Asthma and VO2 Max Sessions

I have full on asthma and find that VO2 max WOs are a bitch but the sweet spot WOs are fine. Anyone else with asthma experiencing the same? I am taking my inhaler on a regular basis.

Do you use a preventive maintenance product such as Advair or just a rescue inhaler? I find that if I use Advair I never have the need for the inhaler. If I go off of the Advair I use the rescue puffer often.

I have a friend that is also a TR guy. We ride and race together. He also has Asthma. Before going on something like Advair there were times he struggled to finish a race. Now that he has a better program for the Asthma I can never catch him. I can’t even keep up with him. This may or may not help you but it is worth a try.

2 Likes

Asthmatic here :raised_hand: And I love these questions

Yup and you should note that (I’m assuming you’re using advair at least once everyday) advair is part “rescue inhaler” in that if you use it in the morning er prior to any workout, it acts as a longer duration but lower strength rescue inhaler dosage :ok_hand:

As you know (I’m going to use Ventolin as the rescue inhaler example going forward) Ventolin, if there are active symptoms should be taken every 4-6 hours.

Whether taking Advair or ventolin, obviously prior to workout, aim to take it 15-20 min prior to the start of your workout.

Relayed from conversations with my allergist (cyclist and TR user :joy:): Beta 2 agonist (rescue inhalers) reach peak performance around 40min after administered and start to taper off after 60min and eventually patients can experience symptoms getting towards the 4 hour mark. If you are an asthmatic you should know this if you want to help yourself be on the same playing field as the other competitors. And also to get the most of every workout the same way it’s suggested to come into a workout “carbed up.”

Also it is impossible to dope with a beta 2 agonist. Once you reach a certain level which is practically 2-4 pumps any more can’t help you “be faster.” And obviously if you aren’t asthmatic it’s impossible to reap any benefit from the drug. All it’s doing is helping you get level or somewhere close to that of a non-asthmatic.

I don’t know what your symptoms are but what I would suggest @oschweidler would be to start the workout with a 5% decrease just for the Vo2 Workout. I know exactly what you’re talking about though with SS being the easiest thing on earth, this would be typical for an asthmatic. A 5% decrease won’t completely alter the workout’s goal adaptations and hopefully will help you have a more “successful” workout. Also (I’m not one to say) but if you are relatively new to TR it could be harder to do the structured Vo2 with asthma. I’ve seen them get “easier” (over the course of a year) just because my heart has been able to keep up better which I guess keeps the respiration rate lower. Lastly, take the recovery valleys super serious, like exhale from the mouth with light effort (described in workout text a lot of the time).

Also if you are competing for a podium of prestige, be IRONMAN, USAT or USAC nationals of sorts, ITU, UCI (duh lol), etc. highly recommend filing for a TUE. It’s a stupid process with outdated material, I’m not competing at national podium level but prior to doing an IRONMAN a couple years back I had to submit for one (and for other drugs for medical conditions)… Basically they told me that I have to submit and did the right thing but since your race result isn’t going affect anyone you don’t receive an actual TUE.

Let me know if you have any more info or questions, glad to help :call_me_hand:
PS sorry for the long blabber, but I really love spilling over whatever knowledge I’ve got on this subject that affects me as well.

5 Likes

I use my QVAIR twice a day and then my rescue inhaler before races, hard workouts, and well everything else when needed. It’s the worst. If I get a cold, chances are I’m going to worthless for a week because my lungs just can’t recover and get full of crap. Restless nights, coughing, can’t sleep. Sigh.
The QVAIR I think helps. My first major issue with it, my doc put me on prednisone and that worked very fast. But, again, get a cold, get sick. Can’t train. I think the QVAIR is helping.
But yeah, just the other day, did some vo2 and started to feel like I was suffocating, tried to control the breathing, and made it through. The hardest thing for me is sometimes when racing, putting my nose in the wind, especially during a headwind and I have a lot of trouble trying to breathe.

2 Likes

Great Answers from above. Fellow Asthma suffer here and the higher the intensity the worse my asthma is. Long easy efforts no problems. Use advair and rescue inhaler. In my case I can not exhale as fast as “normal.”

2 Likes

Now I’m curious about advair over my qvar. But, I’ll go with what my doctor prescribes. The other main thing for me is, I try and avoid super cold rides, or at least ride with a buff to cover my mouth. That’s usually what gets me sick and off the bike for a week. A hard cold ride, and my symptoms will be through the roof and back to square one. Sucks.
We have a crit this weekend on a track I do well, but weather is sub 50. So, play it by ear.

Depending on your symptoms, you might find an acapella device beneficial. http://www.acapella-pep.com. It is particularly helpful if mucous production and secretions are a problem. Using it twice daily helps with mucous clearance.

