7 Surprising Signs You Might Actually Have Asthma
Here’s the understatement of the century millenium: Breathing is a pretty important part of staying alive. As such, it can obviously be terrifying when you have to struggle to catch your breath—but when does that become a sign of asthma?
Asthma currently affects just under 25 million people in the United States, according to the Centers for Disease Control and Prevention (CDC), with about 6 million of them being children. That means around 18 million adults have the condition. While some have had it since childhood, it’s possible to develop asthma when you’re older, too—and maybe even not know it. “Many people do not realize they have asthma and deal with daily symptoms,” Purvi Parikh, M.D., an allergist and immunologist with Allergy & Asthma Network, tells SELF.
First up, a little anatomy refresher: Your airways, which extend between your nose and mouth and your lungs, have the very important job of carrying air in and out of your body, according to the National Heart, Lung, and Blood Institute (NHLBI). These airways can get inflamed in response to triggers like animal fur, pollen, mold, cold air, cigarette smoke, exercise, and respiratory infections like colds, according to the NHLBI. That swelling can then prompt the muscles around your airways to tighten, further restricting your air intake. Your airways may also produce more mucus than they typically do, which ultimately only makes it even harder to breathe.
While these effects can be mild and abate on their own, if they get worse, they can lead to an asthma attack, which can be life-threatening. That’s why knowing you have asthma—and creating a plan for how to treat it—is so important. Although you might imagine that having this condition must be obvious, asthma signs can be surprisingly subtle. Here are seven to keep in mind.
1. You have a cough that never really goes away.
Here’s a pretty cool fact: When an irritant gets into your throat or airways, it stimulates nerves that prompt your brain to make the muscles in your chest and abdomen expel air from your lungs with a cough, according to the Mayo Clinic. Since a sensitivity to irritants can cause asthma symptoms, coughing is a hallmark sign of this condition, Sadia Benzaquen, M.D., a pulmonologist and associate professor in the department of internal medicine at the University of Cincinnati College of Medicine, tells SELF. In fact, it’s the most common sign of asthma Dr. Parikh has seen people ignore.
After all, coughing is a normal process that doesn’t necessarily mean anything about your health—and even when it does, there are various potential culprits. It makes sense that your mind wouldn’t necessarily jump straight to asthma. But it’s possible to have a cough be your only sign of this, Anastasiya Kleva, M.D., a board-certified allergist at ENT and Allergy Associates NY, tells SELF. If you suddenly take pause and realize you’ve been coughing for several weeks, you need to see a doctor to figure out what’s going on.
2. You experience random bouts of shortness of breath.
There’s nothing strange about experiencing shortness of breath when you get back into the gym after a break. But if you get winded doing normal things, like walking at a typical pace, don’t just chalk that up to needing more exercise. Asthma can cause some extra huffing and puffing when doing low-key activities like household chores, Dr. Parikh says, and it can be subtle enough that it doesn’t seem worrisome at first. “If you frequently have shortness of breath...that is a sign you may have asthma or a heart condition [that] should be investigated,” she says.
3. You have trouble sleeping because you can’t breathe well.
Sure, there are plenty of reasons why you may have difficulty sleeping, but asthma makes it happen in a pretty scary way: “Asthma will cause people to wake suddenly from sleep due to shortness of breath, cough, or wheezing,” Dr. Kleva says. With that said, you could also blame that on something like anxiety rather than asthma.
Experts aren’t totally sure why asthma can flare up at night, but it may be tied to hormonal changes, Emily Pennington, M.D., a pulmonologist at the Cleveland Clinic, tells SELF. At night, your body can release higher levels of the stress hormone cortisol. Though it’s not set in stone, experts think this may promote more bodily inflammation, including in your airways, Dr. Pennington says. That can then lead to sudden coughing fits and shortness of breath, which can wake you up.
4. You hear a weird whistling sound when you breathe.
This is what’s known as wheezing. “The wheezing sound comes from the airways narrowing and air trying to get out of the body despite this,” Dr. Parikh says. “It's as if you are blowing through a narrowing straw.” If you’re not aware that you have asthma, you may think the way you wheeze every time it gets cold out is a strange yet harmless quirk, but this is definitely something you need to get checked out.
