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Sore Throat At Night When Tired, No Symptoms In The Morning. Reasons ?

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Posted on Wed, 6 Jun 2012
Question: Hi, have you ever of this?
When i get tired i will get a sore throat at night (sometimes it will feel like i'm getting a cold), next morning its gone and i feel great? It can happen 3-5 hours after a hard workout at the gym. I hardly ever get colds, i exercise regularly, i eat plenty of veggies and fruits. From blood tests my doctor considers me very healthy and i feel very healthy. I'm 44 caucasian male.
doctor
Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)
Hi

Thanks for the query

The features you have described could be exercise-induced bronchospasm (EIB). The cause of which is not known.

It is thought that the airways in the lungs shrink while exercising, which usually starts after a few minutes following the exercises and more pronounced while exercising in cold climate. Even though the actual cause and the patho-physiology are not very clearly known, it is speculated that it could be due to allergic related condition or previous vocal cord dysfunction.

Your situation can be attributed to allergic cause which is evidenced by dermatographism. There is no actual treatment; you can follow few preventive measures such as warm up at least 10 minutes before doing any actual exercise and cool down gradually rather than stopping immediately. Also, try exercising in warm, humid places. Medicines like leukotriene inhibitor and antihistaminic can give you some relief.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (2 hours later)
I do not have any lung problems or sensations. The sore throat or feeling like i'm going to get a cold happens usually at night many hours(3 - 5+) after exercising. I do not or have ever suffered from any kind of asthma????
I googled exercise-induced bronchospasm - based on the syptoms /description I do not have that.
so i do not understand your answer??
doctor
Answered by Dr. Naveen Kumar Nanjasetty (14 hours later)
Hello.

Thanks for writing again.

To make things clear for you, Bronchospasm need not happen in those individuals suffering from asthma only. Various other conditions can also induce Bronchospasm. Unlike in asthma, the inflammation of the bronchioles is not noticed in other conditions until due to contraction of the smooth muscles in the bronchioles; it could be of various severities and associated with various other clinical features including sore throat and cough.

With respect to your condition, vigorous exercise makes you more susceptible for minor illness as it suppress the body’s immune response for a period of time immediately after you’ve finished exercising. XXXXXXX Bishop, the author of a review article about exercise and immunity mentions that “the longer the duration and the more intense” the exercise, “the longer the temporary period of immunosuppression lasts — anything from a few hours to a few days.”

During exercise various mediators of inflammation are released in the body which causes cellular damage. The homeostasis in the body is maintained if the exercises are performed to a certain limit, but once the limit is crossed there is increased production of harmful inflammatory mediators which reduces the immunity and makes an individual susceptible for infections.

Not everyone who perform vigorous exercises suffer from this problem, those individuals whose immunity is already compromised to a certain extent are the ones most affected. As I have already mentioned in my previous post, one of the cause for your flu-like symptoms could be the increased production of Histamine in the body, the same component which induces dermatographism also.

As you perform work-out in a closed location, it is easier for your body to attract virus from other individuals and hence cause those flu-like symptoms. And hence, if you have just completed a strenuous work-out, avoid colleagues who are sniffling and wash your hands often. If the symptoms are really bothersome, you can try taking medicines such as Leukotriene inhibitor and Antihistaminics after consulting your doctor.

Following are the few links which can provide you with more information regarding this problem:
WWW.WWWW.WW WWW.WWWW.WW WWW.WWWW.WW
Hope, this answers your query. Wish you good health.

Regards.

Above answer was peer-reviewed by : Dr. Jyoti Patil
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (6 hours later)
Hi, i know you are trying your best. I have researched this more and I do not have those symptoms.
example: I can stay home all day and have an intense workout there where i cant catch other peoples viruses... or i hardly ever get colds/flu maybe 1 every 2 years, so if my immune system is suppressed after a hard workout and a virus gets in me which causes my body to react, why is it that the next day i feel fine???
sometimes i don't get a sore throat or flu like symptoms but the muscles i worked out are in severe pain (unlike standard muscle soreness, its a type of pain i have never felt) and it happens 3-5 hours after the workout, unlike standard muscle soreness that i can feel the next day.
doctor
Answered by Dr. Naveen Kumar Nanjasetty (21 hours later)
Hi

Welcome back

I do understand your apprehension and curiosity to find out an answer for your problem. There are a lot more people who share similar experience after vigorous exercises. But, whatever I have mentioned is the probable cause of your condition, there are still lots of research being carried out to find out the actual cause of this problem.

Q: If my immune system is suppressed after a hard workout and a virus gets in me which causes my body to react, why is it that the next day i feel fine???
A: The suppression of the immune system following vigorous exercise is a transient phenomenon which is reversible (Phys Ed: Does Exercise Boost Immunity? - WWW.WWWW.WW and depends upon the duration of exercise performed, the more the duration of the exercise the longer is the period of recovery of immunity. The duration of recovery lasts from few hours to days depending upon the individual’s immune status.

Q: I can stay home all day and have an intense workout there where i cant catch other peoples viruses...
A: virus and bacteria are omnipresent, the concentration of these microorganisms are more in a closed area, humid environment and gatherings.

Q: Sometimes i don't get a sore throat or flu like symptoms but the muscles i worked out are in severe pain (unlike standard muscle soreness, its a type of pain i have never felt).
A: This could be because of acute electrolyte imbalance and increased accumulation of lactic acid in the cells of the muscles. In an individual performing regular exercises the body usually gets adjusted to the electrolyte imbalance caused and the cells get modified accordingly. But, during certain occasions when a more difficult task is performed or the duration is prolonged or the exercises are performed after certain interval, then there is excessive accumulation of lactic acid causing damage to cells and thus the soreness.

The medical conditions are categorized after taking collective information of the symptoms experienced by a group of individuals. It is not necessary that an individual who suffers from a particular condition need to have all the symptoms as per the description of that condition. Sometimes, there will be many symptoms which may not fulfill the criteria of that condition which are termed as atypical forms.

Hope I have answered your query, if you have any more doubts you are welcome.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Naveen Kumar Nanjasetty

Otolaryngologist / ENT Specialist

Practicing since :2001

Answered : 2544 Questions

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Sore Throat At Night When Tired, No Symptoms In The Morning. Reasons ?

Hi

Thanks for the query

The features you have described could be exercise-induced bronchospasm (EIB). The cause of which is not known.

It is thought that the airways in the lungs shrink while exercising, which usually starts after a few minutes following the exercises and more pronounced while exercising in cold climate. Even though the actual cause and the patho-physiology are not very clearly known, it is speculated that it could be due to allergic related condition or previous vocal cord dysfunction.

Your situation can be attributed to allergic cause which is evidenced by dermatographism. There is no actual treatment; you can follow few preventive measures such as warm up at least 10 minutes before doing any actual exercise and cool down gradually rather than stopping immediately. Also, try exercising in warm, humid places. Medicines like leukotriene inhibitor and antihistaminic can give you some relief.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon