What Is Exercise-Induced Asthma—And How Do You Know if You Have It?
Feeling out of breath when exercising is a common occurrence and typically a good indicator of how hard you’re working. That’s because it may mean you’re making the effort necessary to keep or enhance your fitness level.
However, it’s not always a good sign if your workout leaves you gasping for air. Why? Possible symptoms of exercise-induced asthma, which is easily diagnosed and treated but can be life-threatening if left unchecked.
So, how can you distinguish between the typical breathlessness of an exercise and anything more concerning? This is the information you require.
What is Exercise-Induced Asthma?
Exercise-induced asthma, also known as exercise-induced bronchoconstriction or exercise-induced bronchospasm (EIB), occurs when physical activity triggers the narrowing or spasming of the muscles around the airways, leading to breathing difficulties.
EIB is relatively common, affecting approximately 5 to 20% of individuals. It is often seen in people who already have chronic asthma triggered by other factors such as allergies, pollution, or respiratory infections. However, about 20% of individuals with EIB do not have chronic asthma and only experience asthma symptoms during exercise, according to Dr. Purvi S. Parikh, an allergist and immunologist at NYU Langone Health.
Although EIB may sound concerning, it is a highly manageable condition. With proper treatment and care, EIB is unlikely to significantly affect your exercise routine. In fact, many elite athletes, including Olympians, have successfully managed their EIB and continue to excel in their sports, as noted by Dr. Parikh.
Symptoms of Exercise-Induced Asthma
During or after your workout, symptoms of exercise-induced asthma (EIB) may arise. While these symptoms may initially resemble the normal response to exercise, there are important distinctions to be aware of. Recognizing these differences is crucial in order to halt your workout if you suspect an asthma attack. Dr. Parikh emphasizes the danger of continuing to exercise with compromised breathing.
Uncontrolled exercise-induced asthma, as well as any form of asthma, can be life-threatening. Dr. Parikh advises individuals experiencing the following symptoms to immediately cease exercising and promptly consult their doctor for an EIB diagnosis. It is particularly important to seek evaluation since other serious conditions, including heart problems, can mimic EIB.
Symptoms of EIB include:
1. Difficulty breathing: This goes beyond mild breathlessness associated with exercise. It can feel as if you are trying to breathe through a straw and may persist even after you’ve finished exercising.
2. Coughing: Occasional coughing is typically harmless, but excessive coughing during or after your workout may indicate EIB.
3. Chest tightness and pain: More intense than the usual exercise-induced chest tightness, this sensation involves a squeezing feeling in the chest, ribs, and possibly back. It may persist after you’ve stopped exercising.
4. Wheezing: Characterized by a whistling or rumbling sound during breathing.
5. Dizziness: This is a more severe symptom of EIB and occurs when the airway is significantly constricted, leading to inadequate oxygen intake.
What Are the Causes or Risk Factors
Individuals with chronic asthma and allergies are at a higher risk of developing exercise-induced asthma (EIB), although the exact reasons why some people develop EIB while others do not remain unclear. Genetic factors may contribute to its occurrence, according to Dr. Parikh.
Various factors can trigger EIB in those who have the condition. While any form of exercise can potentially induce EIB, activities that are more cardio-focused and intense, such as running, HIIT workouts, swimming, and heavy weightlifting, are more likely to elicit symptoms, explains Dr. Parikh. Additionally, endurance sports that involve sustained effort, like soccer and long-distance running, are more commonly associated with EIB compared to activities involving intermittent high-intensity bursts, like baseball and football, as stated by Dr. Smart.
Weather conditions can also play a role in triggering EIB. Cold weather exercise, such as cross-country skiing, ice skating, or winter running, can prompt symptoms due to the irritation caused by cold, dry air, leading to the constriction of airway muscles, according to Dr. Anand. Conversely, for some individuals, exercising in hot and humid weather can trigger EIB, as mentioned by Dr. Parikh. Other triggers for EIB include pollution, allergies, and irritants like chlorine.
How is Exercise-Induced Asthma Diagnosed?
The process of diagnosing exercise-induced asthma (EIB) can vary depending on the individual, but typically doctors will begin by gathering information about your medical history to assess the possibility of EIB. They may then conduct a pulmonary function test, during which you blow into a tube connected to a computer that measures your lung function and detects any inflammation in the airways. The results of this test can help determine whether asthma is present, as explained by Dr. Parikh. In some cases, your doctor may also have you exercise on a treadmill and then assess your lung function afterwards to determine if there was a significant drop, which would indicate the presence of EIB, according to Dr. Smart.
If your doctor suspects that allergies may be contributing to your symptoms of EIB, they may recommend allergy tests. Alternatively, if they suspect that another underlying condition, such as a heart condition, is causing symptoms similar to EIB, they may order further evaluations, as mentioned by Dr. Parikh. The diagnostic approach may vary based on individual circumstances to ensure an accurate and comprehensive evaluation.
What Are the Treatment Options?
As previously mentioned, exercise-induced asthma (EIB) is a manageable condition that should not hinder your ability to engage in physical activity when properly treated. Seeking medical attention is crucial if you suspect you have EIB, as it can be effectively managed with appropriate interventions.
The most common treatment for EIB involves using a fast-acting asthma medication, such as albuterol, through inhalation before exercising. Albuterol helps relax the muscles surrounding the airways, preventing EIB symptoms. Taking albuterol approximately 15 minutes before a workout is typically effective in preventing EIB symptoms altogether.
Some individuals, particularly those with chronic asthma, may require daily use of anti-inflammatory medications like Singulair or inhaled steroids. In certain cases, a combination of long-acting asthma medication and steroids may be necessary. Consulting with your primary care doctor or an allergist/immunologist can help determine the appropriate medication regimen for managing EIB.
In addition to medication, incorporating a longer warm-up and cool-down period before and after exercise may help reduce the severity of EIB symptoms. Doubling the duration of your warm-up and cool-down, such as increasing from five to ten minutes of dynamic stretching, is a general guideline recommended by experts like Dr. Smart.
Interestingly, individuals with EIB tend to experience improved symptom severity over time when they consistently engage in regular exercise. Establishing an effective management plan and enhancing overall fitness can contribute to better control of EIB symptoms. However, it is crucial to ensure that the condition is adequately managed before engaging in vigorous exercise, as advised by Dr. Parikh.
To sum up, EIB, or exercise-induced asthma, is a common condition that may cause discomfort and potentially dangerous symptoms during or after exercise. If you suspect you have EIB, it is important to consult with a healthcare professional for diagnosis and management strategies. With appropriate treatment, you can safely participate in activities you enjoy, whether it’s a Peloton class, running routine, or hot yoga session.