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Created page with "{{DISPLAYTITLE: Should you run with a cold or other illness?}} [[File:Sneeze.jpg|right|thumb|400px|Colds and illness affect all of us at one time or another. Knowing how to deal ..."
{{DISPLAYTITLE: Should you run with a cold or other illness?}}
[[File:Sneeze.jpg|right|thumb|400px|Colds and illness affect all of us at one time or another. Knowing how to deal with them is critical.]]
Should you run with a cold or other illness? How does running affect your immune system? Does it make it better or worse? The answers to these questions are as complex as the human body itself, but there are some simplified guidelines that can help in most situations. Only use these guidelines if you feel well enough to train and want to train; if in doubt, avoid exercise and rest up.
{| class="wikitable"
!Training Style!!Mild Cold!!More serious infection
|-
|General fitness and health<br>(light training, but no speed work or endurance training and never exhaustive.) ||Train as normal if symptoms are 'above the neck', otherwise reduce the amount of running. ||Reduce the amount of running.
|-
|Structured training<br>(Specific speed and endurance training, but not pushing your physical limits.)||Avoid exhaustive training during cold. The risk of [[Overtraining Syndrome]] is slightly elevated. ||Exhaustive training should be avoided for a month after infection. Curtail the intensity and/or length of harder workouts. The risk of [[Overtraining Syndrome]] is moderately elevated.
|-
|Competitive training<br>(Pushing the boundaries of your physical capabilities.)||During the cold avoid exhaustive training and reduce the intensity and volume of training. The risk of [[Overtraining Syndrome]] is moderately elevated.||Exhaustive training should be avoided for a month after infection. Significantly reduce the intensity and volume of training while symptomatic, ramping back up afterwards carefully. The risk of [[Overtraining Syndrome]] is significantly elevated.
|-
|}
<span style='color:\#FF0000'>Important note: chest pains (especially stabbing pains) or unusual shortness of breath may be symptoms of [http://www.mayoclinic.com/health/myocarditis/DS00521 Myocarditis], a potentially fatal condition.
</span>
=Running with a cold or other illness=
The common cold (often called Upper Respiratory Tract Infections or URTI in research) is one of the most common problem effecting athletes<ref name="Winter"/> and some claim it causes more problems than all other illness combined<ref name="sportexercisecommoncold"/>. However, there are other more serious infections that should also be considered.
* Exhaustive exercise compromises the immune system and can make an existing infection worse<ref name="OvertraingInSport"/>.
* Light exercise while suffering from a mild infection is generally believed to be safe<ref name="OvertraingInSport"/>. There is a widespread medical opinion that it's okay to run if the symptoms are all 'above the neck'<ref name="MayoCold"/>, but there appears to be little or no research to back up this belief.
* Even a mild infection adds to the overall stress levels and increases the risk of [[Overtraining Syndrome]]. In addition, an infection may be a symptom of [[Overtraining Syndrome]]<ref name="OvertraingInSport"/>.
* Infection from [http://en.wikipedia.org/wiki/Rhinovirus Rhinovirus] (the usual cause of the common cold) does not affect exercise performance<ref name="RhinovirusMax"/>. However, it can be tricky to know if an infection is due to the Rhinovirus or some other agent.
* Some infections, such as those involving inflammation of the heart ([http://en.wikipedia.org/wiki/Myocarditis myocarditis]), can be potentially fatal when combined with exercise<ref name="ViralAndPerformance"/>.
* Many infections will reduce performance, sometimes dramatically<ref name="InfectionHighPerformance"/>.
* Exhaustive training should be avoided for a month after infection, except for mild common colds <ref name="ViralAndPerformance"/>.
=Avoiding Infections=
* Be aware of the factors causing [[Overtraining Syndrome]], as this can result in a compromised immune system. Factors include life stresses, diet, [[Training Monotony]], and adequate sleep.
* Avoid touching your eyes or nose without first washing your hands, as this is a common route for infectious diseases.
* Where possible keep away from sick people and large crowds when your immune system is likely to be weakened.
* Exhaustive exercise compromises the immune system and can make the athlete more susceptible to infection. Taking carbohydrate before during and after exhaustive exercise can reduce the suppression of the immune system<ref name="OvertraingInSport"/>.
* Be particularly careful after exhaustive exercise, including racing.
