What is Allergic Asthma?

Asthma and allergies are two distinctly different conditions. But you may find they are often discussed together. It is important to know that people with asthma don’t always have allergies. And people with allergies don’t always have asthma. But there is a good reason for this marriage of terms.

For those seeking to understand more about respiratory health, it’s essential to learn “what is asthma.” Asthma is a respiratory disease characterized by inflammation and bronchospasm (also known as tightening of the airways). When the lining of the airways becomes swollen and clogged with mucus and fluid, it can lead to airway inflammation. When the muscles around the airways tighten and contract, attempting to keep the airways open, this is bronchospasm. This leaves patients with cough, wheezing, chest tightness and shortness of breath. When breathing issues become severe, this is referred to as an asthma attack, flare or exacerbation.

People with allergic diseases have an overactive immune system. Their immune systems react to normally harmless substances. This is known as an allergic reaction. It can involve many different symptoms. Common allergens include:

• pollen
• mold
• house dust mites
• animal dander
• foods.

An allergic response may vary by person and by allergen. In some cases, the immune response causes the airways to swell and overproduce mucus. When the immune system’s response to an allergen leads to asthma symptoms, it is called allergy-induced asthma. This type of asthma is also known as allergic asthma.

What are allergic asthma symptoms? 

People with allergic asthma experience the same symptoms of asthma as people with non-allergic asthma. These may include:

• Coughing
• Wheezing
• Chest tightness
• Shortness of breath

People with allergic asthma may also experience common allergy symptoms:

• Runny nose, usually with clear or pale-colored mucus
• Red, watery eyes
• Itching around the nose, mouth, or eyes

What are common allergens that can trigger allergic asthma?

What triggers allergic asthma may vary from person to person. Some common culprits that trigger allergic asthma include:

• Pollen from grass, trees and weeds
• Pet dander
• Dust mites
• Mold

People with allergies often find that their body reacts differently to different substances. Some allergens may cause a rash or eye symptoms; others may cause asthma symptoms. That is why it is important to know your triggers and how your body responds.

Allergic asthma vs. non-allergic asthma

You may be asking, “What is the difference between allergic asthma and non-allergic asthma?” After all, the symptoms are similar. It turns out the main difference is the cause of symptoms.

For people with allergic asthma, an outdoor or indoor allergen may trigger symptoms. For a person with non-allergic asthma, there may be other triggers. These triggers include smoke, pollutants, exercise, viruses, and many other things. Interestingly, a person with allergic asthma may experience intensified symptoms from these triggers.

People with allergic asthma will require treatment for their asthma symptoms, similar to non-allergic asthma, but they may also require treatment for their allergies.

It is believed that allergic asthma is caused by a combination of genetic and environmental factors. Genetics often play an important role in the development of asthma. Having a family member with asthma or allergies increases the risk of asthma. So understanding your family medical history is important.

What are some other key differences between people with allergic asthma compared to people with non-allergic asthma? Researchers have learned that people with allergic asthma are usually younger and more likely to have positive skin allergen testing than people with non-allergic asthma. People with non-allergic asthma are more likely to be female and develop more severe disease than those with allergic asthma.

What does allergic asthma feel like?

Distinguishing between non-allergic vs. allergic asthma can be challenging. This is because the asthma symptoms remain the same — cough, wheezing, chest tightness, shortness of breath. The major difference is people with allergic asthma normally experience symptoms after inhaling an allergen. They may also experience other non-respiratory allergy symptoms such as hives on the skin.

Does an asthma attack triggered by allergies feel different than a typical asthma attack? No, there is not really any difference between the two. But if you know you have allergic asthma, you may be able to predict when you may be most at risk for an attack. By knowing what triggers your asthma, you can be extra cautious if exposed.

Video: Diagnosing Allergic Asthma, with William Berger, MD

What’s the best medicine for allergic asthma?

Treating allergic asthma involves medications and other management tools. It involves addressing multiple components of the disease. You need to consider diagnosis, treating the disease, avoiding triggers, and follow-up care.

