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Exercise Can Work Up a Diagnosis Too

Health: Symptoms of hidden disorders ranging from anemia to seizures can be unveiled by physical activity.


WASHINGTON — Exercise is not only good for you, it can help doctors find what is bad for you.

The stress of exercise can unmask a lot of hidden disorders, ranging from anemia to seizures, according to an article in a medical journal.

"Although exercise carries a host of impressive health benefits, it isn't a shield against all illnesses, and symptoms during exercise aren't always benign," said the report in The Physician and Sportsmedicine. "Exercise . . . offers opportunities for early diagnosis, reassurance, comfort and cure."

Exercise in a stress test is a common diagnostic tool for heart or lung disease. Doctors look at such factors as the rate and rhythm of heartbeats measured while the patient is on a treadmill or a stationary bike.

But people doing ordinary, unmonitored exercise also can report symptoms, said Drs. E. Randy Eichner of the University of Oklahoma Health Sciences Center and Warren A. Scott of Kaiser Permanente in Santa Clara, Calif.

Anemia is one example. People with mild to moderate anemia often only find they are tired after they have done something requiring exertion.

Eichner and Scott tell of one elite, 25-year-old male distance runner who often won 5-kilometer races in well under 15 minutes. After disappointing himself with some dead-last staggers to the finish in over 18 minutes, he sought medical help. Because of his symptoms, he was tested for anemia and prescribed iron supplements. They ended the anemia and speeded up his times, the doctors said.

Exertion also can lead to headaches that can be a clue to heart disease, especially in middle-aged men, the journal said. It reported the case of a 57-year-old man who got headaches 5 to 10 minutes into vigorous walking or swimming. Although the man reported vague heaviness in the chest, he did not have chest pain, which could be the symptom of a heart attack.

An angiogram found a circulation problem--severe blockages of three coronary arteries. After bypass surgery, the man returned to his previous exercise pattern and felt fine, the doctors say.

People also can have seizures when they exercise, because the workout can be a trigger that sets off an existing medical problem. A seizure that follows a fainting spell may signal cardiac arrest, the doctors said. In other cases, they said, waste chemicals produced by exercise may push brain tumors into setting off a seizure.

Even slowing down may be a symptom. The article told of a 72-year-old softball player who complained that he was taking longer to get to first base. The man was diagnosed with Parkinson's disease.

"Sometimes, it's the dog that doesn't bark," the article said. "The athlete notes something that should appear with exercise." One 33-year-old runner realized that he was not sweating on parts of his left side. It turned out that the man had Horner's syndrome, in which lesions develop in the nerves. This case apparently was the result of chiropractic manipulation of the man's neck, the doctors said.

And then there are the runners' runs. "Exercise, especially running, can be a stress test for the colon," the report said. Although exercise makes a person stronger, it at first can wear the person down a bit, giving infection a chance to show itself.

The journal article tells of one 8-year-old who developed diarrhea only when playing basketball, and was found to have giardiasis, an infection caused by a waterborne parasite.

Exercise, on the whole, is good for people. It can give them such benefits as stronger hearts and lungs, more powerful muscles--even a better mood. But exercisers should be alert for things that don't normally happen to them during a workout and should take those symptoms to a doctor, the article said.

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