Stewart asks:

After being away from Bikram Yoga for eight years I ventured back with my new wife, Christine, also a previous Bikram student who, prior to our marriage, was hospitalized with Steven Johnson Syndrome (SJS) – a rare but severe allergic drug reaction, which in some cases can be fatal. We were both happy we went and quickly realized this is the best form of exercise for us (we’d spent many years in the gym making minimal gains physically; there’s always been something missing when compared to an all-encompassing (body, mind and soul) session in the hot room). In any event, upon completion of the class, Christine became violently sick on our way home. She vomited several times, and it wasn’t until later that afternoon that she was able to feel herself again. She never experienced this kind of reaction before; could it be explained by the release of toxins through her body?

We consulted two Bikram Yoga instructors and medical doctors – Divi Chandna and Roxana Mavai – about your question, Stewart. While their responses are provided below, please keep in mind that medical information posted on our blog is never meant to replace your own doctor’s or health practitioner’s advice. The following represent suppositions according to the general experience for most people practicing Bikram Yoga. If you have concerns (and perhaps even other medical conditions besides the prior experience of SJS), please consult with your physician.

Divi Chandna says:

I would say that Christine is experiencing huge detoxification now. All allergic reactions are signals that our body is fighting against agents coming in. Sometimes those agents are foreign foods, medications and other substances. Often, people have toxins in their body after such a huge reaction (like the one your wife experienced), and this is likely what she was “detoxifying out.” It doesn’t mean it will happen again, but your intuition was right that she is detoxifying. The more yoga she can do, the more she can release that which is not natural for the body.

Roxana Mavai says:

I am not sure why Christine had the severe vomiting following her first class in a while. I don’t believe that this is related to her SJS several years ago, but could there be a link? I honestly don’t know, but I do doubt it. As for the theory of toxins being released from the body causing the vomiting, I’m not sure.

One possibility may be that she may have been ill prior to class, which may have been aggravated by the exertion. However, most commonly, nausea and vomiting related to exercising in the heat is related to heat stress and heat exhaustion. The most common signs and symptoms are shallow respiration with increased breathing rate, a weak rapid pulse, pale clammy skin, weakness, fatigue, dizziness, headache, nausea and vomiting, muscle cramps and even fainting.

My best guess, without further information, is that it was related to the heat. To reassure you, it doesn’t mean that it will happen regularly. Clearly, you both like this yoga, have previously enjoyed tremendous benefits from it and would like to resume your practice. I believe the most important approach is to learn to recognize the signs and symptoms of heat stress, as described above. To prevent or minimize such effects, drink plenty of water and come to class well hydrated, ensuring you take care of liquids and electrolyte replenishment since salts and minerals are lost with sweat. Finally, acclimatize yourself to the heat gradually. In other words, when you’re in the room, take breaks as you may need. Stopping the effort and exertion of the posture minimizes the body’s own heat generation.

Be very observant of how you’re feeling in the class. Self-awareness will be your best tool of managing in the room. Accept how you feel and don’t have specific expectations. In your past practice you may have been at a certain level of fitness so your expectation might be to do the same level of exertion, but your body may not be quite conditioned to reach that at this point and, if you push hard enough to get the same result of what you could do then, you might overheat. So go easy for now. Be patient and, very soon, the pay-off will be increased conditioning and the ability to do more with the body’s mechanisms, for heat dissipation will keep up with your effort and the heat in the room. You will be able to do more over time.

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