You really can be allergic to exercise

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Flushed skin. Heavy breathing. Profuse sweating.

These are all things that happen with intense exercise or an allergic reaction, but having an allergy to exercise? That’s just what people say to get out of a workout… or is it?

While it’s true that some people might fake a serious illness to get out of physical activity, there is just a thing as an exercise-induced allergy attack. And it’s no laughing matter.

“My eyes were watering, I was having trouble breathing,” Joe O’Leary told Popular Science of an allergic reaction he experienced during a post-workout meal in 2015. “In another five minutes I was struggling to breathe. I looked behind me into the mirror, and my eyes were swollen — every part of my face was swollen.”

He quickly sought medical attention and found that he has exercise-induced anaphylaxis, or a reaction that only happens when combined with exercise. In O’Leary’s case, he can experience a life-threatening reaction if he eats tomatoes, pepper, soy or nuts after a workout.

Exercise induced anaphylaxis is rare, but not uncommon

The good news? It only happens to about 50 out of every 100,000 people and it’s pretty easy for doctors to diagnose. The bad news: There’s no real explanation as to why it happens.

“There are a variety of things that it might be,” Maria Castells, an allergist at Brigham and Women’s Hospital told Popular Science. “And for a proportion it’s nothing, really, just the exercise itself.”

Food is the common trigger, but exercise-induced anaphylaxis can also be caused by weather conditions, hormones and medicines like ibuprofen and aspirin. Low-impact activities — like house cleaning and yoga — are as likely to trigger a reaction as high-intensity workouts, but fitter people typically need more exercise than an unfit person to have an attack.

You’ll be pretty aware of a reaction because symptoms — including hives, nausea, swelling, cramps, diarrhea, coughing and wheezing — come on strong and fast. And, like other allergic reactions, there’s a chance it could be fatal if not treated.

Treatment for exercise-induced anaphylaxis is usually administered via an EpiPen. It’s also a good idea to cut out triggers, too. O’Leary did: He no longer eats tomatoes or nuts at all — better safe than sorry.

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