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Allergies & Asthma

“Treat your symptoms before they get out of control. Don’t feel too proud to get treatment. Know your limits! Remember to follow all of your doctor’s instructions and don’t be afraid to ask questions.”

Dave S., University of Michigan

Allergies and asthma can be triggered by the same substances, but they are two different conditions.

With an allergy, the immune system reacts to a substance (allergen) that is normally harmless.  An allergen can be inhaled, swallowed, or come in contact with the skin.  Allergies refer to many conditions, such as eczema, hay fever, and a serious condition called anaphylaxis.  This sudden, severe allergic reaction occurs within minutes of exposure.  It is a medical emergency.

Asthma is one condition - a chronic, lower respiratory disease that affects the bronchial tubes (the main air passages in the lungs).

A person can have allergies without asthma; asthma with few or no allergies; or both.  About 80% of asthma in children and about half of asthma in adults may be related to allergies.

  Signs & Symptoms

For Common Allergies

	Runny, stuffy, or itchy nose. Sneezing. Burning, itchy, or watery eyes. Dark circles under the eyes.
	Itchy, irritated, or red skin (e.g., skin rash)
	Loss of smell or taste. Frequent throat clearing. Hoarseness. Coughing or wheezing.
	Repeated ear and sinus infections

	Shortness of breath. A hard time breathing or swallowing. Wheezing
	Severe swelling all over or of the face, lips, tongue, and/or throat.
	Pale or bluish lips, skin, and/or fingernails.
	Cool, moist skin or sudden onset of pale skin and sweating.
	Feeling dizzy, weak, and/or numb. Fainting. Decreasing level of awareness.

	A cough that lasts more than a week. Coughing may be the only symptom. It may occur during the night or after exercising.
	Wheezing
	Prolonged shortness of breath.  Breathing gets harder and may hurt. It is harder to breathe out than in.
	Chest tightness or pain

Causes & Risk Factors

In both allergies and asthma, the immune system releases chemicals that cause inflammation.  With asthma, the inflammation is in the breathing tubes.  With allergies, the inflammatory response can affect the eyes, nasal passages, the skin, etc.

For Allergies

	Breathing allergens from animal dander; dust; grass; weed and tree pollen; mold spores, etc.
	Ingesting allergens (e.g., food and medicines). Common food allergens are milk, fish, nuts, wheat, corn and eggs.  Common medicine allergens are penicillin and aspirin.
	Allergens that come in contact with the skin. Examples are cosmetics, latex, poison ivy, and metals. These can result in skin rashes like eczema, contact dermatitis, and hives.
	{Note: Insect stings, nuts, penicillin, and shellfish are common causes of a severe allergic reaction.}

For Asthma
The exact cause for asthma is not known. A family history of it and/or having allergies increases the risk for asthma. It is also more common in children who live in houses with pets and/or tobacco smoke.

Asthma Attack Triggers

	Respiratory infections (colds, flu, bronchitis, sinus infections)
	Breathing an allergen (e.g., pollen, dust, mold, dander, etc.) or an irritant (e.g., tobacco smoke, air pollution, fumes, perfumes, etc.)
	Sulfites (additives in wine and some foods.)
	Cold air. Temperature and humidity changes.
	Exercise, especially outdoors in cold air
	Some medicines, such as aspirin
	Strong feelings, including laughing and crying
	Hormone changes (with menstrual periods, etc.)

Treatment

For Allergies
Avoid the allergen(s). Skin tests can identify allergens. Allergy shots may be prescribed. Medications can prevent and relieve symptoms. Medicine (e.g., EpiPen) can be prescribed to use for a severe reaction before emergency care.

For Asthma
Asthma is too complex to treat with over-the-counter products. A doctor should diagnose and monitor asthma. He or she may prescribe one or more medicines. Some kinds are to be taken with an asthma attack. Other kinds are taken daily (or as prescribed) to help prevent asthma attacks.

An annual flu vaccine is advised. Regular doctor visits are needed to detect any problems and evaluate your use of medicines.

Do any of these signs occur?

• Signs of a severe allergic reaction listed above
• Chest pain or tightening
• Seizure
• Cough that doesn't let up and a hard time breathing

Do any of these signs occur?

• Blue lips or fingernails
• Fainting or dizziness
• You can't say 4 or 5 words between breaths or eat or sleep due to shortness of breath.
• Wheezing and you are taking corticosteroid medicine
• Wheezing doesn't stop after your prescribed treatment.
• A fever with heavy breathing
• Your peak expiratory flow rate (PEFR) is below 60% of your personal best number.

Do any of these signs occur?

• Flushing, redness all over the body or severe hives
• Hoarseness
• Anxiety. Trembling.
• Enlarged pupils
• A severe reaction occurred in the past after exposure to a like substance.

With asthma, do you have any of these problems?

• An asthma attack does not respond to self-care or prescribed medicine.
• Asthma attacks are coming more often and/or are getting worse.
• You use your bronchodilator more than 2 times a week
• A cough keeps you awake at night.
• Signs of an infection, such as a fever, and/or cough with mucus that is green, yellow, or bloody-colored.

Try to keep your bedroom allergen free:

• If you can, use a vacuum with a HEPA filter. Vacuum and dust often. Wear a dust filter mask when you do.
• Sleep with no pillow or the kind your doctor recommends. Use a plastic or "allergen-free" cover on your mattress and pillow (if you use one). Wash mattress pads in hot water every week.
• Use throw rugs, not carpeting.  Don't use drapes.
• Don't use perfumes.
• Put an electronic air filter on your furnace or use portable air purifiers.  Change and/or wash furnace and air conditioner filters regularly.  If you use a portable humidifier or vaporizer, use distilled (not tap) water.

Use acetaminophen, not aspirin.

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March 21, 2007