* Monitor [[Mood State]], as this is can be an indication of reduced immune system functioning amongst other things.
=Running and the immune system=
[[File:URT Infection Risk.jpg|right|thumb|400px|The risk of infection is 'J' shaped in lower fitness people, but as fitness rises, the risk goes down, but does not completely flatten<ref name="urtirisk"/>.]]
There is a general belief in a 'J' shaped relationship between exercise level and risk of infection<ref name="InfectionHighPerformance"/>, but it seems that the shape depends on the level of fitness<ref name="urtirisk"/>. Lower fitness individuals' immune system benefits from some exercise, but as the intensity rises, the immune system benefits decline.
=Racing and the immune system=
Races up to and including the half marathon do not have an increased risk of infection<ref name="urtiriskhalfmarathon"/>, but the risk is significantly higher after marathon<ref name="urtimarathon"/> and ultramarathon<ref name="urtiultra"/> races. However, there is some evidence that those experiencing an infection after the marathon distance may be due to a reoccurrence of symptoms from an earlier infection<ref name="urtimarathonbeforeandafter"/>.
=Nutrition and the immune system=
There are various supliments that may help improve immune system functioning in runners.
* The amino acid glutamine is required by some parts of the immune system<ref name="GluatmineLymphocytes"/>([http://en.wikipedia.org/wiki/Lymphocyte lymphocytes]) and exercise depletes blood glutamine levels <ref name="GluatmineExercise"/>. There is some evidence that glutamine supplementation is effective at reducing the immune system compromise<ref name="GluatmineSuppliment"/>.
* Vitamin C has been shown to reduce the incidence of UTRI by half<ref name="VitCUltra"/><ref name="VitCEUltra"/><ref name="VitCMeta"/>. The doses used in the studies were 600mg or 1000mg daily. However, other studies<ref name="VitCMaraNone"/> have failed to show a benefit.
* Adding Vitamin E to Vitamin C supplementation does not appear to further enhance the benefit of Vitamin C<ref name="VitCEUltra"/>. However, there may be other benefits from the combination of Vitamin C and E together, such as reduction in the risk of Alzheimer's disease<ref name="VitCEAltzh"/>.
* There is some evidence<ref name="ProbioticSuccess"/> that probiotics (e.g. live yoghurt) prevents or reduces the intensity of UTRI symptoms. However, this benefit was not seen in other studies <ref name="ProbioticFail1"/>, nor did probiotics show a reduction in allergy or asthma symptoms <ref name="ProbioticAlergy"/>.
* Taking carbohydrate before during and after exhaustive exercise can reduce the suppression of the immune system<ref name="OvertraingInSport"/>.
=References=
<references>
<ref name="urtimarathonbeforeandafter">Infectious episodes before and after ... [Scand J Med Sci Sports. 2006] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/16895535?dopt=Abstract </ref>
<ref name="urtimarathon">Infectious episodes in runners bef... [J Sports Med Phys Fitness. 1990] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/2266764 </ref>
<ref name="urtiultra">Ultramarathon running and upper respiratory trac... [S Afr Med J. 1983] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/6623247?dopt=Abstract </ref>
<ref name="urtiriskhalfmarathon">Infectious episodes in runners bef... [J Sports Med Phys Fitness. 1989] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/2635263?dopt=Abstract </ref>
<ref name="urtirisk">Does exercise increase the risk of upper respiratory tract infections? http://bmb.oxfordjournals.org/content/90/1/111.full </ref>
<ref name="GluatmineSuppliment">Glutamine and the effects of exhaust... [Can J Physiol Pharmacol. 1998] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/9839078 </ref>
<ref name="GluatmineExercise">Depression of plasma glutamine concentration afte... [Med J Aust. 1995] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/7845291 </ref>
<ref name="GluatmineLymphocytes">Lymphocyte proliferation modulated by glutamine: involved in the endogenous redox reaction http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1905365/ </ref>
<ref name="ViralAndPerformance">Viral illnesses and sports performance. [Sports Med. 1986 Jul-Aug] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/3526508 </ref>
<ref name="InfectionHighPerformance">Immunology and Cell Biology - Infections and exercise in high-performance athletes http://www.nature.com/icb/journal/v78/n5/full/icb200071a.html </ref>
