Asthma is a chronic condition; those diagnosed with it will have to manage it throughout their lives. If you or someone you love is among the more than 25 million Americans who are estimated to have asthma, you know the importance of staying on top of the condition by doing things like better understanding what triggers your symptoms and how to prevent flare-ups.
Read on to get the most up-to-date info on developments in asthma research and how to prevent asthma attacks and minimize symptoms, plus way more about taking control of the condition.
Managing Daily Life and Complications of Asthma
There’s no one-size-fits-all approach to managing asthma. For some people, asthma can be a minor inconvenience; for others, it can be a serious, even life-threatening condition. Some people may experience asthma symptoms only occasionally in response to specific triggers, while others may have symptoms that are frequent and severe enough to interfere with daily activities. There are also different types of asthma, such as allergy-induced asthma and exercise-induced bronchoconstriction (EIB), which is asthma that’s triggered by physical exertion.
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Diet for Asthma
“For the most part, what you eat won’t affect your asthma,” says Mitchell Grayson, MD, the director of the division of allergy and immunology at Nationwide Children’s Hospital in Columbus, Ohio, and a professor of pediatrics at Ohio State University. But it’s still important for people with asthma to eat a healthy, balanced diet.
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Dr. Grayson describes the body as a “fine-tuned machine, designed for a specific type of fuel.” That fuel is a healthy, balanced diet, he adds. And if you take in the wrong fuel — foods that are high in fat and sugar — you increase your risk of health problems like high cholesterol, diabetes, and a compromised immune system, which can put you at risk for all sorts of other health problems, too. If you have asthma, eating a healthy diet becomes especially important: “The healthier you are, the better you can handle an asthma attack and rebound from it,” Grayson says.
It’s also important to point out that some foods and food additives can trigger asthma symptoms. According to the National Heart, Lung, and Blood Institute (NHLBI), certain foods, such as those containing sulfites (which are found in foods like dried fruits, wine, and processed potatoes) can worsen asthma symptoms in some people and should be avoided.
According to the Asthma and Allergy Foundation of America, food allergies may also increase your risk of asthma attacks, so talk to your doctor if you suspect you may have an allergy to certain foods. Common allergy-causing foods that may interfere with asthma management include peanuts, tree nuts, eggs, shellfish, milk, soy, and wheat.
And while a good diet cannot necessarily prevent asthma, there is evidence that eating healthily may reduce your risk of developing asthma. For example, a study published in the journal Lung found that among a group of Peruvian children ages 9 to 19, those who ate a Mediterranean-style diet rich in foods like salmon and other fish high in omega-3 fatty acids, olive oil, fresh fruits and vegetables, and whole grains were less likely to develop asthma than the children who did not eat this way. Another study showed that eating a healthy diet rich in fruits, vegetables, and fiber may help reduce symptoms and help people gain better asthma control.
Exercising With Asthma
Since asthma attacks make it difficult to breathe, it’s understandable that people who have asthma may have concerns about what kind of exercise they should do, or whether it’s safe to work out at all. But exercise is important if you have asthma — for overall health and also to keep the lungs healthy, according to the American Lung Association (ALA).
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In addition to lowering your risk of type 2 diabetes, cardiovascular disease, stroke, and some forms of cancer, as well as strengthening bones and muscles, improving your mood, and helping you live longer, physical fitness has been shown to improve asthma management specifically.
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A study showed that higher levels of physical activity were associated with significantly better asthma control; those who exercised the most (being active approximately 30 minutes most days of the week) were 2.5 times better at controlling their asthma compared with people who weren’t physically active. And exercise can also help you maintain a healthy weight, which can be important for asthma management; according to the NHLBI. Obesity can negatively impact asthma control, and as little as a 5 to 10 percent weight loss can help asthma symptoms.
