Help to control your cholesterol levels

For some people, lifestyle changes, like a better diet and more exercise, may prevent or treat unhealthy cholesterol levels. For others with high cholesterol, medication may also be needed.

Work with your doctor to develop a treatment plan that’s right for you. If medication is required, be sure to take all medicines as prescribed by your doctor. The potential benefit to your health is well worth making these medications part of your normal routine.

Types of cholesterol-lowering drugs

Various medications are used to lower blood cholesterol levels.

Statins are recommended for most patients. Statins are the only cholesterol-lowering drug class that has been directly associated with a reduction in the risk of heart attack or stroke.

Guidelines recommend that people in any of these groups talk to their doctor about the risks and benefits of statin therapy:

  • Adults with a history of known cardiovascular disease, including stroke, caused by atherosclerosis
  • Those with LDL-C level of greater than 190mg/dL
  • Adults 40-75 years, with diabetes
  • Adults 40–75 years, with LDL-C level of 70-189 mg/dL and a 5%to 19.9% 10-year risk of developing cardiovascular disease from atherosclerosis, with risk enhancing factors
  • Adults 40–75 years, with LDL-C level of 70-189 mg/dL and a 20% or greater 10-year risk of developing cardiovascular disease from atherosclerosis

It is important to talk to your healthcare provider about your 10-year or lifetime risk. He or she will assess your risk factors to determine your level of risk and work with you to choose the best treatment approach.

Some people who do not fall into these categories may also benefit from statin therapy.

View an interactive slideshow to see how cholesterol drugs work.

Some of the major types of commonly prescribed cardiovascular medications are summarized in this section. We’ve included generic names as well as major trade names to help you identify what you may be taking. Please understand that the American Heart Association is not recommending or endorsing any specific products. If your prescription medication isn’t on this list, your doctor and pharmacist are your best sources of information. It’s important to discuss all the drugs you take with your doctor and to understand their desired effects and possible side effects. Never stop taking a medication or change your dosage (or frequency) without first consulting your doctor. Some cholesterol-lowering medications may interact with grapefruit, grapefruit juice, pomegranate and pomegranate juice. Please talk to your doctor about any potential risks.


This class of drugs, also known as HMG CoA reductase inhibitors, works in the liver to prevent cholesterol from forming. This reduces the amount of cholesterol circulating in the blood. Statins are most effective at lowering LDL (bad) cholesterol. They also help lower triglycerides (blood fats) and raise HDL (good) cholesterol.

Talk to your doctor about the possible side effects before starting statins. Most side effects are mild and go away as your body adjusts. Muscle problems and liver abnormalities are rare, but your doctor may order regular liver function tests. People who are pregnant or who have active or chronic liver disease should not take statins.

If statins don’t help you enough, or if you develop side effects, your doctor may recommend different medications.

Statins available in the U.S. include:

  • Atorvastatin (Lipitor®)
  • Fluvastatin (Lescol®)
  • Lovastatin (Mevacor®, Altoprev™)
  • Pravastatin (Pravachol®)
  • Rosuvastatin Calcium (Crestor®)
  • Simvastatin (Zocor®)

Statins are also found in the combination medications Advicor® (lovastatin + niacin), Caduet® (atorvastatin + amlodipine) and Vytorin™ (simvastatin + ezetimibe).

PCSK9 inhibitors

PCSK9 inhibitors bind to and inactivate a protein in liver in order to lower LDL (bad) cholesterol. They can be given in combination with a statin. Some names are alirocumab and evolocumab

Selective cholesterol absorption inhibitors

This relatively new class of cholesterol-lowering medications works by preventing cholesterol from being absorbed in the intestine. Selective cholesterol absorption inhibitors are most effective at lowering LDL cholesterol. They may also have modest effects on lowering triglycerides (blood fats) and raising HDL cholesterol.

The first medication of this class, ezetimibe (Zetia®), was approved in 2002 for treating high cholesterol and certain inherited lipid abnormalities.


This class of LDL-lowering drugs, also known as bile acid sequestrants or bile acid-binding drugs, works in the intestines by promoting increased disposal of cholesterol.

Your body uses cholesterol to make bile, an acid used in the digestive process. These medicines bind to bile, so they can’t be used during digestion. Your liver responds by making more bile. The more bile your liver makes, the more cholesterol it uses. That means less cholesterol is left to circulate through your bloodstream.

Resins available in the U.S. include:

  • Cholestyramine (Questran®, Questran® Light, Prevalite®, Locholest®, Locholest® Light)
  • Colestipol (Colestid®)
  • Colesevelam Hcl (WelChol®)

Lipid-lowering therapies

Fibrates (fibric acid derivatives):

Fibrates are best at lowering triglycerides and in some cases increasing HDL levels. These drugs aren’t very effective in lowering LDL cholesterol.

Fibrates now available in the U.S. include:

  • Gemfibrozil (Lopid®)
  • Fenofibrate (Antara®, Lofibra®, Tricor®, and Triglide™)
  • Clofibrate (Atromid-S)

Niacin (nicotinic acid):

This drug works in the liver by affecting the production of blood fats.

Niacin side effects may include flushing, itching and stomach upset. Your liver functions may be closely monitored because niacin can cause toxicity. Nonprescription immediate-release forms of niacin usually have the most side effects, especially at higher doses. Niacin is used cautiously in diabetic patients because it can raise blood sugar levels.

Niacin comes in prescription form and as a dietary supplement. Dietary supplement niacin must not be used as a substitute for prescription niacin because of potentially serious side effects. Dietary supplement niacin is not regulated by the Food and Drug Administration and may contain widely variable amounts of niacin – from none to much more than the label states. The amount of niacin may even vary from lot to lot of the same dietary supplement brand. Consult your doctor before starting any niacin therapy.

Omega-3 Fatty Acid Ethyl Esters

These medications are derived from fish oils that are chemically changed and purified. They’re used in tandem with dietary changes, to help people with very high triglyceride levels (over 500 mg/dL) lower their levels.