<ref name="OvertraingInSport">Overtraining In Sport, Kreider, Fry, O'Toole, Human Kinetics</ref>
<ref name="Winter">Casey JM, Dick EC. Acute respiratory infections. In: Casey JM, Foster C, Hixson EG, eds. Winter Sports Medicine. Philadelphia, PA: FA Davis Co; 1990:112-128.</ref>
<ref name="sportexercisecommoncold">Sport, Exercise, and the Common Cold, Thomas G. Weidner, PhD, ATC; Thomas L. Sevier, MD http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1318446/pdf/jathtrain00018-0060.pdf </ref>
<ref name="VitCUltra">Vitamin C supplementation reduces the incidence of postrace symptoms of upper-respiratory-tract infection in ultramarathon runners http://www.ajcn.org/content/57/2/170.abstract?ijkey=353d1bf015076ca918c148006e8bdae68eb2859b&keytype2=tf_ipsecsha </ref>
<ref name="VitCEUltra">Peters EM, et al, Vitamin C as effective as combinations of anti-oxidant nutrients in reducing symptoms of upper respiratory tract infection (URTI) in ultramarathon runners</ref>
<ref name="VitCEAltzh">Vitamin supplement use may reduce effects of Alzheimer's disease http://www.eurekalert.org/pub_releases/2004-01/jhub-vsu011504.php </ref>
<ref name="VitCMeta">Nutritional modulation of exercise-induced i... [Eur J Clin Nutr. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17136044?dopt=Abstract </ref>
<ref name="VitCMaraNone">Jan9 http://faculty.css.edu/tboone2/asep/jan9.htm </ref>
<ref name="ProbioticSuccess">Oral administration of the probiotic Lactoba... [Br J Sports Med. 2010] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/18272539 </ref>
<ref name="ProbioticFail1">The effect of probiotics on res... [Int J Sport Nutr Exerc Metab. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17962710?dopt=Abstract </ref>
<ref name="ProbioticAlergy">Allergy in marathon runners and effect of Lactoba... [Respir Med. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17196811?dopt=Abstract </ref>
<ref name="MayoCold">Exercise and illness: Work out with a cold? - MayoClinic.com http://www.mayoclinic.com/health/exercise/AN01097 </ref>
<ref name="RhinovirusMax"> http://journals.lww.com/acsm-msse/Abstract/1997/05000/Effect_of_a_rhinovirus_caused_upper_respiratory.3.aspx </ref>
</references>
[[File:Sneeze.jpg|right|thumb|400px|Colds and illness affect all of us at one time or another. Knowing how to deal with them is critical.]]
Should you run with a cold or other illness? How does running affect your immune system? Does it make it better or worse? The answers to these questions are as complex as the human body itself, but there are some simplified guidelines that can help in most situations. Only use these guidelines if you feel well enough to train and want to train; if in doubt, avoid exercise and rest up.
{| class="wikitable"
!Training Style!!Mild Cold!!More serious infection
|-
|General fitness and health<br>(light training, but no speed work or endurance training and never exhaustive.) ||Train as normal if symptoms are 'above the neck', otherwise reduce the amount of running. ||Reduce the amount of running.
|-
|Structured training<br>(Specific speed and endurance training, but not pushing your physical limits.)||Avoid exhaustive training during cold. The risk of [[Overtraining Syndrome]] is slightly elevated. ||Exhaustive training should be avoided for a month after infection. Curtail the intensity and/or length of harder workouts. The risk of [[Overtraining Syndrome]] is moderately elevated.
|-
|Competitive training<br>(Pushing the boundaries of your physical capabilities.)||During the cold avoid exhaustive training and reduce the intensity and volume of training. The risk of [[Overtraining Syndrome]] is moderately elevated.||Exhaustive training should be avoided for a month after infection. Significantly reduce the intensity and volume of training while symptomatic, ramping back up afterwards carefully. The risk of [[Overtraining Syndrome]] is significantly elevated.
|-
|}
<span style='color:\#FF0000'>Important note: chest pains (especially stabbing pains) or unusual shortness of breath may be symptoms of [http://www.mayoclinic.com/health/myocarditis/DS00521 Myocarditis], a potentially fatal condition.
</span>
=Running with a cold or other illness=
The common cold (often called Upper Respiratory Tract Infections or URTI in research) is one of the most common problem effecting athletes<ref name="Winter"/> and some claim it causes more problems than all other illness combined<ref name="sportexercisecommoncold"/>. However, there are other more serious infections that should also be considered.
