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Issue Date: August 26, 2001
Putting allergies on the run
Think you can't work out when allergens are in the air? Take these steps to keep up your exercise regimen.
ONE OF THE BEST WAYS to treat asthma - and particularly bad allergies - is with properly executed exercise, physicians say.
Recent studies from the American Academy of Allergy, Asthma and Immunology have shown that physically fit people have fewer attacks, need less medication and lose less time from work and school. I am allergic to every springtime tree and flower in the Northeast, and as anyone with asthma or allergies knows, the key is to control our symptoms so we can get back to the gym or outdoors to exercise.
Allergies and asthma are different, but they can share symptoms and treatment. Allergy refers to a misguided reaction by the immune system to bodily contact with certain foreign substances. It is misguided because those foreign substances are usually harmless and remain so to non-allergic people. Allergy-producing substances, called allergens, include molds, pollens, dust mites, danders and foods. When an allergen comes in contact with the body, it causes the immune system to develop an allergic reaction (including stuffy nose, sore throat, itchy or watery eyes and tightness in the chest) in those who are allergic to it.
Asthma occurs when bronchial tubes that are chronically inflamed become overly sensitive to allergens or other irritants. The airways may become "twitchy" and remain in a state of heightened sensitivity, called "bronchial hyperactivity." It's likely there's a spectrum of bronchial hyperactivity in all individuals. However, asthmatics and allergic individuals without apparent asthma have a greater degree of bronchial hyperactivity than non-asthmatic and non-allergic people. In sensitive people, the bronchial tubes are more likely to swell and constrict when exposed to triggers such as allergens, exercise, tobacco smoke, or cold, dry air.
Exercise-induced asthma, or EIA, is a common form of asthma, occurring only when a person exercises. However, people who have chronic asthma can develop symptoms whenever they are exposed to a trigger.
About 80% to 90% of people with chronic asthma also have EIA. But you can have EIA even if you don't have chronic asthma. The difference between asthma and just being out of breath from exercise is that a bronchial spasm from asthma means you can't move air in and out of your lungs because of the narrowing of your bronchial tubes. When you are out of breath during exercise, it's not an airway problem; it's an oxygen delivery problem. Basically, either you're out of shape or you're pushing your body so hard that you can't supply enough oxygen to your muscles.
Allergies can strike at any age. Once they hit, it's important to find out what you're allergic to and in which season or situation you need to be most vigilant. Experiences with allergies can "roller coaster" with the seasons. In many instances, allergens that are in the air and in the environment year-round are impossible to avoid. As we head into fall, late summer weeds (think ragweed) pollinate until the first frost. Mold spores proliferate when those beautiful autumn leaves fall. Consequently, if you suffer from airborne allergies, you may need to keep your antihistamines nearby until winter arrives.
And regrettably, for some people, when the temperature drops and they spend more time indoors, indoor allergens become a problem. Winter is when we're closed up inside with nasty allergens such as animal dander, dust mites and mold spores.
Ronnie Sawyer, a 36-year-old New Yorker, has had allergies since his 20s. During the worst of the heat and pollution, he works out at the gym on cardio machines, and he prefers exercising in the morning. "If I can make it past my 15-minute warm-up without any problems, then I know my workout's going to be asthma free," he says. "If I do have an attack, I use my inhaler, wait about 5 minutes and try the warm-up again. There are really cold or really hot days when exercise isn't an option for me, but I usually make it to the gym two or three times a week and manage to stay in good condition."
Gillian Shepherd, an allergist at New York Presbyterian Hospital, confirms Sawyer's experience: "Regular exercise is good for asthmatics because as their lungs get stronger their tolerance level goes up. They can do a little more work with less energy expenditure."
Simple steps for exercising with allergies and asthma
 Always warm up with 15 minutes of light activity (such as walking or cycling slowly) before you crank up your workout, so you warm up your lungs as well as your muscles.
Avoid exercising in cold, dry air. In winter, try to work out indoors. I always feel better 15 to 20 minutes into my cardio workouts in the gym. As my body warms up, the membranes in my nose shrink (it's like taking a decongestant), and breathing becomes much easier.
When you do exercise outdoors, avoid areas where air pollution is high (such as highways). Check your local pollen count. On days when pollution or pollen is higher than normal, exercise indoors.
If you already are fit and the aerobic demand of activities such as running or spinning provokes your symptoms, try substituting sports that involve short bursts of intense activity, such as tennis, volleyball, swimming or basketball. Don't worry: Sports that involve interval exercises still will work your cardiovascular system.
When I want to be active outside, I loosely tie a scarf around my mouth and nose to warm the air I breathe. You also can ask your doctor to recommend a breathing mask.
Many doctors tell their patients to prepare for exercise with two puffs of a beta-agonist inhaler 15 minutes before starting. That will keep your airways open and help to prevent symptoms (such as shortness of breath) during workouts.
After your exercise session, spend 15 minutes cooling down with lighter activity such as walking or stretching. Although it's important to do that whenever you exercise, it is particularly necessary during the allergy season so your breathing pattern will return to normal.
If you develop asthma symptoms or an allergic reaction during exercise, don't try to push your way through them. Stop what you're doing and take two more puffs from your beta-agonist inhaler. If that doesn't bring relief within 15 minutes, call your doctor or seek other medical attention. If you find yourself in that situation and you don't have an inhaler, go see your doctor or head for the emergency room.
For more information, contact the American Academy of Allergy, Asthma and Immunology (414-272-6071 or aaaai.org) or Clear Breathing (clearbreathing.com).
Physically fit people have fewer allergy and asthma attacks and need less medication.
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