Cardio, High Intensity and Resistance Workouts: Which is for Me?


Do you love to exercise, or want to love it? Maybe you wish you could exercise, but your autoimmune symptoms won’t let you…

Most people know that exercise is a fundamental part of a healthy lifestyle. The benefits of regular exercise are well-documented, including: increased muscle mass and metabolic rate (helps regulate weight); decreased risk of cardiovascular disease, type 2 diabetes and cancer; improved bone density; regulation of mood; reduction of stress; and improved immune function. May I have some more, please?


While the general attitude toward exercise seems to be “more is better,” excessive exertion can be detrimental to the body — whether or not you have autoimmunity (AI). Over-doing it can result in an immediate increase in the hormone cortisol, which can increase risk for sleep disturbances, digestive issues, depression, memory impairment, exhaustion and weight gain. Overtraining can affect neurotransmitters such as glutamine and dopamine, leading to depression. The stress of excessive exercise can negatively affect the hypothalamic-pituitary-axis (HPA), which is closely tied to adrenal and thyroid function (read: adrenal fatigue). It can also lead to leaky gut, a critical issue for people with autoimmunity. And most importantly, over-doing exercise increases systemic inflammation – the Evil Superpower behind autoimmunity.

Why bring up these nefarious effects? They are bad news for anyone, but with the added physiological stresses of AI, they can lead to a symptomatic danger zone that disrupts our ability to function on a day-to-day basis. Another factor is that many people with AI tend to be Type A, or push themselves really hard; we need to keep this in mind when we choose our workouts, so we don’t throw ourselves off the symptomatic cliff. Even if you aren’t a Type A go-getter, with AI it’s wise to keep close tabs on how hard you push your body when you exercise. As it turns out, not all workout types are equal when it comes to energy expenditure and depletion, and not all bodies respond the same way to each kind of exercise.


Ten years ago, extended aerobic exercise and weight training were the gold standards for “working out.” In recent years we’ve added HIIT and CrossFit along with a growing list of creative training methods. We also have a healthy pool of research and debate as to the value of each method for reaching various goals (weight loss? muscle mass? endurance? strength? cardiovascular health?). Ideally, we’d be able to handle some of each type every week – long runs, hearty HIIT workouts, and some weight training to round it out – in order to gain all the benefits. But many people with AI can tell you that covering all those bases isn’t frequently an option. If ever.

Let’s take a look at three main exercise categories, then consider how they might fit into the lifestyle of someone living with autoimmunity.

High Intensity Interval Training (HIIT) is a training technique in which you give all-out, one hundred percent effort through quick, intense bursts of exercise, followed by short, low- to medium-intensity recovery periods. For example: Sprint for 30 seconds, jog for 90, repeat cycle for 20 minutes. HIIT workouts are generally more intense and much shorter than aerobic workouts because a body – AI or not – just can’t handle that level of intensity for very long.

HIIT forces your heart and body to learn how to adapt to constantly changing conditions. It also kicks the metabolism into high gear, which continues for hours after the workout in a sort of “after-burn” called EPOC, or Excess Post-exercise Oxygen Consumption. EPOC snapshot: You work at a level beyond what your body is capable of handling (i.e. it can’t keep up), and it uses the next 12, 24, or even 36 hours to ‘catch up’ metabolically. Net effect: Extended calorie burn. Other than caloric output, HIIT also helps modulate insulin resistance, reduce abdominal fat, reduce oxidative stress and improve antioxidant status.

For the amount of time spent “working out”, HIIT burns far more calories than cardio because of the EPOC after-burn; studies have shown a dramatic difference between the fat loss of subjects who did HIIT and those who did cardio.

The Catch: Some AI folks report they actually prefer cardio to HIIT, because the sheer intensity of HIIT can be too much for their bodies despite the short length of the workout.

Cardio (aerobic exercise) is any exercise with relatively low intensity, that you can do for a prolonged period of time. Swimming, cycling, walking, elliptical and rowing are examples of low-impact cardio. Running, jumping rope, and step aerobics are high impact cardio. Cardio isn’t always an intense, heart pounding experience – some bodies can get an aerobic workout during a brisk walk.

Compared to HIIT, cardio doesn’t much encourage EPOC (mentioned above); when the workout is done, things come to a rest and the calorie burn fades.

Cardio stimulates and strengthens the heart and lungs, improving the body’s utilization of oxygen; decreases risk of heart disease; lowers blood pressure; increases “good” cholesterol; helps to control blood sugar; builds strength and tone, and assists in weight management. It also tends to be lower impact on the joints than HIIT, which for some bodies, is necessary.