* Exhaustive exercise compromises the immune system and can make an existing infection worse<ref name="OvertraingInSport"/>.
* Light exercise while suffering from a mild infection is generally believed to be safe<ref name="OvertraingInSport"/>. There is a widespread medical opinion that it's okay to run if the symptoms are all 'above the neck'<ref name="MayoCold"/>, but there appears to be little or no research to back up this belief.
* Even a mild infection adds to the overall stress levels and increases the risk of [[Overtraining Syndrome]]. In addition, an infection may be a symptom of [[Overtraining Syndrome]]<ref name="OvertraingInSport"/>.
* Infection from [http://en.wikipedia.org/wiki/Rhinovirus Rhinovirus] (the usual cause of the common cold) does not affect exercise performance<ref name="RhinovirusMax"/>. However, it can be tricky to know if an infection is due to the Rhinovirus or some other agent.
* Some infections, such as those involving inflammation of the heart ([http://en.wikipedia.org/wiki/Myocarditis myocarditis]), can be potentially fatal when combined with exercise<ref name="ViralAndPerformance"/>.
* Many infections will reduce performance, sometimes dramatically<ref name="InfectionHighPerformance"/>.
* Exhaustive training should be avoided for a month after infection, except for mild common colds <ref name="ViralAndPerformance"/>.
=Avoiding Infections=
* Be aware of the factors causing [[Overtraining Syndrome]], as this can result in a compromised immune system. Factors include life stresses, diet, [[Training Monotony]], and adequate sleep.
* Avoid touching your eyes or nose without first washing your hands, as this is a common route for infectious diseases.
* Where possible keep away from sick people and large crowds when your immune system is likely to be weakened.
* Exhaustive exercise compromises the immune system and can make the athlete more susceptible to infection. Taking carbohydrate before during and after exhaustive exercise can reduce the suppression of the immune system<ref name="OvertraingInSport"/>.
* Be particularly careful after exhaustive exercise, including racing.
* Monitor [[Mood State]], as this is can be an indication of reduced immune system functioning amongst other things.
=Running and the immune system=
[[File:URT Infection Risk.jpg|right|thumb|400px|The risk of infection is 'J' shaped in lower fitness people, but as fitness rises, the risk goes down, but does not completely flatten<ref name="urtirisk"/>.]]
There is a general belief in a 'J' shaped relationship between exercise level and risk of infection<ref name="InfectionHighPerformance"/>, but it seems that the shape depends on the level of fitness<ref name="urtirisk"/>. Lower fitness individuals' immune system benefits from some exercise, but as the intensity rises, the immune system benefits decline.
=Racing and the immune system=
Races up to and including the half marathon do not have an increased risk of infection<ref name="urtiriskhalfmarathon"/>, but the risk is significantly higher after marathon<ref name="urtimarathon"/> and ultramarathon<ref name="urtiultra"/> races. However, there is some evidence that those experiencing an infection after the marathon distance may be due to a reoccurrence of symptoms from an earlier infection<ref name="urtimarathonbeforeandafter"/>.
=Nutrition and the immune system=
There are various supliments that may help improve immune system functioning in runners.
* The amino acid glutamine is required by some parts of the immune system<ref name="GluatmineLymphocytes"/>([http://en.wikipedia.org/wiki/Lymphocyte lymphocytes]) and exercise depletes blood glutamine levels <ref name="GluatmineExercise"/>. There is some evidence that glutamine supplementation is effective at reducing the immune system compromise<ref name="GluatmineSuppliment"/>.
* Vitamin C has been shown to reduce the incidence of UTRI by half<ref name="VitCUltra"/><ref name="VitCEUltra"/><ref name="VitCMeta"/>. The doses used in the studies were 600mg or 1000mg daily. However, other studies<ref name="VitCMaraNone"/> have failed to show a benefit.
* Adding Vitamin E to Vitamin C supplementation does not appear to further enhance the benefit of Vitamin C<ref name="VitCEUltra"/>. However, there may be other benefits from the combination of Vitamin C and E together, such as reduction in the risk of Alzheimer's disease<ref name="VitCEAltzh"/>.
* There is some evidence<ref name="ProbioticSuccess"/> that probiotics (e.g. live yoghurt) prevents or reduces the intensity of UTRI symptoms. However, this benefit was not seen in other studies <ref name="ProbioticFail1"/>, nor did probiotics show a reduction in allergy or asthma symptoms <ref name="ProbioticAlergy"/>.