1 Like

Interesting. Thanks for that @Schmedlapp. When my symptoms are bad, my lungs are just full of crap and breathing issues/wheezing is prevalent.

Personally when I was diagnosed, initially was given Qvar and looked for second (and third) opinions. Was placed on advair and made a ton of progress (unconscious in an ambulance to IRONMAN).

Here’s a link to a comparison chart that I believe is pretty accurate.

Exactly what I do, although I live in Florida so we get rare cold days, but is fun to bring out the winter gear and ride. Like someone is trying to chat with me but my mouth is covered lol.

1 Like

Thanks for the info @moshecattan.

1 Like

How do you guys deal with asthma symptoms in the days after a hard race or really tough workout?

I did a cold gravel race two weekends ago, and my lungs weren’t right until the following Thursday. Had to take an unplanned recovery week because anything above aerobic endurance wasn’t happening. My doctor has me on singulair and symbicort. Also use the rescue inhaler, but I’ve never found that it does much.

The Qvar is what saves me. Had two issues last summer, one during an A race weekend that I had to bail on. Just have to deal w it it. Sucks.

Bringing this back:
Just real quick: diagnosed with exercise induced asthma about a year and a half ago. I have my rescue inhaler I use twice before hard training efforts and races. Well, last summer I got pretty sick - as in, I couldn’t breathe, hard to sleep without coughing for hours. Doc gives me some prednisone. Life is good. Got sick again. Gave me a QVAR inhaler. Been using that pretty religiously and the rescue.
I’m doing mitchell right now and for the life of me cannot breathe towards the end of these intervals. I actually stopped after my third set to type this up. I even took some nasal spray to help, but not sure if that’s working. It’s never been this bad.
Is there anything else I can look into? I’ve heard going to a chiro can help with this and sometimes make the symptoms go away.
some other details: 37, pretty fit, racing mtb/cx/road for a while, lactate hearth rate according to training peaks is like 187.
Also sometimes during a race, if I put my nose in the wind it is so hard to breathe, like I’m suffocating. This is new. I can’t put the fan in my face. It’s too much.
Anyone else with this or is this normal?

Suffering from the same symptoms like being unable to breath at efforts at threshold. Been popping salbutamol pills to open up my airway and it did helped. Not sure whether that’s the best course of action. Going for an x-ray in a few hours time to see what is wrong. Inhaler doesn’t work and I have been having post nasal drip for close to a month. Poor sleep from coughing at night.

2 Likes

Good luck. The qvar has helped me w sleeping at night but i hate having to rely on it. Some had mentioned advair and I may talk to my doc about it. I’ll have to schedule an appointment because this week has been ridiculous.

1 Like

Another asthma sufferer here. I recently had Fostair (100 micrograms of beclometasone dipropionate and 6 micrograms of formoterol fumarate dihydrate) added to my asthma management plan by my COPD nurse and this seems to be helping with the recurring symptoms which had me reaching for the salbutamol everyday. Cold air is huge trigger for me so I try and avoid outdoor rides or races when the temperature drops under 5C.

During training I’ve found, anecdotally at least, that my lungs always seem to give up before my legs. When I lower my cadence to around 80 or lower, my RPE and heart rate drop and I tend to be able to hold threshold levels more consistently Even VO2 Max seems more manageable at lower cadences but I tend to try and raise it as fatigue sets in during the latter intervals.

I compete in TT’s so can employ the same cadence tactic for races but appreciate this might be harder to do for more surgey events.

2 Likes

i have exactly the same issue as you and i realise i can complete the workouts you mentioned when i drop my cadence to 80 as well. also trying to raise the cadence a bit higher so my legs don’t fatigue. i am able to complete the O/U that i have been failing since base phase.

is there any long term side effects of taking salbutamol? i won’t be in any uci race so i don’t think i will flout any rules if i use it when i ride outdoors.

I’m not sure about the long term effects but looking at www.globaldro.com inhalation of Salbutamol is “conditionally” allowed by the UCI up to 1600 micrograms over 24 hours in doses that don’t exceed 800 micrograms over 12 hours starting from any dose. I believe (I’m not a doctor!) this is purely a health limit rather than any performance enhancing effect. For my inhaler 1600 micrograms would be 16 puffs which I have never got anywhere near in a day!

i normally take the pills and anything above 3 a day, i can feel my heart racing esp if i take caffeine at the same time. so i am rather cautious about it.

I believe that in ‘systemic’ doses, Salbutamol can be performance enhancing which is why oral ingestion of salbutamol is banned by WADA in any dose.

The 1600 micrograms ‘limit’ is to allow use of inhalers which only act locally.

Mike

1 Like