Is It Actually Possible to Be Allergic to Exercise?

By Adem Lewis / in , , , , , , , , , , , , , , , , , /

Most couch-potatoes have probably at some
point in their lives said, “I can’t run a mile without feeling like I’m going to
die!” They might also sarcastically proclaim they
must be allergic to exercise. And, amazingly enough, it turns out there
is a rare disorder in which someone can be deathly allergic to exercise, a condition
known as Exercise Induced Anaphylaxis (EIA). Allergies, in general, come with a wide range
of symptoms, and can range from mild to deadly. Fortunately for most, a deadly allergic reaction,
known as anaphylaxis, is rare. It’s generally accepted anaphylaxis affects
approximately 2% of the population and EIA is thought to represent only about 5%-15%
of all of those anaphylactic cases. Interestingly, of those, women seem to be
twice as likely to suffer from it, than men. It’s important to note that although the
symptoms of anaphylaxis can be brought on by exercise, exercise itself might not be
the only cause of the reaction; typical allergy mediators like foods, pollens and medications
when combined with exercise may result in such a reaction. Among these, food dependent exercise induced
anaphylaxis is the most common, accounting for 1/3 to 1/2 of all EIA cases. In essence, your body can handle the offending
food, and it can handle exercise, but when you combine them, you get an over-reaction
of your immune system. So what’s going on here? Our immune system is extremely complex and
requires numerous types of cells and molecules working together to fight off a foreign pathogen. Any reaction from your immune system is generally
divided into two different categories- innate and adaptive, both of which have specific
types of cells working in response to an infection. All of these cells are broadly classified
as white blood cells. An innate immune system reaction uses cells
that can recognize several different types of foreign invaders, pathogens like viruses,
bacteria, and fungi. It can be activated by some non-infectious
problems, like simply being exposed to cold or hot temperatures, and even just pumping-some-iron! The specific types of innate immune system
cells include basophils, eosinophils, neutrophils, monocytes and mast cells. Adaptive immune cells, on the other hand,
react to specific pathogens. Usually produced by your lymphatic system,
they’re known as B and T cells. While they work differently, both B and T
cells have the same goal- defend the body against specific types of invaders. Your immune system can make T and B cells
that match the surface molecules of invading pathogens, with the T and B cells able to
quickly multiply, producing large numbers of identical cells that can recognize and
destroy the foe. B cells do not directly attack infected cells,
rather they primarily produce antibodies- unique protein molecules that attach to specific
harmful pathogens, called antigens. This antibody acts like a red-flag to T cells
(and other disease killers known as phagocytes) to recognize the foreign body and destroy
it. Once the infection disappears, memory B cells
can stay around for years, sometimes throughout your entire life. If the same invader appears, it will once
again mobilize and attack the pathogen. Produced by your Thymus (thus T cell), T cells
come in several different types, performing different functions. Helper T cells produce chemicals triggering
B cells to develop into plasma cells. Killer T cells target and kill cells that
have become infected or are cancerous. Regulatory T cells help control your immune
systems reaction, preventing it from getting out of hand. Memory T cells, like memory B cells, stick
around for a while, quickly reacting should the same invader appear. When your immune system reacts to an allergy,
it can present with symptoms ranging from mild to life threatening. The more common, less problematic symptoms
are things like fever, cough, runny nose, itchiness, hives and general body aches. These mild symptoms usually don’t require
a visit to the doctor, and if annoying enough, you might treat with over the counter medications
like Benadryl, Tylenol or ibuprofen. Should your immune reaction continue, or become
out of control, it can progress to anaphylaxis. Generally accepted as life-threatening, this
reaction is more systemic and involves several organs and body systems. It can produce more severe symptoms like nausea
and vomiting, abdominal pain and dizziness. It can also result in difficulty breathing
from swelling in the face, throat and lungs. Your veins and arteries might begin dilating
to the point that your blood pressure becomes extremely low and you pass out. All of this can progress to rapid heart rates,
cardiac dysrhythmias and even cardiac arrest. Anaphylaxis (or any lesser immune response)
caused by exercise isn’t different from any other anaphylactic reaction. It was first reported in the Journal of Allergy
and Clinical Immunology in June of 1979. The authors described a case where a patient
had an anaphylactic reaction to shellfish, but the reaction didn’t occur until the
patient went for a run. The authors further noted the allergic reaction
was only mild and well tolerated when the patient ate shellfish without exercise. If he didn’t eat shellfish, he could run
without issue. When combined, however, the patient would
