Allergies affect approximately 20-40 million people each year. In this country alone, an estimated 15 million people live with asthma and its ensuing complications; sadly, this number continues to increase. As a result, many such individuals understandably shy away from exercise, fearing it may trigger an asthma attack. Learn how we can safely work with patients who have all kinds of allergies.

Pollen Allergies and the Workout Challenge

Any serious bout of exercise elicits an increase in ventilation. During those times of the year when flowers bloom and pollen seems ubiquitous, individuals, especially athletes, find outdoor workouts tend to bring on allergic symptoms. Mid-exercise, individuals may experience a sneezing frenzy, runny eyes, and difficulty breathing. Less common but still disruptive reactions include fatigue and mood swings. In rare but frightening cases, anaphylaxis may set in, a condition that rapidly turns life-threatening if not addressed in a timely manner.

The Precarious Physiology

The sympathetic nervous system bears responsibility for the increase in nasal airway space during periods of exercise. In the presence of allergens, however, the narrowing of these spaces brings about the aforementioned nasal congestion. For the serious/competitive athlete, such factors as sinus pressure, headaches, and potential disruption of sleep can take a toll on athletic performance.

A study looking at how allergic reactions may compromise the central nervous system yielded some upsetting results. Researchers found that allergy complications can bring about decreases in attention span as well as reflex response time, both of which can make the difference between winning or losing a sporting event. More severe reactions include anxiety and depression. Each of these, or any combination thereof, can derail even a top athletic competitor.

In spite of these discouraging data, studies continue to demonstrate the benefits of exercise, even during the height of pollen season. Since aerobic movement causes a stronger flow of blood, any inhaled allergens will systematically proceed at a faster pace through the body, and just as rapidly get discarded via the kidneys. A body at rest, experiencing a slower blood flow, enables allergens to remain rooted in place, where they eventually erode delicate tissues such as those found in the eyes and nose.

Options Abound

Even if trail running fails as a sport of choice in the presence of considerable airborne allergens, many exercise options can help an allergy sufferer maintain his level of fitness.

Water exercises, from lap swimming to aquatic resistance training and flexibility, present a highly suitable option for individuals living with asthma, whether exercise-induced or more prevalent in daily life. The moist environment of indoor pools lends itself to maintaining clearer sinus passages, and also proves gentler on delicate lung tissues. Asthma and allergy sufferers need not fear even the most invigorating of exercises in the water, as such an environment rarely causes the emergence of severe symptoms.

Other options, such as Pilates and yoga-based movements, encourage deep breathing as part of their protocol. This too can facilitate easier movement for those dealing with seasonal or general allergies. The American Academy of Allergy, Asthma and Immunology strongly urges athletes with respiratory challenges not to downplay the importance of warming up as a means of holding symptoms at bay.


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Can Allergy Medications Help?

For those individuals tempted to resort to the apparently easy fix of antihistamines to control asthma outbreaks during workouts, reading labels serves an important function. Many over-the-counter products tend to induce fatigue, not an ideal situation for the high-performing athlete. Choose a product that clearly claims “non-drowsy formula” on the packaging. When in doubt, always consult a pharmacist or medical professional. Dr. Sanjeev Jain, MD, Board Certified allergist and immunologist at Columbia Allergy, strongly believes that “antihistamines should not directly affect a person’s workout performance and the benefits one should get from exercise”.

Fitness and Food Allergies

Much like pollen, certain foods can bring on allergic-type symptoms, even for those individuals who find that “intolerance” or “sensitivity” more aptly describe their exposure reactions. Anything, from itching and hives to shortness of breath, seems exacerbated when coupled with poorly-timed exercise. Individuals with allergies/sensitivities to certain foods may discover that eating a meal several hours prior to the gym helps thwart unwanted symptoms.

A rare condition known as food-dependent exercise-induced anaphylaxis flares up when consumption of food gets coupled too closely with workouts. Often neither the particular food nor the exercise on their own elicit a reaction; but when paired together, the body experiences very unpleasant effects. Anaphylaxis carries life-threatening potential; as such, athletes with a tendency towards allergic reactions, in general, might choose to carry an EpiPen in their gym bags. Once again, savvy timing of food intake makes a big difference here.

Common Offenders

While every individual possesses a unique DNA makeup, some ingredients found in foods favored by the sports-minded population have earned labels of “common culprits” in regard to causing allergic reactions. The list below outlines a few of these:

  • Fructose (present in many sports beverages and energy/protein bars)
  • Gluten
  • Cocoa powder
  • Milk
  • Nuts
  • Oats
  • Preservatives (notably, sodium benzoate and potassium sorbate)

If clients mention that they typically reach for such bars and beverages either before or immediately following a workout, merely out of convenience, trainers might choose to inform them of such ingredient considerations.

Understanding the Immunology

When a human body faces an allergic reaction, the immune system kicks into high gear by promptly producing antibodies, our body’s defense mechanism against what it perceives as a foreign invader. The challenge presented with exercise-induced anaphylaxis (EIA) stems from the production of antibodies even in the absence of any foreign substance other than the mere act of exercising.

The process of intense aerobic movement potentially elicits the release of mediators from substances known as IgE-dependent mast cells. These mediators proceed to degrade the mast cells, thereby triggering the severe EIA. Exercises of higher intensity, performed frequently within a few days’ time, tend to exacerbate this condition. Altering one’s exercise format of choice to something performed at a lesser yet still effective level of intensity serves as a safe platform, something to which trainers may want to adhere for their clients who frequently exhibit potentially dangerous allergic-type symptoms.

Allergies to Pharmaceuticals

Recognizing when an allergic reaction of any sort presents itself during client training requires quick action on the part of the trainer. It may turn out that the client recently began a new course of medication (antibiotics in particular) to which he did not realize he was allergic. Chances are he did not bring an EpiPen, having never before experienced such a problem. Escort the client to a quiet area of the gym, where he can consult his physician or pharmacist on his safest course of action at this point. By knowing the signs, we can help calm the individual as he seeks professional medical advice.


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Food Allergy and Intolerance in Sport

Exercise Control of Your Allergies

Cathleen Kronemer

Cathleen Kronemer is an NFPT CEC writer and a member of the NFPT Certification Council Board. Cathleen is an AFAA-Certified Group Exercise Instructor, NSCA-Certified Personal Trainer, ACE-Certified Health Coach, former competitive bodybuilder and freelance writer. She is employed at the Jewish Community Center in St. Louis, MO. Cathleen has been involved in the fitness industry for over three decades. Feel free to contact her at She welcomes your feedback and your comments!