Omega-3 fatty acid ethyl esters may cause serious side effects. They may also interact negatively with other medications, herbal preparations and nutritional supplements. People with allergies or sensitivities to fish, shellfish or both may have a severe adverse reaction to these medications. The same precaution applies to those with sensitivities to certain drug components.

Omega-3 Fatty Acid Ethyl Esters available in the U.S. include:

  • Lovaza®
  • Vascepa™

Marine-Derived Omega-3 Polyunsaturated Fatty Acids (PUFA)

Marine derived omega-3 PUFAs, commonly referred to as omega-3 fish oils or omega-3 fatty acids, are used in large doses to lower high blood triglyceride levels. They help decrease triglyceride secretion and facilitate triglyceride clearance. The amount of marine-derived omega-3 PUFAs needed to significantly lower triglyceride (2 to 4 g) is hard to get from a daily diet alone, so supplementing with capsules may be needed.

Use these supplements only under a doctor’s direction and care, because large doses may cause serious side effects. These can include increased bleeding, hemorrhagic stroke and reduced blood sugar control in diabetics. Negative interactions with other medications, herbal preparations and nutritional supplements are also possible. People with allergies to fish, shellfish or both may have a severe adverse reaction to using these supplements.

Atorvastatin is a prescription medicine used to treat high cholesterol. It is marketed as a calcium salt under the brand name Lipitor (atorvastatin calcium), produced by Pfizer. It is also available as a generic medicine.

Atorvastatin is one of the most popular medicines for treating high cholesterol. Tens of millions of people use it, said Ken Sternfeld, a New York-based pharmacist. Atorvastatin is a member of the drug class HMG-CoA inhibitor (statin). Statins are typically used to help patients with high cholesterol. Since there are many statins, “it’s important to test patients to find out which is the best one for them,” Sternfeld said. He recommends a simple swab test that can determine which drugs a patient can best metabolize.

Atorvastatin, and other statins, work by potentially decreasing the production of cholesterol in the body through blocking the cholesterol-producing enzyme in the liver. Consequently, the amount of cholesterol (a fat-like substance) that collects in the arteries may be reduced. “Statins are drugs you take for the rest of your life,” Sternfeld said. “Though the dosing could change and perhaps you take it once a day or every other day.”

“Cholesterol has a useful purpose in the body when it’s doing what it’s supposed to do,” says Dr. Stephen Neabore, a primary care doctor at the Barnard Medical Center in Washington, D.C. “It helps keep the cell membrane somewhat soft, which is necessary for movement. But our bodies make all the cholesterol that we need. The recommended daily allowance is 0.”

Excessive cholesterol in arteries may block blood flow to the heart, brain and other parts of the body, leading to heart attack, stroke, chest pain, and other problems. Significant improvement often depends on combining a medicine, such as atorvastatin, with lifestyle changes.

“We try to really promote a lifestyle that can make a big difference in cholesterol management,” said Neabore. “We try to get people to consume less cholesterol. It’s essentially only found in animal products. Animals need it to help keep their cells soft like we do. A plant-based diet has been shown in many studies to be the most effective for promoting overall health.”

Atorvastatin would likely still work if a patient did not change his or her lifestyle, but there would be much more improvement if they did, said Neabore.


Atorvastatin calcium’s potency is dosage-related, meaning that the higher the dose, the more cholesterol is inhibited. Typical doses are 10, 20, 40, or 80 mg daily, and the usual starting dose is 10-20 mg daily. Doctors may increase dosages gradually. Dosage should not be increased more than once every two to four weeks.

To find the proper dosage and help determine if a statin is the right choice, Neabore looks at risk calculators created by the American Heart Association. “We look at things like blood pressure, diabetes, and other conditions to get an estimated risk for patients for heart attack or stroke,” he said. Statins can cause severe side effects. “But if a patient scores over a certain percentage on the risk calculator we believe that that the benefits of a drug like this are worth it.”

Atorvastatin calcium comes in an oral tablet that is usually taken once a day. It should be taken at the same time every day, and can be taken with or without food. The tablet should not be crushed or chewed. It is important that patients continue to take atorvastatin even if they feel well.

If a dose is missed, it should be taken as soon as remembered unless there are less than 12 hours until the next scheduled dose. In this case, the missed dose should be skipped. Patients should not take a double dose to make up for a missed one.

Side effects

“One of the side effects of statins is that they can cause muscle cramping and weakness,” said Sternfeld. If experienced, a patient should see a doctor immediately. “Doctors and pharmacists have to work together to balance out the importance of keeping cholesterol low and cramping. It’s important to find the right balance because people take these drugs for the rest of their lives.”

The NIH lists the following additional side effects as less serious, though a doctor should be consulted if they persist or become severe:

  • diarrhea
  • constipation
  • gas
  • headache
  • joint pain
  • forgetfulness or memory loss
  • confusion

The NIH lists the following symptoms as serious. If a patient experiences any of them, a doctor should be consulted immediately:

  • muscle pain, tenderness, or weakness
  • lack of energy
  • fever
  • chest pain
  • nausea
  • extreme tiredness
  • unusual bleeding or bruising
  • loss of appetite
  • pain in the upper right part of the stomach
  • flu-like symptoms
  • dark colored urine
  • yellowing of the skin or eyes
  • rash
  • hives
  • itching
  • difficulty breathing or swallowing
  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • hoarseness


It is important for patients taking atorvastatin calcium to maintain a low-fat, low-cholesterol diet. If a diet or exercise plan is prescribed by a doctor or dietician, it should be followed.

Alcohol intake should be limited, as it may increase the risk of liver problems when combined with atorvastatin. The NIH recommends telling a doctor if you drink more than two alcoholic beverages per day, and warns that drinking alcohol can “increase the risk of serious side effects.” No more than one quart of grapefruit juice should be consumed per day while taking atorvastatin.


