute again with the common demominator being intense exercise. I doubt if that would have been the case had I not had a symptomatic acute stage, but anyway that's what happened.

-- Jim

-- Jim

[CoWriter]

Aerobic exercise is good because it helps you create more mitochondria (the power plant of liver cells and site of the interferon response).  But as bjlaker said, over doing it can create oxidative stress.  

I posted a study a while back about how long periods of intense exercise could cause relapses for people with Hep C, especially if you were not used to exercising.

So as Jim would say, everything in moderation.  Gee, this is scary, I'm starting to quote Jim too much....LOL

And for those of you who might be reading this post and don't exercise....a 3 minute workout can help IR.....



Regular sprints boost metabolism

January 28th, 2009

A regular high-intensity, three-minute workout has a significant effect on the body's ability to process sugars. Research published in the open access journal BMC Endocrine Disorders shows that a brief but intense exercise session every couple of days may be the best way to cut the risk of diabetes.

Professor James Timmons worked with a team of researchers from Heriot-Watt University Edinburgh, Scotland, to investigate the effect of 'high-intensity interval training' (HIT) on the metabolic prowess of sixteen sedentary male volunteers. He said, "The risk of developing cardiovascular disease and type two diabetes is substantially reduced through regular physical activity. Unfortunately, many people feel they simply don't have the time to follow current exercise guidelines. What we have found is that doing a few intense muscle exercises, each lasting only about 30 seconds, dramatically improves your metabolism in just two weeks."

Current exercise guidelines suggest that people should perform moderate to vigorous aerobic and resistance exercise for several hours per week. While these guidelines are very worthwhile in principle, Timmons suggests that a lack of compliance indicates the need for an alternative, "Current guidelines, with regards to designing exercise regimes to yield the best health outcomes, may not be optimal and certainly require further discussion. The low volume, high intensity training utilized in our study substantially improved both insulin action and glucose clearance in otherwise sedentary young males and this indicates that we do not yet fully appreciate the traditional connection between exercise and diabetes".

The subjects in this trial used exercise bikes to perform a quick sprint at their highest possible intensity. In principle, however, any highly vigorous activity carried out a few days per week should achieve the same protective metabolic improvements. Timmons added, "This novel approach may help people to lead a healthier life, improve the future health of the population and save the health service millions of pounds simply by making it easier for people to find the time to exercise".

Reference: Extremely short duration high intensity training substantially improves insulin action in young healthy males, John A Babraj, Niels ** Vollaard, Cameron Keast, Fergus M Guppy, Greg Cottrell and James A Timmons, BMC Endocrine Disorders.

http://www.biomedcentral.com/bmcendocrdisord/

[susan400]

Thanks for pointing that out.  Fortunately, I have not yet reached the point of cirrhosis, don't know how long that will last, but I'm hoping I clear before I reach that point.  I have bridging fibrosis though.  In Dec. 2008, I had my esophagus tubed to check it out to see if I have any signs of anything looming.  Dr. found nothing unusual in there, no varices, for which I was very relieved to hear.  This morning, I woke up hurting alot though and have had some RUQ pain; which is a little disconcerting; and all over pain, too.  I'm hoping that it will be better tomorrow.

Susan400

[HectorSF]

Yes, exercise is generally is a good thing. But as in all cases it depends on each person's individual health status.

Since you are asking about exercise for persons with HVC, I assume that you are including persons with advanced liver disease also.

Here I am speaking of persons with Stage 4, cirrhosis, with portal hypertension. Persons with HCV and portal hypertension need to be aware that it can be dangerous to exercise as many exercises will increase blood pressure (including a person’s (HVPG)) hepatic vein pressure gradient). Exercise can increase your blood pressure to a point where (if you have esophageal varices) it can cause a bleeding episode which can be life threatening.

Patients with cirrhosis and varices should speak to their health care professional BEFORE engaging in exercising.

Hectorsf

[bjlaker]

The reason for having normal body weight with HCV is because being over weight creates more inflammation which damages the liver and other organs. Since HCV is doing this too, we try to lose weight  to reduce the damage. Exercise causes damage and inflammation too.Yes, in short, some exercise is good. But remember, moderation and that cool down time is more important to us. Its important to keep moving the muscles to remove the wastes you've created so wastes don't accumulate and cause you even more pain and fatique.

