JUNE 4 — Nowadays exercise has become part of everyday life for many Malaysians. Parks are busier in the mornings, gyms are filled after office hours, and activities such as hiking, cycling, and pickleball continue to attract people across different age groups. For many, staying active is no longer seen as optional. It has become part of the effort to live healthier and age better.
At the same time, many of these individuals are also 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, what is less commonly discussed is that the two can sometimes influence one another in unexpected ways.
Every semester, while teaching pharmacology to students at Pusat Kanser Tun Abdullah Ahmad Badawi, Universiti Sains Malaysia, I often ask a simple question: is exercise always good for everyone, in every situation?
The answer, naturally, is more complex than a simple yes or no.
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, however, 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. Exercise remains an important part of recovery, but it must be approached with awareness of each patient’s medical condition, physical limitations, and ongoing 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.
Similarly, cholesterol-lowering medications such as statins are generally safe and highly effective, but some individuals may experience muscle aches or weakness, particularly during intense physical training. In rare situations, excessive strain may contribute to more serious muscle injury that can place stress on the kidneys.
At the same time, modern fitness culture has also introduced another layer of complexity through supplements and performance-enhancing products.
Pre-workout drinks, energy chews, fat burners, and various powdered supplements are now widely marketed as part of an active lifestyle. Because 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, reduce disease risk, 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.
Modern healthcare is increasingly recognising that health does not depend on a single factor alone. Sleep, nutrition, stress, medication, and physical activity all influence one another in complex ways.
The goal, therefore, is not simply to exercise harder, but to exercise more wisely.
Sometimes, understanding how your own body responds to medication may be just as important as the workout itself.
* Dr Mohd Yusmaidie Aziz is a Senior Lecturer at the Department of Toxicology, Pusat Kanser Tun Abdullah Ahmad Badawi, Universiti Sains Malaysia.
** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.
