Exercise Induced Asthma: 700 Olympic Athletes Have It – Do You?

Problem: inhalers aren’t cool. Solution: Suck drugs from Justin Beiber’s torso! Personally I’m going for the My Little Pony option.

“I don’t mean to be rude but I couldn’t help but notice…”

Having just finished my Tabata sprints, I could barely hear the woman over the sound of my own wind-sucking. I wasn’t even sure she was talking to me until I righted myself – I recover from sprints by either sitting or crouching and putting my head between my knees until my vision clears and yes I know I’m a huge dork – and saw her leaning over her treadmill to reach mine. “Wha…?” I gasped, assuming another gym-flashing incident had occurred.

“Well, I don’t usually give people unsolicited advice but I’ve been a nurse for 20 years and I was just noticing your breathing. Can I make an observation?”

I broke into a grin. “Fire away!” My second favorite activity, right after diagnosing myself with random trendy afflictions, is to have strangers diagnose me with them.

“I think you have asthma,” she declared. This isn’t the first time someone has told me they think I may have EIA, or exercise induced asthma (the technical name is  “exercise-induced bronchoconstriction” in case you need something fancy to throw out over dinner with friends and you don’t feel like reading the information tome that comes with your birth control pills), but it was the first time someone offered to actually whip out their stethoscope and listen to my lungs in the gym. (I’d say this was a new high for me but nothing tops the nurse who offered to strip my membranes in the ladies’ locker room when I was overly pregnant with my last baby. No I didn’t take her up on it. Although I was tempted.)

“How can you tell?” I asked.

“First, it’s the high, tight wheezing noise you make. Everyone breathes hard when they run but not everyone wheezes. And second, it’s the cough. Are you sick? Have allergies?” When I shook my head no she continued, “The only time I’ve heard you cough since you came in was during your run and that’s a sign of asthma too.” She also pointed out that asthma tends to run in families and, as it turns out, my sister, my mom and one of my boys has it. Plus I always kinda believed that athletic stuff was harder for me than it was for most people, especially when I was younger. She recommended I see my doctor about getting an inhaler.

Yessss! At last, my geekdom is complete! I’ve had the rest – bad skin, freckles, frizzy hair, buck teeth, thick glasses, polyester gym shorts – but an inhaler was the one nerdy gym-class accessory I never had. I’m so in now. Can I ironically take a puff??

Unfortunately my inhaler may be cooler than I think as it is estimated that about 700 athletes in this year’s Olympic Games have EIA. Even better, according to Alex Hutchinson in Sweat Science, “those athletes will be roughly twice as likely to win a medal as their non-asthmatic peers.” But it’s not because of the awesome steroid drugs, says Hutchinson. “The most likely explanation for the asthmatic advantage is that the incidence of asthma-like symptoms increases in athletes who have done the most training over the longest period of time, due to environmental stresses.” So basically athletes that have been training longer have been exposed to more bad air and are therefore both more likely to have asthma (from the environment) and excel in their sport (from their prolonged training) although the two aren’t related.

Since my Olympic-Dreams ship has sailed and I’m not worried about my athletic performance, is there any point in treating EIA? When I asked my new bestie the nurse this she asked if I ever got chest pain while exercising. “Doesn’t everyone?” was my response. Apparently no, everyone does not. (All this time I thought that pain was a good sign – like it meant my heart was doing some kind of Incredible Hulk growing or something.) And studies have shown that untreated asthma leads to a higher incidence of “cardiac events” and heart disease. Oops.

Good thing I already made an appointment to talk to my doctor about my possible gluten-anxiety link and my hormone issues! She’ll be so excited to me – I might as well wear a name tag that says “My name is Internet Hypochondriac.” WebMD loves me. Real MDs…not so much.

So how do you know if you’re one of the estimated 5% of the population with EIA (and you don’t have the luck of running sprints next to a veteran RN)?

