Exercise and Your Immune System: Interview with Dr. Jake Deutsch

Similar to eating a healthy diet and getting good quality sleep, exercise helps you maintain overall good health and, by extension, a healthy immune system. Dr. Jake Deutsch joins Get-Fit Guy to talk about the effect of exercise on your immune system.

Brock Armstrong
13-minute read
Episode #519
The Quick And Dirty
  • Exercise helps the body regulate stress hormones which allows your immune system to work correctly.
  • Getting regular and healthy amounts of exercise is important but getting more than that is not necessarily better.
  • The "neck check" is a good rule of thumb but not always the best way to decide when to exercise and when to rest.
  • Exercising in cold weather is not dangerous but you do need to be properly prepared. 
  • Maintaining a clear nose and airway can make exercising more fun and effective. 

In a previous Get-Fit Guy episode called Should You Exercise While Sick, I looked at how it can be hard to do much of anything when you're feeling under the weather. I also took a brief look at whether there are benefits to exercising while sick, or if working out just makes you feel worse.

Well, in this article and podcast episode, I am going to revisit some of those topics and take a deeper look at some other aspects of exercise and illness with a special guest expert, Dr. Jake Deutsch.

Dr. Jake Deutsch is board-certified in Emergency Medicine and the co-founder of Cure Urgent Care in New York City. He attended the University of Massachusetts Medical School and currently holds privileges in the Mount Sinai Health System.

Prior to founding Cure Urgent Care, he practiced emergency medicine at Hackensack Medical Center and was ranked highest in patient care and satisfaction more than a few times. With over 15 years of urgent care experience, Dr. Deutsch is a highly skilled practitioner dedicated to keeping patients happy and healthy.

Dr. Deutsch is also very active on social media with tons of followers on Instagram (where one look will tell you that this is a doctor who knows how to stay fit.) He also regularly appears on several American television networks as a trusted medical source. Recently, he partnered with Zicam to help people get better sooner this cold season.

Cold season concerns

An online survey of 2,000 Americans (described in this press release) showed that people have seen this cold season as different from past cold seasons. More than 50% said they were researching how to be better prepared for the upcoming cold season compared to prior cold seasons, and nearly a quarter (23.48%) reported that they're responsibly stocking up on remedies.

With his facilities seeing more than 4,500 patients every month, Dr. Deutsch truly understands the internal struggle between acknowledging symptoms and taking initiative versus simply "riding it out." Given the ever-present confusion between cold, flu, and allergy symptoms, Dr. Deutsch wants people to understand how to recognize sneezes, sore throats, and coughs and jump into action at the first sign of a cold.

And responding to a cold includes tailoring your workout and exercise program!

RELATED: A Cold vs. the Flu: How to Tell the Difference

The interview with Dr. Jake Deutsch

As always, I encourage you to listen to the audio recording at the top of this page so you can get every nuance. If you can't listen, here is a written transcript of my conversation with Dr. Jake. 


So we can just jump right into the first question, which is kind of the Holy Grail, I guess, of us fitness people when it comes to cold and flu season: Can I actually use my fitness to boost my immune system or at least give myself a more of a fighting chance of staying nice and healthy during the cold and flu season?

Dr. Jake

Yeah, I think that that's just everybody's assumption—when you're physically fit, you're healthier. And part of being healthy is having a robust immune system. So it kind of goes hand-in-hand without saying. But understanding the real science behind it versus just making that assumption has definitely got some nuances to it.

I always encourage my patients to try to exercise as much as possible. There are so many valuable benefits.

So, I always encourage my patients to try to exercise as much as possible. There are so many valuable benefits. And certainly, keeping our immune system at its optimal is one of the most interesting.


So, in terms of the science behind it, can you give us a little more information about that without getting too ... too 'science-y'?

Dr. Jake

Yeah, try to not make people fall asleep?



