The exercise conundrum

Why do some say they feel better after exercising and some say worse? The latter group argue that the exercise has used their dopamine up and that it might be an idea to up meds in order to allow exercise to continue. Others claim they were able to reduce their meds as a result of exercise. All very complicated and a little contradictory!

Best to the community.

43 Replies

  • GR 8 question. I'm usually beating a dead horse when I exercise.

    Other things wear me out and deplete my dopamine. I recently saw the movie "the Brothers Grimbley"? It's pretty gross and I loved it. My wife heard me laughing so hard she thought I was in trouble. Afterward it was my bedtime and I was so depleted that I could barely make it to bed. I was so high from the dopamine rush but paid for it afterwards. Bummer

  • maybe you're assuming too's not depletion of dopamine but a metabolic problem within the mitocondria that is responsible for fatigue?

    I think things like core temp which is regulated by thyroid gland, is responsible for defense, plus other things that is responsible in my case.

    also, when i'm prone I feel normal, my muscles are relaxed, it's as if gravity was responsible for fatigue. weird but telling.

    exercise does relax (warms up muscles?) personally i'm noticing that it's not so much muscle control but a coordination problem, I have to marshal my limbs consciously now, whereas it was spontaneous before.

    my main problem is with balance at this time, but I think that can be relearned.

  • 999-666

    Have you had a diagnosis yet?

  • not really, i'm not on neuro's only offer. I haven't seen a doctor for about two decades and he thinks i'm going on follow orders, lickity split! gp said she thought I had als.....I have no respect for the so-called professionals in this ethno-centric environ't. hard to believe but i'm sure of my case....i'm an invisible minority in a politically hostile environ't and it's all about power. it's a sick society.

  • I had the very same question on my mind last night. I don't have any answer as to why these polar opposite effects happen with exercise, but I can add what my personal observations are.

    Whenever I go for a jog, or a hike which is at a good pace (and gets my heart rate up), I notice that sometimes, if with a friend, I cannot speak well, and my eyes might feel more glazed and unable to focus properly so I may not recognize people that are neighbours I would normally recognize. So, this is when I wonder if I'm using up my dopamine supply! Or maybe the dopamine is being directed to my leg muscles. I have no idea how that works...

    Other times, I have the opposite thing going on: Although at first, I notice I really have to concentrate on how to walk or run. "heel, toe, heel toe, oh oh, my spine is not straight, straighten up, stomach in, okay ...heel toe...etc." This self-talk goes on for 20 -30 minutes usually, and then I realize I'm not having to monitor myself. It's as if I'm creating more dopamine. Even my stiff hand that normally doesn't make a fist can go into a fist easily.

    Both things happened to me last week. I have to say that more often than not, AFTER exercising, and my body is relaxed I feel as if I could almost skip a sinemet pill!

    Like you, I'd love to know more about this puzzle.

  • I wish someone knowledgeable would produce the metabolic pathway, from stomach to neurologic feeding. has a newsletter about concentrated source of glutathione in whey. (builds muscle)

  • Hi Oceanflower,

    Glazed eyes and fuzzy memory, I have that too. A very good explanization! Exactly how I feel when I over exert myself, I get this way when I push myself to do anything! My husband notices and thinks I am taking pain meds , when I have had none. Guess he sees the glazed eyes.

  • I walk 2-4 miles every day, I have no idea if it helps my condition, or not. I do, however, believe that the oxygen in take helps fight depressive thoughts.

  • The exercise keeps you flexible, improves your balance, gait and endurance...and can improve other symptoms your exercises are designed to improve. You start slowly and gradually add more to your work out routine. For me, I wanted to focus on my walking. Before PD diagnosis I could easily walk 3-5 miles whenever I wanted...after PD diagnosis I could only walk .5 miles...I walk every day. Each week I tried to go a little farther...after 18 months I was walking 1.5 miles in one setting. Now after 2 years I can go 1.6 to 1.7 miles.

    So it does not happen overnight. It helps slow the progression of the disease and you are more mobile and fit...I still take as many drugs and more...the disease still progresses, but hopefully more slowly and you can do more and enjoy your life more. If you are too beat after exercise, take a nap, or cut back some. You may be trying to do too much and may need to take it a little slower. I have not been able to reduce my meds...but I can only hope the increase is more gradual...after 6 years I am on low dosages lots of medicines. I want quality of life now, so I take the drugs. Lately I have noticed stiffness setting in, so I am looking to add Tai Chi to my schedule. For balance,I take ballroom dance classes. I try to find fun activities that I enjoy.

  • I imagine exercise prevents atrophy of muscles, something that happens to bedridden and they have to be exercised by therapists, so count blessings you're able to stil do this much for yourself?

  • Dancing in groups, backward walk, cycling, yoga, boxing (dummy), have reduced my medication by 25%>

  • backward walk?

  • Yes. Your muscles get the opposite effect. Scientific one hundred metres of backward walk = 600 metresof forward walk.

