How could simply exercising trigger a fatal reaction?

A trip to Cheshire’s beauty center was supposed to be the perfect summer vacation.

But shortly after she started a moderately strenuous hike on the Alderley Edge with her husband, Lauren Layfield felt her legs “itch like hell”.

Within minutes, the excitement was so unbearable that 34-year-old radio host Capital had to stand still in a field, tearing his jeans and scratching his painful limbs helplessly.

The problem wasn’t the usual rural hazards like stinging nettles or insect bites – the extreme itching was simply caused by the effort of walking.

The cause, a little-known condition known as exercise-induced urticaria (or cholinergic urticaria), is surprisingly common. About one in 2,000 people, or about 33,000 Britons, are affected. While anyone can get it, you’re more likely to have eczema, asthma, or other allergies.

Even light exertion can cause bumps and uneven, red and severely itchy skin. Symptoms usually disappear 15-30 minutes after stopping physical activity.

“It was so bad I had to take off my clothes because my legs burned,” recalls Lauren, who also covers BBC1’s The One Show and lives in London with her 34-year-old comedy writer husband Luke Beddows.

‘I was scratching like crazy. I had to sit there until the itching went away and then crawl back into the car at snail speed to prevent it from happening again.

This wasn’t Lauren’s first attack of this kind, but it was her most serious.

He started experiencing symptoms in late adolescence. “If I went camping or hiking with my friends, I would notice that my upper legs were itchy and my skin looked red and blotchy,” she says.

“It didn’t matter what I wore, it was just going to happen. I was studying acting at Lincoln University at the time. When I was a student, I didn’t exercise much, but I started to make the connection that if I did any exercise, my skin would become itchy and red.’

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

These cause dilation of blood vessels (causing a skin rash or redness) and leakage (causing swelling and itching).

Allergy counselor and Understanding at Imperial College Healthcare NHS Trust. Allergy’s author, Dr. “Our skin cells, called mast cells, contain histamine and can become ‘hyperactive’ with exercise in people with cholinergic urticaria,” explains Sophie Farooque.

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

“Some people with certain food allergies may only have a reaction when they exercise,” explains Dr. Faruk. “Exercise can be very light, such as walking or jogging on the train, and people may react up to four hours after a meal, or sometimes longer.”

Foods commonly involved in food-induced exercise-induced anaphylaxis are wheat and shellfish.

He started experiencing symptoms in late adolescence. “If I went camping or hiking with my friends, I would notice that my upper legs were itchy and my skin looked red and blotchy,” she says. A photo of the file was used above

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

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

“This slows down digestion and the food stays in the gut longer, allowing the person’s allergic food to be better absorbed, and this triggers a reaction,” says Dr. Faruk.

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

Lauren, 26, couldn’t even take the bus to work (at BBC Media City in Manchester) for fear of having a seizure, and Lauren decided to see a doctor.

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

“This happened every day. It really started to affect my life. I didn’t do any exercise other than lifting some weights in the gym.

“And because it got worse, I stopped wearing certain outfits like skinny jeans. Every day, ask, “How will I plan my day to prevent these flare-ups from happening?” I thought. ‘

Her primary care doctor was stunned and referred Lauren to an allergist, who diagnosed her right away.

“I had to laugh when I was told,” she recalls. “I knew my skin was responding to physical activity, but I never realized it was real.

“It looked ridiculous. But I was also relieved that I wasn’t just imagining it.

To confirm the diagnosis, Lauren took a blood test and walked around the hospital parking lot and up and down the stairs to see what had happened to her skin.

Ten minutes later, not only was his body covered in spots, but his pupils were dilated, the first sign of anaphylaxis, a severe allergic reaction that caused the immune system to release a flood of chemicals that could cause a sudden drop. and airway obstruction, making it difficult to breathe.

People with cholinergic urticaria who continue physical activity without taking antihistamines are at risk for this potentially fatal complication. “I realized for the first time that this condition can be quite dangerous if not treated properly,” Lauren says. “It was terrible.”

Dr. Farooque says treatment for cholinergic urticaria includes taking antihistamines regularly or at least one hour before exercise to prevent a reaction, and that if they develop a rash, those affected should stop exercising immediately. For some, taking a break or exercising during the cooler part of the day is 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, she.

This regimen allows Lauren to manage her condition, even if she avoids running, exercising, or walking too fast for fear of a seizure. There are many things Lauren would like to do but cannot do because of her condition.

“I’m often asked to run the London Marathon and other charity events and I want to say yes but I can’t risk it,” she says.

“I’m grateful that I found a way to control the dreaded itch and figure out what to do to stay safe.”

Maybe a mini muscle

Small muscles play an important role. This week: suprahyoid muscles

The suprahyoid muscles are four groups of muscles under the tongue that pull the Adam’s apple up and forward when swallowed – closing the airways to prevent food and drink from entering – and opening the muscle at the top of the tongue. drink to pass to allow the stomach to drink.

Muscles weaken with age (called presbyophagia), which causes difficulty swallowing and puts the elderly at risk for pneumonia. To keep them tight, speech therapist Elizabeth Boaden recommends the “chin against resistance” exercise. This involves placing a 12cm diameter soft ball under the chin, holding it still, and repeatedly pressing and releasing the chin.

Elizabeth Boaden has created a series of courses on swallowing problems at myAko.online.

You can also ask your doctor to refer you to a speech therapist.