Symptoms of EIA include:

  • Coughing
  • Wheezing
  • Shortness of breath
  • Chest tightness or pain
  • Fatigue during exercise
  • Poor athletic performance
Yeah, I know. Kind of sounds like symptoms of high intensity exercise in general, right? Apparently there are some tests docs can run to see if you have EIA but they’re expensive and time consuming so according to WebMD (and my nurse friend) most doctors will simply prescribe you an inhaler, tell you to take a hit off it 20 minutes pre-exercise and see if it helps. If it does, then yep, you’re asthmatic! If not, then yep, you’re just a wimp! (kidding!)
Other options for treating it, besides a steroid inhaler, are making sure you have a long warm-up before engaging in intense cardio (Huntchinson recommends 20-30 minutes) and increasing your cardiovascular capacity through exercise. There’s one for the irony file: the best thing to heal EIA is the one thing that the EIA makes it difficult to do…
Any of you have asthma or EIA? Anyone else always felt like athleticism didn’t come as easily for them as it did for most people?

 

38 Comments

  1. I’ve been nodding along with you. Only during high intense efforts like an all out 5k or 95%-100% effort sprints, but I have coughed and wheezed during intense running. Let us know what your doctor says!

  2. Wheee, more drugs, just what we all need!

    I USED to have asthma; I got over it several years ago by working on increasing my lung capacity with jump-rope intervals. Wheezed and coughed like crazy for a couple of months, then I got over it. (I was diagnosed with bronchial asthma; suffered from it for over 20 years. Now I’m cured.)

    • Although many people grow out of asthma sometime in their childhood or early adulthood, this happens independent of any specific exercise. Do you continue to do those or similar exercises? If not, and the asthma was “cured” from the exercise, then the asthma will come back. Asthma medication is not “just another medication” if you have asthma it is extremely necessary to treat it, even if that treatment is high intensity exercise. It is stupid to assume all doctors overprescribe all medications for all conditions.

  3. LOL, I’ve had every one of those markers of geekdom too! And the asthma. Mine is strongly linked to environmental factors. When I lived in an apartment full of mold I used my inhaler all the time but once I moved it dropped back down to once a month or so. So I’m lucky. My cousin and my dad have it bad, as well as a bunch of other family members having minor cases. (At family reunions we share inhalers the way other families share potato salad.)

    It’s interesting, I definitely find myself coughing sometimes during exercise and breathing very, very hard. And I get ridiculously more sweaty than everyone else. I never connected it to my asthma since a normal (non-exercise induced) asthma attack doesn’t feel the same way to me. I might have to experiment with using the inhaler before working out, see if it makes it easier.

    Also, yes! When everyone in my gym class in middle school could do at least 1 pull-up and I couldn’t do any it seemed sooo unfair.

  4. I have both allergy-induced asthma & EIA….some seasons are better than others.

  5. I’m glad you mentioned the chest tightening. When I’m tired my chest tightens. Although I don’t wheeze, I cough a lot. Again, especially when i’m already tired. Maybe I should get checked out too. You know, because there is nothing a doctor loves more than a patient coming in already knowing what they “have”!

  6. Rebecca Eitelberg

    Just call me Wheezer!!! I recently found out that I have EIA. I wondered why I could not keep up with other riders in my bike club, because I am just as fit and I work just as hard. But then one day a guy pulled up along side of me and said “do you have asthma?” Whaaaaat? You mean wheezing and coughing while tackling hills isn’t normal? Turns out, I just can’t breathe. I even ended up having testing and I do have an obstructive lung defect. Fun huh!!! I raced a practice recently where I ended up coughing so hard afterward I literally thought I was going to throw up (TMI, I know, but I know you like that). So now I know why I can’t keep up. It changes my mindset, so I don’t feel like such a wimp, but it does kinda suck.

  7. Same! I wasn’t diagnosed with asthma until my mid-20s, and I had always assumed I was just non-athletic and everyone’s chest hurt during exercise.

    Maybe if you eliminated gluten it will go away too. Half kidding! (I’m allowed to kid- I have eliminated gluten, and while I feel great, I wouldn’t say I’ve seen improvement in my asthma or anxiety. But I understand some people have seen improvement., and I can see how that makes sense.) The inhaler works great and has no long-term effects. Good luck!

  8. Oh my, and I’ve always thought I was just a wimp.
    On the other hand, I can already hear my doc: “You wheeze and cough when you run? Then just stop running!”
    Yeah, right. Thanks a lot.

