Alex Hutchinson: Don't be alarmed so many Olympians take asthma meds - they need it as they train harder than you

Seems like if you’re fit and healthy you shouldn’t need an inhaler.

I had one as a kid. It may have increased performance as a bronchodilator, but at the end of the day I have no idea what I’m putting in my body so I gave it up.

I buy it.

I have had Exercise Induced Asthma since I started back running about 12 years ago. The funny thing is that it started out really bad, but as I got into my early and mid-sixties, it became much less of an issue. So much so, that I only need to do the inhaler before a really strenuous workout or race now.

I attribute that to the fact that with advancing age, I don't run as fast and consequently, there is less of a need since my lungs don't constrict nearly as much.

And yes, it is the cold and dry air that is the biggest antagonist.

Yes I do. Both the effects and the discovery of ailments from super high level training is quite huge. You don’t understand if you haven't trained at the elite level, like many views on this site.

Prolonged use of salbutamol has an anabolic effect. It's not going to get picked up by any study but it does make a difference. It's the kind of gray zone stuff that the Norwegians use.

THEY said I had asthma but looking back on it I think I was just out of shape

Asthma is almost 10 times more prevalent among amateur endurance athletes than the general population, this is backed up in numerous studies so do I think its also going to be more prevalent in a subset of those runners who are elite too, yes.

This is correct. And especially because repeated high strain of the lungs e.g. in very cold conditions can cause asthma. If you truly have it exercising at a high level without it is literally impossible. My husband is young and fit and has allergy caused asthma. If he wants to do a hard workout he literally needs his inhaler. A lung test has shown that without it he only has 75-80% of lung capacity. He literally sounds like he is asphyxiating trying to push the pace without his inhaler. Its seriously a limiting disease for an athlete. His e.g. Marathon PR is relatively speaking much much stronger than is 5k PR for that reason.

Thing is that in Pros judging how severe asthma is and which dose of inhalers puts them back to normal baseline is really hard to know. If someone is at 90% of lung capacity without it but takes two inhaler shots before competition and now they are at 110% capacity it would be indeed unfair.

The solution, as always, is to just let anyone who chooses to use an asthma inhaler use it. No TUEs. These arguments about medications are asinine.

You don't need a TUE for a salbutamol inhaler anymore anyway. There are only a couple of inhalers that you do need one for.

It is only "10x more prevalent" because athletes say they are asthmatic because - inhalers and medications are a stimulant. When I was a kid asthmatics were looked on sympathetically because they were weak. They weren't elite athletes.

This sounds like the same reason they also need anabolics and thyroid supplements. Because they train harder.

It's kind of interesting that asthma has only become a discernible issue amongst today's athletes. So many elites so sickly. It is easier to get an asthma prescription than many other drugs.

Look the asthma medicine lets them train harder and because they train harder they need the asthma medicine.

That sounds like a good argument for EPO.

Wouldn't the cold and dry air be the agonist and not the antagonist?

Exercise induced asthma is real so I'm not sure what the issue is. Plenty of top athletes have it.

I got an inhaler in high school because I kept hacking up a lung during cold outdoor training and racing. I also had a series of throat infections at the time. Doctor measured my lung output or whatever, I blew into a tube, and she was like, "Wow impressive lung capacity! Just to be safe, here's an albuterol inhaler, try it!" It made a huge difference.

I relied on it in college, especially breathing dusty, stale indoor air. I coughed up a bit of blood a few times from racing indoors. I don't train super hard indoors anymore, and I rarely rip super hard reps in the freezing cold, so I don't need it anymore.

I could never figure out why after 40+ yrs of running, I developed what my doc called “adult onset asthma.” Symbicort and albuterol was/is the protocol. Don’t need it all year, but now? …absolutely.

Upvote if you love big pharma