Exercise causes new surprise

As I have been feeling better and better as I have more Humira shots I have been exercising more including riding and walking.

I decided I was ready to undertake a longer ride and rode for two hours, about 20km, along bush tracks. Had no problems doing so and felt great at the end of it.

About two hours after finishing I started to feel very unwell as though I had a bad dose of the flu; all the tendons in my hands, wrists, forearms, shoulders, neck, ribs, lower back, knees, shins, ankles and feet hurt and ached like mad and I had sudden and severe diarrhea.

This all lasted until I went to bed. I had taken a dmard at tea time. I woke at about 1am and felt fine.

I am fine still this morning although a bit muscle sore which I expected after my first longer ride.

I have been told that the prolonged exercise set of my immune system resulting in a cytokine storm that overrode the humira.

The tnf-a cytokine is involved in systemic inflammation, it sets off inflammation in response to a threat. A cytokine storm is a potentially fatal immune reaction and also occurs with bad infections such as bird flu.

And there was I thinking exercise was the best thing I could do. PsA always seems to have another surprise up it's sleeve.

It's strange you would mention this today, Allan. I have a friend with RA who reported a very similar experience just last week. He did more physical activity than usual, had the pain reaction and then the diarrhea and vomiting. I'm sorry I am unfamiliar with this reaction, and can offer no help with an explanation. But it does sound exactly like what happened with my friend.

Sorry you had such an awful experience on what apparently should have been a very good day! I hope you never have to go through it again and that you are feeling well now.


Just read your discussion on exercise and found it very interesting. I have been feeling better since being on MTX now for a few months and have planned to start exercising more. I plan on walking and maybe riding my bike but didn't think I should just jump in and hit it really hard at first. Did you talk to your doctor about this? Interested in what he recommended. I know the MTX is different than the Humira but thought the way it worked was similar.

I often exercise vigorously with no ill effects. Enbrel is completely controlling my PsA. I'm very happy with Enbrel right now.