Can I exercise with liver damage - British Liver Trust
Can I exercise with liver damage
Depends on how much exercise you mean and your condition. Prior to him being diagnosed with Cirrhosis / AIH my hubby was a very fit and active bloke (long distance hill walker) but latterly found himself becoming lethargic after only short strolls. As I mentioned in an answer earlier he has been put on a high carbohydrate / high protein diet to provide enough food to prevent muscle wastage. He asked his doctor and dietician about exercise and they said really that he shouldn't exercise - other than regular daily activity, short strolls, doing the garden, shopping etc. as it would undo the work being done in getting energy in via food, if he exercised too much the energy would be expended quicker and muscle wastage continue. BUT, again this I guess depends entirely on your liver disease, its cause and your body. I'd be getting all these questions written into a list for when you next see your consultant as they should be able to advise for your own particular circumstances. If you are only seeing a gastroenterologist and not a liver specialist, push to see the latter as you will get much further and better advice.
K
Hello Stacey,
Most books I have read about liver disease as well as advice from my own Specialist and GP advocate that it is essential for a person suffering with liver disease to exercise regularly but obviously not to over do it and to stay within the parameters that the type of liver disease will allow. The main message is to just Do IT.
Prior to my own diagnosis with AIH and advanced fibrosis I was a near fanatical endurance athlete and had been for most of my life continuing well into old age.
For about 2 and a half years following diagnosis and commencement of steroid treatment I just continued to carry on exercising and participating in all kinds of challenge events but that was clearly because my physical abilities allowed me to continue to do so and my liver was coping. However that came to an abrupt halt at the start of the current year when it became clear ( through the development of mild ascites) that my fibrosis had advanced to cirrhosis and like AyrshireK's hubby I was devastated. Most of my friends told me that I was past my sell by date (70 plus years) in any case so to still be taking part in competitive events with youngsters one quarter to a third of my age was foolish,at least in their views. However it is extremely hard to give up something you have been part of for more than half a century.
For me the main problem was the retained fluid pushing up against the diaphram and causing breathing problem as well as as an increase in fatigue and lethargy.
I was started on diuretics and amazingly this has resulted in a reduction in the amount of fluid retained and although I have lost a large amount of weight (the diuretics effect) as well as some muscle I can now at least breathe quite freely as well as exercise regularly again but I still become fatigued ( who with liver disease doesn't?). Nevertheless I probably have to accept that whereas 8 to 9 months ago I would have had no hesitation in running in a marathon my now realistic target is say 10 km.Similarly with cycling and walking both of which I am now doing again but my realistic goal is no longer a 50 or 100 mile challenge but a cycle ride of 12 to 20 miles and a brisk walk of say 8 to 15 miles. I am now back performing both exercise activities on several days each week but I do try to be sensible and when I become fatigued I do not hesitate to shorten the distance.
I too have had a consultation ( in fact only yesterday) with a Registered Dietician who practices within the NHS so is well familiar with the kind of liver problem I have. Her first comment to me was that she was pleased to see I was exercising regularly as this is something normally recommended by her profession. As with AyrshireK's hubby a diet with increased and frequent intake of proteins and carbohydrates was recommended and I believe that took into account my increased physical activities and existing muscle loss
There is a fairly well known book entitled " Guide To Hepatitis & Liver Disease-What You Need To Know" by Hepatologist Dr Melissa Palmer and if you haven't read it or had chance to view it, may I recommend it as something that is well worth a read. She advocates that regular exercise is an important component necessary to combat liver disease and she explains the benefits and reasons why. She does however say that people do not have to do a lot of exercise in order to reap the benefits nor does it pay to over do it. Its the actual doing it that matters and she also adds a caveat that for people with liver disease it is important they discuss it with a doctor before commencing an exercise program. Aerobic and weight bearing exercise is said to be best for people with liver disease and as both have different effects on the body it is necessary to try and incorporate both.
This is just an attempt at providing you with an alternative view point and also my own personal experience on this aspect.
