How simply taking exercise can trigger a deadly reaction

The trip to the Cheshire beauty spot was supposed to be the perfect summer outing.

But shortly after setting out on the moderately challenging walk around Alderley Edge with her husband, Lauren Layfield felt her legs start to ‘itch like crazy’.

In a matter of minutes, the feeling was so unbearable that the 34-year-old Capital radio host had to stop where she was, in a vacant lot, rip off her jeans and helplessly scratch her stinging limbs.

The problem wasn’t the usual rural hazards like nettle stings or insect bites: the extreme itching had been triggered by the sheer exertion of walking.

The cause, a little-known condition known as exercise-induced urticaria (or cholinergic urticaria), is surprisingly common. It affects one person in 2,000, that is, about 33,000 Britons. While anyone can develop it, it’s more likely if you also have eczema, asthma, or other allergies.

Even mild exercise can cause raised lumps and blotchy, red, and severely itchy skin. Symptoms usually go away 15 to 30 minutes after stopping exercise.

“It was horrible, I had to strip naked because my legs felt like they were on fire,” recalls Lauren, who also reports for The One Show on BBC1 and lives in London with her husband Luke Beddows, 34, a comedy writer.

How simply taking exercise can trigger a deadly reaction

Shortly after setting out on the moderately challenging walk around Alderley Edge with her husband, Lauren Layfield felt her legs start to ‘itch like crazy’. In a matter of minutes, the feeling was so unbearable that the 34-year-old Radio Capital announcer had to stop where she was, in an open field, rip off her jeans and helplessly scratch her stabbing limbs.

I was scratching like crazy. I had to sit there until the itching subsided and then go back to the car at a crawl to prevent it from happening again.

This was not the first such attack for Lauren, but it was the most serious.

He began experiencing symptoms in his late teens. “If I would go camping with friends or go for a walk, I would notice that my upper legs would start to feel itchy and the skin would look red and blotchy,” she says.

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‘It didn’t matter what I was wearing, it would just happen. I was at Lincoln University at the time, studying drama. Being a student, I didn’t exercise much, but I started to make the connection that when I did any type of exercise, itching and redness on my skin would occur.’

As with any allergic reaction, its trigger, exercise, causes the release of histamine and other chemical messengers.

These cause blood vessels to dilate (resulting in red or pink skin) and leak (causing swelling and itching).

“Our skin cells called mast cells contain histamine, and in people with cholinergic urticaria, exercise can make them ‘overactive,'” explains Dr Sophie Farooque, allergy consultant at Imperial College Healthcare NHS Trust and author of Understanding Allergy.

Other factors such as heat, UV rays from the sun, and sweat can also play a role. In some cases, it is the combination of exercise and a certain food that triggers the reaction, called food-dependent exercise-induced anaphylaxis.

“Some people with certain food allergies may only experience a reaction when they exercise,” explains Dr. Farooque. “Exercise can be very light, like going for a walk or running to catch a train, and people can react up to four hours after eating or sometimes longer.”

Foods often implicated in food-dependent exercise-induced anaphylaxis are wheat and shellfish.

He began experiencing symptoms in his late teens. “If I would go camping with friends or go for a walk, I would notice that my upper legs would start to feel itchy and the skin would look red and blotchy,” she says. A stock photo is used above

But since the reaction can occur hours after exercise and eating, it can be difficult to pinpoint which food is to blame.

Doctors believe the condition occurs because when we exercise, our cardiovascular system redistributes blood to working muscles and sends less to other areas, such as the gut.

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“This slows down digestion and the food stays in the gut longer, allowing for more absorption of the food the person is allergic to, and this triggers a reaction,” says Dr. Farooque.

Over time, Lauren’s condition worsened and itching spread to her stomach, chest, and neck during exercise.

At the age of 26, unable even to run to the bus to get to her job (at the BBC’s Media City in Manchester) for fear of a seizure, Lauren decided to see a doctor.

“The itching was absolutely maddening,” she says. ‘My skin was red and blotchy, but it was the urge to scratch that drove me absolutely crazy.

‘This happened every day. It really started to affect my life. I didn’t do any exercise, except for a little weightlifting at the gym.

‘And I stopped wearing certain clothes, like skinny jeans, because it made things worse. Every day she used to think, “how am I going to plan my day to prevent these flare-ups from happening?” ‘

Her GP was puzzled and referred Lauren to an allergist, who diagnosed her on the spot.

“I laughed when they told me,” he remembers. I knew my skin was reacting to physical activity, but I never realized it was a real thing.

‘It sounded ridiculous. However, I was also relieved that I wasn’t imagining it.

To confirm the diagnosis, Lauren took a blood test and ran around the hospital parking lot and up and down the stairs to see what was wrong with her skin.

After ten minutes, not only was her body covered in spots, but her pupils were dilated, an early sign of anaphylaxis, a severe allergic reaction that causes the immune system to release a flood of chemicals that can cause a sudden drop in blood pressure and blockage. of the airways, making it difficult to breathe.

People with cholinergic urticaria who continue to be physically active without taking antihistamines are at risk for this potentially fatal complication. “I realized for the first time that this condition had the ability to be quite dangerous if not managed properly,” says Lauren. It was terrifying.

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Managing cholinergic urticaria includes taking antihistamines regularly, or at least an hour before exercise to prevent a reaction, Dr. Farooque says, and if a rash develops, those affected should stop exercising immediately. For some, stopping exercise or exercising in a cooler part of the day will be enough to reduce or stop symptoms.

Lauren now takes strong antihistamines and carries an EpiPen in case of a severe allergic reaction. She hasn’t had to use it yet.

With this regimen, Lauren is able to control her condition, although she avoids running, playing sports, or walking too fast for fear of an attack. There are many things that Lauren would love to do but she can’t because of her condition.

“I’m often asked to run the London Marathon and other races for charity and I’d love to say yes, but I can’t take any chances,” he says.

“I am grateful that I found a way to control the horrible itching and realize what I need to do to keep myself safe.”

mini muscle might

The tiny muscles that play important roles. This Week: Suprahyoid Muscles

The suprahyoid muscles are a group of four muscles under the tongue that pull the Adam’s apple up and forward during swallowing, closing the airway to prevent food and drink from entering, and open the muscle at the top of the esophagus to allow food and drink. in the stomach.

Muscles weaken with age (called presbyphagia), leading to swallowing difficulties that can put older people at risk for pneumonia. To keep them toned, speech-language therapist Elizabeth Boaden recommends the “resistance chin retraction” exercise. This involves placing a 5-inch diameter soft ball under your chin, holding it there, and repeatedly pressing down on your chin and releasing.

Elizabeth Boaden has created a set of courses on swallowing difficulties in myAko.online.

You can also ask your GP for a referral to a speech and language therapist.

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