  9. Beware the heartrate increase! Just to remind you, and anyone else out there, albuterol will increase your heartrate! Even Xopenex, which is touted to not increase the heartrate like albuterol, can have some heart raising effects!Anyway, keep that in mind when you puff and then start exercises like sprints!

  10. I do, I do! Actually I developed mild all the time asthma about ten years ago, but I do notice that I cough when I exercise a lot more than others. I didn’t realize that wasn’t typical and just me being out of shape. I always learn new stuff on your blog! Unfortunately, steroid inhalers make me soooo jittery. I’m spastic enough as it is!

  11. Ha ha. I was diagnosed at the age of 35. Same as you- I was surprised to learn that not everyone’s chest hurts when running!
    I only need my inhaler when exercising in cold weather and sometimes after doing Tabata type workouts. If you forget your inhaler, nose-breathing deep into your belly works. I ran a whole half marathon this way once.

  12. I have Exercise-induced-asthma. When I was a kid it was just straight-up asthma (although pretty mild, because I never had an attack that I can remember), but it turned into just exercise-induced asthma somewhere around when I was 13.

    The other fun thing? My sister read an article in a science journal somewhere recently that talked about how quite a few (meaning not the majority, but not 0.1%) of people with asthma don’t have asthma- they have something where their vocal cords contract. It results in basically the same thing- something in your throat tightens up and makes you wheeze and gasp- but it isn’t fixed by inhalers. And since my inhaler has done absolutely nothing for me for years, I’m now leaning towards that. Luckily, the treatment is to see a speech pathologist to learn how to relax your throat, and my aunt is a speech pathologist!

    I wish it made me better at sports though! Usually it just means that half way up the hill on a hike/bike, I turn into the gasping wheezing lump who is way WAY slower than everyone else.

  13. I do. It ramps up in the spring and fall with my allergies, but the more regularly I exercise, the better it behaves. It makes it hard when I first started to really ramp up and really workout hard to a level where I sweat, but once you focus on proper breathing it gets easier. For really intense workouts my doc said to use one puff of my inhaler before I start and that has worked well for me. I always have my inhaler in my bag for when deep nose breathing doesn’t help me get my breathing back under control…nothing is more scary than not being able to breathe. I have to watch myself to not push too hard, but it really has made me be more in tune with my body and focus on fitness and not overdo it.

  14. I’ve had allergy related asthma since I was a small child (yea for weekly allergy injections for 8+ years!), and noticed exercise affected it as well in middle school. But when I was pregnant with my oldest we moved from northern California to Las Vegas. I’m not sure whether it was the change in locale or pregnancy, but I went from using an inhaler daily to not at all, despite a monumental increase in physical activity. But this year there’s something new in the air and my allergies have been terrible and then after an outdoor run I found myself struggling to breathe. I hadn’t used an inhaler in over 5yrs, but luckily the expired one in my medicine cabinet ended the episode. Since then, my mile times improved suddenly, so I wonder if I could’ve been using it all along, but since I felt *relatively* great, I didn’t notice I could feel better while exercising.
    I hope you notice marked improvement once you treat it as well!

  15. I’ve always felt I’m not naturally athletic. At school I was rubbish at sport – other people seemed to be able to run faster, for longer, and not get as out of breath as me. I just accepted it in the way that I was better at maths than some people – and that’s the way it was.

    Now I think that everyone can achieve a certain level of athleticism – after I did the couch to 5k program and realised that I can jog without stopping for a while. However I’m still jolly slow.

    I can’t decide if I’m just lazy (I dislike pushing myself at exercise) or genuinely don’t have the fitness capability that many people have. Either way, I can always improve on myself, which is what really matters.

  16. Sable@SquatLikeALady

    I have exercise-induced asthma!!! My gym teachers just thought I was lazy in school since I was “cured” of, I guess, ‘regular’ asthma in middle school, but I was diagnosed with EIA not long after I graduated high school. Max has it too! It must be a sign of greatness 😉

  17. May I suggest stop eating gluten, sugars of any kind and eat more fat. It got rid of my EIA.

    • Hi, do u mean just refined sugars as in processed foods and added sugars? Or also sugars in fruits too? I’m eliminating processed foods, sugars, dairy and gluten to see if I can get rid of my asthma as I’m an elite level runner. But I’m eating lots of fruit, veg and meat…paleo diet really. Are these sugars in fruit ok?

