CLL Specialist Shares Proven Exercise and Nutrition Tips to Help Patients Reduce Fatigue

People living with chronic lymphocytic leukemia (CLL) often face fatigue, even when the CLL is in its earliest stages. In a recent HealthTree webinar, CLL specialist Dr. Alessandra Ferrajoli from MD Anderson Cancer Center explained how changes in nutrition and movement can help reduce fatigue and improve quality of life. 

In this article, you'll learn how diet and exercise support your body, how a CLL-focused wellness program works, and tips to get started today. 

Why fatigue is common in CLL, even in early stages

Many individuals with CLL report feeling tired, regardless of how advanced their CLL is. Dr. Ferrajoli shared that even people with very low levels of CLL often describe being exhausted and needing naps just to get through the day. In some cases, fatigue is the main reason someone starts treatment.

This makes fatigue an important part of CLL care. It can affect your daily activities, emotional health, and social life. Understanding the causes of fatigue and learning ways to manage it can help people feel better and regain parts of their daily life they’ve had to give up.

A new focus on survivorship and long-term wellness

Dr. Ferrajoli emphasized the importance of survivorship, a term used to describe life from the point of diagnosis onward. CLL is unique in that many people live with it for years without needing treatment. Because of this, taking care of overall health becomes even more important.

Survivorship programs now include topics like diet, exercise, mental health, and infection prevention. These areas can improve energy, boost immune function, and support longer-term well-being.

Exercise helps with fatigue, strength, and immune health

In the HEALTH4CLL study at MD Anderson, Dr. Ferrajoli and her team tested different types of exercise and support strategies to see what helped most. Participants used wearable devices to track steps and activity and received coaching by phone, email, or text.

They found that people who completed the exercise program had:

• Lower fatigue scores
• Improved physical strength (such as better arm curls and grip strength)
• Better performance on walking and mobility tests
• Weight loss that brought body weight closer to ideal levels

Exercise didn’t just help people feel stronger. Blood tests also showed improvements in T-cell function, a part of the immune system important for fighting infections. This is especially meaningful since CLL can weaken the immune system. 

Diet adjustments help support energy and immune function

Participants were guided to follow a version of the American Diabetes Association’s healthy diet. This plan focuses on:

• Eating more whole foods high in fiber
• Getting enough protein
• Reducing processed foods and sugars

While not overly strict, this approach helped participants maintain energy and improve their overall nutrition. People with additional health conditions like heart disease or high blood pressure saw even greater benefits.

Getting started: Tips if you're too tired to exercise

Starting small is key. Dr. Ferrajoli recommended:

• Begin with five minutes of brisk walking a day, then gradually increase.
• Use commercials during TV shows as reminders to stand or take a few steps.
• Find a buddy, either in person or virtually, to help stay motivated.
• Try swimming or water aerobics for a low-impact option.
• Join classes made for your fitness level, especially senior-friendly options.

Regular, not strenuous exercise, helps most. The goal is 30–45 minutes of movement, three to five times per week.

Supplement recommendations

Dr. Ferrajoli also shared additional recommendations:

• Check levels of iron, vitamin B12, and folic acid if your red blood cell count is low.
• Avoid taking extra vitamins unless you're deficient. More is not always better.
• Most people benefit from a daily multivitamin and calcium with vitamin D for bone health.

A follow-up study is now available 

MD Anderson now offers HEALTH4CLL2, a virtual program using the best parts of the original study. It is open to people with CLL, whether on treatment or in watch-and-wait, and regardless of other health conditions. While an in-person visit to establish care at MD Anderson is needed, the rest of the program is virtual.

Conclusion

Fatigue is common in CLL, but research shows that a mix of regular movement and better nutrition can make a meaningful difference. Even small steps can help improve energy, immune function, and overall well-being. Programs like HEALTH4CLL2 show that lifestyle changes are not only possible but beneficial for people living with CLL.

Watch the Full Webinar Recording

Read more content about CLL-related fatigue: 

• What Causes Fatigue in People with CLL?
• Managing Fatigue, Anemia, and GI CLL Side Effects with Nutrition