* Taking carbohydrate before during and after exhaustive exercise can reduce the suppression of the immune system<ref name="OvertraingInSport"/>.
=References=
<references>
<ref name="urtimarathonbeforeandafter">Infectious episodes before and after ... [Scand J Med Sci Sports. 2006] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/16895535?dopt=Abstract </ref>
<ref name="urtimarathon">Infectious episodes in runners bef... [J Sports Med Phys Fitness. 1990] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/2266764 </ref>
<ref name="urtiultra">Ultramarathon running and upper respiratory trac... [S Afr Med J. 1983] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/6623247?dopt=Abstract </ref>
<ref name="urtiriskhalfmarathon">Infectious episodes in runners bef... [J Sports Med Phys Fitness. 1989] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/2635263?dopt=Abstract </ref>
<ref name="urtirisk">Does exercise increase the risk of upper respiratory tract infections? http://bmb.oxfordjournals.org/content/90/1/111.full </ref>
<ref name="GluatmineSuppliment">Glutamine and the effects of exhaust... [Can J Physiol Pharmacol. 1998] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/9839078 </ref>
<ref name="GluatmineExercise">Depression of plasma glutamine concentration afte... [Med J Aust. 1995] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/7845291 </ref>
<ref name="GluatmineLymphocytes">Lymphocyte proliferation modulated by glutamine: involved in the endogenous redox reaction http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1905365/ </ref>
<ref name="ViralAndPerformance">Viral illnesses and sports performance. [Sports Med. 1986 Jul-Aug] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/3526508 </ref>
<ref name="InfectionHighPerformance">Immunology and Cell Biology - Infections and exercise in high-performance athletes http://www.nature.com/icb/journal/v78/n5/full/icb200071a.html </ref>
<ref name="OvertraingInSport">Overtraining In Sport, Kreider, Fry, O'Toole, Human Kinetics</ref>
<ref name="Winter">Casey JM, Dick EC. Acute respiratory infections. In: Casey JM, Foster C, Hixson EG, eds. Winter Sports Medicine. Philadelphia, PA: FA Davis Co; 1990:112-128.</ref>
<ref name="sportexercisecommoncold">Sport, Exercise, and the Common Cold, Thomas G. Weidner, PhD, ATC; Thomas L. Sevier, MD http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1318446/pdf/jathtrain00018-0060.pdf </ref>
<ref name="VitCUltra">Vitamin C supplementation reduces the incidence of postrace symptoms of upper-respiratory-tract infection in ultramarathon runners http://www.ajcn.org/content/57/2/170.abstract?ijkey=353d1bf015076ca918c148006e8bdae68eb2859b&keytype2=tf_ipsecsha </ref>
<ref name="VitCEUltra">Peters EM, et al, Vitamin C as effective as combinations of anti-oxidant nutrients in reducing symptoms of upper respiratory tract infection (URTI) in ultramarathon runners</ref>
<ref name="VitCEAltzh">Vitamin supplement use may reduce effects of Alzheimer's disease http://www.eurekalert.org/pub_releases/2004-01/jhub-vsu011504.php </ref>
<ref name="VitCMeta">Nutritional modulation of exercise-induced i... [Eur J Clin Nutr. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17136044?dopt=Abstract </ref>
<ref name="VitCMaraNone">Jan9 http://faculty.css.edu/tboone2/asep/jan9.htm </ref>
<ref name="ProbioticSuccess">Oral administration of the probiotic Lactoba... [Br J Sports Med. 2010] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/18272539 </ref>
<ref name="ProbioticFail1">The effect of probiotics on res... [Int J Sport Nutr Exerc Metab. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17962710?dopt=Abstract </ref>
<ref name="ProbioticAlergy">Allergy in marathon runners and effect of Lactoba... [Respir Med. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17196811?dopt=Abstract </ref>
<ref name="MayoCold">Exercise and illness: Work out with a cold? - MayoClinic.com http://www.mayoclinic.com/health/exercise/AN01097 </ref>
<ref name="RhinovirusMax"> http://journals.lww.com/acsm-msse/Abstract/1997/05000/Effect_of_a_rhinovirus_caused_upper_respiratory.3.aspx </ref>
</references>
