Exercise induced allergic reaction
slbbw
Posts: 329 Member
I have been getting full body hives every so often the last couple of months. This bout is the first I can recall being both delayed and possibly related to lifting and not running. Anyone else get this. It's not consistent, so I am not sure how to avoid it. Also in case anyone asks no new foods or lotions or detergents or anything. It always follows an intense run or lifting session, but not every one.
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Replies
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In most cases, exercise is a co-factor that triggers or augments the reaction to an allergen. I've mostly heard it in context of food allergies. But there are other possible triggers.
This factsheet gives a pretty good outline of it, and why it's a good idea to get it checked out by a medical specialist:
https://www.anaphylaxis.org.uk/wp-content/uploads/2015/06/Exercise-induced-anaphylaxis-V7-formatted.pdf
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Do you workout at a gym? There could be a trigger there.0
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I was diagnosed by an allergist as having FDEIA: Food-Dependent Exercise-Induced Anaphylaxis. After eating a lot of different foods, even hours after, if I walked around after or did anything but sit I would get hives. Sometimes mild but sometimes very intense. It seemed certain foods gave a more intense reaction than others. I didn't have any reactions to the common food allergy test, so I was told to just take Zyrtec daily and hope for the best.
A few years later I found a better allergist; my allergy was sulfates and sulfites the whole time. Now I know what foods to avoid so that I can eat and still move around. Granted if I ate something with sulfates I may simply get itchy skin unless I went out for a walk and then I'd get hives so it is exercise induced in some way. However, it was still something specific triggering the reaction the whole time.3 -
Anyone else get this. It's not consistent, so I am not sure how to avoid it. Also in case anyone asks no new foods or lotions or detergents or anything. It always follows an intense run or lifting session, but not every one.
As was mentioned above, there can be a few different situations that trigger an allergic response (like hives, anaphylaxis) after exercise.
Something that may help understand WHY, though, might be helpful.
Many of the common allergy symptoms can be caused when the body has too much histamine released (like itching, hives, wheezing, anaphylaxis). The thing is, histamine is released by our bodies all the time, constantly, because it is used for more than allergic reactions. So it's more than just histamine release.
So one thing it's helps to know is that one of the things histamine does, if released from mast cells in particular areas, is cause the heart rate to increase. So histamine is released whenever the body NEEDS the heart rate to increase, like when you are scared, or when you exercise. This does not cause hives in the normal situation.
Because...you can think of histamine in your body like histamine in a bucket. Having histamine in the bucket is no problem. But if the histamine level gets so high that it starts to overflow the bucket? That's when you start to have allergic reactions and symptoms.
If someone has a food allergy and has that food, they'll have elevated histamine levels and the bucket can overflow. But - and this is the irritating bit - if someone has a LOW LEVEL food allergy, they may almost never release enough histamine to overflow the bucket. But it MAY be enough so that later, when MORE histamine is released due to a normal activity like exercise, the bucket can overflow.
it's a right pain to figure out, because if you don't outwardly react to a food, even if it is raising histamine levels, it can be hard to track it down. Although it might help to keep track of what you eat on the days you exercise, so if/when you get hives, you'll hopefully start being able to find a pattern.
Re: no new foods, etc... - sadly, doesn't matter. Allergies are more likely to develop to things you DO eat a lot, so you've been exposed to for a while. So if this is a new, low level allergy? It's often to a food you have a lot of. :-( Allergy testing might help, but it might not - the tests are not as accurate to lower level allergies (per my allergist, who specialized in weirder or more oddball allergies). But taking some pictures when you DO get hives, and bringing it with you, might help. And it is probably important to try and figure out what is elevating your histamine level, because histamine levels getting too high is what can lead to anaphylaxis, so you don't want to mess around, you know?
That said, there can be some other things going on, too. Some people can develop what is called 'histamine intolerance' where they stop breaking down histamine as rapidly as they should, so it builds up (DAO enzyme). You can actually find this enzyme in online to purchase, though, so I know some people who have used that and had some relief.
There is also something called a mast cell activation disorder, where people will start releasing histamine (from triggered mast cells) to all sorts of weird things (like cold, heat, chemicals, and so on). Basically, they have to treat these things like one would treat an allergy and try to avoid them, basically.
If you aren't exercising every day, until you figure things out, an anti-histamine the day you exercise might help keep the histamine levels low enough to be okay during exercise, you know?
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Go to an allergist. New allergies need to be taken seriously, since dangerous allergic reactions can develop unexpectedly.3
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Anyone else get this. It's not consistent, so I am not sure how to avoid it. Also in case anyone asks no new foods or lotions or detergents or anything. It always follows an intense run or lifting session, but not every one.
As was mentioned above, there can be a few different situations that trigger an allergic response (like hives, anaphylaxis) after exercise.
