EIA- Excercise Induced Asthma anyone? Question:

I'm 40 with a resting heart-rate of 60 beats/minute.  Does asthma influence my heart-rate during a cardio work out? If I run a modest 12 minute mile how fast should my heart rate be and what is too high or too low? Should I just slow down or stop entirely when I "hit that asthma wall", that is, I'm panting.

thanks for any input I can get, especially if you've been studying your own EID and how to work with it.  I haven't used my inhaler in a long time because I don't like that "rushy" feeling. 

Unfortunately there is no optimal heart rate that will necessarily avoid exercise-induced asthma (EIA). The narrowing of the respiratory tract during exercise is essentially due to a hyperactive set of muscles in the area and not how hard you are exercising.

The primary trigger for EIA is cold and dry air. Running on an indoor treadmill in the colder months, or running with a scarf over the mouth when outdoors can greatly reduce the chance of triggering asthma.

The challenge with asthma, as you know, is actually the breathing out and not the breathing in. It creates shallow breathing, hyper-ventilation and low blood pressure. So yes, you need to stop entirely when asthma hits and although you may not want to take your beta-agonist inhaler, it is actually dangerous not to do so.

However there are lots of alternatives to taking your current inhaler as it makes you feel buzzed. First, a very lengthy warm up can help avoid the trigger. This means about 20-30 minutes of moderate walking. It seems to help keep the airway staying moist and warm and it presumably acclimatizes the windpipe so that there isn't too much cold dry air hauled into the lungs all at once triggering EIA.

Another option is to use cortico-steroid inhalers more regularly and/or a long-acting beta-agonist that will not give you the buzzed feeling.

Until a few years ago, cortico-steroid inhalers were prescribed for severe asthmatics only. However, studies have shown that these anti-inflammatory inhalers treats the chronic bronchial inflammation effectively and because it is inhaled the steroid does not seem to spread systemically through the body (which is good).

Recently, allergists have done a complete 180 on the use of cortico-steroid inhalers because there is such good data showing it keeps your lungs healthier with less scarring and damage than just using beta-agonists when you need them.

In fact, there is evidence that treating asthma with cortico-steroid inhalers protects an asthmatic from developing emphysema and chronic obstructive pulmonary disease in later life.

The most common brand is Advair (US/Canada) and it combines fluticasone (cortico-steroid) and salmeterol (long-acting beta agonist). You can also get separate inhalers for the same drugs. And there are many other choices.

You may see literature that indicates salmeterol and Advair increase the risk of dying due to a severe asthma attack. The risk is very small, but it does exist. So, depending on what you and your health professionals discuss and decide, you may decide to use just a cortico-steroid inhaler.

As far as I can tell from what you have said, you will likely not need a very high dose at all of cortico-steroid and/or long-acting beta-agonist. You may take one inhalation every two days or so or maybe once a day and this will eradicate any EIA or any other forms of asthma you may get from time to time.

Given that the treatment of asthma has changed radically for the better in the past 5-7 years, I would really recommend you see an allergist to reconsider what pharmacotherapy is best suited to your needs.

Asthma-related deaths peaked in 1996 in the US. Since the introduction of salmeterol, it has declined about 25%. More women than men have fatal asthma attacks. If you have rhinitis (hay-fever like symptoms) and/or any nocturnal symptoms, then it is definitely a good idea to see an allergist.

Your resting heart rate indicates an active and healthy woman so by better controlling your asthma now, not only will you be able to maximize your aerobic activities, but you will also prevent damage to your lungs which may worsen in later life.

Sorry for the rather clinical response but I hope it helps.

I've got mild exercise-induced asthma as well.  I'm currently not using anything for it.  The main trigger is running - that's really the only exercise that gets me out of breath enough to trigger wheezing.  I do get short of breath with other strenuous activities before my body is really struggling (for example, hiking - have to pause to breathe although my legs are fine).

You stated that your asthma wall is "panting" - there is a difference between panting (normal shortness of breath from exercise) and wheezing (truly struggling to breathe because your airway is contstricted).  You need to figure out what your wall is and stop before/when you ge tthere.  I would also second hedgren's recommendation of seeing an allergy/asthma doc.  I used to take an inhaler about 30 mins before working out instead of waiting for there to be a problem. 

I have noticed that my asthma is less noticeable when I have better lung function - i.e. I'm in better shape.  Swimming really helped improve this for me several years ago, although I haven't been doing much of it lately.  Hope you can figure out some ways to help or inhaler alternatives!

I have had regular asthma for years, which is occasionally triggered by exercise. I have been doing Jillian Michaels 30 day shred and the first 3 or 4 times, I ended the session with an asthma attack each time. And then as I became more accustomed to it, the attacks lessened and then stopped.

I'm now on level 2 and they're back again, but I feel confident the same thing will happen, and after a few days I won't be having them anymore.

I don't slow down or stop, but it's because I know my limits. I don't use my inhaler, unless I have an underlying reason for the attack besides the exercise (such as a chest cold). When I rest, if I feel that it's getting worse rather than lessening, I take it, of course.

I would say to challenge your asthma, but safely. Do so with a friend around if you prefer, and listen to your body! Know when to stop.

Really great information and advice, everyone.  It has been suggested that I try Advair but I'm just afraid that I'll get dependent on yet another product. 

I guess I just need to keep at it and build up my endurance.  It's just so frustrating when I feel like I can run like the wind one day and the next day or two be wheezing from carrying a 10 pound back-pack up hill.  It does feel like fitness doesn't seem to "translate".  In the gym, where it's all moist and warm, I do just fine but then I try something else that I haven't done in a while, like hiking up hill with weight, and the harder I breath, of course, the harder it makes me breath, then the harder it makes me breath etc.  Thanks so much for the advice, just when I think I'm in great shape I'm baffled.

You are in great shape -- I know the shortness of breath feels like you are not, but it's completely unrelated to what your cardio-vascular strength is actually capable of doing.

While I understand the concern about being dependent on prescription drugs, think about weighing it up against the damage that every asthma attack does to your lungs -- it scars them and can lead to COPD and emphysema in later life.

The advantage of a cortico-steroid inhaler is that the cost/benefits of using that kind of prescription as about as good as it gets in favor of benefits. While cortico-steroid pills and creams enter the entire system and can cause osteoporosis over a lifetime of use, the inhaler has been shown to work in the bronchial tubes and doesn't seem to enter the rest of the blood stream in appreciable amounts. But you are right, every drug has a cost (by that I mean possible side-effects and such) that must be weighed up against its benefits.

Exercise is a fabulous way to maximize lung capacity and the ability of your body to pull oxygen into the blood stream (for asthmatics and non-asthmatics alike) but it does not take away the damage of either the chronic or acute bouts of inflammation that cause asthma attacks.

There is unfortunately data that show a patient with asthma where the asthma is not well-controlled (i.e. occasional attacks); where the patient also has occasional nocturnal symptoms of asthma; and where the patient may also have rhinitis; then the risk of dying from all causes including an asthma attack are significantly higher than patients with well-controlled asthma (i.e. no attacks, regular medication).

I don't want to scare everyone because it is very specific to each case of asthma and it's best to discuss it with your allergist/physician and then weigh up what you think is the best course of action for you.

Again, best of luck to all the asthmatic posters on this thread and great to see so many unhindered and active asthmatics getting out there!

Thank you for all of the great information!