have an anaphylactic reaction. Since this 1979 report, there have been numerous
accounts of patients who have had anaphylactic reactions from exercise, including recognizing
the link between food and other allergies when combined with exercise- as previously
mentioned with food dependent seemingly the most common. To be specifically diagnosed with EIA, you
need to have symptoms of anaphylaxis associated with exercise. The cause must also be differentiated from
an anaphylactic reaction due to food dependent anaphylaxis or being exposed to an allergen
before the workout. It should also be noted that EIA can be brought
on by things some people might not consider strenuous, like a mild stroll in the park,
though it’s much more commonly seen when a more aggressive workout is attempted. Interestingly enough, the reaction is also
not always repeatable- the same exercise causing it today, might not cause it tomorrow. This brings us back around to what exactly
is going on in the body to cause this. While the specific factor, or factors, producing
exercise induced anaphylaxis aren’t proven, it’s generally agreed among researchers
that histamine release is the key component in the reaction. Histamine is known as an autacoid, which acts
like a hormone, only it has a more localized reaction. It’s released from the innate immune system
cells, Basophils and mast cells. The process is called degranulation. Once secreted, histamine helps increase the
absorption of allergens to the body’s organs, like the skin. Once there, other mast cells get stimulated
to degranulate by an antibody (immunoglobulin isotope) known as IgE. IgE attached to mast cells has long been known
to signify an acute allergic reaction. The acceptance of histamine being the mediator
in EIA, comes from the fact there is an increase in plasma histamine, along with the IgE being
present on mast cells within the skin, in patients experiencing EIA. These patients also tend to be more susceptible
to degranulation of their mast cells and basophils, compared to people who don’t have EIA. The reason for this lowered threshold, and
the exercise-specific reason for degranulation producing histamine, hasn’t been proven. There are some widely accepted theories, however. They include- increased gastrointestinal permeability
(absorption), blood flow redistribution, increased osmolality, and increased endogenous endorphin
release. In slightly more layman’s terms- exercise
increases the absorption of nutrients and other molecules from the GI tract. The speculation is then that allergens will
have greater contact with the parts of the immune system associated with the gut, which
happens to be a lymphoid organ. (Probably nature’s way of protecting us
from the many potential pathogens we put in our mouths.) As for blood-flow redistribution, this is
thought to contribute because, during exercise, it’s redirected from inactive tissues like
those found in your digestive tract, to active tissues like those found in your skeletal
and muscle tissues. Those tissues mast cells are different from
the ones found in your GI tract. So the thinking is that as long as a food
allergen remains in the gut and only exposed to those types of mast cells, it doesn’t
cause histamine release. But should it go to the skeletal muscles and
skin, those mast cells will degranulate and cause a reaction. Exercise also causes the release of endorphins,
giving you the same type of feeling taking morphine would. The release of these endorphins has been known
to enhance mast cell degranulation. It seems reasonable then that the aftermath
of this increased endorphin release would escalate the degranulation of mast cells,
resulting in a histamine response that causes the cascading effects of anaphylaxis. This brings us to the final, forerunner in
the theories of why certain people get EIA, involving increased osmolality in your intestines-
meaning there is more allergen getting to certain areas of your intestines, specifically
the worm-like processes called villi, in your small intestines. It’s thought, when you exercise, the mast
cells at the bases of your villi get exposed to more of an allergen. This exposure then secretes histamine, which
in turn results in an increased distribution of allergen to many of the body’s organs,
such as skin, and the cascading effects of histamine then produce anaphylaxis. No matter the exact cause, the treatment for
EIA is the same as any other anaphylaxis- avoid repeating the same behaviors causing
a reaction in the first place. As any good doctor would say, “If it hurts
to do that, stop doing that”. For those who want to “do that” anyway,
recent evidence has suggested that pre-treating people with agents that inhibit cell degranulation
may prevent food dependent EIA. Should you unsuccessfully avoid experiencing
anaphylaxis, I’d recommend calling 911. The doctor, or paramedic, will treat the life-threatening
symptoms, like the swelling in your respiratory tract and extreme low blood pressure, first,
usually using medications like epinephrine, albuterol and atrovent. They will then attempt to stop histamines
cascade of death, with antihistamines like Benadryl, and corticosteroids like Prednisone
or Solu-Medrol. In the end, yes, a person can be allergic
to exercise. But as it’s an exceptionally rare condition,
should your body mass index be higher than your age, you probably aren’t one of those
who can use it as an excuse not to hit the gym.

