AMGwagon

I have searched through threads with little luck, but I wanted to see what other people have done to help cope with asthma. I first felt the severe effects of asthma about 4yr ago, while ramping up my training for the NYC Marathon. I hate running, and got into it b/c I was limited on time as the kids were little. Long ago, I grew-up in Denver where I raced road as a jr and shortly while a senior Cat 3. Moved to NYC after college where I engaged in corporate slavery and would run + lift weights. I had a few spurts of getting back on a road bike with no perceived breathing issues, but only recently (last 4yrs) have I gotten back into structure and miles (<10K per year). So I have some background, and basis for knowing that asthma is killing my peak capacity. I ride and train far more than other guys and am just not able to get to "next level" like I used to (or these guys at similar age to me can do).

I have consulted with physician, but he is not a sports medicine specialist and is more apt to put me on drugs than to advise me on best approaches for sustainable sports-oriented goals. Aside from Froome or notable pros with questionable drug remedies, what successful approaches have folks used to counter-balance the effects of asthma?

TIA

pdlamb

Before I get too far, have you confirmed your asthma diagnosis? Are you following a structured training plan that was developed by, or reviewed by, a reputable coach?

Now on to internet doctoring and speculation.

If you can, you might consider moving someplace where the air is clean and you won't suffer allergies (if that's part of what's kicking off the asthma.)

If it's definitely asthma, your best answer is probably going to be drugs. (Or, as they say in the business, legitimate pharmaceuticals.) Perhaps your next step is to find a doctor in whom you trust, who can work with you to find the minimal regime that will allow you to train and race effectively.

Carbonfiberboy 

1) With what have you been diagnosed? Chronic asthma or exercise- induced asthma (EIA)?
2) Have you seen a pulmonologist? I realize that these are in short supply these days.
3) What did the the doctor you saw prescribe and what was their specialty?

My wife has had chronic asthma for the past 45 years. I had EIA but got rid of it. We both ride to our physical limits, no asthma issues.

Any suggestions depend on the answers to those questions.

canklecat

Lifelong issue, here -- asthma, allergies, chronic upper respiratory inflammation. Fortunately prescription meds and OTC supplements are better now. Back then all we had were epinephrine rescue inhalers, first generation antihistamines, and stuff like atropine.

For years I've used albuterol (not really effective for me), Flonase and switched between Zyrtec, Claritin and others. By autumn 2019 none of those were working anymore. I had to drop out of fast club rides because I couldn't breathe well enough to keep up. Constricted throat, wheezing, the works. Much worse in cold dry air, or when airborne allergies were bad. Which is pretty much always in Texas.

This year I've had a few appointments with an immunologist and ENT docs, despite the pandemic. Yeah, took a bit longer to get in but they saw me.

Currently I'm taking:
Asmanex (mometasone) as a preventive. Very effective if I remember to take it as directed.
Albuterol -- supposedly a rescue inhaler but it's never worked quickly for me. To me, waiting 15 minutes for effect is not a rescue inhaler. And it still barely works for me anyway. I use it at least once a day as a preventive, usually just before a bike ride or any outdoor activities. My immunologist doesn't want me to do that but it doesn't work for me as a rescue inhaler if I wait until the wheezing and constriction are bad.
Primatene Mist is still the most effective and fastest true rescue inhaler. Fortunately I haven't need it in years. It was unavailable for awhile but is now widely available as an OTC again, reportedly spurred by a couple of deaths of kids who might have lived if epinephrine inhalers had still been readily available.

Nasal:
Flonase (fluticasone) nasal inhaler.
Ipratropium bromide -- this is the stuff. Nothing else but Sudafed would relieve my chronic painful sinus congestion and inflammation. This does. I was wary of an anti-cholinergic inhaler 2-4 times a day, but it works so well I'm continuing to use it. It doesn't seem to have the same side effects as other anti-cholinergics that I used to take.

With those I've been able to cut back on the oral antihistamines. Xyzal has been the most effective, but Zyrtec still works for me. I don't need them every day now.

I still keep Sudafed (the real pseudo-ephedrine, not the useless OTC stuff -- phenylephrine, which is useful mostly in hemorrhoid ointments but not for nasal congestion). And Primatene tablets or generic ephedrine. I keep a couple of those in my saddle bag for emergencies. I may have needed those once or twice this year. I try to avoid these because they jack my heart rate and BP.

OTC supplements:
Bromelain works for some folks to relieve asthma and upper respiratory inflammation. It's just an enzyme from pineapple. Virtually no side effects. Worth a try.

Potassium nitrate -- found in toothpaste for sensitive teeth, also a traditional remedy for asthma. I'm not sure there's enough in toothpaste to help with asthma but I use it every day anyway.

Last month my ENT doc suggested bee propolis. That really raised my BS caution flags. But I tried it anyway. Darned stuff does seem to help. I've heard locally sourced honey is supposedly good as well, although I can't say I've noticed any benefits from local honey. But the propolis is worth a try. I just ordered some off Amazon but may try a local source next time.