Allergic to Exercise: Is She For Real?

Did you just read the title and go “Huh? How can you be allergic to exercise? Is this woman for real??”

Well if you did, you would not be alone.

I just find that it is easier to drop that bombshell than use the technical term, cholinergic urticaria.

And, before you read any further, here is my disclaimer:

While I do have training as a CPR / First Aid Instructor which covers initial response to emergencies, I am NOT a medical professional.  Everything in my post is based upon personal experience and information given to me.  None of this should serve as a way to diagnose or treat medical issues. Additionally, links in this post may be affiliate links.

weight room in gym
When you are Allergic to Exercise, the gym can be a scary place.

Allergic to Exercise ~ One Woman’s Experience

This is something that I’ve struggled with for a while now. 

It started up in 2013 when I noticed hives forming after a long, sweaty workout. 

I figured it was just from irritation.  Then, some people started to suggest maybe my daily Shakeology was to blame and my body was continually trying to ‘detox’ from something. (After experimenting with this hypothesis in fall 2019, I have stopped using this daily.)

Since it was just those longer workouts, I went to shorter ones thinking it would stop.  Sharing this ‘allergic to exercise’ statement with friends had me laughing along with them that it was the perfect excuse to NOT exercise or at least tone down what I was doing.

As you can see, I wasn’t smiling when a workout was done when I could feel the hives popping out all over.

Allergic To Exercise Timeline Photos
Working out leads to hives which can worsen and spread over time.

 

Eventually, the sporadic hives turned into hives all the time when I exercised, even after 15 minutes of yoga! 

What had me stop exercising completely this past fall was when I started to have my mouth feel different, too.   By then, I felt like my immune system was overloaded. 

The hives started coming with stress of any kind and I walked around with a continual itchy feeling around my nose and mouth. This alone had my regular doctor writing a script for an EpiPen just in case it morphed into full anaphylaxis.

Receiving the Diagnosis 

Finally, I was convinced I needed to see an allergist. 

I have had environmental allergies (dust, pollen, furry creatures) since I was a young child.  I had to wait a little while to get in and then had them do a full screening to see if anything new (besides the sweat thing) had developed. 

Sure enough, I’m not allergic to birch trees (which are all around us in Alaska) but thankfully had some molds and a few other things that didn’t light up like a Christmas tree on my back. 

Desensitization was presented as an option which I’m still considering as the boys hate that mom is allergic to any furry pet they’d want and having allergy issues year round really stinks.

With a short confirmation test, he also diagnosed me with cholinergic urticaria. Basically, he told me that I have an allergic reaction to exercise. Particularly when I sweat (or as it progressed, do anything to cause a rise in core body temperature.)

The good news from the allergist about my being allergic to exercise is that it usually goes away after a few years (average of 5 to 7 years for length of problems.)  Note ~ As of early 2020 it has NOT gone away for me at all!

The bad news is that it can become bad enough to need that EpiPen.

If you suspect you are experiencing something similar to what I have, definitely make an appointment to get a proper diagnosis.  They did a methacholine skin test to what happens during exercise ~ increased body temperature and sweat.

However, I thought I’d share what cholinergic urticaria is and what I was told to do.

Allergic to Exercise ~ What is Cholinergic Urticaria?

Cholinergic urticaria is basically hives that are the result of acetylcholine being released.

Normally, acetylcholine aids the nervous system with the transmission of signals. 

However, someone experiencing cholinergic urticaria has the acetylcholine stimulating mast cells to release chemicals which then resemble an allergic response.

Exercise, hot showers, sweating and anxiety trigger the release of acetylcholine producing hives (small bumps) surrounded by redness.

I found the following books on the subject, but have not read them yet.

