When medication changes the way you exercise

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FOR many Malaysians, staying active is part of their efforts to lead healthier lifestyles. For those who are living with chronic conditions such as hypertension, diabetes, asthma and high cholesterol, daily medication has become part of their routine alongside walking shoes, fitness watches and gym memberships.

Both exercise and medication are important for health. However, the two can sometimes influence one another in unexpected ways.

Exercise places stress on the body, although it is usually a beneficial form of stress. Heart rate increases, breathing becomes faster, blood vessels expand and muscles demand more energy. In response, the body adapts over time, becoming stronger and more efficient.

But medication can alter many of these same physiological processes. Someone taking beta-blockers for hypertension, for example, may notice that their heart rate does not rise as easily during exercise. Even when exerting significant effort, they may struggle to reach the same training intensity as before.

This can be frustrating, especially for individuals who closely monitor performance during workouts. In many cases, the medication itself is contributing to the slower cardiovascular response.

For individuals with asthma, certain inhalers may produce temporary sensations such as shakiness or palpitations during exercise. Meanwhile, people living with diabetes who combine glucose-lowering medication with intense physical activity may face the risk of hypoglycaemia, particularly if meals or hydration are not properly managed beforehand.

Symptoms such as dizziness, trembling, confusion or sudden fatigue during exercise should never be ignored. Sometimes, the issue is not poor fitness or lack of effort but rather the way medication and physical exertion are interacting within the body.

This is something I frequently observe among patients undergoing rehabilitation programmes, including cancer survivors gradually rebuilding their strength after treatment.

The interaction between exercise and medication is also not limited to how drugs affect the body during physical activity. Exercise itself can influence how medications behave inside the body.

Changes in blood circulation, hydration, metabolism and body temperature during exercise may alter how certain medications are absorbed and processed.

Someone taking diuretics, commonly known as water pills, may already be losing significant amounts of fluid through urination. Combined with prolonged outdoor exercise in Malaysia’s hot and humid climate, this may increase the risk of dehydration, dizziness or fainting.

At the same time, modern fitness culture has also introduced another layer of complexity through supplements and performance-enhancing products. As many of these products are sold openly, people often assume they are harmless.

However, some supplements contain extremely high levels of caffeine or other stimulants that may interact with prescription medications, particularly those related to blood pressure and heart function. Without proper understanding, combining multiple stimulants with existing medication may place unnecessary strain on the cardiovascular system.

This does not mean people should avoid exercise simply because they take medication. In fact, regular physical activity remains one of the most effective ways to improve long-term health and maintain quality of life.

What it does mean is that exercise should not always be approached with a one-size-fits-all mindset. Patients should feel comfortable discussing their exercise habits openly with doctors and pharmacists, including the type, frequency and intensity of their workouts.

Likewise, fitness trainers should be aware when clients are managing chronic medical conditions or taking long-term medication, as this may influence exercise tolerance and recovery.

Most importantly, people should learn to pay attention to their own bodies. Feeling challenged during exercise is normal. Persistent chest discomfort, severe dizziness, unusual fatigue, abnormal heartbeats or sudden weakness are not.

Sometimes, understanding how your own body responds to medication may be just as important as the workout itself.

DR MOHD YUSMAIDIE AZIZ

Senior lecturer

Department of Toxicology

Pusat Kanser Tun Abdullah Ahmad Badawi

Universiti Sains Malaysia