Stacey I do hope things work out OK for you and AyrshireK ;I hope your hubby is making continued good progress with his walking again and is no longer feeling the initial despair that I seem to recall you mentioned in an early posting of yours.
Regards.
Hi again 'find a solution' - sadly hubby isn't improved much and still gets very depressed with things, we've had a bad time with our local doc who didn't follow through on referrals he was meant to etc. However, we have now gone under the care of the Scottish Liver Team at Edinburgh Royal Infirmary who have advised that hubby has cirrhosis (compensated at present) probably due to Auto Immune Hepatitis which they arn't even sure is still active or dormant as biopsy done last year was too small a sample as to say either way. He isn't receiving any treatment for his liver at all. He has portal hypertension with varices as we knew and the SLTU wants to focus on obliterating these, he has to go and get them treated every 2-4 weeks starting on August 1st. He has also recently been told he has anemia so has just been put on iron tablets. Sadly it seems like there is no return from where he's at, just a control of the side effects and like you as a previously fanatical outdoor athlete he gets down looking at what he's done in the past and can't do now. He is still limited to 2 litres of fluid a day too so in this hot whether even our shortish strolls are curtailed. His dietician advised him not to over do exercise as he has already suffered muscle wastage and she rather he tried to build himself up rather than expel all the energy he's having to stuff into himself with this diet regime of meals and snacks. He's actually gained weight and is the heaviest he's ever been, he's actually having to move into bigger trousers - his 28 waist is no more & we are certain its not fluid so that's a positive. Hubby used to walk with the LDWA as a youngster (20's) and his walking companions were often 60 - 80 year olds and he's anticipated having a future like those post retirement and it hits him that unless something major happens (like a transplant, which isn't on the cards just now) those plans are scuppered. Anyway, I try and keep him upbeat as possible and we'll need to take one step at a time, get these varices sorted (hopefully) and see what treatment comes next.
Katie
2016 are you still exercising, cycling? I am, your story is like mine, mine like yours.
Hi Catfish jumping,
Yes still doing all of those things. Cycling not a problem even at 40/50 mile distances. Running is more problematic due to the fast onset of fatigue caused by the cirrhosis and breathing is sometimes compromised by the ascites. Have also recommenced taking part again in nordic walking challenge events and that helps keep the competitive edge alive. However knocking on in years now and even though I always said I would stop serious exercise on reaching age 70 it is now several years later and I am still plodding on and will hopefully continue to do so until the cirrhosis advances to a stage that forces me to finally stop.
Glad to learn that you are also keeping active and hopefully it is helping you cope with the liver disease better than might be the case if you were not.
Best wishes
Ah yes still into endurance exercise but living in liver failure. I cannot take diuretics as they cause a life threatening drop in my serum sodium level. I have an extremely low platelet count off and on and its never higher than almost 70. I put exercise first, all else must wait. Of course food is always ready. I must cook everything I eat and its mostly juiced veggies. High quality grains and fuels like dates for my liver. At times after I ride for 3 hours I lie down for 2 to 5 full days but my blood is circulating, my oxygen count high, fluid retention lowers, my blood pressure is always that of a 30 something. My depression disappears and is replaced by gratitude and hope as well as acceptance. This disease has blown up in my face a few times, 3 times over the years I have come very close to bleeding to death. I joined this site b/c ours in America just are not as informative, people here are strong and objective, there is a lot of ego and bickering in our sites in this country. Its great you are doing so well, me I am almost chock full, my liver, with the web if cirrhosis. They are always surprised to see me still coming in for my 6 month office visits and yearly endoscopes. I am very thankful for every day as now I have had liver cancer, one encapsulated tumor fir two years. At this point I keep telling the transplant center where my doc is, no, not yet, I do not want to be on the transplant list. But I may want to be one day. Thing is with this one isolated tumor of cancer, it bumps me right now to the top of the list. I am not sorry to not go along with them, if I do not accept the next liver in line for my match, it means someone who wants a transplant gets that liver. Call me crazy, I take my chances but I am turning 65 this year, I have been blessed for a long time in life, many do not get 65 years. Man I envy your cycling ability, I so want to be able to cycle 6 hours on the ocean highway...i also am a mountain biker, nothing big time but I do that too plus I get on a board on the Pacific Ocean alone, I swim alone and do hours of rythym gymnastics on the beach in hot sun.