5. You’re absolutely sure your colds are way worse than the ones your friends get.
Colds are viral respiratory infections, and they suck all around. But they can be especially hard for people with asthma, even those who don’t know they have it. Infections can add to the airway inflammation and irritation people with asthma already experience, Dr. Kleva says. “This is why physicians strongly urge all asthma patients to get their flu shot,” she says.
If you find that you tend to get obliterated when you have a cold while your friends seem to coast through with some meds and extra tissues, it’s worth flagging for your doctor.
6. When you work out, you have way too much trouble catching your breath, get really tired, and just generally seem to struggle more than you should.
This is known as exercise-induced bronchoconstriction, sometimes called exercise-induced asthma, according to the Mayo Clinic.
When you work out, your body needs higher-than-usual amounts of oxygen. “If your asthma is not well controlled, it can make it harder for you to breathe and exercise,” Dr. Parikh says.
There’s a big difference between getting tired because you’re going extra-hard at the gym and feeling wiped because you have asthma. A few signs you might be struggling with asthma, per the Mayo Clinic: You regularly cough and wheeze when you work out, you have chest tightness, you struggle more than you feel you should to catch your breath when you stop, you’re still feeling tired hours after you work out, and you feel out of shape even though you know you’re not. These symptoms typically set in during or right after exercise and can last for upwards of 30 minutes.
While people with “regular” asthma can also struggle during exercise, those with exercise-induced bronchoconstriction may mainly have symptoms when they work out, Dr. Pennington says. This may be because, in some people, exercise creates a molecular domino effect that makes the airways become inflamed and produce too much mucus, according to the Mayo Clinic.
7. You feel wiped out all the time.
Asthma limits your body’s ability to efficiently collect oxygen. When you can’t get enough oxygen in your body, it can make you feel tired, Dr. Kleva says. There is obviously a slew of reasons why you might be feeling tired on the regular, but if you’re grappling with fatigue that seems abnormal, it’s always worth talking to your doctor, whether or not you think it’s asthma.
When you see a doctor to determine if you have asthma, they’ll want to run various tests.
Your doctor will probably give you a physical exam first to examine the general state of your health. After that, they’ll likely put you through some lung function tests, like a spirometry, which checks how much air you can exhale after taking a deep breath along with how fast you can expel air, according to the Mayo Clinic. Or they may do a peak flow test, which measures how hard you can breathe out. If you can’t exhale enough air or breathe out quickly, it may be a sign your lungs aren’t working well, which could point to asthma, Dr. Benzaquen says.
There are other exams they can use, too, like exposing you to methacholine, a known (and mild) asthma trigger, to see if your airways narrow, or allergy testing, since allergies and asthma are so often connected.
If you are diagnosed with asthma, it’ll be with one of four categories, according to the Mayo Clinic. Mild intermittent asthma means you have minimal asthma symptoms for up to two days a week and up to two nights a month, while mild persistent asthma means you’re experiencing symptoms more frequently than twice a week, but not more than once on any given day. Moderate persistent asthma ups the ante; you’ll be dealing with symptoms once a day and more than one night a week. Finally, severe persistent asthma involves constant symptoms most days and frequently at night, too.
And here’s what you can expect with treatment, which is generally either long-term and preventive or short-term for quick relief.
Your doctor will determine your treatment plan based on the severity of your asthma, what triggers your asthma, and your lifestyle.
Long-term preventive medications, like allergy medications and anti-inflammatory corticosteroids you can inhale, are meant to control your asthma so you’re not as likely to have an asthma attack, according to the Mayo Clinic. Quick-relief treatments can help relax your airways during asthma attacks (your doctor may also decide they’re good for you to use before exercise). Short-acting beta agonists, which you breathe in through an inhaler to relax your airways, are a classic example of this form of treatment.
After you’ve discussed treatment, you and your doctor need to nail down an asthma action plan, which is basically a written summary of your medication regimen and how to avoid your known triggers through lifestyle changes like having your pets groomed more regularly, according to the Mayo Clinic. This will help you prevent asthma flares and also track your symptoms over time to see whether your medications need any adjusting.
Asthma is different for everyone, but if you have it, you’ll want to treat it. Doing so could change your life for the better. “If your asthma is under control, you shouldn’t have any symptoms,” Dr. Benzaquen says.
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