Before embarking on any physical activity, be sure to talk with your doctor about how you can exercise safely with asthma. Your doctor may recommend strategies like warming up before workouts and taking breaks to avoid unnecessary physiological stress or overexertion, or advise which combination of medications you might need and when to take them before workouts, says Paul V. Williams, MD, emeritus physician at the Northwest Asthma & Allergy Center in Seattle and secretary-treasurer of the American Academy of Allergy, Asthma & Immunology. Your doctor may also have tips to avoid asthma triggers, like working out indoors to avoid cold weather (which may increase the likelihood of an asthma attack), checking pollen counts, or planning to steer clear of high-pollution areas before going outside for a workout, says Dr. Williams.
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Exercise strategies should be individualized for each patient’s symptoms, says Williams. If you have a problem with pollen, you may want to check pollen counts and avoid exercising outdoors in the morning during certain times of the year, since that’s when some types of pollen are at their highest levels, says Williams. And nearly anyone with asthma should avoid exercising outdoors when the air quality is bad, he adds. “Know your triggers and work with your doctor to get medication to improve your ability to exercise,” he says.
Minimizing Environmental Asthma Triggers at Home and Work
You can take measures to keep your home asthma-friendly by identifying and minimizing common indoor asthma triggers, such as pet dander, mold, dust mites, chemical irritants (like cleaning agents, paint, and air fresheners), and cigarette smoke, advises the Environmental Protection Agency. Some smart strategies for managing asthma triggers include designating pet-free zones in the house (such as bedrooms), washing bedding and mopping and vacuuming frequently (use a face mask or a vacuum with a HEPA filter if you’re doing it yourself, or ask someone without asthma in your home to do the vacuuming or dusting), and putting dust-mite covers on pillows and mattresses.
If you’re experiencing asthma symptoms at work, speak with your supervisor and coworkers to try to identify the triggers — it could be anything from moldy carpets to dust to industrial cleaning chemicals — and then figure out a way to minimize your exposure.
Managing Your Prescriptions and Creating an Action Plan for Asthma
It’s important that you follow your healthcare provider’s instructions for your asthma treatment, which may include quick-relief medications taken at the first sign of an asthma attack, long-term control medications, and allergy shots. The ALA suggests setting up a medicine schedule showing what you should take when, taking your medicine in conjunction with a routine habit (like when you brush your teeth or before or after certain meals), or setting an alarm on your phone or watch.
You should also set up a detailed asthma action plan with your doctor, which should include information about what medications you take (with the prescribed dosage and when you should take them), as well as what to do if your medications don’t relieve symptoms like coughing, wheezing, shortness of breath, or chest pain. The asthma action plan should also have a section that details what to do in an emergency and includes important information, like emergency telephone numbers for your healthcare providers, family, and friends.
Make copies of your plan and share it with loved ones, coworkers and, if your child has asthma, your child’s teachers and school nurse.
Make sure that you keep your rescue medication nearby at all times so you don’t have to go looking for it in the event of an emergency, says Williams. Keep extras in a desk drawer at work, your purse or backpack, and other convenient and easily accessible places. Check expiration dates regularly to make sure they haven’t expired. And above all, work with your healthcare providers to be certain that you know how to use your rescue inhaler correctly.
Finally, keep track of your symptoms in an asthma journal, noting things like when you wake up at night with a cough or experience symptoms like wheezing or shortness of breath, or what leads to asthma flares and when they happen, says Williams. “This can be especially helpful if you’re a new patient or if your asthma treatment is not working,” he says.
If your asthma treatment isn’t working (if you’re taking your prescribed medication as directed but your symptoms persist or you’re experiencing frequent asthma attacks), it might be a sign that you need to adjust or change your medication.
Complementary and Alternative Medicine for Asthma
Some complementary or alternative therapies may help with asthma management. They include breathing techniques, yoga, meditation, acupuncture, caffeine, and dietary supplements, such as vitamin D. There’s also some evidence that certain teas, such as licorice, fennel, eucalyptus, and green and black tea, may have some beneficial effects on lung function and may be good for people with asthma.
Other complementary and alternative medicine approaches that have been touted as being helpful for asthma but don’t yet have solid scientific evidence to back them up include Himalayan salt lamps, essential oils, and accupressure.