Can you excercise with liver damage? Basically, I physically cannot do much....I was tested for everything under the sun to see what was causing extremely high sets of blood test results related to liver. Some kind of viral hep, but not A B C et al, nor AIH. Previously, extremely fit aerobic / cardio, resting pulse 44. Overnight, suddenly very fatigued, out of energy just getting out of bed! 8 weeks in, I can walk slowly round the garden for pottering for 30 minutes. Then need to lay down and often sleep for an hour, and rest the remainder of the day. If I do something needing a bit more effort, say sitting and using a trowel, I've maybe got 10 minutes - then suddenly drained of energy. So, if you are like me, you just cannot exercise. I was used to cycling flat out hard for 90 minutes, then this! Overnight.
Liver specialist says all that fitness will come back, but for about another month (so that's around 12 weeks) rest, rest, rest. That is based on the rates my test results are reducing towards normal. The rest is so that my body can target the energy at healing. In his experience, by my rates of blood tests results, I should start to see some symptom improvements in a month.
I do have short times of a few hours when I feel fine and think I could do more, but when I do I suffer extreme exhaustion for more than a day. When you've been really fit, it's tempting to want to start training again. I've found anything remotely strenuous counter productive.
Ask your liver specialist.
Another thing I've found is to keep my fat intake down to 3g per meal. Or I feel sick and even more tired.
Hi Stacey and Coastman,
This is a link to a report (2012-Australia) on the clinical research carried out to try and determine the potential benefits of exercise on persons with liver disease and especially pre- transplant where it is thought it could potentially improve outcomes. It also incorporates the effects of physical training on those with cirrhosis both compensated and decompensated. It seems that the data gathered during the trials suggest that exercise is safe although more tests needs to be done in relation to decompensation to determine the safety factor. You may find it interesting :
onlinelibrary.wiley.com/doi...
Clearly exercise capacity is compromised by VO2 max reduction and reduced ejection factor etc but it seems these as well as lost muscle mass may be improved by gentle exercise (preferably aerobic) subject to there being no other limiting or disability factors. Needless to say the caveat is always speak to your doctor before embarking on an exercise programme so he or she can determine what is right for you within the limits of your individual capability.
Finally this is for Coastman. I do not know if you have seen my earlier response to Stacey's question but if you have you will know I have decompensated cirrhosis with ascites although the latter is mild and being kept under control with diuretics. A few months ago I went through a period of feeling just like you say you feel now i.e. always exhausted and unable to do anything remotely physical as well as wanting to sleep all the time and I still have occasions where I have those same feelings.( who with liver disease doesn't?) Additional there has been weight loss (14 st down to circa 11 stone in about 4 months probably due to the diuretics) as well as significant muscle loss. However it has never entered my head that I could not exercise even if just for a few minutes of very simple exercises within the confines of my own back garden. Furthermore I haven't yet come across a doctor or specialist who has told me not to exercise, in fact it has always been quite the opposite although to do so within sensible parameters. When I did venture out on to the roads and byways again to walk or cycle I did so for very very short periods and only once or twice a week. When out walking I always take my Nordic Walking poles with me and find these of great help as they aid forward momentum and can always be used as something to rest on if starting to feel fatigued.Gradually physical ability has improved along with the muscle and to the extent I find I can now go out to walk or cycle for much longer periods and much more frequently. In fact it seems to be getting easier all the time so by the slowly slowly gradually build up approach exercise for me is working although my goals have had to be re set to take into account the reduced physical capacity associated with the cirrhosis.
The previous paragraph is very much about my own experience but I have referred to it with some detail just so you can see there is some hope . Even though you say you just can not exercise hopefully time will prove this wrong and after a while you will be able to start exercising again albeit on a slowly slowly basis.. Do not despair and even if things can not be as they once were hopefully you will make progress from your present position.
Regards
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