Loosing the Tour de France Because of Allergies

I could not pass up the opportunity to comment on a news item that combines two of my favorite subjects: allergy and cycling.

The Tour de France – arguable the hardest endurance sporting event in the history of particularly hard sporting events – concluded this week.  “The Tour” is a three week long cycling race.  Participants ride more than 4-5 hours a day, distancing more than 100 miles, up and down mountains, in freezing rain and gale force winds, at a pace that burns a mind boggling 8000 calories each day. Most adults would consider any work-out that consumes more than 500 calories to be an exhausting challenge.   Needless to say the event includes some of the strongest athletes in the world.Untitled design (53) 2

Two men were favored to win the tour this year: Chris Froom (two-time winner and defending champion) and a young columbian rider, Nairo Quintana.  Unfortunately, although eventually taking third overall  (Chris Froom finished first), it was clear that Nairo was struggling and riding well below his -and his fan’s-expectations.

When asked about his difficulties, this is what Nairo had to say:

“It’s not fatigue that I’m feeling, but still, the body isn’t responding. It could be some sort of allergy I’ve got at the moment because my legs aren’t getting enough oxygen. “It could be some sort of allergen in the area that’s been affecting me these last few days. I hope with the rain that is coming in these next days I can keep it at bay.”

Although some may find watching a four hour bike race a bit boring, I am mesmerized by the scenery as the cyclists sale through the countryside of France and into the alps or the Pyrenees mountains bordering Spain.   Untitled design (54) (1)The dreamy state of captivated longing as the peloton winds through river valleys, past medieval castles,  across fields of sunflowers and mountain meadows, is acutely enhanced by the fact that the tour takes place in July. In July the “countryside” of Phoenix is looking a bit scorched after more than a month of  115 + degree days and 100 degree nights with very little rain.

With the record-breaking heat comes very low pollen counts – the plants have a hard enough time surviving much less reproducing – but you could image a very different story in the spring like weather in the mountains of France.  In fact, it is likely that these areas are experiencing their peak allergy season.  Which is why I think Nairo Quintana’s assessment of the source of his struggles has merit.

So how can allergies adversely affect an athlete’s performance?  Here are a few thoughts:

  • Allergy is the primary risk factor for asthma and asthma can certainly have a significant negative impact on any athlete participating in an aerobic sport.
  • Allergies can disrupt sleep and if there is anything that a Tour de France rider needs during a month long bike race is adequate sleep.
  • Energy that the body spends dealing with allergies means less energy available to ride your bike up mountains and sprint to the finish line.
  • Mouth breathing because your nose is congested from allergies means that you loose the conditioning and filtering affect of the nose.  This can lead to increased irritation of the upper and lower airways as well as the  lungs
  • Medications taken for allergy symptoms such as antihistamines and decongestants can negatively impact performance.

Possible the best treatment option for athletes who suffer from allergies (besides staying home) is allergy immunotherapy.  Immunotherapy prevents the allergic response from occurring (rather than treating symptoms after the fact) so that the risk of asthma is reduced, sleep disruption, energy loss, and mouth breathing do not occur and the need for medications is eliminated or significantly reduced.

Hopefully, Nairo Quintana will look up a good allergist when he gets home to Columbia so that he can give Chris Froom a run for his money next year.

Brian Millhollon,MD