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If you want to try some complementary and alternative therapies for asthma, make sure you talk to your healthcare provider first. Some supplements may interact with your medications or cause health problems, and just because something is promoted as “natural,” it doesn’t mean it’s safe, advises the National Center for Complementary and Integrative Health. Never use complementary therapies as substitutes for the conventional asthma treatments prescribed by your doctor.
When it comes to complementary medicine, “There’s a lot we don’t know,” says Williams. “There isn’t good quality information, and much is myth or anecdotal.” He also points out that unlike medications, dietary supplements are not reviewed for safety and effectiveness by the Food and Drug Administration, so a product may not contain what you think you’re buying. “We don’t know if it might interfere with your asthma medication or increase the potential toxicity of your medication,” cautions Williams.
Traveling With Asthma
You can tailor your home and workplace to minimize triggers that may set off your asthma symptoms, but traveling can make it a bit trickier to adjust your environment to control your asthma. Whether you’re traveling by plane, train, or car, make sure your asthma medications are on hand and not packed away in luggage that’s inaccessible in case you have an asthma attack, advises Grayson. And be sure to bring extra medications in case you run out or need more than the usual amount, suggests the Asthma and Allergy Foundation of America (AAFA). If you use a nebulizer, don’t forget to bring plugs (and adapters if you’re traveling to a foreign country) and extra batteries for portable models; and remember to pack any other equipment you use, like spacers and peak flow meters.
If dust mites trigger your allergies, you might want to consider bringing a dust-mite-proof pillow and mattress cover. Contact your health insurance company to see what services may be covered at your destination and bring all relevant medical records, including your asthma action plan and an overview detailing your asthma history. “Even if you have mild or well-controlled asthma, have some idea of what you would do in an emergency,” Grayson says — and some idea of what part of the costs you might be responsible for.
Your asthma might be controlled, but when you travel and are in enclosed spaces with people who may be sick, you face an increased risk of catching a cold or another illness that could exacerbate your asthma, notes Williams.
Also, if you plan to hike or engage in other physical activity you don’t typically participate in during your trip, be sure to talk to your healthcare provider about any precautions you may need to take. The AAFA advises using services like AccuWeather.com and Pollen.com to check the pollen and weather forecasts for your destination.
Finding Doctors for Asthma
Which healthcare professionals are on your asthma treatment team may depend on factors like what your insurance covers and what services are available where you live. Depending on the severity of your asthma, your individual needs, and what you have access to, your asthma care team may include the following experts:
- Primary care physician
- Nurse practitioner
- Pulmonary rehabilitation specialist
- Exercise physiologist
- Mental healthcare provider
Do You Need an Asthma Specialist?
Primary Care Physician
A primary care physician is often the first medical professional who diagnoses asthma in a patient. They may even be the one treating a patient’s asthma, but if the condition is severe, or if the treatment isn’t effective in controlling symptoms, your primary care doctor may refer you to an asthma specialist, such as an allergist-immunologist or a pulmonologist.
An allergist-immunologist, like a pulmonologist, is an asthma specialist who can help you better manage your condition. Since people with asthma frequently have allergies, too, an allergist-immunologist can identify asthma and allergy triggers, and conduct allergy and breathing tests to find the cause of your asthma.
Pulmonologists are physicians who are specially trained in treating the respiratory system, and some pulmonologists focus on specific conditions, such as asthma or chronic obstructive pulmonary disorder (COPD).
An otolaryngologist, also known as an ear, nose, and throat (ENT) doctor, may be a part of an asthma healthcare team because asthma is often linked to chronic sinus infections.
A nurse practitioner is a highly trained nurse who can help take your complete medical history, give you a physical examination, and conduct some diagnostic procedures and testing. These professionals can help people with asthma become familiar with best practices for managing their symptoms and answer questions about asthma treatment.
Pulmonary Rehabilitation Therapist
If your asthma is severe enough that it interferes with daily activities like exercise or sleep, your doctor may recommend that you see a pulmonary rehabilitation therapist to help you with things like how to improve symptom control and learning proper breathing techniques. “Pulmonary rehabilitation therapists usually help people with severe asthma or COPD who can’t do physical activity,” says Williams.
A pharmacist can answer questions about asthma medications and educate you about side effects, medication interactions, and other helpful information to help your asthma medication work effectively.
