While it sometimes can sound like a bad excuse, some people
can really be allergic to working out or exercise in general.
Skin reactions, like hives, and respiratory problems, like asthma,
are common complaints among those who work out in the gym or outdoors, and
their complaints could sometimes be warranted.
Many of the exercise induced conditions are due to
histamine, which is a chemical in the body that usually is released to augment
the immune system, and when histamines are released in the body at the wrong
time, this can wreak havoc on how you feel.
However, determining whether these problems are due to an
allergic disease involves going to see an allergist and getting a complete
workup. Below are a few of the more common conditions, and if you have ever
experienced any of the following, or other exercise induced illnesses, do your
body a favor and schedule an appointment with us before your next workout.
Cholinergic Urticaria
(CU)
A very common and frustrating disease, cholinergic urticaria
(CU) is a condition where a person breaks out in hives just before (or after)
they begin to sweat due to exercise or heat.
The exact cause of this condition is not completely understood, but it
tends to occur most commonly in young men, but can also occur in women. Because sweating is the trigger, it occurs
most frequently under the arms and around the chest and neck, but it can happen
anywhere on your body. Classic CU
consists of small hives that cover the whole body, and they are extremely
itchy, and can even be burning or painful; however, large, plaque-like hives
have also been described. The disease is set off by the allergy cells (mast
cells) releasing histamine, which causes the hives, and in sufficient
quantities, can lead to full blown anaphylaxis with wheeze, abdominal pain, and
fainting. What makes this type of urticaria (hives) different from most, is it’s
relative lack of response to traditional antihistamines. However, there are other steps you can take
to help mitigate the symptoms, and we can help you feel better.
Exercise induced
anaphylaxis (EIA)
Dramatic, sudden and potentially life-threatening, Exercise Induced
Anaphylaxis (EIA), is by far the most alarming allergic reaction seen in people
exercising. Thankfully, the condition is rare, but it is also almost certainly
underreported. Symptoms include hives,
asthma, angioedema (swelling of lips and tongue), a drop in blood pressure, and
even death. Some cases of EIA are
triggered by something in the environment including high pollen counts or
eating certain types of food (particularly grains and seafood) just prior to
working out. Immediate treatment with epinephrine will usually reverse the
attack. Luckily, many of these patients have a spontaneous resolution of the
symptoms. Anyone with a history of EIA needs a prompt evaluation by an
allergist.
Exercise induced
bronchoconstriction (EIB)
Exercise induced bronchoconstriction (EIB) is a very common respiratory
complaint at the gym, and is usually the mildest. It is so common that some studies suggest
that up to 30% of all high school athletes, and as many as 50% of Olympic
winter athletes have some form of EIB. Basically,
if you’ve ever run or worked out strenuously and then developed difficulty
breathing and wheezing, you may have EIB.
It happens when the airway gets too cold and dry during exercise (this
is why its so prevalent among winter athletes). Once the airway rewarms and
moistens up, a signal is sent to the allergy cells to blow up and release their
histamine. This causes the lungs to
tighten up, causing that wheeze and shortness of breath. The majority of people
with asthma have EIB, but the majority of EIB sufferers do NOT have asthma.
Treatment is simple, and usually stops the whole process before it starts.
All of these conditions can be diagnosed and treated by a
board certified allergist. If exercise or work out regularly, and feel some of
these conditions, any of our board certified allergists could treat you. Before
you cancel your gym membership, set up a same day appointment with one of our New York allergists. Your body will feel better, and anyway, you probably can’t get out
of that 2 year contract.
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