  • Hi Becky! Hope all is well with you. Peaches

  • Good question! Since starting the meds (Sinemet) I get dystonia, which makes exercise harder since my feet hurt!

  • I agree Beckey, I did not have foot pain

    before I was put om sine eat.

  • Sorry, sinemet.

  • try swimming!

  • I bought an ABDoer on shopping channel (under 200.00!) you can exercise while seated, it has a flexible rod as backrest, with rollers to massage your back while you bend 180*) I THINK it starts to describe calistenics-muscle against muscle idea, maybe. can use door frame to lift yourself for this exercise, if you believe in building muscles and not losing calories.

  • For me exercise is as good as if not better than meds BUT I have been exercising to a good level for most of my life and so my core fitness was good when diagnosed with PD.

    If ,like a lot of people who have never taken proper regular exercise ,its going to take a lot longer and a lot more effort to feel and recognise the benefits.

    People without PD who start an exercise programme often give up because it makes them feel exhausted so with PD you are already at a disadvantage!

    But please please persevere.With or without PD ,exercise

    is so important for so many other things which will help with slowing down the progression of this inconvienience .

    I use an activity monitor and try to achive 10000 steps a day.On Saturday I did 23503 that's after 3 days skiing .!

    A 68 year old without PD would struggle to achive that!

    I find the more I do the more I'm able to do.

    If I have a few days off my PD is noticeably worse.

  • I'm one of those who was a complete couch potato until Parkinsons. Well, not entirely true - two years before diagnosis I lost a lot of weight deliberately and started exercising but I'm not very good, I'm not very fit, I've always disliked walking and my endurance and stamina is rubbish. I was just horrified when I landed on this forum and heard it was about exercise. But it so is. I go to the gym 3/4 times a week and I also turned my conservatory into an exercise space. I think you have to do what works for you but I absolutely agree with the need to exercise intensively although I have to do short bursts. For me, PD warrior has shown really good results. I'm recovering from an absolutely hideous bout of flu which morphed into whooping cough so I've lost a month - I hate having to build up again. But I've started again this week and I already feel better.

  • Hi Jeeves. Long time no hear! I don't know if your questions are asked with tongue in cheek or not.

    First of all, we are not all the same! I am constantly reminded of that!

    Sometimes I feel very good after my walk, and other times I don't. Today I did not feel so good after four kilometers, so I stopped. I have been away from home for two weeks, travelling around the country, perhaps that has had something to do with it. I am not on medication, so that can have nothing to do with it. I am sure that when I walk on Wednesday I will be fine.

    The effects of exercise are not felt immediately. They are accumulative, whereas the effects of levodopa medication are immediate and once finished have to be replaced. The effect of MAO-b medication lasts a lot longer. Don't ask me why.

    I think that we have to accept that exercise has a lot more to do with muscle tone and the state of your muscles has more to do with how you feel after doing exercise than what your dopamine levels.

  • But exercise can make me tremor John whereas before the exercise there was none. I don't think this is due to muscular issues. Thanks for posting though. Nice to hear from you.

  • Hi jeeves. Very good question. I haven't ever questioned exercise in that way but sometimes it frustrates me because I'm one of the ones it (boxing) helps and some people just don't seem to want to listen. I pretty sure John Pepper feels the similar frustration with others not listening to him about his walking. I have been doing the non-contact boxing for over 10 yrs now and it has always made me feel better afterwards & I have not changed my meds in several yrs. My symptoms have progressed a little but not as much as my doctor s would have thought. I will try to get in touch with the professor in Indiana that did a study with Rock Steady Boxing, and found that RSB and intense exercise does help, and see if she can answer your question. It may take awhile ( I only know her from the study), but I'll hopefully get back with you with an answer.

  • Please do. I look forward to it. Thanks.

  • i do have the same. Tremor After and during exercise but two hours later i feel the reward (no tremor).I even skip the medication. I don't know why?. Lately i wear gloves during my exercise to calm the tremor.

  • Hi Jeeves. I won't labor the subject but must say that when my muscles are weak they definitely do cause me to shake, which is only natural.

  • right, he has lost muscle tone. too young to allow that, pd or no pd. males are physical beings, do construction, fly drones, whatever.....

  • Hi Jeeves. There have been many times in my life, after being in hospital for an operation, which has happened 22 times, and on each occasion I have experienced that same shakiness immediately afterwards. I am a strapping man weighing over 90 Kg's and as strong as an ox.

  • Medication impacts after an hour. So the best period to do your exercises is between 1-3 hours.

  • A ''hard'' workout builds muscle. Try resting for 30 minutes to one hour after working out. Move your body any way just MOVE yoga is great improves flexability, balance, muscle mass, pilates. I ike to hit the heavy bag -box I beat the sh&%€ out of Mr. P. The body can do 1 thing at a time walk or talk :)

  • funny you should mention that. I recall something about that, on the subject of psycocybernetics, the book. I cannot walk upstairs and talk?!?!