An exercise physiologist can measure the lungs’ response to physical activity and help develop an exercise and fitness program for people with EIB, which causes shortness of breath, coughing, wheezing, or other asthma symptoms when you exercise. “Most people with asthma won’t need an exercise physiologist, but they can be helpful for people with exercise-induced asthma that’s severe, or for whom conventional therapies aren’t working,” says Williams. “They can also help athletes with asthma.”
Mental Healthcare Provider
Living with a chronic condition can pose some challenges for both patients and their loved ones, and asthma is no exception, according to the AAFA. Talking to a therapist or another mental healthcare provider may be helpful for asthma management, since stress can be a contributor to asthma flares, as well as for overall emotional and mental health (more on that below).
Your Mental Health and Asthma
Asthma can very much affect your mental and emotional health, and vice versa: Your mental and emotional health can affect your asthma. According to the AAFA, there is evidence that emotions like anger, fear, excitement, and laughter may trigger asthma flares, possibly because your breathing changes when you experience strong emotions. Anxiety and stress may be associated with poor asthma control, too.
Managing Stress and Asthma
Stress and anxiety can trigger asthma symptoms, and in turn, uncontrolled asthma can (quite understandably) increase stress and anxiety. By managing stress through therapy, breathing practices, and other relaxation techniques, people with asthma can reduce their risk of having a stress-induced asthma attack or episode. Studies show that mindful breathing and observation can reduce stress and enhance overall health, according to the AAFA.
Managing Mood Disorders (Like Depression and Anxiety) and Asthma
Research shows that both depression and anxiety are complications that can develop as a result of having uncontrolled asthma. A study found that people with asthma were almost twice as likely to develop depression compared with those who didn’t have asthma.
“Stress can exacerbate asthma,” notes Grayson. If stress, anxiety, or any emotional concerns are interfering with your life or relationships, you should ask your doctor about whether it might be appropriate to see a mental health professional. Mental health concerns, like depression or anxiety, may also interfere with asthma medication and treatment plan adherence, Grayson adds. Those issues should be addressed so asthma can be better managed.
How Asthma Can Affect Your Relationships
For some people, asthma (particularly uncontrolled and severe cases) can take a toll on relationships. The results of a survey released in 2018 by the AAFA called “My Life With Asthma” revealed that asthma not only affects the person who has it but, unsurprisingly, it can also negatively impact that person’s family, caregivers, and coworkers. The survey found that as many as 64 percent of people with severe and uncontrolled asthma reported that the condition affected their family relationships, and 55 percent said it negatively impacted their relationships with significant others and friends.
Romantic Relationships and Sex Life With Asthma
In a 2017 survey by Asthma UK, a nonprofit that works to stop asthma attacks and funds asthma research, a whopping 68 percent of the 544 survey respondents reported that their sex lives had been directly affected by their asthma. As many as 73 percent said they felt embarrassed about using their inhaler on a romantic night out and nearly half (46 percent) admitted that they would have felt more sexually confident if they didn’t have asthma.
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Another study examined the impact of the condition on intimacy and relationships was examined in nine people with severe asthma. All of the patients said that asthma affected their personal relationships. They reported having a negative self-image and less desirability due to the corticosteroids they had been prescribed; experiencing fear at being perceived as a burden; or having difficulty adjusting to their partner acting as their caregiver. Some also expressed feeling undesirable or guilty about their inability to feel romantic or perform sexually.
Some people with asthma might find that their relationships are impacted by side effects of their medication, like weight gain or sleep problems — which can, in turn, affect self-esteem or mental and emotional health, says Williams. If you’re experiencing side effects or any other issues that are impacting your relationships, talk to your doctor about alternative approaches, he says. “Sometimes, lifestyle adjustments may need to be made or medications adjusted. Today, we have a great armament of medications,” says Williams.
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Family Planning With Asthma
If you’re planning to start a family, the most important thing to remember is that you need to control your asthma during pregnancy, says Williams. “About one-third of women say their asthma becomes worse, one-third say it gets better, and one-third say it’s the same,” says Williams. (Those statistics have also been reported by the AAFA.)