Diagnosis

Before deciding on the best treatment option(s), your doctor will need to examine you and confirm the diagnosis. They will take a personal medical history and family medical history. They will want to hear about your symptoms and triggers. Diagnosing asthma can be done based on clinical history. It also involves lung testing. This includes spirometry, fractional exhaled nitrous oxide (FeNO), and methacholine challenge tests.

Diagnosing allergies is done through skin prick and/or blood testing.

Treatment

Treatment for allergic asthma typically requires a two-prong approach. You must treat both the allergies and the asthma.

There are a lot of treatment options for allergies. Doctors often start with antihistamines. These medicines block histamine, which are the chemicals released during allergic reactions. These can be used when needed, but they often work better if taken daily during allergy season (depending on the allergen).

If you have had a severe allergic asthma flare, you and your doctor may want to consider allergen immunotherapy. This comes in either allergy shots or tablets. Immunotherapy helps build your tolerance to the allergen, with the goal of reducing or eliminating symptoms.

There are also several medications to treat patients with asthma. Some medications prevent or reduce airway inflammation. Others interrupt the allergic reaction that triggers symptoms. Still others relieve coughing and wheezing, making it easier to breathe. Treatment will depend on your symptoms and asthma severity. You and your doctor can develop an Asthma Action Plan to help you manage your disease. It is crucial to always carry your quick-relief inhaler to treat severe asthma flares.

Avoiding Triggers

If your doctor has confirmed you have allergic asthma, one of the things you want to do is prevent symptoms. You can do this through recognizing and avoiding your triggers.

That’s why recording your potential triggers and allergy testing are so important in determining the diagnosis. Once you know what you’re allergic to, you can monitor your symptoms to see if exposure to that allergen causes symptoms. If it does, then you can take steps to avoid the allergen or limit your exposure.

Follow-Up

Following up with your doctor is an important part of your asthma treatment plan. At your follow-up appointment, your doctor will discuss the frequency and severity of your symptoms. This helps the doctor determine your disease severity. Then you can work together to adjust your treatment to prevent uncontrolled asthma. This is the best way to ensure you are controlling the disease, rather than it controlling you.

Is allergic asthma curable?

There is no cure for allergic asthma, but it is manageable. With treatment of your allergies, you may be able to limit the frequency of your symptoms. Allergy immunotherapy can significantly reduce your allergy symptoms or even eliminate them. Not all allergens have immunotherapy options, so discuss the best treatment option with your doctor.

Does allergic asthma go away?

Some people think you can outgrow asthma, but this isn’t really true. Asthma can cause airway remodeling, so even if your symptoms subside over time, you don’t really outgrow it.

However, some people do outgrow certain allergies — or rather their body doesn’t have as strong of an allergic response. You may believe that your allergic asthma is going away, but think of it more like being in remission. Even after years without symptoms, an allergen exposure can trigger an allergic asthma attack.

Conversely, there is also increasing awareness that allergies and allergic asthma can develop in adulthood.

Is allergic asthma dangerous?

Allergic asthma, like any type of asthma, can be very dangerous and lead to an asthma attack. An asthma attack can happen when a trigger causes the lungs to become inflamed and swollen. Then the muscles around your breathing tubes tighten and spasm while more mucus than usual is produced. All these factors make the breathing tubes narrow and make it harder to get air into your lungs.

If you think you are experiencing an asthma attack, dial 9-1-1, use your quick-relief inhaler and seek urgent care.

Living with allergic asthma, you may feel frustrated or scared. This is normal. Asthma can be frightening but know that you can work with your doctor to develop a plan to treat both your asthma and your allergies. With treatment, you should be able to reduce the frequency and severity of your symptoms. Don’t let your allergic asthma prevent you from living a happy, healthy life.

Is allergic asthma affected by climate change?

Climate change poses a danger for people with allergic asthma. This is due to an increase in temperatures impacting the start, duration and intensity of pollen allergy seasons and pollen allergenicity. It is especially problematic for people with allergic asthma triggered by pollen. Extreme weather events, such as thunderstorms, may also lead to allergic asthma attacks.

For people with non-allergic asthma, climate change poses a risk when air quality is poor — often due to pollutants in the air.