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Asthma

AsthmaWhat are your triggers and how can you deal with them?

When you have asthma, thoughts about your condition are never far from your mind. There are usually a number of triggers, some of which you may not really be aware of. You may know, for example, that your asthma is often worse at night, or perhaps staying with friends, but may not have looked into why that might be. Or it may be cold weather induced or coincide with the hay fever season.

When you do feel well you live a normal life and may forget to be aware of triggers. You may forget to take your preventative which can then leave you unprepared. Winters can be particularly hard and you may be under the weather for a long time. Catching a cold can turn into real illness.

You may believe there is not much you can do about your condition other than take the preventative. We realise that asthma can be a debilitating and even life threatening condition triggered by different things in different people. However, through our work with asthmatics we have found that many respond very favourably to reducing the allergens in their indoor environment. Read on for more information on asthma, its symptoms and triggers...

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What is asthma?

Asthma is a common chronic inflammatory condition of the lung airways, affecting many of us in the UK. Symptoms can include:

  • Coughing
  • Wheezing
  • Chest tightness
  • Shortness of breath

Symptoms can often be worse at night time. 

Bronchospasm is the key event in asthma; a sudden, but reversible, tightening of the bands that surround the airways. The narrowed airways stop the air from leaving the lungs at the normal speed. This means that the lungs are still half full when it is time for the next inhalation. Taking more air in produces pain and tightness in the chest. Insufficient oxygen reaches the bloodstream because there is so much stale air in the lungs. This causes a feeling of breathlessness. Even when the muscles relax after an asthma attack, the underlying inflammation still remains. This may be caused or partially caused by allergy. Among asthmatic children, allergies are thought to be detected in 80-90%. Inflammation makes the lining of the airways swell up. The inflamed airway lining often makes more mucus than usual which can clog up the airways even more. The inflamed airways send nerve impulses direct to the airway muscles telling them to contract.

What causes asthma?

More research needs to be done into this topic. However, it is believed that a predisposition to asthma can be partly inherited. Asthma may also be partly caused by lifestyle. A poor diet and too much cleanliness have previously been suggested as potential causes.

What triggers asthma? 

Inflammation of the airways can often begin with an allergic reaction to something in the air; such as house-dust mite or pet allergens. It could also start with a viral infection or a large dose of an irritant such as chlorine.

Once inflammation of the airways has begun, they become oversensitive and may contract at the smallest provocation. Triggers vary from one asthmatic to another and could include one or more of the following:

  • Cold or dry air
  • Strong smells including perfume and fragrant flowers
  • Irritants in the air (cigarette smoke, traffic fumes, indoor pollutants such as gas, industrial pollutants)
  • Sulphur dioxide used as preservatives in some foods and drinks
  • Weather conditions particularly thunderstorms
  • Any altered breathing pattern (laughing, coughing etc.)
  • Stress and anxiety
  • Strong emotions
  • Food sensitivities 
  • Exercise
  • Allergens
  • Colds, flu and chest infections.

How is it diagnosed?

If you think you may have asthma you should go for a consultation with your doctor. In order for a diagnosis of asthma to be given two tests need to be carried out. The peak flow test is the top speed of the outgoing air from your lungs measured with a peak flow meter. Because of inflamed airways, asthmatics tend to have a lower than normal peak flow. The reversibility test measures peak flow before and after inhaling a beta-2 reliever drug which relaxes the airway muscles. If the improvement is more than 15%, this strongly suggests asthma.

Asthma may be affected by and combined with other diseases which include allergic problems in the nose, sinusitis, the fungi causing athlete's foot and gastro-oesophageal reflux, emphysema and bronchitis.

Your doctor may send you for skin prick tests to determine which airborne allergens are the basic cause of airway inflammation. Alternatively you can use simple detective work to determine which allergens may be affecting your asthma. Keeping a diary to record your symptoms can help with this. In some cases food sensitivity is the initiating cause of asthma but because the reaction is delayed the link may not be obvious and an elimination diet (with your doctor's consent) may be necessary to identify the offending food. It has been suggested that as many as 60% of brittle asthmatics have a food sensitivity. Asthma that is unstable and difficult to manage is described as brittle asthma. Despite extensive and careful treatment with drugs, it can very easily develop into a severe asthma attack.

How is it treated?

The most important factor in the treatment of asthma is to follow your doctor's advice regarding your medication. Following this you need to look at environmental control, minimising contact with triggers, allergens and irritants. Remember that bronchospasm needs to be addressed with your doctor, who may recommend the use of reliever drugs as part of a treatment plan. 

The link between asthma and allergies

Allergic reactions can cause asthma symptoms. The same triggers that set off dust mite allergies, eczema, hay fever or even some food allergies can also sometimes set off signs of asthma. This is known as ‘allergic asthma’.