Women who are breast-feeding or pregnant should not take atorvastatin. The NIH warns that taking atorvastatin while pregnant may harm the fetus. If a woman is planning to become pregnant, she should tell her doctor before taking atorvastatin, and if she becomes pregnant while taking the medicine, she should stop taking it immediately.

It is very important that patients tell their doctors and pharmacists what prescription and non-prescription medicines they are taking before beginning an atorvastatin prescription, said Sternfeld. Antifungal medications, birth control pills, and other cholesterol-inhibiting medications should especially be noted. Patients should tell their healthcare providers if they have any history of liver, kidney, or thyroid disease; diabetes; or seizures. Adverse drug reactions involving atorvastatin can be serious and doctors and pharmacists have different areas of expertise when it comes to drug reactions and interactions. “Healthcare is about collaboration. No one has all the answers. People need to take ownership of their own health. The only way the health care industry can help them is if they collaborate, tell their health care providers, so they can collaborate,” he said.

These Are The Best Workouts for When You’re Tired

When you’re feeling exhausted, working out is usually the last thing on your mind. Although it might sound daunting, getting in some movement can actually help you feel better.

Just because you’re tired doesn’t mean that you necessarily have to skip out on your fitness routine, especially if you opt for the right type of exercise. If you’re feeling sleepy, you won’t want to engage in anything with too much intensity, but there are plenty of appropriate workouts for when you are tired.

“It is sometimes good to work out even when you are tired, because, depending on how tired you are, exercise can give you the needed energy boost to help get you through your day or evening,” says health coach Shawna Norton, CPT. “Prior to starting any workouts, ask yourself why you are tired, and then determine which routine to choose.”

If you are tired from poor sleep, fatigue, depression and/or anxiety, or jet lag, you might want to consider fitting in some light exercise, suggests Norton.

However, if you’re tired because of sickness or overtraining, take some time to rest.

Rather than diving into some rigorous exercise routine, you’ll want to opt for something energizing, but easy on the body – Aaptiv has the perfect workouts for however your body is feeling.

If you’re feeling low on energy, try one of these workouts for a much-needed boost.


Yoga is one of the best workouts for when you are tired. It’s movement-heavy, but still relatively low-intensity. “Yoga can help alleviate stress, and focusing on breathing really can change your energy,” says Pam Sherman, CPT.

Research also shows that just 25 minutes of yoga can boost brain function and energy, which is perfect for those days when you’re feeling lethargic and slow.

Start a yoga workout with Aaptiv today!


Since most of pilates involves lying on your back, it makes for a great workout on those low-energy days. Like yoga, pilates consists of controlled breathing, which can help release stress, relieve tension in your body, and improve your energy.

Plus, building core strength can help improve your workouts.

Light Weight Lifting

Lifting weights is a good option when it comes to workouts for when you are tired. “If you lift weights, go lighter than you normally lift, to start,” says Sherman. “If your energy seems to climb, go to your normal routine. Mix it up with exercises you may not normally do with less weight.” View our strength training workouts in app today.

Bodyweight Plyometric Workouts

“Bodyweight plyometric workouts are designed to get your heart rate up and stimulate your central nervous system,” says Norton. “They will have you awake and feeling refreshed by the end.” These require no equipment, so you can even do them at home if you’re too tired to make it to the gym. Bodyweight plyometrics include moves such as jumping lunges, push-ups, burpees, bicycle crunches, etc.


If no other workout sounds attainable, at the very least, take a brisk walk. “Grab a friend or your dog and get outside,” says Sherman. “Breathing in the fresh air is amazing and is a really great natural pick me up.” Taking a ten-minute walk can even be a more effective way to boost your energy than consuming 50 milligrams of caffeine.

Zumba or Dancing

Dancing can help improve your energy, boost your mood, and lower stress in ways similar to aerobic exercise. Plus, it can feel much more attainable than going on a run or hitting the treadmill when you’re groggy. “If you like Zumba or dance, go to YouTube and search for a quick dance workout or hit your favorite class,” says Sherman. “If that doesn’t appeal to you, put on your favorite music and dance your heart out.”

Even if you’re feeling fatigued, there are plenty of workouts for when you are tired.

You might be surprised to find that getting active can actually help you feel better

The Best Ways to Work Out When You’re Tired

Staying healthy is simple: Sleep restfully for eight hours per night, work out for 30-60 minutes at least five days per week, and eat mostly whole, unprocessed foods. Sure, maybe in a perfect world. Instead, we regularly deal with the exhausting side effects of stressful days at work, packed social calendars, kids, and more — all of which impact our ability to hit the recommended dosage of sleep and exercise. Quite simply, we’re tired!

The irony is that exercise can actually improve energy levels and make us feel better overall. So, we certainly want to keep up with our workouts. Fighting through that foggy feeling can be tough, though. We asked Aaptiv trainers to share their best strategies for working out when you’re tired. Keep reading to find out how they push through when they’re just not feeling it.

1. Figure out why you’re tired. First things first: You need to pinpoint what’s tiring you out, says Aaptiv Trainer Jaime McFaden. “Be honest with yourself — are you getting too little sleep or are you just feeling unmotivated to exercise?” McFaden says. From sleep troubles to stress to busy schedules, there are plenty of causes for the drained feeling. But it’s important to pinpoint why you’re tired. If you’re skimping on sleep because of too many late nights out, it’s probably time to reevaluate. If you’re working a standard nine-to-five with a full workload, some sleepy days come with the territory. And you may be able to push through that end of the day haze. “Typically, I find more people using the excuse of being tired to justify skipping exercise,” McFaden says. “You need to love your body enough to take care of it, so make the effort even if it’s small.”

2. Compromise with yourself. If you’re really don’t feel like hitting the gym, try making a deal with yourself. “Workout for 15 minutes and then rest for 15 minutes,” McFaden says. She recommends trying simple moves that will get your heart rate up and your muscles working. Do exercises such as planks, squats, jumping jacks, lunges, and jogging in place for one minute each. “Small increments of exercise can feel more attainable when you’re not in the mood,” she says. “If nothing else, a few minutes is better than nothing.”