[susan400]

My BMI for my height is in the normal range so I am not overweight.  As far as a crappy diet goes, I do try to eat as healthy as I possibly can, but I don't completely avoid meat, carbs, or sugar..., that's about as honest as I can be about it.  I eat fruits and vegatables every day, try not to overdo red meat and try not to run around eating fast food, donuts and pizza and soda.  That is not to say that I don't occasionally have pizza, or occasionally drink a diet coke.  I can't even remember the last time that I ate a fast food hamburger, cheeseburger, or the like!  But, the way I feel about it, is that if I can't enjoy my life and occasionally do some things that I enjoy, then there's no sense in living.  I would be no fun for anybody else and wouldn't be able to help anybody else out because I'd be so blahed out and depressed from not having any fun anymore.  As it is, I can't get out in the sun anymore due to a skin condition that I got from all the treatments; a skin condition that doesn't go away off of treatment.... it totally flares with any sun exposure other than like walking out to my car in the parking lot sort of thing.  Also, I can't get in hot tubs, take a hot bath or shower, etc. So, both of those things are gone.  Things that I used to enjoy.  I can't drink a nice glass of wine.  So, if I occasionally want to eat crappy food as in, eating a steak, eating some pizza, or some good 'ol Southern fried okra...., that's just the way it is.    I am adding in the exercise because it's supposed to help you in many ways such as prevention of heart disease, lowering blood pressure and cholesterol, helping to control blood sugar and hopefully helping out my immune system.  As far as oxidative stress goes, that's a wee- bit over my head.  I basically just wanted to know if, in easy to understand terminology, whether what I was attempting to do, was good for me or not.   I think, if I'm understanding everybody right, it's good as long as I listen to my body and don't push myself to hard to where I am feeling sicker..., is that right???    Susan400

[bjlaker]

Shes not asking how to exercise. Shes asking is it a good Idea to being doing extra cardio if a person has HCV. HCV is an oxidative stress problem, that means a distruction (oxidation)of the inside of the cells(mitocondra) that causes the loss of ATP production and celluar damage. Exercise also causes alot of oxidative damage. If you over exercise, you are compounding the problem, and may as well stay over weight. Both can be a problem or you can be used to your advantage. But you can't exercise your way out of a crappy diet, you will just have a crappy diet and even more cellular damage.

[susan400]

There are these people that work at the exercise club that walk around with a little handheld device that is a heart rate monitor and they hold it up as they walk by if anybody wants a quick check on their heart rate and also, on the treadmill and on the elliptical machine, they have those metal strips on the machine itself that check the heart rate.  During class at spinning the instructor has us do a pulse check at some point during the class.  I know that I need to do better at checking my pulse on my own, when I'm walking on my treadmill at home and such as that.  Oh yea and there's also a chart on the wall at the club that lists everybody's various target heart zones for like if you're 20, 30, 40, 50.., etc., etc.   Above it, it has the 25%, 50%, 80%, 100% on the chart.  They are really good at this club because it's part of the hospital network and lot's of doctor's and nurses do their work-outs there as well since they get a free membership.  Makes me feel better because if I was to pass out or get a heart attack or something like that then, I'd probably have quick health care, especially since it's right across the street from the hospital.  Not that I really want to strive for a heart attack!  :)

Susan400

[pKinCA]

It took me so long to actually post, that jmjm snuck in an answer that was similar to mine :-)

PS  Before tx, after carrying golf clubs on my back for 18 holes (on a hilly course) my legs would ACHE and I mean ache that night!  Now after tx and virus free, no achy legs anymore.  

Hope that you and dointime can get there soon!!!!

[pKinCA]

Dointime beat me to the punch... :-)  

I was gonna suggest monitoring heart rate for either fat burning and aerobic benefit.  In fact, after watching a show about exercise, I learned that there is actually a chart with formulas for figuring out what one's heart rate should be for men and women.  I just bought a "heart rate watch" today to use while on treadmill... I'll be curious as to which (if any!) zone I'm usually in...

PS  You are way more ambitious than me!!  :-)

pK

Here's a chart I copied from thedoctorstv.com

1. Determine your maximum heart rate (MHR) by following these formulas:

Men: Subtract your age from 220.
Women: Subtract your age from 226.

2. Determine what heart rate puts you in what zone, so you can work out accordingly by following these formulas:

Fat Burning Zone: 60-70 percent of your MHR

• Develops basic endurance and aerobic capacity.
• Helps with fat burning and weight loss
• Allows your muscles to re-energize with glycogen, which has been expended during faster-paced workouts.

