Same here. I've been running 50+ years, logged over 105,000 miles, and last year suddenly developed asthma-like conditions that had severe impacts on my running & my life. A rescue inhaler proved insufficient and I had to go to a long term inhaler to get it under control.
I'd had tough cases of both COVID and RSV with a few months and assumed that was the cause, but now I'm not so sure.
I've run very near olympic qualifying times and never used an inhaler or checked to see if I have asthma. Maybe I should get an inhaler to get me that last couple percentage points faster and be an olympian.
Hard exercise increasing exercise induced asthma makes sense in the context of my family. We’ve never had anyone take it as part of training or regularly before races, but we’d always have it around just in case. Asthma attacks for us almost always happen around the hardest bouts of exercise, such as reaching the top of a big hill on a bike ride.
I hate bro science as much as the next person, but in my anecdotal experience, running 6 months of the year in below freezing weather plus running through agricultural areas with high pollen has definitely accelerated my asthma. Covid didn’t help either. The joys of living in the upper Midwest…
You still need a TUE for the good stuff. That's where being an "asthmatic" comes in handy.
You start prescribing kids with salbutamol inhalers and when they're elites, they have a "history" of being an "asthmatic" and TUE gets approved easily.
I've run very near olympic qualifying times and never used an inhaler or checked to see if I have asthma. Maybe I should get an inhaler to get me that last couple percentage points faster and be an olympian.
Do you think you've got asthma?
If you don't have asthma and you don't suffer from any airflow obstruction when exercising an inhaler won't give you any discernable advantage.
This Alex Hutchinson is becoming more and more pretentious. He's clearly looking for more readers at any price, often being controversial but just for the sake of it. He's most of the time against what evidence say, and in favor of what science is stating...
It's kind of interesting that asthma has only become a discernible issue amongst today's athletes. So many elites so sickly. It is easier to get an asthma prescription than many other drugs.
Maybe because about 10 people per day die of asthma in the US, more than 1000/day worldwide. I had a running friend that died of an attack, she was a beautiful and generous person, it was very shocking and sad.
Fortunately death rate is decreasing due to increased use of preventative corticosteroids inhalers (Alvesco, Pulmicort, Flovent etc). Many of these are pro-drugs that only activate when in contact with epithelial tissue, and don't hang around for days like injected triamcinolone (Wiggins flavor du jour) due to having a high first pass kidney clearance, so no, you're not going to get jacked on them. In general you should not have to resort to salbutamol/ventolin if your preventive inhaler is used according to guidelines.
btw - i'd say oxycontin is much easier to get than asthma meds, and overdoses are killing about 44 Americans per day, might be better to rail against that instead of inhaled asthma meds which WADA allows if dosages are to manufacturer spec.
This post was edited 3 minutes after it was posted.
I have had Exercise Induced Asthma since I started back running about 12 years ago. The funny thing is that it started out really bad, but as I got into my early and mid-sixties, it became much less of an issue. So much so, that I only need to do the inhaler before a really strenuous workout or race now.
I attribute that to the fact that with advancing age, I don't run as fast and consequently, there is less of a need since my lungs don't constrict nearly as much.
And yes, it is the cold and dry air that is the biggest antagonist.
I've seen hobby joggers take puffs before a race. if they have asthma, so be it, but if it's to get an edge in the local 5k -- kind of sad, although maybe not any different than them trying to improve through super shoes.
I've run very near olympic qualifying times and never used an inhaler or checked to see if I have asthma. Maybe I should get an inhaler to get me that last couple percentage points faster and be an olympian.
Do you think you've got asthma?
If you don't have asthma and you don't suffer from any airflow obstruction when exercising an inhaler won't give you any discernable advantage.
Have there been any studies to show how advantageous (or non-advantageous) it is for non-asthmatics? I am wondering how it came to be that a TUE is required if there is no competitive advantage for non-asthmatics.
It's kind of interesting that asthma has only become a discernible issue amongst today's athletes. So many elites so sickly. It is easier to get an asthma prescription than many other drugs.
Maybe because about 10 people per day die of asthma in the US, more than 1000/day worldwide. I had a running friend that died of an attack, she was a beautiful and generous person, it was very shocking and sad.
