Have you ever joked that you’re “allergic” to exercise? Well, you may be. According to the American Academy of Allergy, Asthma and Immunology, 15 to 20 percent of Americans are believed to experience allergic responses specifically caused by exercise. International health educator Terrie Heinrich Rizzo, MAS, explains the symptoms and treatment of exercise-induced allergies.

1Understanding Exercise-Induced Bronchospasm (EIB). EIB, the most common exercise-induced allergy, is sometimes called exercise-induced asthma. With EIB, physical exertion triggers breathing difficulties. Researchers believe that exercise-related changes in temperature and moisture levels within the airways trigger immune system reactions, causing respiratory distress symptoms. Symptoms may include wheezing, shortness of breath, chest tightness, coughing during or after exercise, feeling out of shape, or dizziness.
2Getting Help for EIB. If you think you have EIB, or any exercise-induced allergy, see your doctor. Once EIB has been diagnosed, you can prevent or reduce allergies by using pharmaceutical bronchodilators (i.e., inhalers) before exercising and by avoiding certain environmental factors. Exercise modification (see #7) is also crucial.
3Understanding Exercise-Induced Cholinergic Urticaria (EICU). This condition is an allergic response to heat. Although it is uncomfortable and sometimes excruciating, EICU is rarely life threatening. It is triggered by exercise that raises core body temperature 0.5 to 1.5 degrees Celsius (or 0.9 to 2.7 degrees Fahrenheit). Taking hot baths or saunas, or exercising on hot days also can cause it. Symptoms usually include raised hives that appear 30 minutes into exercise, plus flushing and itching, particularly on the neck, trunk and upper limbs. These symptoms generally disappear 20 to 90 minutes after exercise.
4Getting Help for EICU. Antihistamines and topical treatment for itching usually prove effective for EICU. If you have this condition, avoid exercising on warm or humid days, reduce workout intensity and stop exercise at the first signs of flushing, itchiness or hives.
5Understanding Exercise-Induced Anaphylaxis (EIA). This condition is rare, but can be life threatening. It usually happens when you are allergic—often unknowingly—to a certain food, medication, or hormonal or environmental stimulus (allergen). EIA can be triggered when you are exposed to the given allergen and then work out. Symptoms start within five minutes of exercising and can progress rapidly to impair respiration and blood pressure, possibly resulting in complete airway and circulatory failure. Immediate emergency medical treatment is critical.
6Preventing EIA. Avoid known allergens, especially before or during exercise. This is not always possible, so knowledge of symptoms is important. If you have a life-threatening allergy or history of severe symptoms, carry an adrenaline kit, follow doctor-recommended exercise modifications and carefully plan exercise.
7Making Appropriate Exercise Choices. Activities less likely to trigger your exercise-induced allergies include walking, leisure biking, golf, hiking, surfing and downhill skiing, as well as activities that require short bursts of energy (baseball, football, racquet sports, weight training, martial arts and mind-body exercise). Activities requiring continuous exertion such as soccer, basketball, vigorous biking and running put you at higher risk.
8Paying Attention to the Environment. If possible, avoid outdoor exercise in cold or dry weather (EIB), hot or humid weather (EICU
or EIA) and areas with elevated pollen or air pollution levels (all).
9Exercising at Appropriate Intensities. Most people with exercise-induced allergies, especially EIB, should exercise at a lower intensity than is traditionally recommended. Experts also advise a longer warm-up, exercising at 60 percent of maximum for at least 15 minutes, or
at an even lower intensity for 20 to 30 minutes before more strenuous exercise. If you have EIB, cool down for at least 10 minutes. Abrupt fluctuations in airway temperatures during cool-down can trigger postexercise attacks.
10Choosing Exercise You Enjoy. Even with exercise-induced allergies, try to choose activities you like. With proper medical treatment and appropriate modifications, most affected persons can excel even with “high-risk” activities like cross-country skiing or basketball. l#This handout is a service of IDEA, the leading international membership association in the health and fitness industry.

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