More than 26 million Americans have asthma, and the number of people with it continues to rise. A chronic and potentially dangerous disease in which the airways of the lungs become inflamed, asthma is closely intertwined with allergies. “Anything that can cause allergies can also cause asthma symptoms,” said David Rosenstreich, MD, director of the Allergy and Immunology Division at Montefiore Medical Center in New York City.
As many as three out of four adults with asthma have at least one allergy. In fact, the most common form of asthma is allergic asthma, which accounts for 60 percent of all cases. Allergic asthma, also known as extrinsic asthma, is set off by inhaled allergens such as dust mites, mold, pollen, and pet dander. “When some people breathe in allergens, the tubes in their lungs become inflamed,” said Dr. Rosenstreich.
“People think of seasonal allergies as a runny nose, but your airway starts at your nose,” said Boyd Hehn, MD, a pulmonologist at Thomas Jefferson University and Hospitals in Philadelphia. “So it’s a chain reaction where that runny nose will cause the asthma to act up and the airway to become inflamed.”
Non-allergic, or intrinsic asthma, can be triggered by other factors such as anxiety, stress, exercise, cold air, and viruses. But many of the symptoms are the same for both kinds of asthma, including coughing, wheezing, tightness in the chest, and shortness of breath.
Rachel Lewis has been dealing with allergic asthma since she was a child, and she suffered her first asthma attack at age 7. “The doctors told me I would grow out of my allergies, but they’ve only gotten worse,” said Lewis, 30.
For people like Lewis, it’s critical to manage their exposure to allergens that may trigger attacks.
Doctors who suspect a patient has allergic asthma perform tests to see what they’re specifically allergic to. This can be done with a skin test, where a small amount of allergen is placed on top or slightly below the skin with a needle. Doctors then look for an immediate reaction, usually a rash resembling a mosquito bite. A blood test can also be done to look for allergen-specific antibodies in the bloodstream.
Fall allergy season is here, and people sensitive to common autumn allergens such as ragweed and mold are starting to feel its effects.
“Once the ragweed comes out, a lot of asthma patients are coming into the office,” said Dr. Hehn. “Controlling the allergies can only help in limiting asthma symptoms.”
Lewis lives in Texas, where fall can be a windy season with a lot of allergens blowing around. She’s looking forward to winter, “when I can go outside and actually breathe.”
Experts recommend those sensitive to seasonal allergies limit their time outdoors on days when there are high allergen counts. These daily counts can be found online through the National Allergy Bureau, part of the American Academy of Allergy, Asthma & Immunology.
There are several simple steps that someone with allergic asthma can take to control their symptoms. Here are a few suggestions:
- Keep home and car windows shut during peak allergy times.
- Use an in-home air filtration system.
- Protective bedding covers can keep dust mites out of pillows and mattresses.
- Limit cats and dogs to certain rooms in the home, and keep them out of the bedroom.
- Bathing pets regularly reduces allergen counts, and frequent vacuuming can help control dander.
Lewis has her own strategies to manage her allergic asthma:
- She takes hot showers after she’s been outside and exposed to pollen.
- She only uses fragrance-free laundry detergents.
- When she cleans, she wears a mask.
- She keeps a lint roller with her to get pet dander off her clothing.
“It’s a constant effort to keep all my symptoms balanced and controlled,” said Lewis. “Some people think I’m overreacting and making my allergic asthma a bigger deal than it is. But until you go through that experience of not being able to breathe, then you don’t really know what it’s like and how scary it can be.”
By Dr. Sanjay Gupta
October 29, 2013