Asthma and running long distances

[Loverunnin]

I was diagnosed with asthma in Dec 2024,but had symptons for quite a while which gradually worsened. I am an ultra runner and it now seems a battle to get back into training after a couple of bad attacks. I now have an horrendous cold which is affecting my breathing,my pace is slipping madly and I may as well be walking at times! I have already had to cancel Howarth hobble, a 32 mile fell race in march as I know I haven't trained enough..but desperate not to have to cancel Hadrian's wall 70 miler in June. Any advice/experience on how to heal myself/help myself would be amazing. Ironically once I am up and running any asthma issues seem to lessen...I just need to get back to running regularly without killing myself! Currently taking fostair 2 puffs 3x a day. Thank you all x

[Patk1]

I'd take it easy til yr over yr cold and breathing probs.maybe go for walks,and concentrate on breathing till u feel better

[Loverunnin in reply to Patk1]

Thank you x

[Loverunnin in reply to Patk1]

Thank you x

[PW_R]

you probably have influenza a which is rife at the moment. Cold air can be very bad for asthma. I was a massive sea swimmer up until a year ago and now I can barely walk upstairs without being out of breath. Still don’t have a definitive diagnosis - I hate lung disease!

[runcyclexcski]

I could write pages on this, so will try to be brief (which clearly did not work, LOL).

I think the key step is to find a lung doctor who understands endurance athletes. I highly recommend Dr Neal Martin in Leicester Spire; he took me in as a private patient when I lived in the UK, and he has an NHS affiliation as well. He can probably recommend someone in your area as well.

Another key thing is not to stop taking the steroid inhaler once you start feeling better (which you hopefully will). I returned to doing marathons after 4-5 years of being on a steroid inhaler, Xolair and desensitization shots, but then stupidly stopped. The asthma came back with vengeance and I am still struggling to bring it under control.

Asthma is very common among endurance athletes, and ultra-running is prob the worst possible activity for it, a close second behind nordic ski racing. 25-50% elite nordic skiers have asthma, so you are not alone, and there is hope. The current biathlon world cup leader (Sturla Holm Lægreid) has asthma.

Feeling better while running is normal: hormones suppress the airway response during the exercise, and once the exercise stops and the horomes wear away, the attack hits (usually 5-10 min after the stop). If this is what you experience, it could be exercise-induced asthma (EIA), there are many papers on google scholar on it. Running with a heat-exchanger mask (if cold air is a trigger) may help (google LungPlus). You can also breathe through a scarf or a P2 mask whlie running, but expect the breathing to be restricted and performance to drop at least 25%. LungPlus is not restrictive to breathing, but offers no air purification.

You may have to put your racing schedule on hold before you get the asthma under control and learn your body. I initially ignored mine for 2 years and was hoping to run through it, and it was a bad idea.

Breathing warm, humid, clean air during exercise is generally better for asthma than breathing cold, dry and polluted air. In the winter, any air is "dry" by definition (even if it's 0C and raining outside), and wood smoke people use to warm their houses makes it worse. Thus. in the winter, I train at home on a Zwift bike breathing humidified air (90%) which I warm to 37C and HEPA-purify. This is the only way I can push myself to wattage I could do before the asthma. When I need my nordic skiing high, I do it at a local 1000m-high hill where the air is cleaner (verified that with a laser counter).

Based on personal experience, I would highly recommend carrrying your rescue inhaler with you during your long-distance excurions, carrying a charged cell phone, and letting friends know where exactly you are headed. It sucks to be lying on the ground in fetal position 10 km from nearest civilization. My wife had to rescue me several times from this. I also carry an epinephrin shot pen (Epipen) which I learned from scientidic papers. The latter may be controversial; ask your doctor.

You will need to learn your triggers (other than running, if they exist). Mine are pollen, dust and air pollution, so I am stuck with running in a respirator mask in the summer. Did several races in it; it slowed my down by 25%, but it was better than not running.

I used to do 50K nordic ski marathons at -15C competitively, before I developed asthma 20 years ago. The asthma developed following a glorious season when I qualified for an elite team in nordic skiing, but then had viral pneumonia.

Here are two reviews for EIA, one is old and more practical, another one is newer. PDFs are obtainable.

tandfonline.com/doi/abs/10....

bjsm.bmj.com/content/46/7/4...

[Loverunnin in reply to runcyclexcski]

Thank you so much that is so informative x

[Gareth57]

hi, I'm (possibly) just over the hill from you! I cycle when I can rather than run but I find keeping fit and exercising as much as I can while I'm fit helps. I've not cancelled anything so far this year but my first event is still 3 months away.

[Loverunnin in reply to Gareth57]

I do love cycling and swimming so will prob change over to more of that next year

[Gwalltarian]

Boost your immune system by taking Vitamin D3 daily - 4000 iu is the suggested max, you could try tablets at a lesser amount - someone in this site said they take 2000 iu daily to maintain an effective level if D3 in the blood. There are blood tests for all vitamins and minerals it seems. I have seen comments on taking high levels of vitamin C too. For the last few years I’d get colds that would become chest infections I couldn’t get rid of without antibiotics but last May it occurred to me to take a tonic, I tried Ferroglobin Plus and literally overnight the infection disappeared and I haven’t had one since.

It’s advisable to take a puff of your relief inhaler - ventolin or salbutamol - before you exercise, that should help. If you haven’t been prescribed one then you could phone the number on this site and get some advice on what to use as a relief inhaler. It might be that a dose of fostair before exercise might help. Have you explauned your problem to your GP?

[Loverunnin in reply to Gwalltarian]

Thank you so much that is really helpful, dr says ok to run etc as doesn't appear to be a trigger which is good, just need to get myself fitter to run again. Will have a look at fereoglobin plus as well x

[Patk1 in reply to Gwalltarian]

0300 222 5800

[Lysistrata Administrator Community Ambassador in reply to Gwalltarian]

Just to add for information - the max recommended dose of Vitamin C is 2000 mg/day - more info here for anyone looking to take this. nhs.uk/conditions/vitamins-...

[Homely2 Administrator]

I am working on getting back into fell walking and orienteering after my Asthma went out of control four years or so ago.

I am getting there, albeit with setbacks, and not to the same level. My issue is that as well as actual asthma attacks when doing things, I cannot achieve much of a training regime, so have lost some basic conditioning.

Things that are key to me are

1. Being on the correct meds. In the autumn they tried to reduce my meds, three courses of pred later, my Asthma has stabilised again. You need to find what meds are right for you.

2. Spending time with a respiratory physio, particularly learning how to breathe when things are not so good. So pursed lip breathing etc. I still have to stop temporarily when I get deeply out of breath, which is irritating, I cannot just battle through it by slowing down, I have to stop and recover.

3. Going at a pace that suits my Asthma. If I try to keep up with a group or push, it goes wrong. It is very different, in the past, it was good to be tough, now toughing it out is bad.

4.Always carry my full meds and extra clothes with me. Taking a rucksack doing an orienteering race is unusual but for me is needed.

Good luck with it and do not push it. Do easy beginner type courses and ease yourself back into it.

[Loverunnin in reply to Homely2]

Thank you really appreciate your advice, think will build uo from walking to run walking and will continue with jeffing for ultra as it is easier on my body x