If asthma is not controlled in a pregnant woman, it could reduce the amount of oxygen in that woman’s blood. And since a fetus needs a constant supply of oxygen for normal growth and development (which it gets from the mother’s blood), it’s imperative that an expectant mother’s asthma is treated, according to the AAFA.
“Some women may worry that taking medication during pregnancy could cause harm to their baby,” says Williams. “But most studies show that many asthma medications are safe in pregnancy and breastfeeding.” Talk to your obstetrician if you have concerns.
Drugs and Medication for Asthma
Everyone with asthma has unique needs and considerations. Treatment for asthma may include taking preventive medications, using a certain type of inhaler when you experience flare-ups, and lifestyle changes. Your doctor will help design a specific asthma treatment plan that works for your lifestyle and particular needs.
Asthma medications generally fall into two types: quick-relief and long-term control medications.
Fast-acting medications relieve asthma symptoms when they happen; they include these options:
- Short-Acting Beta2-Agonists Albuterol (Ventolin), levalbuterol (Xopenex), and others are inhaled to quickly reduce swelling in the lining of the airways and relax the smooth muscles to ease breathing.
- Anticholinergics These open the airways by relaxing the smooth muscles around the airways and also reduce mucus production. They work more slowly than short-acting beta2-agonists.
- Combination Quick-Relief Medications Containing both an anticholinergic and a short-acting beta2-agonist, these are available as an inhaler or nebulizer, according to the AAFA.
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Long-term control medications, which you may need to take daily through an inhaler or in pill form, reduce inflammation in your airways and make them less sensitive to triggers. Some long-term control medicines for asthma include these varieties:
- Inhaled Corticosteroids These prevent and reduce airway swelling and mucus in the lungs.
- Inhaled Long-Acting Beta-Agonists Opening the airways by relaxing the smooth muscles around that area, inhaled long-acting beta-agonists are always taken in combination with an inhaled corticosteroid.
- Biologics Shots or infusions made from cells extracted from living organisms, such as bacteria or mice, are given every few weeks. They work by targeting a cell or protein in your body to prevent airway inflammation. They’re most commonly prescribed for severe asthma cases and include omalizumab (Xolair), mepolizumab (Nucala), resulizumab (Cinqair), dupilumab (Dupixent), and benralizumab (Fasenra).
- Leukotriene Modifiers Taken by mouth in pill or liquid form, they block the production or the effect of leukotrienes, chemicals that can lead to asthma attacks.
- Cromolyn Sodium This inhaled nonsteroid medicine is less commonly used today. It prevents cells from releasing inflammation-causing chemicals when they come into contact with an asthma trigger.
- Methylxanthines These oral medications help relax and open the airways.
- Oral Corticosteroids Available in pill or liquid form, oral corticosteroids treat certain cases of severe asthma that don’t respond to other asthma medicines.
Money Matters: The Cost of Living With Asthma
Asthma is a chronic condition, which means you don’t take medication for a finite amount of time as you would with, say, antibiotics. Many people need long-term control medications to manage their asthma. There’s also the cost of missing work or school, as well as the cost of equipment you may need. The costs can add up. Here is an overview, along with some tips on reducing your overall expenses for asthma.
Medication Prices for Asthma
In a report from 2017, researchers tabulated the annual medical cost of living with asthma as $3,266 per person. That amount includes costs for prescriptions, office visits, hospitalizations, and emergency room care, based on cost estimates from the Centers for Disease Control and Prevention.
If the cost of your asthma care is a concern, talk to your doctor about your options. Your doctor may be able to suggest ways to help, such as where you can apply for patient assistance programs, how to find manufacturer coupons, and more.
Managing Your Work Life With Asthma
Asthma can affect your ability to do some jobs and work in certain environments. But it shouldn’t stop you from doing your job.
According to the American Academy of Allergy, Asthma and Immunology (AAAAI), as much as 15 percent of all asthma in adults is work-related. Any number of things you’re exposed to every day at work may trigger symptoms, including cleaning products, paint, dust (including fine particles from wood or flour), mold, insects, and cigarette smoke.
