Allergic asthma

What it is

Having allergic asthma means allergens trigger your asthma symptoms.¹ AAAAI says allergic asthma, or allergy-induced asthma, is the most common form of asthma.² Many people with asthma also have allergies, and allergens are the most common asthma trigger.¹

NHLBI says asthma is usually a type of allergic reaction, and people who have asthma often have other allergies, such as food or pollen allergies.⁴ Allergens cause an allergic reaction because your body thinks they are harmful, and your immune system responds by releasing an antibody called immunoglobulin E (IgE). Too much IgE can cause inflammation (swelling) of the airways in your lungs. A similar process happens in the nose and sinus areas with allergic rhinitis, also called hay fever.¹ The airways may also become too sensitive and narrow too much when you breathe in something that is usually harmless. When this happens, they swell, narrow and can make more mucus, and the muscles around them may tighten.⁴

Asthma is common. In 2023, about 27.8 million people in the US, or 8.4%, had current asthma.⁷ Allergies are not the whole story, though: not everyone who has allergies has asthma, and not everyone with asthma has allergies.³

Asthma usually starts during childhood. More boys than girls have asthma as children, while in adults it is more common among women. Family history, such as a parent who has asthma (especially your mother), is one of many factors that may work together to cause asthma.⁴

Symptoms

AAFA says the common signs and symptoms of allergic asthma are the same as other types of asthma: shortness of breath, cough, chest tightness or pain, wheeze (a whistling sound when you breathe), waking at night due to asthma symptoms, a drop in your peak flow meter reading (if you use one), and trouble doing physical activities.¹ Allergy symptoms come along too, such as red and itchy eyes, sneezing, a stuffy nose and an itchy, runny nose.¹

In asthma, the symptoms often follow a pattern: they come and go over time or within the same day, and they are worse at night or in the morning.⁵

During an asthma attack, swelling or tightening narrows the airways, making it harder to breathe.⁶ For some people, an attack starts with coughing. The chest may feel tight or as if someone is sitting on it, and you may start to wheeze or feel lightheaded.⁶

Other conditions can cause these symptoms, but in asthma they often follow the pattern described above.⁵ Asthma is sometimes hard to diagnose because it can look like other breathing problems, such as emphysema, bronchitis and lower respiratory infections.¹⁰ In an NIH comparison of colds, flu, COVID-19 and airborne allergies, chest discomfort is rare with allergies, except for people with allergic asthma.¹⁵

What triggers it

ACAAI says allergens such as pollen, dust and pet dander can trigger asthma symptoms and asthma attacks in certain people, and that this is called allergic asthma.³ AAAAI gives dust mites, pet dander, pollen and mold as examples of allergens, which are typically harmless substances.²

Outdoors, pollen from trees, grasses and weeds is a very common allergen, and pollens peak during different seasons of the year.¹ Throughout the US, trees produce the most pollen from February through April. Grass pollen is most common from April through early June, and weed pollen appears in the late summer and fall.¹² If you have asthma and pollen makes it worse, you may have allergic asthma.¹² Mold spores can also reach the lungs and trigger asthma, and allergic symptoms from fungus spores are most common from July to the first hard frost.¹³

Dust mites are spider-like creatures too small to see with the naked eye. They live in warm, moist areas and are found in places such as beds, pillows, carpets, furniture, clothes, stuffed toys and fabric.¹ Urine, feces, saliva, hair or dander (skin flakes) from animals such as cats, dogs, mice, rats and birds are all allergens.¹ Studies show most urban homes have cockroaches, and their feces, saliva and body parts are believed to be allergens.¹

Asthma symptoms can also start or get worse with viral infections such as a cold, and they can be triggered by exercise, allergies, cold air, or breathing too fast from laughing or crying.⁵

When to see an allergist

If you think you have allergic asthma, AAFA advises seeing a board-certified allergist.¹ AAAAI says knowing if your asthma is allergic is essential for taking control of your condition.² For people with rhinitis, such as hay fever, an allergist can screen for allergic asthma, which is common in rhinitis patients.¹⁴

An allergist will ask about your symptoms and whether asthma runs in your family, then examine your chest, eyes, ears, nose and throat. One of the most common ways to test for asthma uses a spirometer, which measures how well your lungs are working. The allergist may also suggest a skin test, blood test or chest X-ray.⁹ An allergist can determine if you have allergic asthma by doing tests, and by taking a family history and testing with skin or blood tests, can identify the allergens that trigger your asthma.³ An allergist can also help you recognize the early warning signs of an asthma attack.⁸

AAFA’s signs and symptoms of an asthma emergency that need urgent medical care include asthma getting worse quickly, chest tightness or pain, severe shortness of breath, breathing that is faster or slower than normal, breathing that may be hard or shallow, and trouble walking or talking due to shortness of breath.¹¹ They also include chest retractions in children (the skin sucks in between or around the neck, chest plate or rib bones when breathing in), ribs or stomach moving in and out deeply and rapidly to get air in, and shoulders hunched over (“posturing”).¹¹

Asthma can also make it harder to get oxygen to the brain and body, and this can be life-threatening. Signs this is happening include confusion and drowsiness, and a color change on the tongue, lips and around the eyes, or on the fingertips or nail beds, that looks bluish on lighter skin and grayish or whitish on darker skin.¹¹ AAFA says these Red/Danger Zone symptoms are a medical emergency.¹¹ ACAAI says to seek emergency treatment if you have difficulty breathing or your skin turns blue.¹⁰

For young children with asthma, NHLBI says to call 911 if they seem drowsy, confused or troubled, have a blue tint to the skin and lips, or have a fast heartbeat.⁶

For questions about managing asthma, talk to an allergist.