3. Try the indoor cycling bike. Congrats! You’ve made it to the gym. Now, it’s all about picking the perfect machine to get you moving when your legs feel like lead. For Aaptiv Trainer Ben Green, that means the indoor cycling bike. “The treadmill takes me a bit longer to warm up on when I’m tired,” he says. “The bike is an easy way to get my heart rate up and zone out.” He recommends pushing through some intervals to get moving and then up the resistance and climb a few hills when you’re feeling more awake.

4. Go for a walk. If a fast-paced HIIT or challenging strength training workout just isn’t going to happen, keep it simple and take a walk. “Just getting moving is sometimes all the motivation you need,” says McFaden. “Get yourself outdoors and walk — it may change your exhaustion to motivation.”

5. Call a friend. By now we know that a workout buddy is the not-so-secret key to accountability. If you’re feeling sluggish, recruit a friend to push you. “A workout partner can be especially helpful in the moments you’re really dragging and about to skip your workout,” says McFaden. Even if your partner doesn’t get you to sprint it out, he or she may just get you to the gym and, sometimes that’s all it takes to fit in a quality workout. If nothing else, you can commiserate together over sets of sit-ups.

6. Let a trainer be your guide. If you’re feeling energized enough to at least get to the gym or the start of your running route, take the pressure off motivating yourself by enlisting the help of a professional. “Aaptiv has been a game changer for me on days when I’m just not feeling it,” says Aaptiv Trainer Kelly Chase. “As soon as I have the trainer in my ear guiding me through each step, I’m immediately motivated to keep going.”

Chase admits that she’s more likely to pick a shorter workout when she’s feeling tired, but once she starts she typically keeps pushing. “Usually once I’ve done one workout, it’ll prompt me to choose another short one,” she says. “By the time I’m done, 30-45 minutes have gone by and I leave feeling proud and one step closer to living a healthier lifestyle.”

How do you motivate yourself to work out when you’re tired? Share your tips with us @Aaptiv and @BritandCo.

(Photo via Getty)

Is It Better to Sleep In or Work Out?

Hero Images/Getty Images

Staying healthy is so easy, right? Log eight hours of sleep, work out for an hour a day at least five days a week, and steer clear of processed foods. Also drink enough water, meal prep, and meditate. Trying to fit it all in, on top of all the other variables in your life (kids! work! relationships!), can seem impossible. So when you’re debating the choice of lying in bed for another two hours or schlepping to the gym, sometimes shuteye wins. We get it: working out on no sleep can be a real drag.

But is that such a bad thing? After all, some mornings you just don’t feel well, or maybe you overdid it yesterday. Is it ever worth it to sleep in and skip the gym? Turns out, science still doesn’t have the hard and fast answer (yet).

“Both sleep and exercise are main behaviors that contribute to physical and mental health,” says Kelly Glazer Baron, Ph.D., a clinical psychologist and an associate professor at the University of Utah. Her research has found that clocking at least seven hours of sleep can actually help you work out longer and harder the next day. And the exercise/sleep equation goes both ways—people with insomnia who started a regular aerobic exercise program improved the quality of their sleep and felt less tired during the day, another study from Northwestern University found. So working out on no sleep can actually help with the whole “no sleep” thing! (Even more proof: Why Sleep Is the #1 Most Important Thing For a Better Body)

Considering multiple studies point to the direct relationship between sleep and exercise, there’s no denying that you should strive for adequate amounts of both, adds Shannon Fable, director of exercise programming at national gym chain Anytime Fitness. “If that’s impossible, try to only sacrifice your sleep two to three days during the week in order to hit the early morning cycling class. Get some extra sleep the other days and on the weekends.”

That said, there are still a few hard and fast rules you can follow to determine what to do on those tough days when your bed feels oh-so-comfy.

Sleep or Sweat?

If you got seven to eight hours of sleep the night before… You’re good to hit the gym, says Fable. Seven to nine hours of sleep is what most adults need, according to the National Sleep Foundation.

If you’ve been sleeping less than six hours most nights that week… It’s time to rethink your schedule, recommends Baron. See where you can cut corners to be more efficient: Head to bed 15 minutes earlier or shave 10 minutes off your morning routine to get a bit more sleep. If you’re not a morning person, consider a lunch break or an after-work gym time. (Try this insanely effective 15-minute workout when you’re crunched for time.)

If you were up all night… Definitely skip the a.m. sweat sesh, Fable says. (And maybe stock up on these possible insomnia cures.) Not only do you need the sleep, but your coordination will be affected, making exercise potentially more dangerous. Your ratings of perceived exertion will also make exercise feel harder than it is, she warns. Even if you’re working out at the same intensity as you usually do, sleep deprivation can mess with your mental performance, according to research in the journal Sports Medicine. Moderation is key when working out on no sleep or when tired. Exercising too hard can make you more tired and increase your risk of injury, because fatigue can hamper concentration and form. “When you’re feeling sleepy, back off a little from your workout status quo; reduce the intensity and duration of your exercise,” says Shawn Youngstedt, Ph.D., a professor in the College of Health Solutions at the University of South Carolina in Columbia.

If you’ve only worked out once that week (and it’s Friday)… If you’re aiming for three to four workouts per week, it’s time to move, says Baron. Just 40 minutes of moderate to vigorous exercise three times per week can lower your risk for heart attack and stroke, says the American Heart Association. So don’t hit snooze!

If you’ve been consistently killing it at the gym that week… Skip your workout, advises Fable. Everyone deserves a day off and your body needs sleep to repair after heavy workouts. Rest days allow for protein synthesis, which is crucial for building muscle, according to a study in the Journal of Strength and Conditioning Research.

If you’re sore… Sleep in and take a day off. Overtraining can cause a decrease in sleep quality and duration, Baron says.