The Catch: Some AI folks report that cardio’s more extended nature is too exhausting and wears them out more than shorter-length HIIT or Resistance Training.

Resistance (Weight) Training is exercise that uses weights for resistance, such as circuit training, weight lifting, and body weight exercises. Benefits of resistance training include improved muscle strength and tone, healthy weight, increased bone density and strength, improved cardiovascular health, and improved cholesterol levels. As with HIIT, resistance training enables the body to go somewhat into the “after-burn” state of EPOC; studies show that subjects who add weight training to a cardio workout lose a higher percentage of body fat than those who only do cardio.

The Catch: Some AI folks report that Resistance Training’s intensity too exhausting and wears them out more than cardio.


As you can see above, each of these categories has its potential benefits and drawbacks, and there may not be an obvious leader for the AI contingent. Interview ten active people with AI, and you’ll hear a variety of passionate opinions on what works best. Which type – or types – of exercise work for you will depend entirely on your unique physiological needs. With autoimmunity, we are more prone to limiting factors such as adrenal fatigue, micronutrient deficiencies, chronic high cortisol, anemia, sleep issues, genetic defects that affect detox, joint pain, inflammation, and more *gasp*. What a list! All of these factors make us more prone to depletion, and this demands a more thoughtful approach to exercise – what works for one person might not work for the next. And remember, there can be a fine line between the right amount of exercise, which benefits health, and too much, which can actually cause more problems.

This is where you get to exercise your finely-tuned skills of listening really well to your body. And then responding accordingly. Figuring out what is right for you may take some patient experimentation; it’s the ever-present “biohack” that we get so good at as we navigate the autoimmune world.

Not sure what to look out for? These are clear signs of overdoing it:

  • hard time recovering from workouts
  • can’t complete workouts
  • decline in performance
  • need for naps or serious rest after workouts
  • loss of general motivation and enthusiasm
  • depression
  • irritability or aggression for minor reasons
  • weakened immune function
  • loss of menstrual cycle
  • unexplained change in weight
  • sleep disturbances
  • increased leaky gut symptoms

On the bright side, if you do your workout and feel energized and balanced afterward, you’re likely on the right track. Keep it up, while keeping an eye out for signs of overdoing it down the line – as our bodies change, so can our exercise tolerance.

Need a change but not sure what to do? Some scenarios:

  • If you’re just starting to exercise, use your best judgment and start out gently. Try out different exercise styles, and make sure to give your body plenty of time to recover between workouts – that way you’ll have the space to listen to the messages it sends you. Only increase your exertion once you feel totally ready to do so.
  • CrossFit, P90X or HIIT trashing you? Stop it and try light cardio for a week; if you recover better, great, stay away from the intense stuff. Next, try adding some light weight training to the mix twice a week. Take your time and respect your body’s messages.
  • Running habit draining you? Maybe your body would respond better to shorter, more intense HIIT workouts. Or, reduce your run by half, and add in some resistance training twice a week. Listen to your body and respond.
  • Nothing’s working and you’re still trashed? Time to take a break from working out for a week or two. The world won’t end while you give your body a rest!

With autoimmunity, the topic of exercise has wide boundaries; there are many added physiological issues that make this terrain a bewildering place. In my next article, I’ll write about the topic of when exercise recovery becomes harder to handle, and offer tips on how to work with it.


About Susan Vennerholm

Susan Vennerholm is the blogger behind Backcountry Paleo, where she shares AIP-specific recipes and autoimmune-friendly tips for backcountry enthusiasts. She also geeks out on the medical side of autoimmunity, and loves to write about it. Susan wholeheartedly believes that self-education and networking in the AI community are two of our strongest tools in living successfully with autoimmunity. As a way to pay forward the support she received during her recovery, she blogs so that others will have more resources for their healing journey. A certified yoga teacher, code wrangler, and freelance writer, Susan loves climbing mountains, watching Orca whales, trail running, volunteering for dog rescue, and a good fantasy novel. You can connect with her on Facebook and Pinterest.