  18. The more correct name for your associated condition is “Cyberchrondria.” I have it myself: the immediate onset of symptoms just discovered on the Web.

  19. When I was younger my asthma was AWFUL. I mostly grew out of it, but it rears its ugly head when I get sick. I thought for a long time that I had EIA, but looking back I think it was having mild panic attacks. Be careful with the inhaler – mine screwed with my depression/anxiety. Take notes about your mood when you take it.

  20. I had asthma as a kid, and still have an inhaler, Maxair, just in case. I rarely have to use it, thankfully. But the high-pitched wheezing is definitely a symptom of asthma. I don’t think it’s cyberchondria, with all respect to the previous commenter!

    Just a side note: not all inhalers used to treat asthma and EIA are steroids. Mine is Maxair, which is Pirbuterol, I believe, and is not a steroid. Albuterol is another non-steroidal inhaler medication. Thought you might want to know that! Hugs and good wishes to you, Charlotte!

  21. I have asthma, usually triggered by weather (cold & damp = asthma attack) or laughing too hard. Sometimes I notice some wheezing/chest constriction during exercise, but it’s never as bad as the attacks I’ve had when I’ve gone camping and slept in a cold damp tent – a couple of times it has been downright scary. I always make sure I have an inhaler, even though most of the time I don’t need it. Better safe than sorry!

    • P.S. Athletics have never come easily for me, so I do think it has an effect, even if I’m not actually having an asthma attack. I should probably try using my inhaler before exercise to see if it makes a difference.

  22. Oh wow, this was exactly my experience when I was diagnosed with EIA at 17. I was sitting in the Dr.’s office saying “You mean not everyone feels like there’s an elephant on their chest when they run??? Really? Man, I have much less respect for marathoners now… I thought they were fighting chest pain the whole way.”

  23. Emergency inhalers, which is usually prescribed are not steroids. To help with the jitters and/ or shakes, eat some protein like cheese or some peanut butter aftee taking a hit. I am also a nurse as well as an asthmatic. I think it is oart of the nerd gene

  24. My mum has asthma and I have only seen her used her inhaler for like twice. Symptoms coughing, wheezing and shortness of breath are very noticeable. I bought her a nebulizer instead to help her. She only uses it though if its really necessary. She doesn’t have asthma attack lately, thank God.

  25. After reading this and realizing I probably had this as well I got prescribed an inhaler by my doctor. I haven’t tried it yet, but I was wondering if you had and if so, has it helped? I’ll be trying mine for the first time tonight.

    • I have tried it! Exactly twice. It was helpful I think. My chest didn’t hurt and I didn’t cough at all during sprints. It didn’t make me feel like superwoman or anything though – I think I ran about the same speed, it just hurt a little less:) My doc gave me albuterol – what did you get? She told me it is “the asprin of inhalers” meaning that it’s not super powerful but probably helps. I was worried it would bring on a panic attack since the primary side effect is an increased heart rate but I didn’t notice a thing! Good luck and let me know how it goes for you!

  26. I got Eia too! When I did some exersice outside I was coughing like mad. Hate Eia but I still got a pretty good level in active (5A!) Oh, and my doctor said that I got infection. How wonderful eh?

  27. Yes!my mom and gym teachers always made me feel lazy. I would tell my mom my problems and her response? “you aren’t breathing right! in through the nose out through the mouth!” my response was nearly passing out next time i tried this. i was also told i was just “out of shape” regardless of my asthma diagnosis at 8. my mom recently developed EIA and now knows how it feels. no appology but the fact that she now knows what i went through helps!

  28. Yes!my mom and gym teachers always made me feel lazy. I would tell my mom my problems and her response? “you aren’t breathing right! in through the nose out through the mouth!” my response was nearly passing out next time i tried this. i was also told i was just “out of shape” regardless of my asthma diagnosis at 8. my mom recently developed EIA and now knows how it feels. no appology but the fact that she now knows what i went through helps!

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  31. I have EIA and I happen to be a very fit 15yo male. I play volleyball and rugby and scored a 10.2 on the beap test and after every exercise I still need to use my inhaler so regardless of how fit I became I still needed my inhaler

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