100 thoughts on “Is It Actually Possible to Be Allergic to Exercise?

  1. I now wonder if Doodle from "The Scarlet Ibis" had this EIA condition. And I'm surprised to realize it was written by an author from my county!

  2. I have actually had a deadly allergic reaction to exercise at least 3 times in my life. I have several autoimmune diseases that cause all sorts of strange, freak anomalies far too often for my liking.

  3. 2 minute ad at the beginning, 30 second ad in the middle, 6.5 minute ad at the end of what's basically 10 minutes of drawn out content. Usually like the videos, but this is now worse than network television. Sorry, time to unsubscribe.

  4. Today I Found Out – This is probably where the "wait one hour after you eat before you swim" myth came from.

  5. Is that why there were holes in your head before? Shiny glasses reflecting the greenscreen? Glad to see the problem fixed! 😛

  6. glassesusa fails dns lookup =’s server IP address could not be found. DNS_PROBE_FINISHED_NXDOMAIN

  7. Once the advert reached 10% of the video, I stopped watching. Not going to going to waste my time being shilled at to find out a bit of fairly benign trivia.

  8. Hey Simon I have a question I want you to answer: what is the human population carrying capacity of the earth and what will we do when we reach it?

  9. DONT GO TO GLASSES USA go to zenni . com its waaaaaay cheaper and they do the same VR glasses trying thing

  10. could you explain why dogs love chewing sticks so much I've read a few things online saying its because of their similarities to bones but it can't be that simple for example sticks don't smell anything like bones and the majority of dogs should easily be able to tell the difference. Thank you in advance if you've took the time to read this

  11. I like a lot of your videos, but this one wasn't interesting enough to be worth that suuuuuuper extended commercial at the start. Is that removed from the Patrion feed? Is there a way to subscribe to a Patrion feed in YouTube so I don't have to remember to visit Patrion separately to see your videos?

  12. if i felt like i couldn't run a mile (substantially more than a kilometer) i would feel dead. and i don't really exercise at all, i just work and use a bike to get around. that isn't exercise, that is living. if i couldn't do it i would have to find something else to make me propel myself, without legs i would walk on my hands, i can already do that but it would be easier without the legs.

  13. I heard that the Bath School massacre of 1927 was the start of modern day gun control. How about a video about it?

  14. I'm personally in favor of the "Elliot" frame. Totally not because of personal bias or anything……….

  15. The sponsorship didn't bother me one bit. I don't see why everyone is making a big deal about it. If you don't wear glasses, just skip it. If you do, consider looking into it. It's not the end of the world, but Youtube doesn't pay shit anymore so content creators gotta make money somehow.

  16. Bro seriously? 90 second hard ad you can't skip? That's over 10% of your playtime. The only kind of ad that justifies that kind of time is your own product. This is not a recipe for success.

  17. I'm asthmatic. I am allergic to exercise. Even the lightest exercise (sometimes just waking up) causes my bronchial tubes to swell and makes it difficult to breath as a result of an allergic-like reaction.