 

Cholinergic Urticaria: A Guide to Chronic Heat HivesCholinergic Urticaria: A Guide to Chronic Heat HivesCholinergic Urticaria: A Guide to Chronic Heat HivesLosing My Itch: How I Reduced My Cholinergic UrticariaLosing My Itch: How I Reduced My Cholinergic UrticariaLosing My Itch: How I Reduced My Cholinergic UrticariaThe 4-Phase Histamine Reset Plan: Getting to the Root of Migraines, Eczema, Vertigo, Allergies and MoreThe 4-Phase Histamine Reset Plan: Getting to the Root of Migraines, Eczema, Vertigo, Allergies and MoreThe 4-Phase Histamine Reset Plan: Getting to the Root of Migraines, Eczema, Vertigo, Allergies and MoreUrticaria Hives : Treatment Guide For Chronic Or Cholinergic: Remedies And Cures For Hives, Eczema And PsoriasisUrticaria Hives : Treatment Guide For Chronic Or Cholinergic: Remedies And Cures For Hives, Eczema And PsoriasisUrticaria Hives : Treatment Guide For Chronic Or Cholinergic: Remedies And Cures For Hives, Eczema And PsoriasisThe Beginner's Guide to Histamine Intolerance (The Beginner's Guides)The Beginner’s Guide to Histamine Intolerance (The Beginner’s Guides)The Beginner's Guide to Histamine Intolerance (The Beginner's Guides)

 

 

7 Suggested Steps to Manage Cholinergic Urticaria

1. Take allergy medicine daily.

Zyrtec is what was prescribed for me as it is supposedly better with minimizing the itching from hives as well as frequency.

I’ll admit to being terrible about doing this, so I’ll still get hives when I exercise and then take the medicine right after. Eventually, it became part of my morning routine to take one tablet before breakfast.

After a few years of doing this, I weaned myself off the daily Zyrtec and reserve it for bad cases. Why? Because skipping it led to me having hives, too! Also, I found it only helped them itch less.

What I do carry with me is a vial of Boiron’s Histaminum Hydrochloricum 30C. This homeopathic medicine helps provide some allergy relief.


 

2. Avoid triggers, when possible.

Avoiding physical activity is NOT practical and every doctor confirmed that I needed to get back into a regular routine. I just need to do other things to minimize and manage it. 

However, I can adjust the temperature of any bathing so that the heat is not a trigger and I can wear layers that can be removed if I get too warm. Sadly, I can’t remove the trigger when it is a change of life hot flash hitting me.

Anxiety can make it worse. So, doing regular stress relief activities helps. Using a cool towel behind my neck and along the temples can help bring my core temperature down.

3.Never exercise alone.

Anaphylaxis is NOT a joking matter. 

Even with an EpiPen, you need to get advanced medical care. 

Having someone with you does not ensure a reaction won’t happen. Rather, you now have someone to help (call 911, grab your EpiPen, etc.)

4. Keep an EpiPen with you at all times.

I laughed when the pharmacist said my primary care doc had written the prescription for multiples of the EpiPen.  The pharmacy only sells them as a 2 pack, which is all I bought.

I keep one in my purse so I have it when I leave the house and one in my bedroom. Do NOT leave it in your vehicle as high and low temperatures can have an averse effect.

(Note ~ the pharmacy tech told me to register for a coupon with the company before buying my prescription as my insurance did not fully cover the cost.  Actually, I had serious sticker shock at the amount I was billed for that 2 pack.  The coupon brought my final cost down to around $30.)

On a related note, get a new script on a regular basis. Many people will keep an expired EpiPen as backup for the fresh ones. It isn’t that the older one won’t help. It just won’t be as effective.

5. Consider diet modifications.

Research in other countries has shown there are some foods which are more histamine rich or histamine releasing than others.  So, some people have elected to minimize or eliminate them from a person’s diet to help calm the body.

I have NOT adopted the changes so far because I love too many of these foods (giving up chocolate is NOT going to happen for me!) 

However, I am seriously considering if they might be impacting my body with inflammation and keeping me from flushing away the weight gain from the past year. (Read more about diet change experiences on this nonmedical website for cholinergic uticaria.)

Dietary Changes for cholinergic urticaria

Going gluten free is something that can also help to minimize inflammation. This is especially true if you are diagnosed with a hypothryoid disorder like Hashimoto’s.

In June 2017, I did a 5 day juice ‘fast’ and never added gluten back into my diet. Inflammation improved which resulted in my body shedding 21 pounds in 5 months with no other lifestyle changes. Sadly, it has not kept the hives away.  

6.Take Vitamin D daily and support thyroid function.

