According to the Met Office, around one in four adults in England suffer from hay fever. That means more than 10 million people.
It’s a common problem that affects people of all ages. Unfortunately, while cycling boosts physical and mental health, your Pogačar-like power output provides no defence against seasonal allergies. In fact, cycling can exacerbate the situation.
The condition can be debilitating. But don’t despair, Professor James Hull is here to help. Hull is a consultant respiratory physician at the Institute of Sport, Exercise and Health (ISEH) in London, whose specialist interest is sports pulmonology.
“I run a clinical service, but I’m also an advisor to various sporting teams,” he says. “That includes the Team GB cycling team and EF Pro Cycling where I’m a respiratory advisor.” Hull attends the team’s training camps, most recently in Girona, where he helps riders to better understand and manage their allergies, of which there are many.
“The most common is an allergy to grass pollen,” says Hull. “That tends to strike in late spring, early summer, so May through to July. Come August and September, many suffer from weeds, while allergies to trees come earlier in the year; in fact, due to the warming of the planet, symptoms of tree allergies can hit you as early as February.”
That means the directory of seasonal distress: sneezing, runny nose, nasal congestion, itchy eyes, watery eyes… It’s debilitating, both in sporting and non-sporting settings. So, what can be done?
“One of the overriding principles of treatment is staying ahead of the curve,” says Hull. “In other words, you don’t wait until you develop the symptoms because, by then, the race is nearly run.”
That’s due to the activation of mast cells. These are immune cells found in tissues that interact with the environment, so you’ll find them in your eyes, nose, airways, skin and gut lining.
When hay fever sufferers are exposed to pollen, the immune system mistakenly identifies it as harmful and releases pollen-specific antibodies to ‘fight’ the enemy.
These attach to receptors on the mast cells. At this stage, there are usually no symptoms. But when pollen is encountered again, it binds to the anti-bodies on mast cells.
“Once that happens, mast cells start to degranulate,” says Hull. “From then on, you’re trying to put a lid on a box that’s sprung open.”
Degranulation means the mast cells release stored chemicals, including histamines, which leads to one, many or all of the symptoms above.
Antihistamines help to reduce itching, sneezing and runny noses by blocking histamine receptors, but they don’t fully stop congestion because not only is the histamine genie out of the bottle, other inflammatory mediating chemicals, including leukotrienes, are also released.
Rider pollen programme
“It’s why you need to pre-empt,” says Hull. For cyclists, that means a ‘rider pollen schedule’, albeit the pre-emptive idea applies to all hay fever sufferers, athletic or not.
“A rider comes to us with symptoms, so we test their blood to see what exactly they’re allergic to. It’s not just pollen. We test a variety of different common airborne allergens. Once we’ve identified the allergy, that’s when we start creating a plan.
“We’ve undertaken work into the typical pollen exposure pattern for the WorldTour calendar. For instance, if a rider’s racing the Tour of Flanders, their exposure to a certain tree pollen is high.
"That might trigger their allergy. But they might be fine for many WorldTour races in southern Europe where they’re exposed to olive trees that don’t affect them as badly.
"Working with the rider, we create a bespoke diary, so all parties know when they’re most vulnerable. That includes the team’s medical staff and DSes. They also make a diary reminder to remind the rider, ‘Look, this is a potential risk area’.”
Hull’s pollen diaries use European pollen tracking station data from the last five years, plus reports from individuals who live in the respective areas.
Hull and his team undertake the hard yards for elite athletes; for recreational riders, he recommends the Airmine app.
“It’s very good,” he says. “You can input whether you’re allergic to certain types of trees or grasses, and it’ll alert you when you’re in or around areas that might be vulnerable to your allergens in the next few days.”
Hull adds that his riders work “upstream”, meaning they’ll begin treatment a week or two before the race. “That ensures they can sleep because they’re nose isn’t blocked, which clearly isn’t ideal when racing at any level.
"Also, many riders feel that they lose leg power during allergy season. We don’t yet know the mechanism why but it’s a regular comment.”
Treat at source
As for what the treatment entails, Hull says that up until the final two or three days prior to racing in the hay fever danger zone, sufferers should take a standard antihistamine nasal spray.
“Then they should switch to a nasal spray that combines antihistamine and steroids,” he says. “They are transformational and on prescription.” A couple of examples are Dymista and Ryaltris.
“My favoured approach to handling allergies involves treating symptoms where they occur, so use a nasal spray instead of a tablet,” Hull adds.
“I do that because tablets might have a systemic effect [an impact distant from the site of the problem]. I know there’s data that they might impact muscular function.”
This pre-emptive attack is part of Hull’s PEAK approach. “That’s the basis of being allergy sensible,” he says. ‘P’ stands for prepare/prevent and includes working out when you’re affected during the year. ‘A’ refers to acting early. Both, we’ve covered.
“Then there’s ‘E’ or eliminate,” Hull says. “That means avoiding pollen exposure. Dry your kit indoors; wash your hair after a pollen-exposed training session; train when pollen count is forecast to be low (or on the indoor trainer if forecast to be high); wear wrap-around sunglasses; use nasal ointment to catch pollen; and nasal cotton wool if warming up on a turbo before racing outside.
“As for ‘K’, keep on top of things. Don’t just stop treatment because symptoms go away – the pollen count may rise and then you’ll be affected again. If it does persist, then see an allergist because you may be suitable for desensitisation.”
Desensitisation treatment for hay fever means training your immune system to become less reactive to pollen.