Fortunately death rate is decreasing due to increased use of preventative corticosteroids inhalers (Alvesco, Pulmicort, Flovent etc). Many of these are pro-drugs that only activate when in contact with epithelial tissue, and don't hang around for days like injected triamcinolone (Wiggins flavor du jour) due to having a high first pass kidney clearance, so no, you're not going to get jacked on them. In general you should not have to resort to salbutamol/ventolin if your preventive inhaler is used according to guidelines.
btw - i'd say oxycontin is much easier to get than asthma meds, and overdoses are killing about 44 Americans per day, might be better to rail against that instead of inhaled asthma meds which WADA allows if dosages are to manufacturer spec.
Is this a serious post? Oxycotin easier to get than ventolin?
Inhalers are stimulants and can be abused.
Ever noticed how some of these top athletes look bugged eyed? I wouldnt be surprised to see many, many athletes abusing inhalers.
And i'd agree with Armstrong here, when did people at the top end of endurance sports all the sudden have frequent onsets of asthmatic episodes? Explain how those two things can possibly correlate in the long run?
All the people i know and knew who were asthmatic were not/are not runners, and were constantly triggered by the slightest stress on the cardiovascular system.
Now there might be a lot of 'misdiagnosing' here, but just like thyroid meds, some of this is just plain ol training stress, not something requiring pharma intervention
When it comes to exercise-induced asthma, I always thought athletes were more likely to get diagnosed because they were more likely to notice something wrong. If you never exercise, you'll never bring on the symptoms, or if you do on the rare occasion, you'll just assume it's because you're out of shape.
I'd be curious to know if you can abuse basic inhalers so that they function as a performance enhancer rather than just a preventer of symptoms. I have had exercise-induced asthma since I was a little kid, always take 2 puffs of an albuterol inhaler prior to running. In my experience, if I accidentally miscount and take 3 puffs instead of 2 my breathing is way worse. No idea why, but that's my anecdotal experience.
If you don't have asthma and you don't suffer from any airflow obstruction when exercising an inhaler won't give you any discernable advantage.
Have there been any studies to show how advantageous (or non-advantageous) it is for non-asthmatics? I am wondering how it came to be that a TUE is required if there is no competitive advantage for non-asthmatics.
There is no advantage according to a Spirometry tech i talked to who provides test results to doctors. The protocol is: test a persons lung capacity, exhalation flow rate and gas exchange. Give the person a double dose of bronchodilator (usually Ventolin), wait 10-15 mins and retest. If there's no significant change there's no asthma, hence no advantage. He even said that since he knew he didn't have asthma, after cleaning the machine he retests it on himself by expecting his results to be the same before/after bronchodilator. Some Dr's may skip this protocol and prescribe inhalers to people anyway, just like they prescribe opioids and antibiotics for colds without due diligence.
I don't know if there are studies confirming this, and that's for max double dose, maybe taking illegal dosage has some advantage. Note that key measurements are not how much o2 you're getting in, rather, they are the max amount of air you can forcefully breath out, and how much you can breath out in the first second (FEV1), this should be >80%. You need to breath out to get rid of CO2, high CO2 levels (hypercapnia) can lead to organ failure and death. East Africans tend to have 10% less lung volume for same body height compared to Caucasian Europeans, hasn't hurt them. If you want to raise your Vo2 max for running you'd be far better off just training more effectively, reducing bodyfat to optimal values, get enough sleep and a diet that supports hemoglobin and recovery. Maybe buy some super shoes as well.
One crazy thing: in decades of following endurance sports, I never saw an athlete having to stop with an asthma attack that required emergency medication.
Maybe because about 10 people per day die of asthma in the US, more than 1000/day worldwide. I had a running friend that died of an attack, she was a beautiful and generous person, it was very shocking and sad.
Fortunately death rate is decreasing due to increased use of preventative corticosteroids inhalers (Alvesco, Pulmicort, Flovent etc). Many of these are pro-drugs that only activate when in contact with epithelial tissue, and don't hang around for days like injected triamcinolone (Wiggins flavor du jour) due to having a high first pass kidney clearance, so no, you're not going to get jacked on them. In general you should not have to resort to salbutamol/ventolin if your preventive inhaler is used according to guidelines.
btw - i'd say oxycontin is much easier to get than asthma meds, and overdoses are killing about 44 Americans per day, might be better to rail against that instead of inhaled asthma meds which WADA allows if dosages are to manufacturer spec.
