Updated August 30, 2015.
Are You Allergic to Exercise?
The headline in Daily News reads UK Woman Diagnosed as Allergic to Exercise. Is this possible? Can a person really be allergic to physical activity? This is actually a tricky question, and the science isn't one hundred percent clear. While exercise-induced allergy symptoms are well documented, the phenomenon itself is not well understood. In fact, there are multiple sub-types of exercise-induced allergies or related conditions which may occur alone or together.
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- exercise-induced asthma (also called exercise induced bronchoconstriction)
- exercise-induced urticaria
- exercise-induced rhinitis
- exercise-induced angioedema
- exercise-induced anaphylaxis
- exercise-induced food allergies
The most likely explanation, at least in my professional opinion, is not that an individual is allergic to exercise itself but that physiological changes in the body that occur during exercise may trigger or exacerbate the symptoms of other allergies a person might have.
How Exercise Results in Allergy Symptoms
As previously mentioned the exact physiology of exercise-induced allergies is not entirely clear. Symptoms can be triggered by any kind of physical activity but may often be associated with running or jogging. Several theories on the mechanisms involved exist. People with exercise-induced allergies often have elevated blood levels of histamine and a substance called tryptase as well as degranulated mast cells (a type of white blood cell). Therefore some theories include increased mast cell activation, increased histamine release, abnormalities of the autonomic nervous system, and the idea that exercise causes intestinal changes including the activation of immune cells.
Increased body temperature and an exaggerated cholinergic response (think "fight or flight") may also play a role.
Exercise-induced Asthma (Bronchoconstriction)
Symptoms of exercise-induced asthma include:
- shortness of breath
- sore throat
- decreased endurance
Symptoms of exercise-induced asthma usually begin a few minutes after you start exercising and subside approximately 15 minutes after your workout is complete. Treatments for exercise-induced asthma may include making changes to the types of exercise you engage in, not exercising in cold or dry air, and avoiding exercise outdoors when levels of pollutants are high. Environmental factors such as chemicals in the air or high levels of pollen may be a factor. Medications used to treat exercise-induced asthma include inhalers (corticosteroids or bronchodialators).
This condition may also be called cholinergic urticaria. Urticaria is the medical term for hives. Urticaria may be present alone or may occur along with exercise-induced angioedema and/or anaphylaxis. The rash usually begins on the chest and neck but may spread to the entire body. Mild rashes not covering large areas of the body may resolve without treatment. Severe rashes, especially if accompanied by other symptoms may require treatment. Treatment often involves using antihistamines, (for example Allegra or Benadryl), either prior to or after working out.
Rhinitis is a medical term for nasal inflammation. Common rhinitis symptoms include runny nose and congestion. Studies show that rhinitis is commonly exercise-induced in individuals who have a history of allergies and those who do not.
Angeioedema is a fancy medical term for swelling. Exercise-induced angioedema usually occurs along with either urticaria or anaphylaxis. In some cases all three symptoms occur at the same time.
Anaphylaxis is a life threatening allergic reaction. Symptoms of exercise-induced anaphylaxis include:
- redness or flushing
- swelling - often of the face, eyes, or lips
- shortness of breath or wheezing
- difficulty swallowing
- difficulty speaking or slurring words
- dizziness or feeling like you will pass out
- profuse sweating
- stomachache, nausea, diarrhea, vomiting
- feeling like there is a lump in your throat or like you are choking
Anaphylaxis is a medical emergency. If you experience symptoms of anaphylaxis while working out you should stop exercising immediately and call 911. For more information on anaphylaxis read: What is Anaphylaxis?
Exercise-induced Food Allergies
Exercise-induced food allergies occur when someone eats a specific food prior to working out. The actual allergic reaction occurs while they are exercising and usually involves typical allergy symptoms such as itching and hives. In some cases this may progress to more severe symptoms including anaphylaxis. If you suspect exercise-induced food allergies you may wish to see a doctor called an immunologist.
Once exercise-induced food allergies are identified the treatment is simple enough: stop eating the food that triggered your reaction at least two hours before working out.
American College of Allergy Asthma & Immunology. Exercise Induced Asthma. Accessed: August 29, 2015 from http://acaai.org/asthma/exercise-induced-asthma-eib
American Family Physician. Exercise-induced Anaphylaxis and Urticaria. Accessed: August 29, 2015 from http://www.aafp.org/afp/2001/1015/p1367.html#sec-3
Daily News. UK woman diagnosed as allergic to exercise. Accessed: August 29, 2015 from http://www.nydailynews.com/news/world/uk-woman-diagnosed-allergic-exercise-article-1.1297236
Family Doctor.org. Exercise-induced Urticaria. Accessed: August 29, 2015 from http://familydoctor.org/familydoctor/en/diseases-conditions/exercise-induced-urticaria/treatment.html
Medscape. Exercise-induced Anaphylaxis. Accessed: August 29, 2015 from http://emedicine.medscape.com/article/886641-overview
National Institute of Allergy and Infectious Diseases. Oral Allergy Syndrome and Exercise-induced Food Allergy. Accessed: August 29, 2015 from http://www.niaid.nih.gov/topics/foodallergy/understanding/Pages/OASExercise-inducedFA.aspx
NCBI. Exercise-induced allergies: the role of histamine release. Accessed: August 29, 2015 from http://www.ncbi.nlm.nih.gov/pubmed/1371041
NCBI. Exercise-induced rhinitis: a common disorder that adversely affects allergic and non-allergic athletes. Accessed: August 29, 2015 from http://www.ncbi.nlm.nih.gov/pubmed/16498856