Alongside your medication and reducing your exposure to allergens, you can help yourself by treating associated conditions. These may include sinusitis, rhinitis and hay fever, dust mite and mould allergy. It is always a good idea to see where you can improve your diet. Addressing these issues may help to reduce the inflammation in the airways.

Here’s a brief overview of the allergic conditions that can be linked to worsened asthma. Always seek your GP’s advice in the first instance, but you can also try the following measures to avoid the triggers:

House dust mite allergy

The protein allergen within house dust mite droppings can cause issues for some asthma sufferers. House dust mites are extremely common and are present in virtually every home (even very clean ones!). If house dust mite droppings are an asthma trigger for you, you might notice that your symptoms flare up when you are in dusty places, when making the bed or when you first wake up in the morning. Click here to read more about this particular condition.

If you know that dust mites are an asthma trigger for you, then you can take steps to reduce your exposure to the allergen, including:

Mould allergy

Moulds can be found both indoors and outdoors. They release thousands of microscopic spores, which, when inhaled or in contact with the skin, can trigger allergic reactions in some people. Moulds can irritate the bronchial membranes and provoke asthma symptoms. You can read more about mould allergy here.

To reduce your exposure to moulds, try the following measures:

  • Ensure your home is well ventilated. Use extractor fans in the bathroom and kitchen to direct damp air outside and keep doors closed when showering or cooking.
  • Ensure your home is free from leaks and damp patches, and cleaned regularly. You may need to ask a non-allergic friend or family member to do this for you! Pay particular attention to bathrooms, kitchens and bedrooms.
  • Try to keep relative humidity between 40-50% indoors – a dehumidifier and a hygrometer can help you to achieve this.  
  • Many people don’t realise that moulds can grow in bedding and mattresses. Airing your bedding daily is important.
  • Consider using an air steriliser or purifier (these ones are ideal) to destroy airborne mould spores
  • Consider wearing a mask when entering damp basements, cutting grass or walking in woodland areas in mild, damp weather – or avoid these activities entirely if possible.

Pet allergy

Pets are a common asthma trigger. You can read more information about pet allergy here. Proteins in animal saliva, skin flakes and urine can cause reactions in some people and make asthma symptoms worse. If you find that this is the case with you, the following allergen avoidance measures may help:

  • If you are visiting someone that you know has a pet, consider wearing a mask. If your allergy is severe, your GP or asthma nurse may be able to give you a prescription to take in advance.
  • If you already have a pet at home and parting with it is not an option, restrict your pet from your bedroom and main living areas.
  • Ask another family member or housemate to groom your pet, clean their bedding and litter trays for you.
  • An air purifier can be helpful for removing airborne allergens from pet dander.
  • A HEPA vacuum cleaner (preferably a bagless one like these) is ideal for picking up pet hair and disposing of allergens hygienically and safely.
  • Topical treatments and allergy sprays can be very helpful – just make sure they are based around gentle, natural ingredients. View this selection of sprays and topical solutions for our top picks.

Hay fever

Pollen is a common asthma trigger. It is thought that between 20% and 60% of hay fever sufferers are also asthmatic. Around 80% of asthma sufferers are also allergic to pollen. (Source: asthma.org.uk).

There are a variety of different types of pollen, which are released at different times of the year and in different areas of the UK. Grass pollens are the most common hay fever cause, and are prevalent from around May to July. Tree and weed pollens can also cause problems. You can read more about hay fever here.

If pollen affects your asthma symptoms, you can try the following steps to reduce your exposure to the allergens:

  • Change your clothes when coming indoors and leave your shoes outside the door – they can transport pollens.
  • Consider wearing a mask to help prevent the pollens from reaching your lungs.
  • Protect your eyes with wrap-around sunglasses
  • Keep doors and windows closed inside. Consider using an air purifier to remove airborne pollens.
  • Don’t drink alcohol when the pollen count is higher – it can make you more sensitive to pollen.
  • Clean your home thoroughly and regularly by damp-dusting and using a HEPA vacuum.
  • Apply a little HayMax barrier balm underneath your nostrils – it traps more than 1/3 of pollen before it enters the body, along with dust and pet dander.

 

Potential triggers that you may not have considered

If your drinking water is heavily chlorinated you may wish to drink filtered water and use a shower filter to prevent inhalation of chlorine from the shower steam. View a selection of water filters here.

Also take care with the toiletries and cleaning products that you use. Avoid aerosols, harsh chemicals and synthetic fragrances and opt for gentle alternatives.


Please note: Information included in this website is intended for information purposes only and is not to be used as a substitute for consultation with a medical practitioner.

References: The Allergy Bible, Linda Gamlin

Clinical Medicine 4th edition, Kumar and Clark.

 Professor Jonathan Brostoff and Linda Gamlin: Asthma The Complete Guide.

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