“Basically, you expose your body to a small amount of the allergen every day, so that when the allergy season arrives, the body’s immune reaction is dampened down, so you don’t endure such a vigorous reaction. It seriously reduces the amount of symptoms people suffer from.
“For instance, there’s a treatment for grass pollen called Grazax. It’s a prescription medicine, isn’t the cheapest in the world and is generally reserved for people who are seriously impacted by allergens.”
Rider experience
One athlete on a course of Grazax is Cofidis rider Simon Carr. “I’ve been on it since 2025,” the British rider says.
“You pop it beneath your tongue and it dissolves. For the first couple of weeks, you endure a tingly, itchy sensation, but that soon disappears. It’s a three-year course, so you must be diligent. But hopefully it’ll smooth out my performances and I’ll have a strong 2026.”
Carr is one of many riders on the men’s and women’s WorldTour who suffer from grass pollen. The 27-year-old rider also suffers from an Alternaria allergy, caused by mould spores, which is often at its highest with fallen leaves.
“Managing both has been the biggest challenge of my career,” he says. “Things first came to light in 2015 during my first year in the juniors. Come mid-season, I had six weeks off the bike because of fatigue and loss of power; we thought I was overtraining.
“The following year, I raced on the Saturday, riding in a bunch of 80 riders and was dropped. On the Sunday, it rained heavily, I was one of the strongest in the peloton and finished second.
"In 2017, I won three stages of the Tour of Martinique. It’s in the Caribbean, is a different climate to the UK and Northern Europe, and they don’t have the same seasonal allergies like we do.
“That season, I had a medical screening that identified my allergies, which revealed why I performed better in the rain. When it rains, it literally dampens the effects of pollen.”
Carr’s worked with Hull since his EF days [2021 to 2024] to manage a condition that’s threatened the Hereford-born rider’s career.
“When my allergies are at their worst, I’d lose up to 100 watts, meaning I could go from leading a race to being dropped.”
“My symptoms are exacerbated by dysfunctional breathing,” he adds. “It’s a condition called ‘inducible laryngeal obstruction’ or ILO. Basically, it feels like your vocal cords are collapsing.
"The scenario is I’m wrestling with my allergies in the background and then when I’m at a race, working hard and breathing hard, the dysfunctional, shallow breathing kicks in. As soon as I’d tip over threshold, I couldn’t breathe sufficiently and would just explode.
“That’s happened at the Ardennes and Giro d’Italia in particular. The Ardennes is grass pollen season, albeit if it’s a rainy week, I’d be fine. Being Northern Europe, it’s hard to predict. I struggle at the Vuelta a Burgos in August, too. That might be down to the Alternaria, so I miss that race now.”
As Hull mentioned above, Carr follows a rider’s pollen diary, which helps “especially if you’re planning to go to altitude, as the pollen season can come on later”. This diary and desensitisation forms half of Carr’s allergy-battling programme.
“I also take antihistamines for most of the year, which is fine as there are no side-effects. Also, I take a nasal spray called Avamys and a Flixotide inhaler.
“All of this helps but I feel the most transformative has been working on my breathing from deeper in my body. I have daily breathing exercises off the bike, plus I practise on the bike, too.
"When I was at EF, the doctor would watch me on the turbo trainer and give me tips on relaxing my shoulders and neck, plus optimising breathing in different bike positions.
"That’s made such a difference. Now, when I have difficulty breathing, I focus on breathing pattern and maintaining control. It helps to avoid escalating into something that’ll harm performance.
Carr says that on high-pollen days, he’s not at his optimum but he's much better than days gone by – although, like many, he wrestles with the desert.
“I’ve had issues after competing in the Middle East where you’re exercising hard for four hours in the desert. I’d be coughing up sand for days afterwards, which I believe isn’t very good for you!”
All in all, seasonal allergies can derail performance, but the key is preparation. Identify your triggers, act early and treat symptoms at their source.
Avoid peak exposure where possible and stay consistent with medication. For persistent cases, seek specialist advice. With a proactive plan, allergies needn’t dictate your season – or your results.
Nature's fix
If you prefer giving natural remedies a try, there are several on- and off-bike options…
Nasal barrier
Defending your orifices from pollen attack is the aim, so try applying a balm or cream to your nostrils. Products such as HayMax are designed to trap pollen before it enters your body. HayMax’s research says a liberal application can cut pollen inhalation by a third. Petroleum jelly does a similar job.
Shield of sweetness
Many hay fever sufferers swear by local honey, the idea being that consuming honey created close to your home means you’re exposed to the pollen that accompanies your local rides.
It’s a form of desensitisation that we focus on in the main feature. Unfortunately, studies show little difference between honey and placebo, partly because the pollens that trigger hay fever aren’t present in meaningful amounts in honey.
That said, it can ease a sore throat (and the honey will give you an energy boost). Go for raw, unprocessed local honey consuming two teaspoons daily. Ideally, start weeks before allergy season.
Herbal help
Rosemary is a rich source of rosmarinic acid, known to dampen the body’s reaction to pollen-related allergies and help ease nasal congestion. For the highest concentration of rosmarinic acid per gramme, choose the dried form. Other rosmarinic-rich herbs include sage, oregano and thyme.
Goodbye coffee
You might not want to hear this, but pollen season is the time to cut back on caffeine, because it’s linked to increased histamine release. Instead, switch to herbal teas.
Chamomile is a strong option, offering natural antihistamine and anti-inflammatory benefits. German chamomile is particularly effective against hay fever thanks to its high levels of azulene, a natural antihistamine.
