I’ll get to the doctors next week and see what they say. Other than the fact that I never cough postnasal drip sounds about right. But then other than the fact that I don’t have an aching face chronic sinusitis sounds about right!
I saw an ENT some time ago and complained about the phlegmy/choking sensation while I run. She put me on a prescription acid reflux medication for 3 months and the problem went away. Of course it still happens when I’m congested. But it doesn’t happen when I’m not congested anymore.
My peak flow is between 380 - 410 recently. Just shy of half what an adult male should be able to produce 
What keeps me going is thinking about performances I could achieve if that were perhaps even 10% better.
Not yet! I remember being put off by some stories I read online.
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Yeah, the worst story is the “… and his brain was eaten by amoebas” one, but don’t despair. Just do the following:
- buy neti pot, salt packets, and one jug of distilled water
- heat 2 cups / 470ml of water in microwave until blood warm – when you put your finger in it, it shouldn’t feel warm or cold, just wet
- add salt packets (I usually use 2 for this much water) and stir until fully dissolved
- fill the pot, pour it through your nose, repeat for each nostril. Doing this without feeling like you’re drowning can be weird, at first, but there are plenty of youtube guides to help.
- For the love of God, when blowing the residual water out of your nose, blow super gently otherwise you’ll end up with snot-water in your ear canals
- Be sure to look up towards the ceiling and down to the floor, a few times, to ensure you got most of the water out of your sinuses
- when you get low on distilled water, boil a few liters in the kettle, then leave it overnight to cool. in the morning, pour it into the jug. Repeat as necessary.
The more you do this (and you can do it as many times a day as you want, without any ill effects) the better your sinuses should feel. Avoid doing it right before bed – give yourself 30 to 60 minutes for it to drain.
Good luck!
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Wasn’t it a pulmonologist, not an ENT? 
Please be careful with anything from this type of insitution. Their specialty is extracting money from vulnerable people and not providing evidence based care.
From their own website:
“All claims made regarding the efficacy of Lung Institute’s treatments as they pertain to pulmonary conditions are based solely on anecdotal support collected by Lung Institute. Individual conditions, treatment and outcomes may vary and are not necessarily indicative of future results. Testimonial participation is voluntary. Lung Institute does not pay for or script patient testimonials.”
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My guess is the GP won’t feel annoyed by talking to you. They may ask about coexisting conditions like gastroesophageal reflux and allergic rhinitis. Don’t be hesitant to go talk to them about it, I bet they will help!
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I totally agree with that, GP live to help … but when they are diagnosing stuff they are most likely to give the most likely diagnosis first , so doing things like keeping a illness\food\event diary might help … give them more information, if you can say. happened on the 8th, no sign of cold either side, didn’t have dairy … you will help them lots
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This. Simply cutting out milk has helped me significantly. I still indulge in cheese.
It sure sounds to me like the OP has exercise induced asthma. I would have it checked out. They can do a test to make sure if you insist.
It took me until I was 60 to realize I had asthma. Exercise really kicked it off. The things that have gone away since I started using simbicort and albuterol are interesting. There were times when I used to think I was bonking, but it actually was a low level asthma attack. Can’t burn fuel if you don’t have oxygen. And I suppose I thought it was normal to wheeze on a cold ride. The thing that really made me go see a doc about it was a severe attack on a hot mountain climb. It kept getting worse even after I got off my bike and stopped. I really thought I was going to pass out. Funny thing is I used to blame things like that (but not so severe) on inadequate training. But thinking back, I have had incidents like that when I was in really good shape.
I still have to use albuturol about a half hour into a VO2max ride or a sweet spot ride.
Yep. I’ve only been taking it about 6 weeks. At this point I plan to take it indefinitely, perhaps cycling off for a couple months in the fall/winter to evaluate if I still need it. It made me a little sleepy initially (nothing even close to something like benedryl as an example), but I’ve since taken it during the day and didn’t even notice.
My doctor offered me to trial either another inhaled corticosteroid or montelukast. She said that historically montelukast was seen more as a second line medication after trying the steroids, but more recently, studies are showing it has fewer and less severe side effects than earlier studies showed (which didn’t seem bad/risky to me), so it’s becoming a more common first-line medication.
For those who don’t think they could have asthma, I agree with what other people have said - if you feel like you have excess mucus/sputum during exercise and/or allergy season, get checked out just for peace of mind. I’ve never had an ‘asthma attack’, have never felt like I struggled to breath, have never needed an inhaler due to respiratory emergency. I always thought the shortness of breath and mucus/coughing at high intensity was ‘normal’. I wouldn’t have called what I have asthma, but medicine apparently does. It wasn’t until this medication started working that I realized my struggling wasn’t normal. Yes, everyone struggles during vo2 work, but my breathing was significantly limiting - I’d run out of air long before my muscles would start burning and fading - and I didn’t even realize it because it was all I knew. Now: the higher intensity stuff still hurts, but it hurts everywhere more evenly and I don’t spend large portions of the workout coughing and gagging on my own lung butter.
That sounds ridiculous. Are there scientific studies you can reference?
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Yeah all the studies I looked at specifically debunked this. there is no statistical significance to the theory that milk increases mucus. In fact, the only population that reported an increase in symptoms, were those who had identified with believing that milk caused mucus production.
In other words, according to the science, it’s all in your head.