Both of these are suspected to have a role in cholinergic urticaria. 

Vitamin D was something I was already started to do as Alaskans tend to have low levels due to lack of sunlight for much of the year. The allergist said to take it year round rather than just in the summer.

My thyroid was tested by my general practitioner and fell within ‘normal’ range at the time of the allergist visit. Within 2 years, I was diagnosed with hypothyroid disorder and put onto Synthroid.

Working with a functional medicine professional, my suspicions that it is Hashimoto’s was confirmed. And, my Vitamin D levels were extremely low again. 

My regular physician put me onto high doses of Vitamin D to bring it up to the low end of the ‘normal’ range. However, I am working to boost it more since Vitamin D has a role in thyroid funtion. Once my current prescription runs out, I am switching to over the counter tablets with 5,000. Below is the product I elected to order after significant research.

 

I do still get as much natural sunlight as possible. Spending more time out of Alaska has helped me do that during the winter.

7. Improve Your Gut Health

This is not something the allergist spoke to me about. However, there is a lot of research which shows a tie between gut health and immune function. 

I thought I was eating a healthy diet, but testing showed an imbalance of gut flora for me. I am now using Seed’s Daily Synbiotic which contains both prebiotics and probiotics.

Seed Daily Synbiotic Welcome Pack

So, I am trudging along now and have added daily exercise back into my routine.  I have to modify the workouts done with my husband as my body had a real backslide this past year.

We are doing a new round of Beachbody’s P90X3 at the moment. And, I still get hives. But, I am more confident now knowing what the problem is and how to manage it.

 

Do you or someone in your life struggle with allergy issues?
Had you heard about someone being allergic to exercise before?
How do you overcome obstacles to fitting exercise into your day?

This post was originally published on Jan 6, 2015  and has since been updated.

21 Comments

  1. I am allergic to exercise as well. I use to run a couple of miles a week then all of a sudden one year I broke out in hives ALL over. It only happens when I exercise outside and I am running. If I exercise inside or am outside and sweating (not running) I am fine. It really is scary. Each time it happens the reaction gets worse. My last reaction involved puffy lips and my tongue felt thick with hives all over my body. I end up taking 2 Benadryl when this happens. It takes a good 3 hours to subside. Also, I notice my stomach cramps and feels nauseas before the hives begin. I’ve read taking histamines before exercise won’t prevent hives but it’s better than nothing. I do need to make an appt for an epi pen order. I live 30 minutes from the nearest hospital ?

  2. I have RA and stay away from the nightshade family (tomatoes, potatoes, eggplant) because they can aggravate my immune system. But luckily I have no allergies and I can swim 3 times a week.
    Some of my favorite fools are on that list so I know I’d have a hard time with that.

  3. wow, that’s incredible! When I exercise, I rash up, but I think my case is due to the fabrics rubbing since it tends to be only where my clothing is. Very interesting read – passing it on!

  4. I’d not heard of this before, but I was in the army with a guy who was allergic to the sun (but not albino). It is crazy. My wife and kids all struggle with various allergies and it makes me thankful that i’ve never had to deal with it personally.

  5. Wow. I had never heard of this before either so this was pretty mindblowing. So sorry you have to live with it. Thanks for the understanding.

  6. This is so interesting… I never heard of being allergic to exercise before! Thank you for sharing your story and how you manage it- AND good for you to keep pushing! I hope you update us on how you’re doing with your routine later this year!

  7. I have never ever heard of this. I always joke that I am allergic to exercise but wow… never thought it was real. I am so happy you are okay and coming up with a plan.

  8. I had never heard of this before. I definitely don’t like working out, but you have a legit excuse.

    1. Well, I’d rather know that it CAN go away than hear it is a permanent thing for the rest of my life. But, I totally agree that it stinks.

  9. Wow! I have never heard of that before. The hives look pretty bad. That sounds kind of terrible, I’m sorry you have to deal with it. While it’s good that it isn’t permanent, 5-7 years sounds like a long time. Hopefully you are able to continue to manage it and get back in your exercise routine. It seems like there are enough things to discourage an active lifestyle, it’s terrible that your body is preventing you from doing what you would like.

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