Exercise-Induced Asthma


“Exercise-induced asthma” or “exercise-induced bronchospasm” is a condition in which individuals develop asthma symptoms only when exercising.  The bronchial tubes become narrowed making it difficult to move air out of the lungs. If one has chronic asthma however, one can still have their asthma triggered by exercising, but in addition, their asthma may be exacerbated by other factors such as allergies (e.g., dust mites, cockroaches, pets, molds, pollens), upper respiratory tract infections, cold air, hot air, increased or decreased humidity, cigarette smoke, diesel fumes, strong scents, and other irritants.  Many individuals with exercise-induced asthma are not diagnosed in a timely fashion since many clinicians do not recognize the condition.  It may go undiagnosed for years and the symptoms may be attributed to poor exercise tolerance or just being “out of shape.” Children often avoid exercise without telling anyone that exercise is bothersome.

The classic symptoms of exercise-induced asthma include wheezing, chest tightness, coughing, and/or shortness of breath.  Individuals with exercise-induced asthma generally develop asthma symptoms within 5 to 20 minutes after beginning their exercise.  It is also typical for them to have symptoms after they stop exercising. Exercise-induced asthma tends to occur more often on cold, dry days rather than on warm, humid days.

The diagnosis of exercise-induced asthma is made by way of a comprehensive history and physical examination in conjunction with pulmonary function tests.  It is also helpful for the patient to have a peak flow meter to use at home so that he or she can measure their outflow of air before and after exercise. A decrease in the peak flow while or after exercising helps the allergist determine if the patient is exhibiting an exercise-related decrease in air flow.  Other conditions that should be ruled out include cardiac disease, GERD (i.e., acid reflux)chronic sinusitis, chronic obstructive pulmonary disease [COPD (e.g. chronic bronchitis, emphysema)], anxiety attacks, and vocal cord dysfunction, to name a few.

Although patients with exercise-induced asthma develop symptoms upon exercise, it is important that the patient understand that with treatment, it is usually possible to exercise.  In fact, exercise is generally encouraged in almost all individuals with this condition. There are many examples of famous athletes who have won Olympic Gold Medals, football championships, etc. that have had exercise-induced asthma.  It may be helpful for the some individuals to get an asthma action plan from their allergist so that he or she knows exactly what to do to treat or prevent the symptoms. In addition, the use of a short-acting beta-2 agonist rescue inhaler medication such as albuterol e.g., (Proventil, Ventolin, ProAir, Xopenex) about 30 minutes before exercise may prevent symptoms from developing.  If needed, the inhaler may also be used after symptoms occur if this plan is discussed and agreed upon with an allergist. There are other medications which can be utilized such as Singulair (i.e., montelukast) which have been shown to help prevent the symptoms of exercise-induced asthma. More severe cases may need inhaled corticosteroids in order to control the condition. In addition to medications, warm-ups and cool-downs may mitigate or even prevent symptoms.  It is also prudent to avoid exercising in the high pollen season if the individual is allergic to pollens. Avoidance of exercise is also recommended if the person is experiencing an upper respiratory tract infection or if the air is cold and dry.

The board certified allergy specialists at Black & Kletz Allergy are always available for our patients to ask any questions that they may have regarding asthma or allergies.  We have been treating pediatric and adult patients with exercise-induced asthma, as well as patients with chronic asthma, allergic rhinitis (i.e., hay fever), allergic skin conditions such as eczema and hivesinsect sting allergies, medication allergies, eosinophilic disorders, other allergic maladies, and immune disorders for more than 5 decades.  We have 3 office locations in the Washington, DC, Northern Virginia, and Maryland metropolitan area with offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  All of our offices offer on-site parking and the Washington, DC and McLean, VA offices are Metro accessible.  There is a free shuttle that runs between our McLean, VA office and the Spring Hill metro station on the silver line.  If you would like to be evaluated today for exercise-induced asthma or any other allergic or immunologic problem, please call us today.  You may also click Request an Appointment instead and we will respond to your request within 24 hours by the next business day.  The allergists at Black & Kletz Allergy pride ourselves in providing the highest quality asthma and allergy care in the Washington, DC metro area.