EDIT: that’s not to say that increased symptoms aren’t happening to you, but they’re happening to you because you believe that they should happen to you. Classic nocebo effect.
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I’ve done some looking on this in the past as well and my take was that milk/dairy doesn’t increase mucus production, but the fat and proteins in dairy can increase mucus adhesion. So while you don’t increase production, what you do typically produce can become more sticky and harder for the body to clear (particularly in the mouth/throat/esophagus where physical contact occurs). Been a while since I looked into it, but definitely recall that the science shows higher mucus production caused by dairy is a myth. Just be careful not to confuse lack of higher mucus production with lack of negative effects dairy may cause.
edit: actually think it was sticky mucus back when I was in a sound booth that an audio engineer recommended sipping some apple juice to clear my throat. Definitely worked for me, and science backs it. Think they make throat lozenges with pectin now as well. Not for asthma – just for loosening mucus present in the esophageal tract.
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I’ve had asthma all my life and I’m sure its worse than yours. What you are describing during training is what I go thru many times–that my lungs are the first limiter for me.
You may want to try Sudafed–in many instances that has helped me with my breathing, expecially during allergy season when the pollens trigger my asthma, but you should know it can give you dry mouth. I don’t know where you live, but you and I should try riding together because I know what you are going through and struggle with the same thing.
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Been on the montelukast for a week now. Whether it was in my mind or not, I was starting to feel “drier” by Tuesday, and was actually being able to cough up a load of gunk. However… I note one of the side effects is “upper respiratory infections (very common)”, and I am now suffering from something quite nasty on my chest. 
Picked up a neti pot and have been using that for some relief from the snot.
It’s not about coughing.
I have exercise induced asthma and maybe just regular asthma (TBD) and yeah I cough, but during these hard efforts, racing, etc, I was feeling suffocated, shortness of breath, struggling. Thought it was normal. It’s not. I’m an inhaler twice a day and my rescue inhaler before races, hard rides, etc. It sucks.
I’m not even coughing during my racing or after. Well, after yeah. especially a crit.
I knew this topic would be in here somewhere. 
I wonder @downhiller did you get to the bottom of your issue?
I’ve just swallowed, spat, coughed and spluttered my way through a set of threshold intervals and thought “enough of this!” I wonder if there’s anything I can do. I’ve previously (2014) been tested for asthma and was at 70% capacity for my age or whatever. At the time I was given a prescription for salbutamol and some brown ‘preventer’ inhaler after an incident during a cold race, but I only carried the blue puffers during events and never really seemed to need them again (I have some still in boxes from 2016 - do they get better with age? :))
I guess the obvious answer is “go see your GP” which I’ll do but I also like to get some anecdotes and/or discussion going so I at least know something about what I’m asking.
For me, it seems my legs aren’t struggling, my HR is up but not crazy high and drops pretty well during the rest intervals but during the work blocks I’m constantly having to ‘swallow away’ gunk and/or clear my throat like some kind of smoker (I’m not a smoker). It’s not a digestive thing so far as I can tell - I can pretty much eat/drink anything and work pretty hard. My nose isn’t running. I don’t have a cold. I’ve never been an “asthmatic” save for that very cold race where I had some kind of breathing episode which prompted me to get tested.
Writing this it seems the next step is to go see GP again and see what they say but is there something I should be asking about? Like, what’s the difference between exercise-induced bronchoconstriction, or exercise-induced asthma and could I have either?
My Throat Tightens & Closes During Exercises | livestrong suggests it could simply be a lack of fitness, which I can live with but it seems at odds with the numbers I’m seeing.
I’m in London, riding inside with the window open and a fan running. Not generally that bad with hayfever although some years I’ve taken hayfever meds because it’s been bad. Pretty hit and miss though.
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I went through this too, especially as I began cycling and a bit recently as I have returned to the bike, slowly, after almost a year off. And I can remember as a kid this being an issue. Sticky, sticky phlegm that choked me.
My n+1 suggests that yes, overall relative fitness is a part of it. Two other things that anecdotally seems to help me is make sure to drink super cold water on the bike, make sure you have the indoor room as cool as possible with good fans, etc. As I said, anecdotal, but it seems to be that when I got a proper handle on cooling down my body, and keeping my mucus membranes moist the symptoms went away.
Also, I am less sure that the drinking through the day helps this specific symptom, but I tend to have very low BP and blood volume, especially after a while away from exercise and I notice I generally feel better when being mindful to top off.
Cheers. I can’t really do a lot more to cool my room but it is the UK so it’s not that hot and I do quite well in the heat generally. I have been adding ice cubes to my bottles but that’s just because it’s nicer to drink cooler drinks compared to room temperature drinks.
With my lifestyle I’m never really fit but I do ok and my FTP is basically where it has been ‘in season’ for the last 10 years. The only time I’ve really bumped it up was during COVID when I was doing HV + extra. Normally I ride ultradistance stuff so my threshold and VO2 suffers due to fatigue and not training at the higher end much. But basically I don’t see this being a lack of fitness thing given where I’m at.
That article is quite interesting and better defines things like asthma (which I don’t believe I have) versus exercise-induced bronchoconstriction (EIB) which sounds more like what I’ve experienced in the past and is perhaps the thing I’m getting now to a lesser extent.
I’ve got a blood test booked for other ailments soon so I might ask them about this at the same time.
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