Something that may help understand WHY, though, might be helpful.
Many of the common allergy symptoms can be caused when the body has too much histamine released (like itching, hives, wheezing, anaphylaxis). The thing is, histamine is released by our bodies all the time, constantly, because it is used for more than allergic reactions. So it's more than just histamine release.
So one thing it's helps to know is that one of the things histamine does, if released from mast cells in particular areas, is cause the heart rate to increase. So histamine is released whenever the body NEEDS the heart rate to increase, like when you are scared, or when you exercise. This does not cause hives in the normal situation.
Because...you can think of histamine in your body like histamine in a bucket. Having histamine in the bucket is no problem. But if the histamine level gets so high that it starts to overflow the bucket? That's when you start to have allergic reactions and symptoms.
If someone has a food allergy and has that food, they'll have elevated histamine levels and the bucket can overflow. But - and this is the irritating bit - if someone has a LOW LEVEL food allergy, they may almost never release enough histamine to overflow the bucket. But it MAY be enough so that later, when MORE histamine is released due to a normal activity like exercise, the bucket can overflow.
it's a right pain to figure out, because if you don't outwardly react to a food, even if it is raising histamine levels, it can be hard to track it down. Although it might help to keep track of what you eat on the days you exercise, so if/when you get hives, you'll hopefully start being able to find a pattern.
Re: no new foods, etc... - sadly, doesn't matter. Allergies are more likely to develop to things you DO eat a lot, so you've been exposed to for a while. So if this is a new, low level allergy? It's often to a food you have a lot of. :-( Allergy testing might help, but it might not - the tests are not as accurate to lower level allergies (per my allergist, who specialized in weirder or more oddball allergies). But taking some pictures when you DO get hives, and bringing it with you, might help. And it is probably important to try and figure out what is elevating your histamine level, because histamine levels getting too high is what can lead to anaphylaxis, so you don't want to mess around, you know?
That said, there can be some other things going on, too. Some people can develop what is called 'histamine intolerance' where they stop breaking down histamine as rapidly as they should, so it builds up (DAO enzyme). You can actually find this enzyme in online to purchase, though, so I know some people who have used that and had some relief.
There is also something called a mast cell activation disorder, where people will start releasing histamine (from triggered mast cells) to all sorts of weird things (like cold, heat, chemicals, and so on). Basically, they have to treat these things like one would treat an allergy and try to avoid them, basically.
If you aren't exercising every day, until you figure things out, an anti-histamine the day you exercise might help keep the histamine levels low enough to be okay during exercise, you know?
Very relatable. I have a very low food allergy to wheat that is not normally noticed but can be triggered into the hives, low blood pressure, anaphylaxis - the whole nine yards and 2 ambulance trips before it was figured out. Any intense and/or prolonged working which includes getting heated up (so this includes yard work as well as intentional exercise) can throw me over the edge. I know now that I have to avoid wheat within 2-3 hours of exercise/heating up - so I just do that as much as I can and remember. Doesn't happen that often because I avoid a lot of wheat anyway but it is scary when it does.1 -
No concurrent food/food intolerance/food allergy necessary for someone to have this. It can be due to an increase in body temperature alone if it is from cholinergic urticaria.
This illustrates why medical diagnosis is the gold standard - since there is more than one pathophysiology behind the occurrence of, and the list of currently known causes needs to be gone through and narrowed through rule out elimination.
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Definitely seek medical advice on this one.
I get hives and sometimes my airways constrict after exercising outdoors in winter. My doctor recommended Zyrtec and Singulair beforehand which help me quite a bit. I also add caffeine which is a mild bronchodilator and helps me breathe a little easier. When it's really cold out I don't take chances and run on a treadmill at the gym instead.0 -
My daughter has this!!! Starring to come back and read through comments.0
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grinning_chick wrote: »No concurrent food/food intolerance/food allergy necessary for someone to have this. It can be due to an increase in body temperature alone if it is from cholinergic urticaria.
This illustrates why medical diagnosis is the gold standard - since there is more than one pathophysiology behind the occurrence of, and the list of currently known causes needs to be gone through and narrowed through rule out elimination.
True, there can be many reasons behind this symptom. And it is always great to have a diagnosis so you know whatnis going on.
But to be fair, people sharing what they have seen/know about possible causes for X symptom? That can mean the difference between getting diagnosed and not getting jack all.
Because medical diagnosis is what you hope for but with situations like the OP’s? Good luck getting one. A great doctor will do testing, have the patient try out different situations at home to see what can trigger, and so on. They will listen to ideas if the patient has something to add, like potential diseases or conditions to test for, based on the patient’s own research or someone else’s.
The average doctor- so the majority of that bell curve- will give anti-histamines and call
It a day. And ignore whatever symptoms don’t match whatever average condition they have decided the patient likely has, because it is the most common.