Aerobic Zone: 70-80 percent of your MHR

• Burns fat and carbohydrates.
• Builds heart strength and develops your cardiovascular system.

Anaerobic Zone: 80-90 percent of your MHR

• Burns carbohydrates.
• Helps build endurance.
• Helps build your lactic acid system.

[Rockerforlife]

The best exercise in the world is brisk long walks

[jmjm530]

Exercise is good but you have to listen to your body. If you're feeling more tired than before, that's a sign that you're over training.

Do you use a heart rate monitor? Thats a must in vigorous cardio training like for example spinning classes. Get a monitor and learn how to use it, educate yourself about aerobic zones and start training low in the zone even if you have to "fake it" a bit in class and turn the knob all the way down.

Another good barometer is your morning pulse. If your morning pulse -- take it before you get out of bed first thing in morning -- is up, then you probably over did your cardio the day before. So pull back some or take the day off.

As to weights and yoga, again, all good in moderation. Those that really know how to train understand that the muscles grown on "rest" days, not on the days you work them. No rest day, not much growth.

Its not really rocket science. If exercise is dragging you down, then it's time to make adjustments. Classes are the absolute worse UNLESS you make it a rule only to work out at YOUR pace and not the pace of the class -- unless youre like 20 something of course :)

-- Jim

[dointime]

I do an hour at the gym most days.  I monitor my heart rate and do 30 mins in the low intensity, fat burn range, then 30 mins in the medium intensity aerobic range.  I never drive my heart rate over the aerobic range, mainly because I want to burn fat and calories.

So far it's working.  My weight is under control without starving myself and I don't feel exhausted afterwards.  

But here's what I've been thinking.  HepC tends to lower body temperature and blood pressure.  What if that's it's preferred habitat?  What if exercising, raising body temp. and blood pressure might be making our bodies less hospitable to it.  I don't have any evidence for that, just an intuitive feeling.  We know that the body kills some viruses like the flu by getting a fever, so we do know that some viruses are sensitive to body temperature.  Well anyway, the thought has been giving me extra incentive to get out there and burn viral @ss.

dointime          

[bjlaker]

I have read sveral places where low intensity exercise is good for HCV. HCV is a disease of oxidative stress. Exercise causes oxidative stress, hence your feeling really tired after a work out is the build up of metabolic wastes in the cells. Its a catch 22, you have to excercise to feel good but if you do too much your going top feel bad. I think your better off slowly working your way up as your endurance increases and use the fatique to tell you when you've done too much and back off. Or use protoelectic enzymes after your work out to help clear out the metabolic wastes.

[R Glass]

  I wish I had an answer but the more I learn about this “Demon”, I realize how much I don’t know about it.

[Isobella]

Spinning is my favorite.....altho I haven't done it in a while.  I say let your body be your guide.  It will let you know when you are over doing it.  I am  told a good rule of thumb is that if you are unable to talk while excercising.....back it down.  What you don't want is for your heart rate to get too high and become anerobic.

Good for you Susan!!!  I'm impressed.....think I'll go do some yoga right now, lol!

[Marc1955]

You go girl! Your docs right that staying thin is important. Hit that gym.

Of course you should listen to your body and if you overdo it, rest. I think it's important for everyone as they age to avoid excess and work within their limits. In the long run it gets you in better shape. Enjoy.

[eureka254]

Gotta agree with meakea.  Can't quote any research or data either, but from a personal experience standpoint, even after hcv diagnosis my husband was 'highly recommended' to do as much cardio exercise and weight control as possible.  During hep treatment his cardiologist is not as insistent, but before treatment it was "as much as you can."

Hope that helps.
~eureka

[meakea]

Congrats to you for trying so many new things for your exercise regimen!  I don't have anything to quote to you from things that I've read but everything that I know about health in general, and about Hep C, is that exercise is a good thing.  Hopefully, someone will post something about a specific article or study for you but, in the meantime, I think you should continue with a good cardio and weight regimen much like you listed in your post.

My personal experience tells me that exercise is a very, very good thing.  I have had Hep C my entire life (I'm 54) and I have always been an exercise buff and I think that played a huge part in my liver biopsy being a 1/1 even after having had Hep C so long.  I'm sure there are other reasons too (very little alcohol, no drugs, body mass index always less than 20, low cholesterol, etc.)

If you have no health issues that would otherwise keep you from exercising, I'd say exercise away girl and keep that Hep C at bay!