If You’re Feeling Beat…Eat for All-Day Energy

After a rough night, whether you’re working out on no sleep or heading straight to work, skip the energy-drink IV in favor of revitalizing nutrients. “It’s amazing how eating the right foods can help you make it through the day,” says Lauren Antonucci, R.D., the director of Nutrition Energy, a private nutrition-counseling service in New York City. (See more about how to eat for better sleep.)

Antonucci’s meal plan will keep you revved—and full—until dinner.

  • When you wake up: Dehydration compounds fatigue, so down two glasses of water first thing. Aim to sip half your body weight in fluid ounces by bedtime (for a 145-pound woman, that’s 72 1/2 ounces, or about nine cups).
  • Breakfast: Go for eggs, scrambled or hard-boiled. “They’re one of the most absorbable types of protein, with just the right amount of fats and a dose of energy-boosting B vitamins,” Antonucci says. For staying power, add healthy carbs, like a slice of whole-grain toast and some fruit. A hit of caffeine will kick-start your day; if java makes you jittery, grab a mug of green tea. It has some caffeine, plus a compound called epigallocatechin, which, studies show, produces a relaxed and attentive state.
  • Midmorning: Improve your focus with a handful of mixed nuts, such as almonds, walnuts, and peanuts. The protein provides a jolt of energy, while the combo of filling fiber and omega-3 fatty acids tides you over until lunch.
  • Lunch: Build your meal out of lean protein, slow-burning complex carbs, and healthy fats—try a skinless chicken breast with a broccoli, black bean, and quinoa salad—to power through the next few hours.
  • Late afternoon: Chips or chocolate chip cookies may sound awfully good right about now, but after causing a quick spike in your energy level, they will send it crashing. For a steady, long-lasting pick-me-up, choose nutrient-rich high-fiber snacks like hummus with a whole-grain pita or baby carrots.
  • By Sara Angle @saraangle22
  • By Sara Angle and Nicole Yorio Jurick

Ask an expert: Should you workout when you’re feeling tired?

Whether you’re suffering jet lag, you’ve worked a late shift or you just simply couldn’t nod off the night before, there’s nothing worse than feeling like you haven’t had enough sleep.

Everything feels more difficult when you’re tired, from simply getting out of bed in the morning to concentrating at work. But what do you do if you’ve got a workout scheduled and a training plan to stick to?

THAT first week back…⠀ ⠀ The gym.⠀ Tupperware life.⠀ Waking up in the night. ⠀ ⠀ Sound right? Now for #fridaynightin ⠀ ⠀ 📷: @laylee_emadi_photography @letterfolk

A post shared by Amy Hopkinson (@wellness_ed) on Jan 5, 2018 at 10:44am PST

Is it better to power through a HIIT session, or is it safer to give in to the exhaustion and take a rest day? We put the question to Andy Vincent, an elite personal trainer from London gym Third Space. Here’s what he had to say…

“Usually, the clients I train miss the important sleep that is needed for recovery for two reasons: because they’ve either tried to squeeze a session into an already busy schedule, or they’re simply trying to train during a period of high stress. It’s a serious problem, and I often get asked whether it’s worth training when you’re feeling physically and mentally exhausted.

“Here are my six key signs that should tell you that you’re too fatigued to train.”

1. Your performance drops

“If you’re tracking any kind of performance-based marker such as maximum load, distances or watt outputs, you will be able to notice when your training efficiency is lowered. A single session with a lowered output isn’t a problem, but consistently underperforming is a warning sign that you’re not recovering enough.”

2. You have more than three poor night’s sleep in a row

“Parents with young children who like to keep fit will know that a lack of sleep can seriously hinder your performance. If you’re not sleeping well, for whatever reason, you probably need to consider if training is worth it. Your body may well benefit more from rest and recovery until your sleep pattern is back on track.”

3. You keep getting ill or picking up injuries

“If you can’t fight off a cough or cold, and you keep getting small, nagging injuries that don’t seem to go away, it may be time to bolster your immunity by taking a well-earned rest.”

4. You’re sore for long periods after training

“Still feeling the effects of that leg session, four days later? Muscles recover when you’re resting, so if you’re not able to recover properly, you will usually feel achy for longer than usual.”

Schedule time for muscle recovery, says Vincent (Thinkstock/PA)

5. You need to use excessive stimulants to get you through training

“Caffeine is the most researched supplement when it comes to its effect on training. However, you shouldn’t have to rely on excessive amounts of caffeine just to get you through a session.”

6. You aren’t seeing results

“You’re eating right and training as hard as you can, yet your body shape is staying the same. There is only so much stress the human body can handle, and it can often be more beneficial to spend a few days recovering so you can head back into the gym with more energy and a clearer mind.

“The bottom line is that training needs to be high quality to yield the optimum results, which you will struggle to do when exhausted. Within training, I always remind my clients of the importance of the ‘SAID principle’, which asserts that the human body adapts specifically to imposed demands.

Would you like to do that?! 🙈

A post shared by OUTDOORCHICKS (@outdoorchicks_org) on May 17, 2018 at 11:52pm PDT

“Training is all about asking the body to adapt to certain stressors, be it placed on your muscle tissue or brain, to make muscles stronger and burn fat. When you are training at levels far below your capabilities, you’re not going to be able to make decent changes.

“There’s a big trend for high-intensity exercise at the moment – intensity being the measure of how much output we can generate, be it aerobically, anaerobically or with load on the bar in a strength setting. Training hard can often leave us feeling tired after a gym session, but don’t confuse training while feeling fatigued with training to fatigue.”

The smart way to train

“If you’re regularly feeling tired at the gym, you may need to adapt your training plan. Think of sleep and recovery as just as important as how hard you can train or how many sessions you can do. Program active recovery days when you just come in and do some soft tissue work on a foam roller, stretch and go for a swim or a long walk to get the blood flowing.

