Physicians generally rely on a medical history and description of symptoms when diagnosing exercise-induced anaphylaxis. They do not use exercise testing when diagnosing the disorder because it is considered too risky.

Exercise-induced urticaria typically is diagnosed by passively warming a patient’s extremity with a heating blanket or warm water to raise the body’s core temperature. The physician then looks for symptoms of urticaria.

A methacholine challenge test also can be used to diagnose exercise-induced urticaria. In this procedure, a mixture of saline and the bronchoconstrictor methacholine is injected under the skin, and the patient is monitored for a reaction. However, some with exercise-induced urticaria will not react to methacholine, so the test is not widely used.

Those who have not been diagnosed with exercise-induced anaphylaxis or urticaria, but who experience sudden hives, pruritus and flushing, may receive an injection of an antihistamine.

If symptoms progress to indicate exercise-induced anaphylaxis, a dose of epinephrine, or adrenaline, will be injected into the patient. This drug constricts the blood vessels, prevents fluid leakage, opens the airways and raises blood pressure.  It is the only way to immediately relieve the life–threatening symptoms of anaphylaxis.

Once a diagnosis of exercise-induced anaphylaxis has been established, physicians might suggest that patients carry their own epinephrine auto-injection kit (allergy kit) so they can treat themselves in an emergency. This prescription medication is known as an autoinjector, and the medications generally last 18 months.

Those who are found to have exercise-induced urticaria may be prescribed an antihistamine to relieve symptoms. Antihistamines also can be taken as a preventative measure, as they inhibit the ability of histamines to produce future symptoms of an allergic attack.  An epinephrine auto-injector kit may be prescribed to some patients with exercise-induced urticaria, as there is a very small risk that exercise-induced urticaria can develop into exercise-induced anaphylaxis.

A physician may also ask the patient to keep a diary of all foods eaten before exercise. When maintained over a few weeks, this data can reveal patterns between certain foods and the appearance of symptoms. Patients can then avoid foods that appear problematic and see if the symptoms stop.