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Even if you’ve never received a diagnosis of asthma, you may experience certain symptoms during exercise. How can you know whether the breathlessness you feel when you work out is typical or a sign of a bigger issue, such as exercise-induced asthma?

Your first step will likely be to consult a healthcare professional and share the symptoms you’re concerned about. They may then want to test you for exercise-induced asthma. Here’s what you can expect from the process, from testing to diagnosis.

Exercise-induced bronchoconstriction (EIB), or exercise-induced asthma, is not uncommon. It can be a concern for athletes at all levels, whether they have conventional asthma or not. Symptoms include tightness in the chest, difficulty breathing, and coughing while engaging in physical activity.

This narrowing of the airway during exercise can affect up to 90% of people with asthma and up to 20% of those without.

How do you know whether you have EIB or whether your symptoms are typical of someone at your level of cardiovascular fitness? Coughing is probably the biggest signal, as shortness of breath commonly occurs during or after strenuous exercise.

If you find yourself coughing during physical exertion, it may be a good idea to ask a healthcare professional about testing for exercise-induced asthma.

Diagnosing EIB can be tricky, and healthcare professionals often misdiagnose it when assessment is based solely on symptoms. A healthcare professional may use a variety of direct and indirect tests to determine a diagnosis.

Spirometry at rest

This test, which measures how much air your lungs take in and release and how quickly air can be forced out of your lungs, is often performed first to rule out underlying chronic asthma and get a baseline value for your respiration.

But the results will often be normal since the test is performed at rest. This test is useful in conjunction with tests for exercise conditions but is less accurate and useful for diagnosing EIB when used alone.

Exercise challenge testing

This testing method, which is a bronchial provocation test, involves exercising at various intensities in a controlled environment. Healthcare professionals measure your heart rate and respiration throughout, as well as during recovery, to assess working and resting ventilation.

Pulmonary function testing

This test, which healthcare professionals do not always perform, includes allergy testing to rule out possible airborne causes of a cough and any other respiratory symptoms.

You can prepare for testing by going to your appointment well rested, free of caffeine, and ready to exercise at a moderate to high intensity for a short time. Be sure to eat a meal 2 hours before your test. If you regularly take asthma medications, you’ll need to stop taking them at least 24 hours before testing.

On testing day, your doctor will likely start with spirometry to test your general lung function. After this, they will likely direct you to exercise at a moderate pace for up to 20 minutes while they measure your heart rate and respiration.

You’ll most likely have to wear a mouthpiece and a nose clip so that you breathe only from your mouth. They may also ask you to wear electrode stickers to measure your heart rate via electrocardiogram. Finally, you may wear a pulse oximeter on your finger to measure your blood oxygen levels.

The medical team administering the test will watch for coughing, wheezing, and other symptoms you may experience while exercising.

When you’ve finished the exercise portion of the test, they’ll observe your symptoms as you recover, noting which symptoms disappear and how quickly. Your doctor may give you a bronchodilator medication to see whether your symptoms and airflow improve.

Depending on the findings, your doctor may allow you to resume your usual activity level, perhaps with some modifications, or may prescribe medication or other treatment options.

If you receive a diagnosis of EIB, your treatment may include non-medication strategies to manage your symptoms, such as warming up for 15 minutes before exercise, using a face mask or scarf to warm the air you breathe, and avoiding pollutants.

If these approaches are not enough to manage EIB, healthcare professionals may prescribe a number of medications, such as short-acting beta-agonist medications like albuterol. They may also prescribe other medications for use at different points before or during exercise.

If you have chronic asthma and have received an EIB diagnosis, treatment options will likely focus on better managing the underlying asthma. Your treatment plan will be based on your individual needs and diagnosis, and your medical team will be the best resource to find out what that plan might entail.

Exercise-induced asthma is a real condition that healthcare professionals can test for and treat. The test itself is relatively straightforward and can help your medical team determine whether you’re a candidate for medication.

Knowing how to respond to your EIB can minimize or eliminate its effect on your fitness, comfort, and activity level. This condition is usually manageable, and testing and treatment can help you enjoy sports and activities for a long time to come.