Is this a serious post? Oxycotin easier to get than ventolin?
Inhalers are stimulants and can be abused.
Ever noticed how some of these top athletes look bugged eyed? I wouldnt be surprised to see many, many athletes abusing inhalers.
And i'd agree with Armstrong here, when did people at the top end of endurance sports all the sudden have frequent onsets of asthmatic episodes? Explain how those two things can possibly correlate in the long run?
All the people i know and knew who were asthmatic were not/are not runners, and were constantly triggered by the slightest stress on the cardiovascular system.
Now there might be a lot of 'misdiagnosing' here, but just like thyroid meds, some of this is just plain ol training stress, not something requiring pharma intervention
Yuup, serious post. Are you happy with over 110,000 deaths from Oxi in 2023, that's just USA, and just the people that died, that doesn't include those who abuse but have not (yet) died. It's not so hard to buy this stuff on the street, or talk an unscrupulous doctor or pharmacist into getting some. I've yet to hear of someone on the street or at a party saying "Psst, hey, ya wanna buy some ventolin, chix dig it.". That being said in Jr High we did have some nutbars who would strong arm inhalers from the resident wheezer and dare each other to puff until they passed out, but they definitely weren't on the track team. btw, opiates and painkillers are also abused by athletes to allow them to train harder or race without distraction of pain.
As for inhalers being abused, like any med, there's no doubt someone is taking a dosge beyond the prescribed limit, but will it help? According to the BMJ, there is no pulmonary limitation to aerobic performance, because when humans are exercising at the VO2 Max threshold (about 3k race pace) they can still breath much faster and inhale much more air then their body can use, it's easy, give it a try, just don't hyperventolate till you pass out. The limiting factor is cardiac output and muscle/mito efficiency, not how much air you breath. Maybe you have evidence inhalers are providing some other benefit? If so talk to WADA, not me, they allow most all asthma inhalers. Note that many of the same drugs in inhalers are NOT allowed as injectables, without a TUE, because they can result in systemic effects and the half life is about 5-10 times longer, and the effective systemic dosage is much much higher. That's the route Wiggins went, very suspicious because you would normally have to be carted off to ER in an ambulance before being prescribed an injection or high power steroids.
When did top athletes start having all this asthma? Good question, multiple reasons: part of the answer is that worldwide, rates in asthma have been soaring since1980s, no one knows exactly why. As for athletes having it more often, this is partly explained by the fact that until 1970s, and later 1990s, really effective treatment did not exist, and those that could have been successful athletes simply opted out. Ventolin really wasn't mainstream until 1970s, and became highly "abused" in the 1990s so, sorry Armstrong, that's not new. By abused, i mean they didn't initially didn't have to prove they had asthma, but now they require proof from spirometry testing. Like TUEs for thyroid meds or low T, that proof can be faked, and so can pissing into a cup with someone else's urine. Allergy based asthma is what the majority of most kids suffer from and was by far the most common asthma type, in adults, there are now over a dozen asthma phenotypes identified that require a perfect storm of environmental and epigenetic changes to trigger it and now we have new drugs invented that act as preventatives (not broncho dilators) allowing more people to safely get into athletics, so that's another reason why there's an increase of athletes with asthma. I'm only guessing, but training has changed a lot since 1990s, especially in cycling - a lot more high altitude training, which is a trigger, a lot more training volume, a lot more air pollution exposure, another trigger, the "Too clean hypothosis" - asthma is much lower in Amish and other farming communities because they are exposed to less clean environments as kids allowing their bodies to learn to adapt (this has somewhat been debunked or re-phrased), a lot more microplastics and forever chemicals in our body acting as hormone disrupters and immune system influencers. It's not just runners/cyclists, Hockey players are also prone to asthma due to the colder ice rink air coupled with stale air and exhaust fumes from zamboni's and other equipment. A lot more strains of viruses than years ago, we know elite athletes are often one bad sleep away from illness. During the H1N1 outbreak years ago, some patients with no family history of asthma never lost their wheezing/phlegm after recovery and became asthmatic. Here's some other comments on why:
To me, the point that is very concerning (if really true) is the following: "studies have found that athletes with EIB who somehow make it to the Olympics are more likely to medal."
Even if elite athletes are more likely to have asthma because they train harder, do we really believe that those on the podium train harder than those that get 5th place??