“It might be a good idea to invest in a fitness wearable that can track your sleep, so you can monitor how many hours you’re actually clocking per night. My other tip would be to track Heart Rate Variability (HRV), to monitor the variation in the time interval between heartbeats. This variation is controlled by the autonomic nervous system (ANS). It regulates, among other things, our heart rate, blood pressure, breathing and digestion.

First night with a #fitbit. Is it strange that I woke up feeling wide awake and refreshed? #4hoursofsleep #sleep not at all #sleepy and yes, I got out of bed around 2… pretty normal for me. #sleeptracking #sleeptracker

A post shared by Thomas Hazlett (@beard_ee) on May 11, 2018 at 10:07pm PDT

“Higher variability is better, and indicates a well-recovered, calm state, whereas persistently low values of HRV indicate chronic stress. So, if your daily HRV measure indicates a stressed state, you can take that as a warning from your body that you should take a day off.

“Chest straps like the Polar H10 (£76.50, are a good place to start. They can give you a daily HRV information directly to your preferred phone or tablet, so you can make your training more productive and schedule rest days when your body most needs it.”

– Press Association

Body shop | Should you exercise when you are tired?


Is it best to skip exercise if you are tired, or should you force yourself to exercise regardless of how you feel? That depends. If you think you are ill or coming down with something, it may be best to rest and let your body use its energy to fight off what’s attacking you. Otherwise, let’s take a look.

The argument for

I try to get some exercise every day if I can. What I do varies, depending upon how I feel and how much time I have. Some days I work out somewhat hard by lifting weights, then pushing myself on the treadmill or elliptical trainer. Other days, I walk at a comfortable pace on the treadmill and watch TV or read.

Recently, when driving home 60 miles from Hanover College, I intended to exercise. But when I came in the door, I felt tired, so I crashed in my favorite chair and clicked on the TV. As I sat there, I felt myself fading fast and realized that if I lingered much longer, I wouldn’t exercise. But it felt so good, (yummy, in fact) just sitting there doing nothing. This started a conversation in my mind.

On the one hand, I was fatigued, mostly mentally, and my body wanted to give in to it. Moreover, I know the human body is programmed to conserve energy, and it is ingrained at a very deep level to rest when it can. It’s our natural state, in other words.

On the other hand, I didn’t want to doze off and lose the evening, which is where I was headed if I stayed put. I also knew from previous experience that if I got up and got going, I would perk up and feel better. But taking that first step can be rough, so there I was, arguing with myself inside my head. Sound familiar?

Ultimately, I compromised, telling myself I’d do only a little exercise, just enough to get my juices flowing. In response, I sucked it up, put on my exercise clothes and got on the treadmill for a comfortable walk. Soon, I felt wide awake, which inspired me to do much more exercise than I had intended. When I finished I felt great and I was thankful I exercised.

For us recreational exercisers, a good rule of thumb is to fight through feelings of being tired, and do something physical. You will be rewarded, as I was, for your efforts.

The argument against

Now, let’s shift gears to athletes, or those who train like an athlete. If you do, you typically look forward to working out. When I was young, I recall sitting in high school algebra class, jotting down ideas for my workout when school was out. I couldn’t wait to get home to lift weights, to push myself to the limit.

This kind of gut-busting workout takes a big toll on the body, and as I discussed last week, you have to be certain to fuel your body with good nutrition, and to get lots of quality sleep each night. This is critical for full recovery from your workouts. But what if something interferes with eating and sleeping right? If so, you might not recover fully and be ready for your next workout. Unfortunately, even if you eat and sleep right, if you are doing too much, too often, you can become over-trained. When this happens, the body can’t keep up, and it starts to decline.

When you train hard, feeling tired and losing interest in training can be the body’s way of warning you to cut back, to rest more. Forcing yourself to keep going can make things worse.

The bottom line

Feeling that you’d rather watch TV than exercise is natural, and you have to be disciplined to overcome it. But pay attention to what your body is telling you, because sometimes the desire to rest is legitimate, and it’s smart to give in to it.

Bryant Stamford is professor and chairman of the department of kinesiology and integrative physiology at Hanover College. To contact him, email [email protected]

(Last Updated On: April 16, 2019)

Once you’re committing to staying fit, you don’t want anything come between you and your workout. Even when you’re on a tight schedule, you find a way to fit in an exercise session. Fortunately, when you’re exercising at home, that’s not so hard to do.

Commitment to fitness is a good thing as long you keep the bigger picture in mind – your health. Some people become so committed to their workout that they exercise when they’re sick or exhausted after a night of too little sleep. To be fit AND healthy, it’s important to strike a balance. That means making rest a part of the equation – and know when rest is the best option. Here’s the question. If you’re exhausted from lack of sleep – should you work out when you’re tired and sleep-deprived? Find out why rest is the best option.

Your Performance Will Be Sub-Par

Even one night of little sleep can affect your workout. A study published in the International Journal of Occupational Medicine and Environmental Health showed that reaction times decrease and performance on tasks like driving and operating machinery declines. Cognitive function suffers too. It becomes harder to make decisions and memory is impaired. Plus, sleeplessness increases sensitivity to pain. That means your workout will feel all the harder even when you aren’t working as hard as usual.

Another study showed that one night without sleep decreased performance during endurance exercise and participants had a higher perceived level of exertion. In other words, even though they ran a shorter distance than usual, it felt harder.

The take-home message? If you work out when you’re sleep-deprived or very tired, it’s unlikely to be a productive session.

Your Risk for Injury Goes Up

With your reaction time slower and thinking skills and judgment clouded by fatigue, your risk for injury goes up when you’re tired or sleep-deprived. Why risk an injury just to say you worked out? Better to rest and approach your workout with fresh enthusiasm because you’re rested and operating at peak efficiency.