Dr. Jake

I think the number one point to consider is our hormones that regulate stress in our body. Exercise actually reduces the release of stress hormones. So some of those like cortisol, which are what our body releases because we're not taking care of ourselves, are in a deep decrease in production when we exercise. So that's really, I think, the biggest regulatory mechanism. By reducing those hormones, the body has less inflammatory response. And then the immune system is ready to do what it needs to do.

Exercise actually reduces the release of stress hormones.

So that's kind of, I think, the most important and really scientifically documented benefit of exercise. But yeah, there's a handful of other ones that we see incidentally, too.


That's really interesting. So it's more that you're getting those hormones out of the way so the immune system can do its job, rather than bolstering the immune system. Did I understand that right?

Dr. Jake

Yeah, it's almost like preventing unnecessary inflammation, which overworks the immune system, if you will. So, we've all kind of thought about endorphins that are released because of exercise, and those have a positive effect on our mood and energy. But when we are not taking care of ourselves, the stress hormones are higher.

So the idea is to keep those down and get a better immune response. So, it's not so obvious. And endocrinology is probably one of the most difficult aspects of medicine. So I think that's the best way to kind of summarize it and keep it simple.


So a little while back, you actually said you try to encourage your patients to exercise as much as possible. Is there a benefit to doing so? Let's say if you're used to doing 30 minutes of exercise. Would you want them to increase it to 60 to 90? (Of course, I'm being a bit of a devil's advocate here.) Is there a tipping point?

Dr. Jake

Anything in excess is never good. So once you start going beyond the healthy amounts of exercise where your body can recuperate and is able to, sort of, be balanced, then you start putting more stress on the body. And so that idea of those stress hormones being positively reduced with a good amount of exercise, the flip side is an excessive amount of exercise could increase those stress hormones. And that's really where the balance I was speaking about comes in. I think that anything in excess is never good, whether it's exercise or drinking or diet.

I think that anything in excess is never good, whether it's exercise or drinking or diet.

There's a lot of people who are really fit and are almost fanatical about it. You have to be careful. Our body needs sleep to recover. We need to break down in order to build up. That's seen in the physical parts of our exercise, but also in the non-physical parts, like our immune system.

I just always want to make sure that people don't think that you can't get enough of a good thing when it comes to things like exercise, because, of course, you don't want to be running on fumes, burning the candle at both ends, if you will. Which, of course, is not going to end up being positive.


So that includes taking those all-important recovery days and rest days as well as getting your exercise days in, I expect?

Dr. Jake

Yes. My training is in emergency medicine and some of the most extreme cases of illness come into the ER. And as an example, rhabdomyolysis, which is the breakdown of muscle tissue from overuse, would be an example of that. We see that in soldiers that are marching or ravers that are partying all night and doing drugs so their muscles are just working and working. And you actually get muscle breakdown from the excessive exercise.

There is such a thing as too much of a good thing.

So, you know, there is such a thing as too much of a good thing. And just like rhabdomyolysis would be an example of that—overdoing it—you're going to have the negative effect of the immune system. And you know, wintertime is when our body is most at risk for infections and for illness. And, we want to optimize what that looks like for our immunity.


Okay, so we want to make sure that we're getting enough exercise, but not too much, we're getting enough rest, but still making time for the exercise to give us the best chance of not getting sick in the first place.

But once we've already gotten sick—let's say we've got some congestion, sore throat, all that kind of stuff happening—how can that actually impact our ... not necessarily just our fitness performance but actually our ability to get the exercise done?

Dr. Jake

The body is a balance between our cardiovascular system, our pulmonary system, our circulatory system, and also other things like our immune and musculoskeletal system. So when you're sick, you're going to basically have the systems not firing at maximum capacity. Just being sick from a cold, you'll have a fever, and what we call a cytokine response, where there are these modulators that get into our body that cause us to feel crummy. But the other manifestations that [are] respiratory—like, if you get pneumonia—you're not going to be able to absorb as much oxygen.

Or if you have other severe illnesses, and you're not able to circulate blood as well, like you're anemic, or you have other lung problems, you're going to see the effects, that exercise certainly wouldn't be able to be performed to capacity.