  • If you really push yourself you are going to hurt. I feel euphoric for about an hour and then reality. Pain for a day or two, that is if you are being dosed correctly. ( testosterone or bioidentical hormones greatly reduced the lactic acid build up and quicker recovery. ) If you push yourself a nice muscle relaxer will make sleep easier.


  • PD is a movement disorder so it stands to reason that one MUST move. However, an important precursor for the production of dopamine is GDNF, which the brain produces when one exercises with enough intensity to raise the heart rate to 80% of the maximum for that person, calculated by age and size. So being that intensive exercise produces GDNF and GDNF is a precursor for dopamine production, we must exercise. The best form of exercise is interval training; 30 seconds of intense movement; 5 to 10 seconds of recovery and then repeat.

    That said, everyone is different and every day is different.

    Good luck.

  • I've been exercising daily for 16 years, last eight with Parkinson.

    A year ego I started taking medication because my dopamine production came almost to an end.

    Sometime when I start, especially with walking, my right foot hurts and I attribute it to sinamet as I didn't have this pain before.

    If I continue though, the pain disappear.

    I vary the exercises, doing yoga, tabata, body pump, aerobic exercises, walking.

    I sleep well and enjoy life without depression, anxiety and I am convinced that this is the impact of my daily work in the gym. Plus I enjoy having good balance and flexibility.

    When I come home from the gym I feel tired and unable to do much for day. Whether it is entirely the symptom of PD or partly attributed to working out in the gym I don't know but if I don't go I am tired nevertheless.

    Yesterday for the first time I forgotten to take my second 100gr of Sinamet and only had it at four pm. Feel it is quite an achievement . And I only take 300gr of Levadopa which I think is quite a low dose.

    For me the biggest advantage of doing exercises is that I don't feel completely hopeless, at the mercy of PD. I feel I can influence its dynamic and I am in charge at least some of the time. And I am hopeful.

    My problem is that I don't push myself to the limit. I just can't do it. Still I push myself daily and do what I can.

    As I understand you need to break a sweat and keep it for at least 20 minutes to reap a reward!

    I rarely achieve such a result, only in aerobic class.

    I don't know where I would be without moving myself but surely it wouldn't be a nice place,

    But I realise that for people that didn't exercises prior to PD, then take medication for a few years to mask the symptoms and then push to start exercising it is an almost impossible undertaking. Its really hard. But it is worth it.

  • Lovely post. Thanks for your generosity. Some say you shouldn't exercise every day and that you need a day to rest and repair. Any thoughts on this? Actually I have a PD friend who places guided relaxation before exercise in her hierarchy of things that keep her PD at bay. She's 7 years in and doing very well indeed. Calm and peace probably work wonders if we had more self control to do a daily emotional workout!

  • Yes you are right

    Parky is not straight forward.

  • jeeves19

    Hi. I copied your question in an email & sent it to the Associate Professor and Director of Research at U of I and here is her reply. Hopefully this will help.....

    "Interesting question actually. I think the problem comes back to fatigue - and this would be fatigue related to PD. Some people are affected more so by fatigue than others, but there are ways to work with these patients to figure out how to work around their fatigue. For some that could mean altering their meds (although I have not heard that increasing meds makes that much of a difference in fatigue). Sometimes we need to consider the time of day they are exercising. For example, if it's near the end of the day, when they are already fatigued then exercise could make it worse, so exercising in the morning might be a better time to offset the effects of daily fatigue. Also, one can't expect to go "all out" with exercising if they have not built a tolerance to exercise, so these patients need to gradually increase their intensity over a longer period of time to order to not become too fatigued. I've had conversations about that with the coaches are RSB and know that they do try to keep that in mind - but I'm sure it's difficult with the large classes to manage everyone there."

  • Thanks very much for doing that LagLag. I don't have that much of a problem with fatigue but notice that I can tremor a fair bit during and after exercise at times. Odd furthermore as I don't have a resting tremor. Anyway, thanks again. Much obliged.

  • I've noticed an encouraging improvement, my only consistent pattern is that I get up, I am raring to go and my speech is good my gait is dosen't, last. today with milder temp I lasted noticeably longer. I climbed basement stairs maybe 20 times + other chores!!?

  • jeeves19

    I just thought of another theory. I think your frame of mind, the type of exercise, and the drive and motivation has a lot to do with it also. When I was working, I used to leave work and just be totally exhausted. My drive to Rock Steady was about 30 minutes away and I could barely drive because I was so tired from a long day at work, but I knew in my mind that once I got there they would get me motivated and the boxing and other exercises would help me feel better and give me energy. And every time it would. Some people just don't have that drive and motivation and they can't get themselves motivated to workout, so when you're in that down mood, your dopamine is low. So you have to keep that dopamine going by talking yourself into it and find something you like to do. I, and lots of other PwP's love doing RSB because the coaches make it challenging & motivating and you leave feeling good about yourself and you know after experience with the program that it really helps.


    this might go a ways to decide about exercise/rest conundrum.

    lactate is byproduct of exercise, it tyres us but people that exercise get less cancer, on oxidadif disease, just eat a lot of anti-oxidents when exercising.

  • Thank you 😊

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