Weird or unusual health issues are much harder to get diagnosed. The symptoms are more often viewed as outliers or exaggerations and thus ignored. The patients are more likely to spend years and far too much money just finding a doc that will listen and do the proper testing.
The gold standard is only useful if you can GET the diagnosis, you know?
the majority of people I know with similar issues to the OP took, on average, 3-8 years to get a diagnosis. I had something similar that took over 20 years to get diagnosed. I only got a diagnosis because I asked for testing based on information I got from a forum- so sharing with each other, about medical possibilities, is rather near and dear to my heart, as you can imagine.
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Thank you shaumom, your explanation was very helpful. Its happened 3 times in the last several months. Once before I started food tracking and one time I can't recall the date. I made a note when the symptoms appeared this go around. I did have more bread, which I rarely eat, in the day and meal preceding the reaction. I know its not gluten as I eat gluten on the regular, but my bread, and cereal intake recently went up, so there might be a non-gluten protein, starch or additive in prepared grains that I am reacting to. I do exercise daily, so I would rather figure this out then just take antihistamines all the time. I have low luck with allergist in the past, so I am definitely on board with going in with ideas.
The hives have persisted low level since Friday, but did not further flair with exercise on Sunday. I will pull wheat bread and cereal out of the diet again and see how it goes.
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Good luck!!
A couple tidbits I wish I knew when I started trying to figure this out, in case it helps. :-)
- if histamine is the issue, quantity can definitely matter. You might be fine with x amount, but react to a higher amount, you know? So recording amounts you eat, as well as what you eat, may be important.
- Brand name may matter- if you, say, react to something like a preservative rather than a food ingredient, that means that one brand of bread could be an issue, while another could be fine.
- with food processing being what it is, there can be patterns in your consumption/reaction you may not be able to see. In that case, if you, say, are reacting after 10 different foods, googling some of them in combination with allergy or reaction can sometimes help you find a connection.
For me, for example, i reacted to lemon juice concentrate, caramel coloring, corn syrup, wine, and a few other seemingly unrelated things. They all turned out to contain sulfites, which was what I reacted to. However, a number of them contain enough sulfites to make me react, but not enoigh to require labeling, so I never would have known the real issue without some research on my own, you know?
Hope you can find the answer and stop reacting!!
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Good luck!!
A couple tidbits I wish I knew when I started trying to figure this out, in case it helps. :-)
- if histamine is the issue, quantity can definitely matter. You might be fine with x amount, but react to a higher amount, you know? So recording amounts you eat, as well as what you eat, may be important.
- Brand name may matter- if you, say, react to something like a preservative rather than a food ingredient, that means that one brand of bread could be an issue, while another could be fine.
- with food processing being what it is, there can be patterns in your consumption/reaction you may not be able to see. In that case, if you, say, are reacting after 10 different foods, googling some of them in combination with allergy or reaction can sometimes help you find a connection.
For me, for example, i reacted to lemon juice concentrate, caramel coloring, corn syrup, wine, and a few other seemingly unrelated things. They all turned out to contain sulfites, which was what I reacted to. However, a number of them contain enough sulfites to make me react, but not enoigh to require labeling, so I never would have known the real issue without some research on my own, you know?
Hope you can find the answer and stop reacting!!
Interesting that there are two of us here with the sulfites issue. I've read that it's anything that's more than 2ppm that can cause reactions. Gelatin and pectin can contain sulfites but it falls in that small range so never seems to cause issues but anything moderate to high is a nightmare.0 -
I thought I was the only one who had this!
I posted about it about 5 years ago and nobody thought I was serious? Allergic to excercise? Yeah right.
Mine can go into full blown anaphylaxis so I do carry an epi pen and have a medic alert bracelet.
Many doctors, a diagnosis of EIA and yet no real answers later I have just learned to keep it in some control. I do find it's worse in high or very cold temperatures. (I live in Canada so we have both extremes)
The doctor who did diagnose me said whatever the trigger, don't give up the excercise.
Sulphites/sulphates are definitely on my watch list as possible triggers. Just have not been able to pinpoint any culprit yet.
Anyone with this condition who wants to add me as a friend I would love to hear from you!1 -
I always get heat hives in the start of summer. They usually are between my legs but I have gotten them on my breast. I know they dont last long and are gone within a day and my body eventually gets used to the heat within a week.0
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grinning_chick wrote: »No concurrent food/food intolerance/food allergy necessary for someone to have this. It can be due to an increase in body temperature alone if it is from cholinergic urticaria.
This illustrates why medical diagnosis is the gold standard - since there is more than one pathophysiology behind the occurrence of, and the list of currently known causes needs to be gone through and narrowed through rule out elimination.
True, there can be many reasons behind this symptom. And it is always great to have a diagnosis so you know whatnis going on.