Listening to your body is such a simple mindset. But when you're sick, it's even more important.

So, listening to your body is such a simple mindset. But when you're sick, it's even more important because you really might be limited from what you're used to. Elite athletes can go from elite status to needing to be benched because of illness. So it's really important to get that whole picture when it comes to taking care of yourself when you're sick.

And certainly, you know, a little bit of exercise when you have a mild cold ... I don't mind sweating it out. But when there's something more significant going on, heeding your body's warnings, being smart about what you need to do to take care of yourself is 100% what I recommend to my patients.


Do you follow that recommendation of what they call the “neck check,” where if you're sick from the neck up, it's okay to exercise, but if your sick from the neck down, take the day off. Is there any validity to that?

Dr. Jake

I like that, that's kind of clever. But you could have meningitis, and that's above the neck, and then you're not really going to be in good shape to be working out. So I don't think it's an absolute, but you know, it's probably a decent rule of thumb.

Anything that's respiratory is going to be much more prohibitive.

Really, I think the biggest thing is anything that's respiratory is going to be much more prohibitive. That's really where the gas exchange is that's critical to our cardiovascular system. So it's the stuff that's going on in the lungs that's going to be really your danger zone to be thinking about.


So if you've got that wheeze or cough or difficulty breathing that's when to take it easy?

Dr. Jake

Yeah, take it easy. It's funny, I see so many patients that are really into fitness—I live in New York City, and I am very active, working out five or six days a week—and they always are like, "so, I'm good to go, right?' when they're feeling sick. And I say “it's okay to take time off. You've been training hard all year and if you have one or two illnesses a year where you need to take a week off. That's okay.”

I think that really has to be an expected course of the year, especially when you're not 20. You know, as we mature, our bodies need a little bit more time to recover.


I like how you said that: "As we mature." As someone who's sneaking up on 50, I appreciate that language.

Dr. Jake

Me too! But there's no reason not to be able to be active. I certainly highly encourage my patients to take care of themselves and exercise. And with the pandemic, we've seen so many people become couch potatoes, which is a slippery slope of kind of staying at home and not taking care of yourself and being depressed by everything that's happening in the world. So we need to make sure that we're being smart, but also not discouraging people from continuing to do what we know is very, very positive.

RELATED: Covid Couch Potato? Stay Active with Movement Snacks


Right. And at this point, when we're recording this mid-January 2021, not only do we have the pandemic but it's also the middle of winter, in the northern hemisphere, anyway. And I know there's a lot of questions about exercising outdoors during the winter. I grew up in northern Alberta, so I'm no stranger to the cold. But from an actual physician, can you let the listeners know, in terms of exercising outdoors in cold temperatures, is that going to hurt you, health-wise?

Dr. Jake

I don't think “hurt,” but it's a certain set of circumstances. You know, an additional layer of circumstances.

In the Northeast, we have some really frigid temperatures. And the most critical factor is making sure that our body acclimates to that and our respiratory system is protected.

I like to kind of think of our nose as the entry point into our respiratory system. Our nose is responsible for filtering our air, sort of humidifying the air, and making sure that the temperatures are regulated. So being aware of your nose and your nasal status is kind of a key factor.

Being aware of your nose and your nasal status is kind of a key factor.

I'm a big fan of Zicam. They make Nasal AllClear swabs, which basically are a way to maintain the nasal passages in an optimal setting. And so, getting your airway prepared to work outside is like my always go-to.

And then it's possible to adjust with other factors like whether it's your head covering or water wicking clothing, or just taking extra precautions, because there's still sun in the winter, so using sunscreen. But the foundation is a good airway, making sure that you're going to be able to tolerate the colder temperatures with the respiratory system, which I mentioned was so important. And then adding on those other layers.

The one thing that I love about my secret weapon, the nasal swabs from Zicam, is they just are using menthol, which is what we use typically for other respiratory treatments, and it's very cooling, it opens up the passages. And maximizing that airflow is going to maximize our workout. So it's something very simple that I always make sure is in my gym bag and recommend to my patients.