  18. I went into anaphylactic shock when administered either morphine, codeine and possibly heroin (never tried it, but doctors informed me it's likely). These opinions are "Group-A" Opioid Types. But if I take Vicodin (hydrocodone) OR Percocet (oxycodone) and Dilaudid (hydromorphone) are in "Group-B" and wouldn't ya know it? I didn't get ill from them! Dilaudid is given to weirdos LIKE ME for THIS VERY REASON!

  19. Simon, I'd love it if you would do a video on Eosinophilic Gastrointestinal Disease. My 10 year old son has had Eosinophilic Esophagitis and Eosinophilic Gastroenteritis his whole life. It's still a widely unknown disease and I'm surprise at how many people, including those in the medical field, have never heard of it. Please help us spread awareness.

  20. in other words, exept the extraordinairly rare cases, it is not the specific act of exercise that they are allergic to, it is a combination of multiple things, and exercise in combination with those works as a trigger.

  21. The only example I’ve run into was my friend, who does triathlons and who’s maintenance is 200m bike rides, got skin rashes. I thought it was a sensitivity to her own sweat, but it was diagnosed as a food allergy. I didn’t quite grok it before but the in-depth explanation here certainly provides clarification.
    (I was probably tilted towards suspecting that as another friend allergic to cold experienced an anaphylactic reaction while scuba diving that was complicated by the necessity of a hyperbolic chamber after emergency measures to get her to the surface risked the bends)

  22. My son does not have asthma…. But after every heart surgery he suffers from exercise induced asthma.
    Similar situation

  23. …SciShow released a video where they talked about this around the same time that you guys did…I was going to yell at you in the comments for stealing their content, but you provided more information about this specific "allergy"/immune disorder. So, I want to say: Sorry, and Thank You.

  24. i am! most people with mast cell disorders have issues with exercise and/or heat. i will break out in a cold sweat that burns and itchs my skin, nose runs, chest tightens til i cant breathe, headache, sometimes puke and pass out.

  25. These glasses look like shit btw. Disliked because of shitty intrusive product placement. The shit glass company you advertise can shove their glasses up their ass

  26. You are British… Why not get a sponsor that actually sells to the British and the rest of the world and not just some yank only company?

  27. No need to thank them you blabbing about them for over 1/8th of this video means they owe your wife some RayBans and your Crew 50% off. Just saying.

  28. Too many ads. I got one before the video, then there's the 2 minute advertisement included at the start, and I got another one in the middle of the video.

  29. Now that you know whether it's possible to be allergic to exercise check out this video and find out Why are Some People Allergic to Domestic Cats and Are They Also Allergic to Tigers and Other Big Cats?:

  30. WHAT ARE YOU DOING!? Online ads accompanying videos like this are just a few seconds long. You of all people should be up on the offensiveness of long promos. Please do not shove prolonged advertising at us.d

  31. That ad was so long that I lost stopped watching before it was over, but managed to find the end of it, and then was so annoyed that I only watched three minutes of the video. Onto another video.

  32. Aaaaand of course the comments are filled with people complaining about that absurdly long ad and claims of being a speshul rare snowflake with exercise allergies. The rarer you say something is, the more people there will be who claim to be in that rare category.

  33. The question "can you really be allergic to x" can always be answered with "yes." There are people allergic to water, and sunlight. If you're particularly unfortunate you can be allergic to anything.

  34. I have been training for a whole year 6 days a week, about up to two hours a day. I have never had any health problem in my entire life. Yesterday at the gym, I was running on a treadmill, and about 5 minutes in I felt way out of shape, my cardio seemed way worse than usual. I stopped and felt my throat become small and my nose was completely clogged, I could not breathe for about a whole minute. My throat opened and I managed to go to the local pharmacy where they injected me. I was brought to the hospital and everything is fine today. My question is regarding all this, I know I'm not allergic to exercise, and i actually went training today even if my doctor told me not to. There is nothing I can think about that I ate different BUT I did have almond milk the day before. Is it possible that the exercise triggered the almond milk allergy reaction 12 to 16 hours after the food was injested? I asked this question to my doctor, and I need one month before I get an appointment with an allergy doctor. I want to know if I'm gonna die on the treadmill lol.