If you are experiencing asthma flares at work, the AAAAI advises working with your doctor and employer to identify your triggers and take measures to avoid your exposure as soon as possible, since long-term exposure to allergens could lead to permanent lung damage.
“Let your supervisor know if you’re experiencing a problem,” says Dr. Grayson. They may be able to take measures, like asking coworkers near you not to wear strong perfumes if that’s a trigger, finding alternative chemicals or materials, ventilating your workspace, or eliminating sources of mold.
The Americans with Disabilities Act (ADA) is a federal law that gives people with disabilities the right to ask for accommodations in cases where policies, practices, or conditions leave you at a disadvantage (such as if a moldy carpet at work or school is making you or your child sick). The ADA mandates that employers must make reasonable accommodations to allow employees to work safely, though in some cases, there may be limited options, Dr. Williams explains (for example, if you work in a bakery and flour is triggering your symptoms).
Can You Apply for Disability if You Have Asthma?
Yes; in most cases you can apply for disability if you have asthma, according to the AAFA. Asthma and allergies are usually considered disabilities under the ADA.
Thanks to a change that was made to the ADA in 2008, conditions that may show symptoms only at certain times, like asthma, are included under its umbrella, meaning that people with asthma (even if it is well-managed) are protected by the law, according to the AAFA.
If you need to ask for changes to be made at your workplace, talk with your employer or, if possible, a disabilities service coordinator at your workplace. You can also contact the Department of Justice’s ADA hotline at 800-514-0301 or 800-514-0383 (TTY). Operators can answer questions, provide free informational materials, and explain how you can file a complaint. You can ask them about legal options if you feel there has been a pattern of discrimination or there is a public safety risk.
Clinical Trials for Asthma
Most clinical trials related to asthma involve medications, but they may also investigate lifestyle changes and behavioral and environmental factors, like avoidance of triggers, says Williams.
Clinical trials are important because they can help doctors and researchers better understand how and when drugs work, says Grayson. Clinical trials, he says, can pursue these goals:
- To show if a new drug is as good as or better than current medications
- To identify people who may do better on a certain drug
- To reveal biomarkers or environmental factors that will tell us who is more likely to have asthma, and which medications may work better for certain individuals
How to Find a Clinical Trial
For a comprehensive list of asthma-related clinical trials, you can search “asthma” and subcategories such as “asthma in children” at ClinicalTrials.gov. You can also find asthma clinical trials at the National Institute of Allergy and Infectious Diseases.
What to Consider Before Joining a Clinical Trial
A person with asthma may decide to join a clinical trial to receive a treatment or medication that may not be otherwise available, or they might be motivated to help others with asthma and expand broader medical knowledge, says Grayson. And in some cases, you may have access to medical care or medication for free, potentially even after the trial is over, notes Williams.
The study researchers will screen your eligibility if you apply, but you should also consider your own commitment. You should only join a clinical trial if you plan to follow the researchers’ directions, such as taking medication as instructed, says Grayson.
Another reason you may not be a good candidate is if you are uncomfortable with the possibility that you might be unknowingly assigned to a placebo arm of a trial and not receive the active treatment or experimental therapy, Grayson adds.
Latest News and Research on Asthma
There is currently a lot of work and research being done in the field to improve what managing asthma means.
News and Research on Asthma
Stay up-to-date with current research findings about asthma by paying attention to news from asthma research and advocacy organizations, like the AAAAI and AAFA. Or look for asthma news stories on EverydayHealth.com, such as the following:
- Asthma, Allergies Tied to an Increased Risk of Heart Disease
- What You Need to Know About the New Coronavirus if You Have Asthma
- Study Suggests Asthma and COPD May Increase RA Risk in Women
Asthma Awareness Month
People who live with asthma or allergies know that staying up-to-date on the latest news and guidelines about their condition is important for symptom management and avoiding flare-ups. Asthma and Allergy Awareness Month, which was established by the AAFA in 1984 and has been observed every May since then, is an opportunity for organizations, healthcare providers, patients, and caregivers to come together to raise awareness about asthma and allergies.