Have you ever heard someone say that they are allergic to exercise? It may sound like a joke or a bad excuse to avoid the gym; however, for a small number of people (roughly 0.05% of the global population), exercise-induced anaphylaxis is a real and serious threat.
Let’s look at what exercise-induced anaphylaxis is, why it can occur, and what patients can do to protect themselves from experiencing this reaction while staying active.
What Is Anaphylaxis?
Anaphylaxis is the most severe type of reaction the immune system can have, usually to an allergen like:
- Peanuts and tree nuts
- Eggs
- Milk or dairy products
- Fish and shellfish
- Soy
- Wheat
- Insect venom
- Latex
- Certain medications like antibiotics
It occurs in people with hyper-reactive immune systems, with progression that happens in four stages:
Stage 1 – Patient develops mild symptoms like:
- Runny nose
- Itchy skin
- Itchy mouth
- General discomfort
Stage 2 – Patient experiences more severe symptoms like:
- Rashes and hives
- Facial swelling
- Breathing troubles
- Nausea
- Vomiting
- Diarrhea
Stage 3 – Patient develops the most severe symptoms like:
- Weakened pulse
- Drop in blood pressure
- Chest pain
- Dizziness or lightheadedness
Stage 4 – Patient does not develop new symptoms but faces an increased threat of:
- Heart attack
- Death
Why Can Anaphylaxis Occur?
The immune system is a highly complex network of organs, tissues, and cells that all work together to defend the body from invaders like viruses, bacteria, and allergens. Some people have well-balanced immune systems that are quick to ward off infection, while others may have weaker immune systems that are less efficient at flushing harmful viruses or bacteria from the body. In allergy patients, their immune systems are not necessarily weak; they are just overly sensitive to foreign substances like allergens.
For those with ultra-sensitive immune systems, the patient risks experiencing anaphylaxis after encountering the allergen(s) that trigger the immune system.
What Is Exercise-Induced Anaphylaxis?
There is still much to be researched about this condition, but exercise-induced anaphylaxis is suspected to occur when a patient ingests a food-based allergen either before or after they have physically exerted themselves.
While a standard anaphylactic reaction is triggered by a foreign substance like the allergens mentioned above, exercise-induced anaphylaxis requires the combination of a food-based allergen and physical exertion to trigger a reaction. Without physical exertion, the patient could never show allergy symptoms, even mild symptoms, after ingesting the triggering food. But for whatever reason, exercising before or after ingestion can result in anaphylaxis.
Substances That Can Trigger Exercise-Induced Anaphylaxis
The majority of triggers for exercise-induced anaphylaxis are food-based, with others being medication-based.
Some known triggers of exercise-induced anaphylaxis include:
- Alcohol
- Eggs
- Fruits like apples and peaches
- Meats like beef, pork, shellfish, and fish
- Dairy products
- Peanuts and tree nuts
- Wheat
- Mushrooms
- Tomatoes
- NSAID medications like Advil or Aspirin
How Can I Know I Have Exercise-Induced Anaphylaxis?
There are a few ways to test for exercise-induced anaphylaxis, including:
Blood test –Following an anaphylactic reaction, your allergist or medical provider can test a sample of your blood to see the levels of tryptase, a substance released by mass cells during an anaphylactic episode. The presence of tryptase will confirm that you did, in fact, experience anaphylaxis after exercising.
Scratch test – Your allergist can perform a scratch test to see what foods or medications you might be reactive to. Using a scratching tool on your skin, they will introduce allergens to the immune system and observe your skin’s reaction to each substance. Should the skin of the sample area react, you’ll know that you are reactive to that particular substance.
Food challenge test – Your allergist may recommend a challenge test in which you ingest a potential allergen, and your allergist observes you to see how you react. Should you begin showing signs of anaphylaxis, they will administer epinephrine to stop the reaction. If you do not show signs of allergy, you may be cleared for an exercise challenge.
Exercise challenge test – Your allergist may ask you to ingest a potential allergen and run on a treadmill or exert yourself physically in some other way to see if the combination triggers exercise-induced anaphylaxis.
How Can I Protect Against Exercise-Induced Anaphylaxis?
Protecting yourself from exercise-induced anaphylaxis is crucial to your overall health.
Know Your Allergy Triggers and Limits
Knowing what foods or substances your immune system is sensitive to can help you avoid them, decreasing the likelihood of experiencing an anaphylactic-level reaction.
Also know your body’s limits. If you have experienced exercise-induced anaphylaxis before, consider the activity you were performing at the time and the amount of energy you were exerting. It may be wise to avoid reaching the same level of physical exertion in your workouts moving forward.
Carry Epinephrine, Like an EpiPen
You never know when your allergies will flare up. By having an EpiPen or another form of an epinephrine injection ready, you can better protect yourself in the event of anaphylaxis.
Note, however, that epinephrine is a temporary treatment to reverse the symptoms of anaphylaxis. It is still essential to seek medical care ASAP, even after injection.
Don’t risk experiencing exercise-induced anaphylaxis at the gym, on the field, or anywhere else. Know your immune system’s triggers with thorough testing offered at Langford Allergy.
Dr. Langford, Dr. Mathew, and our team of allergy specialists offer specialized care and treatment to allergy patients, including those who suffer from exercise-induced anaphylaxis. We create individualized and effective treatment and management plans that promote safety, no matter what allergens you might encounter or when your immune system might react.
Schedule an allergy appointment today: 478-787-4728
Langford Allergy delivers allergy, asthma, and immunodeficiency care to patients throughout Middle Georgia, including:
- Bonaire, GA
- Byron, GA
- Forsyth, GA
- Fort Valley, GA
- Gray, GA
- Macon, GA
- Milledgeville, GA
- Perry, GA
- Warner Robins, GA
And other surrounding areas.
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