But to be fair, people sharing what they have seen/know about possible causes for X symptom? That can mean the difference between getting diagnosed and not getting jack all.
Because medical diagnosis is what you hope for but with situations like the OP’s? Good luck getting one. A great doctor will do testing, have the patient try out different situations at home to see what can trigger, and so on. They will listen to ideas if the patient has something to add, like potential diseases or conditions to test for, based on the patient’s own research or someone else’s.
The average doctor- so the majority of that bell curve- will give anti-histamines and call
It a day. And ignore whatever symptoms don’t match whatever average condition they have decided the patient likely has, because it is the most common.
Weird or unusual health issues are much harder to get diagnosed. The symptoms are more often viewed as outliers or exaggerations and thus ignored. The patients are more likely to spend years and far too much money just finding a doc that will listen and do the proper testing.
The gold standard is only useful if you can GET the diagnosis, you know?
the majority of people I know with similar issues to the OP took, on average, 3-8 years to get a diagnosis. I had something similar that took over 20 years to get diagnosed. I only got a diagnosis because I asked for testing based on information I got from a forum- so sharing with each other, about medical possibilities, is rather near and dear to my heart, as you can imagine.
I made no post stifling or criticizing anyone, let alone the sharing of information in an online forum to improve patient education. I was adding to the list of rule outs, not subtracting. That's it. The entire reason I bothered to post.
Good luck? That's a bit fatalistic, don't you think? There's only three differential diagnoses that are the horses (most common reason for) as opposed the zebras (uncommon or "exotic" weird or unusual health issues causing by masquerading/mimicking) for the OP's presenting chief complaint, as offered. When it comes to the practice of medicine that usually increases the likelihood an accurate diagnosis can be correctly arrived at, not decrease.
Yes, MDs/DOs are humans first and doctors second which means competency at their job is on a rheostat vs. fixed line. If that wasn't true, the "What do you call the doctor who graduated last in his/her class?" joke wouldn't be a thing.
This is where advocating for yourself, and firing primary care providers (PCPs) if they give you no choice, comes into action. Just like with psychiatrists, veterinarians, dentists, therapists, massage therapists, chiropractors, etc., no one in the US is stuck with a doctor or other person offering a service that involves a practitioner-patient relationship who will not listen or will not refer or pursue appropriate diagnostics.
If you complain and demand to have a new one assigned, it does happen. I am unaware of any Patient Bill of Rights that does not include the right to choose ones PCP. The key is, you have to know your rights before you can demand they are not steamrolled out of convenience to/policy of some facility. And not only actively know what additional protections your individual state may have cemented in law to guarantee those rights are not denied, but be ready to deploy them if need be.
Health insurance companies may/may not be a nightmare concerning coverage, but that is an entirely separate issue from actively working to have a PCP who practices medicine to the level/manner/style you want. A collaborative relationship vs. hierarchical. It is not an unrealistic or unattainable thing. Heck, your own story above corroborates this. 2 -
I have exercise induced anaphylaxis, it’s not triggered by food, the reaction occurs during or immediately (within 10 minutes) after stopping exercising with me, I don’t have a delayed response beyond 10 mins.
What you describe as a delayed response could be something called deep pressure urticaria, if it presents in areas whereby a pressure has been, it’s a subset of a condition called physical urticaria (another co-existing condition I have)0 -
Maxematics wrote: »Good luck!!
A couple tidbits I wish I knew when I started trying to figure this out, in case it helps. :-)
- if histamine is the issue, quantity can definitely matter. You might be fine with x amount, but react to a higher amount, you know? So recording amounts you eat, as well as what you eat, may be important.
- Brand name may matter- if you, say, react to something like a preservative rather than a food ingredient, that means that one brand of bread could be an issue, while another could be fine.
- with food processing being what it is, there can be patterns in your consumption/reaction you may not be able to see. In that case, if you, say, are reacting after 10 different foods, googling some of them in combination with allergy or reaction can sometimes help you find a connection.
For me, for example, i reacted to lemon juice concentrate, caramel coloring, corn syrup, wine, and a few other seemingly unrelated things. They all turned out to contain sulfites, which was what I reacted to. However, a number of them contain enough sulfites to make me react, but not enoigh to require labeling, so I never would have known the real issue without some research on my own, you know?
Hope you can find the answer and stop reacting!!
Interesting that there are two of us here with the sulfites issue. I've read that it's anything that's more than 2ppm that can cause reactions. Gelatin and pectin can contain sulfites but it falls in that small range so never seems to cause issues but anything moderate to high is a nightmare.
I used to get itchy after having foods like dried fruit with sulfites. Fortunately, I don't react to levels that don't require labeling, so just avoiding foods labeled as containing sulfites was enough to solve this for me. (In my case, there was no exercise component.)0
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