    Thanks in advance.

  35. I suffer of (FDEIA)
    The first time this happened to me I passed out and ended up at the ER. I was in complete disbelief that this was the cause and of course I ignored the warnings and went back at it, I even asked for 2 Physical Education classes back to back and guess what it ended me up at the ER again. The last time I took a bit more precautions but it inevitably hit me . I knew for good that I either drop the classes or don't eat at all until the end of the day. I decided not to eat which was a pain but I got through it. Currently I am not taking any physical classes because looking back I was literally playing with death with my 2 ER visits.

  36. I still cannot find my trigger but I get an itch all over my body and my hands and feet swell, and sometimes just for taking a walk ; o ;

  37. please dont talk about stone man syndrome please dont talk about stone man syndrome please dont talk about stone man syndrome please dont talk about stone man syndrome please dont talk about stone man syndrome please dont talk about stone man syndrome please dont talk about stone man syndrome please dont talk about stone man syndrome

  38. Much simpler example: I have seborrhoeic dermatitis, which means that my skin is more sensitive then normal and it is easily irritated. Unfortunately, in some cases (and in my case as well) this means that the skin becomes very sensitive to sweat. When I sweat my own sweat irritates my skin and I get rashes, especially on my back. My skin gets very red, itchy and even a bit bumpy. I can still workout and do physically intensive jobs, I just do my best to not scratch myself and I power through it until I'm done and I can take a shower, but you could say I'm pretty much allergic to my own sweat and therefore I am allergic to working out.

  39. I am allergic to exercise. I had no idea growing why I had the reactions to working out that I did, it's pretty relieving yet shocking to learn what it is. I found out through an allergist who was a friend of a friend that it comes from food allergies and the proteins not leading up to a reaction upon digestion, but the proteins sitting in cells and then when stirred up during exercise causing swelling through circulation. What's more amusing is that my regular doctor has the same reaction and didn't know what it came from, even after trying everything(yes we've tried everything you would suggest) and it doesn't work. It is extremely rare. I am have copious amounts of food allergies that showed up in an allergy test but I blew them off and tossed the paper out because I don't show actual reactions to them after eating them but only some. I also have anaphalaxis from horses and worse with barns with horses. I think the worst was running down a mountain with an ex walking behind and coming back to him screaming from the sensation of pain and extreme itchiness, he never believed me until he saw it. His resonse was,"JESUS. I HAVE TO GO". (was on the phone with business) Pulled down the back top of my pants. It was bloody looking red from the top of my hips to my ankles, back of arms as well. I laid on my back that night and woke up to hike the mountain to give you a better understanding. I am also extremely active- was a powerlifter, ran 8 miles 3x a week and hiked a mountain once a, boxing, silks..everything else. I'm not a pansy. Not to be long winded but I want others who have this to understand how it feels to recognize it. If you have this and have questions feel free to ask.

  40. I just found out today that it everyone gets itchy when they exercise!! Holy crap what why am I like this haha 😭

  41. I know I do have EIA. It has to do with me drinking soya milk and pushing my body to certain limits when I run.

    The first time it happened to me my skin turned red, which was much more alarming , i couldnt breathe and my nose was completly clogged up. I had to use an Epipen and go to the hospital.

    Something very simular just happend months later which is tonight. I was hitting the heavybag for half an hour nonstop and i started sneezing, alot. Which is what happend the first time. My nose got blocked untill i couldnt breathe trough my nose. My throat started closing up but never shut down completly. All this sounds alot like its life threatning. The big difference is that the first time, my skin had turned red from head to toes, and my skin was very ichy. Its been over an hours now and my nose is still clogged, im able to breathe easily trough my throat now and i just feel less dizzy, mucho better. Is is possible that I dont need the epipen to calm my body down when I have an attack like this? Or am I just lucky to be alive right now? Can i go to sleep tonight xD Please let me know if im safe.

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