It Negatively Impacts Your Immune System

It doesn’t take much sleep deprivation to cause problems. Even one night of poor or inadequate sleep raises cortisol levels. This puts a damper on your ability to fight off infection. Combine that with the added stress of a hard workout and you put yourself at greater risk for whatever virus happens to be making its rounds. When you’re exhausted, you need rest to lower your cortisol levels and get your immune system back up to snuff.

The Effects of Inadequate Sleep Are Cumulative

If the time you’re using to work out in an exhausted state cuts into your sleep time the next night, you’ll feel even less “perky” the next day. After being sleep-deprived for a few nights, your performance, cognitive function and reaction time declines even more. That means you could end up having several days of less productive workouts and be more likely to injure yourself.

It Interferes with Tissue Repair

When cortisol levels are high, it interferes with tissue repair and growth. In addition, anabolic growth hormone is released primarily during the deeper stages of sleep. When you’re sleep-deprived, it creates an unfavorable metabolic environment for growth and repair. Better to rest and get a good night’s sleep than further stress your system with a workout. This will only raise your cortisol levels further.

Other Reasons Sleep is Important

Sleep doesn’t just impact your workout and ability to build muscle, sleeping less than 7 hours a night has been linked with a greater risk for health problems like type 2 diabetes, heart disease, hypertension, an increased risk for weight gain and higher mortality. Plus, it has a negative impact on mood. Who doesn’t feel grouchy and a little anxious when they haven’t slept?

The Bottom Line?

When you’re exhausted and slept very little the night before, take a rest day and let your body recover and stress hormones normalize. If you work out in an exhausted state, your workout won’t be as productive, tissue repair will be compromised and you’ll increase your risk for illness due to decreased immunity. Plus, you probably won’t work have a very productive workout. Maximize your nutrition and give yourself a day to rest and recover. It won’t negatively impact your fitness level. It’ll help you be fitter and healthier in the long run.

Int. J. Occup. Med. Environ. Health. 2010: 23 (1): 95-114.

Eur. J. Appl. Physiol. 2009 Sep: 107(2): 155-61.

Washington State University. “How sleep affects sports performance” “Insufficient Sleep Thwarts Weight Loss Efforts”

Sleep. 2010 May 1; 33(5): 585–592.

Should you exercise despite lack of sleep?

Have you been constantly smashing your exercise routine and now finding it hard to miss even one session? We get that (or not). It’s normal to be afraid you’ll lose the progress you took so long to build. But sometimes it becomes difficult to avoid sleep deprivation because you juggle amongst many responsibilities, so you end up in some sort of cognitive dissonance – should you exercise despite lack of sleep?

Find the balance

We know from elementary science that exercising does wonders to your body. It lowers the risk of type II diabetes, high blood pressure, and even a heart attack. Without a doubt, it also gives you a great state of mind – fresh, healthy, and always ready to seize the day.

So does sleep. Although it requires less physical effort than working out – it gives you a sound mind and body too. Well, sleep and exercise, it’s a powerful tag team these two.

Much like everything else in life, striking a balance is key. In fact, the Australian Government has provided physical activity guidelines that state doing any physical activity is better than none. So how you find your balance depends on your current level of exercise, and how much sleep you have on you.

I lack sleep, should I exercise when…

I pulled an all-nighter? When running on ZERO hours of sleep, it’s recommended to go home and get enough rest. Not only does this increase your risk of injury, but also impacts your body’s ability to recover and repair itself. Being sleep deprived also raises cortisol levels that make your immune system vulnerable to any viruses around. So, yes, just get the day off… from working out, that is.

I’m hungover? If you’re still feeling nauseous first thing in the morning, don’t do it. The most important thing you need to do when hungover is to rehydrate. Once all the hangover begins to settle down, breaking a sweat with a gentle exercise could do the trick. Try simple stretching exercises like yoga.

I feel jet lagged? Absolutely, but do listen to your body. Pause right away should the exercise start making your jet lag worse. Fortunately, some studies show that regular exercise AT THE SAME TIME can help achieve quicker recovery. So, if you exercise at 7AM in Melbourne, do it at 7AM wherever you go.

I slept under six hours (but still feel okay)? This is where you can do some compromising to balance sleep and exercise. If your sleep deprivation is not chronic and you feel that it hasn’t sucked the life out of you yet, it should be fine to exercise for a maximum of 30 minutes. DON’T do high-intensity, long-duration, or even heavy weight-lifting exercises. It’s best to just be on the move – stay on the treadmill, do some walking, incorporate light weights, or even just do a short yoga session.

I always work out? If you work out between four to all days of the week and feel exceptionally weak, it may be your body’s way of telling you to rest. Slow down for a bit. Rest days can significantly improve your muscle strength as it recovers because your growth hormone (GH) levels are highest during sleep. Overtraining and failing to rest will only get you to a plateau – unable to see any more improvements in muscle growth nor fat loss.

Related Article: Can We Work Out Before Sleep?

In ALL the mentioned cases, don’t succumb into the trap of pre-workout drinks or stimulants. You’re way better off taking a nap than relying on a temporary adrenaline rush.

Bottom line? Listen to your body.

Often your instincts will tell you when you can or cannot exercise. Listen to what it tells you because it all comes down to how you feel. And we don’t mean the lazy feeling – we mean the feeling of not being able to push your body any further. If you feel like forcing it, pack your bag and go. It will only do more harm than good.

Finding the balance between sleep and exercise ties well with listening to your body. Over time, you’ll get a good rhythm of your on/off days and it’ll be second nature to know just when to rest.

Is It Bad To Work Out When You’re Tired? Here’s Why You Shouldn’t Lift On A Lack Of Sleep

If you love doing your workout in the early morning hours, you’ve probably experienced the excruciating feeling of trying to wake up for a sweat sesh after you’ve been tossing and turning all night long without a wink of sleep. Maybe you’ve been able to coax your bleary-eyed self to the gym in these instances, but you always felt like absolute crap in the process, and you realize now it’s probably not a good thing that you nearly fell asleep on the stationary bike that one time. While working out when you’re tired isn’t necessarily the worst thing in the world, there are different degrees of fatigue that you should be mindful of when it comes to your sweat sessions.