Yeah, that's really interesting. When I used to ride my bike to work in Toronto in the middle of winter (in snow and minus-20 Celsius or colder) I'd wear a complete balaclava over my face. And there is a little tiny mesh part right in front of my nose. And as soon as your nose starts to get kind of stuffed up, that little mesh part would become completely, for lack of a better term, encrusted with ice (and other things). And yeah, that can really turn your bike ride from being kind of a fun adventure to a torturous affair.

Dr. Jake

Yeah, once you go from open nasal passages to blocked, you're no longer really able to do what you set out to do. So that's where it should sort of be the first point of preparing for outdoor exercise and when it's cold like that.


In the spirit of that, then, with the Quick and Dirty Tips network and especially on my show, I love to wrap things up with a little bit of homework, or at least some tips that the listeners can use right away. For the folks who want to really take charge of their winter exercise, and still be able to protect their health, what would your main tips be?

Dr. Jake

First of all, be realistic. If you haven't been working out, don't go try to run a marathon tomorrow. Start with reasonable goals and set goals. You know, it's still kind of the New Year, so having some sort of plan that's reasonably attainable. Once you start to hit goals, the success seems to be much more positive and more productive. So make sure that you've got some sort of realistic goals going on.

Burnout is probably going to set in after a couple of weeks, so have a plan in place to have variety.

Think about ways that you're going to make your workouts creative. Don't just say "I'm going to cycle" or "I'm going to do an indoor bike ride because I got a new bike." Burnout is probably going to set in after a couple of weeks, so have a plan in place to have variety.

Make sure that you have had your annual physical in some way—either telemedicine or otherwise with your doctor—because everybody is kind of not paying attention to the health maintenance that you probably need.

And then get stocked up with the sunscreen I mentioned before—people don't think about it. Make sure you have masks that are great to use for outdoor activities if you need them. Gear that is appropriate. And then, of course, I'm going to go back to my secret weapon, some Zicam Nasal AllClear. Get it stocked away, so then when you do have one of those days where your nose is stuffed up, you can open up your airways and get to work out.


And if you're feeling a little under the weather, and you still want to get a workout in, what matters? Just stay moderate and make sure that your lungs are clear?

Dr. Jake

Yeah, stay moderate, make sure that you're not having anything that is, you know, saying "this doesn't feel right." You should still be able to do what you would expect. So if your body is sort of telling you that it's not an ideal performance, listen to it. You know, that's okay.

We should be listening to our bodies. But of course, we want to continue to encourage people to get active, have some positive fitness goals, because we are going to get out of this pandemic, we are going to be back on the beach before you know it. We are going to want to spend time with our family and our kids and get all the benefits of being on top of our health. So we don't want that to fall to the wayside. Now as much as any other time.


There you go—you heard it here first, folks. Dr. Jake says we are going to get through this!

Dr. Jake

Oh, wow. Yeah, we definitely are.


All right. Fantastic. Well, thank you very much for joining me on the Get-Fit Guy podcast today. If people want to reach out to you or find out more information about you, where's the best place to find you?

Dr. Jake

I'm pretty active on social media @DrJakeDeutsch. And it's an Instagram. So if you are scrolling through and you want to look me up, glad to share information. Of course, you know, nowadays, direct messages, emails, you know, we're all about transparency and trying to communicate with people. So glad to help out.


Perfect! Well, keep up the good work. And thanks again for joining us on the podcast.

Dr. Jake

My pleasure.

All content here is for informational purposes only. This content does not replace the professional judgment of your own health provider. Please consult a licensed health professional for all individual questions and issues.

About the Author

Brock Armstrong Get-Fit Guy

Brock Armstrong was the host of the Get-Fit Guy podcast between 2017 and 2021. He is a certified AFLCA Group Fitness Leader with a designation in Portable Equipment, NCCP and CAC Triathlon Coach, and a TnT certified run coach. He is also on the board of advisors for the Primal Health Coach Institute and a guest faculty member of the Human Potential Institute.