  • Thank you for this article. I have struggled with finding my “happy place” in re: exercise ever since I was diagnosed with crohn’s disease 14 years ago. Prior to that, I was a runner + weight lifter. I have found that I can practice yoga, go for regular walks and kayak without distress but I am not the person I was before crohn’s and it has been hard to let go of “what I used to be able to do”. Great article <3

    • Susan Vennerholm says

      Thanks, Jessica! I’m so glad you liked it. I’ve had conversations with a lot of people in the AI community, and it’s funny how people are so passionate about What Is Right for Autoimmune Bodies… some swear by HIIT or weights, some swear by cardio. Many swear any other method than their own is bad for everyone with AI… clearly everyone has different needs! So much of what we learn to do on this journey is really listening to our bodies – and responding in kind. NOT doing that has a lot to do with why many of us landed in this tough spot in the first place.

      I had a yoga teacher who reminded me that pining away over “what I used to be or do” was not being in the present with who and what I am now, and it prevented me from seeing myself clearly in the present. I hope you keep in touch with that!

      • Melodie says

        Thank you for sharing this! “pining away over “what I used to be or do” was not being in the present with who and what I am now, and it prevented me from seeing myself clearly in the present.” This is where I am at now and it is difficult for me. I had been training with some people IO work with to do a Spartan Sprint in August and my body became so run down I knew I was over training. I backed off for a couple weeks and started to feel better and then went right back to the intense workouts and ended up right back where I was. I know where my “happy place” is but am having a hard time accepting it.

        • Mickey Trescott says

          I hope you find that “happy place” soon!

  • […] also cautions against over-exercise as a person with an autoimmune condition, and writes about cardio, high intensity interval training and resistance […]

  • Sue Weeks says

    Thank you! Having RA I often overdue my exercise. Need to understand to back off sometimes.

    • Susan Vennerholm says

      Sue – That’s a hard one to master for many of us. Many people who end up with autoimmunity (especially women!) report having been very demanding of themselves for many years, physically, mentally, and emotionally. In my estimation, that way of living has a lot to do with why we ended up in hot water… and reining our drive in is one of our hardest won skills!

  • Edith says

    Posting this on here as well as another workout article on this website – just in case this might be helpful to someone 🙂
    Right before getting diagnosed with Hashi’s, I had finally worked my way up to a 1 hour/day workout, 5x/week. Right after getting diagnosed (I had had Lupus for 7 years as well at that point), I did more research and found this website, and have been AIP for 1 year now. I’ve been too scared to start re-introductions, but probably will start in a month or so.
    To be fair, so far I’ve had a milder form of all AI conditions I’ve been diagnosed with – I’m only on vitamins and an adrenal supplement, no traditional ‘medication’. AI has also never landed me in the hospital. But it HAS caused severe fatigue, severe depression (to the point that I felt I was a danger to myself and others – thankfully this has vanished with the right supplements, regular naturopath visits, and eating AIP), brain fog, hair loss, other mental health problems. All of which have improved greatly on AIP. Anyway!! I’m an expert at rabbit trailing. Back to my point:

    About 2 weeks ago, I decided it was time to try HIIT again. I missed it so so much, and had been doing nothing but yoga, intermediate weight training, and walks for the past year.
    1) DO cut back on exercising/bring it down to very very gentle exercising. I firmly believe this played a huge part in my healing! It felt like I was letting my body take a sabbatical, in all areas. Food, exercise, everything.
    2) Don’t be afraid to try bringing in harder workouts again after a time of healing and seeing progress. Start super slow (I use FitnessBlender and on their website, you can choose the level of difficulty I would pick level 3 HIIT/cardio, and started off with 4 minutes tacked on to the end of my regular, gentle workout. I’ve since worked my way up to about 15 minutes, but I did it very carefully, very slowly, never pushing too hard).
    3) Listen to your body! This advice used to drive me insane. But the longer I’ve been on AIP, the more I’ve realised how easy it gets to listen to your body. Doing something hardcore like AIP, really tunes you in. It took me quite a few months to develop this ‘sixth sense’, but now I find it super easy and it’s one of the best skills that AIP has taught me. I can now easily tell whether the challenge I’m feeling during a workout is just a good one, where I’m carefully pushing my body out of it’s comfort zone and again increasing my ‘workout range’, or if it’s a bad one of me causing stress to my system. If it’s the latter, I immediately stop, guzzle some water, lay down, and call it a day where working out is concerned. And that’s ok!
    4) Ties in with the last part of #3 – don’t force yourself to adhere to some regular workout schedule. If you’re having an off day, you’re having an off day. And you’re doing yourself a much bigger favour by resting that day, rather than forcing yourself through a workout that will just cause you to experience a big setback.

    Anyway. I ramble. Clearly. Thank-you SO MUCH for this website, this community, the recipes, the advice, everything!

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