First of all, you should definitely be able to distinguish the difference between being legitimately tired and being low-key lazy. You know your body best, my friend, so you’ll know when you’re letting little things like traffic or a temporary bad mood totally derail your workouts, as opposed to a genuine lack of quality rest.

If you’re feeling both mentally and physically exhausted from lack of sleep, it’s probably best to skip out on your scheduled sweat sesh for the day — yes, even if you paid for it.


According to the National Sleep Foundation, getting seven to nine hours of sleep per night is recommended for optimal mental and physical health. If you know for certain you’re already on top of getting the proper amount of shut-eye, Shannon Fable, the former director of exercise programming at Anytime Fitness, told Shape that you’re in the clearto hit the gym.

However, if you were up all night trying to catch some Zs, and you’re positive you didn’t hit those coveted eight or so hours, it’s best to stay in bed for some additional, glorious sleep and avoid any form of strenuous exercise, according to LIVESTRONG. The reason why this is so important is because, if you attempt an intense HIIT circuit or a challenging cardio routine when you can barely keep your eyes open, you might be too careless and distracted to execute the movements properly, and you really could hurt yourself.

Personal trainer and fitness video pioneer, Cathe Friedrich, cautioned in a blog post on her website that exercising while you’re sleep-deprived can be so bad for your body that it can actually derail your immune system defenses, hurt your body’s ability to repair your muscles, and interfere with your cognitive function — meaning, again, your fuzzy, tired brain could cause you to inadvertently injure yourself while you’re trying to navigate the weight rack through droopy eyes.

To understand just how strong the relationship is between fitness and sleep, a 2009 study by researchers at Stanford University showed how you can actually improve your workouts by clocking in more snooze time.

The New York Times reports that the small study looked at five athletes on the women’s tennis team at Stanford University. The women were told to maintain their normal training schedules for two to three weeks without changing their usual amount of sleep. After those few weeks had passed, they were tested with sprinting and hitting drills as a performance marker.

For the next part of the experiment, the players extended their nightly sleep schedule to 10 hours for an extended five to six weeks. After getting much more sleep on a consistent basis, the athletes were tested with the same initial drills, and according to The New York Times, the results showed that the women performed significantly better when they were getting more sleep. Now, this study’s sample was pretty small, but even so, the results don’t lie, people. Sleep truly is the real MVP.

Of course, getting enough shut-eye is often easier said than done, but there are plenty of steps you can take to increase both the amount and the quality of your nighttime rest, and in turn, make sure you’re always able to make that morning cycling class.

For starters, make sure you’re not taking electronics to bed with you, so that the blue light behind your technology won’t stimulate your brain and keep you wide awake. You can also add some soothing essential oils or calming breathing techniques to your nighttime routine to make sure you’re sleeping soundly through the night.

If you implement these small changes into your bedtime routine, you’ll be on the road to sleeping like a baby in no time. Then, you’ll be able to bask in the glory of a balanced workout and sleep schedule, without having to compromise one over the other.

Sleep and fitness are intimately related. Not just because it’s so hard to get up for your morning workout if you’ve slept poorly the night before — although that definitely doesn’t help — but also for biological reasons. When you sleep, your body releases natural growth hormones that improve your fat burn, build stronger bones, and help your muscles grow and recover, according to past studies (which is key if you’re trying to lose weight). But even knowing this, it’s easy to fall into the trap of skipping out on sleep to squeeze in your workouts; we’ve definitely done it over here. That’s why we wanted to know, once and for all, what exactly happens when you exercise on a less-than-full night of sleep? And why is it so bad?

It comes down to your REM sleep, said Kin Yuen, MD, a sleep medicine doctor at the UCSF Sleep Disorders Centre. You might know REM, which stands for “rapid eye movement,” as the stage of sleep when you do your dreaming. It’s also the time when your brain files away all the information you picked up that day, recovers, and gets ready for tomorrow.

What does that have to do with workouts? “Whether you’re an athlete, a musician, or a scientist, we know that reasoning, judgment, and coordination all improve when we have enough REM sleep,” Dr. Yuen told POPSUGAR. Those skills become clouded when you’re deprived of REM sleep, which can have a major impact on your workout the next day. Not only will you underperform — maybe you’ll finish fewer reps or have to drop to lower weights — but your degraded coordination can also result in poor form, which can lead to injury and majorly impact your results, be that building muscle or losing weight.

And it’s not only about sleep, Dr. Yuen said, but when and how you wake up. “The longest cycle REM sleep is typically right before we get up,” she said. “That’s why we hate the snooze button.” Your alarm pulls you out of your REM cycle, and when you hit snooze, your brain sends you back into it. The problem is that the precious few minutes of sleep you grab from the snooze button aren’t nearly enough to complete a full REM cycle. You’ll wake up midcycle, which throws your body off completely and actually leaves you more tired and groggy than before.

“It’s really important to complete the cycling of the deep sleep and REM sleep so we reap the benefit,” said Dr. Yuen. That means both resisting the temptation of the snooze button but also getting enough sleep that you can complete your REM cycle. How much sleep is that exactly? Dr. Yuen says there’s no set number that applies to every person, but in general, women should try to get about eight hours, while men typically need seven or seven and a half.

The amount of sleep you need is dependent on you, though; you might feel better with more or less than the recommended amount. It’s a matter of listening to your body and paying attention to when you go to bed and wake up on the mornings you feel the best (or the worst). If you’re trying to lose weight in particular, here’s exactly how much sleep you should aim to get per night.

If it comes down to choosing between a workout and getting enough sleep, Dr. Yuen recommends skipping the workout. The rest of your day is going to feel a lot better if you prioritise your shut-eye. Tomorrow, try heading to bed an hour earlier so you can do both. (Easier said than done, but we’ll try if you do.)

Image Source: Getty / svetikd

Working out while sleepy

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