Common Triggers of Bronchial Asthma

Patient

Q: I have been diagnosed once when I was younger with asthma, however, I have also been tested for my IgE levels, which came out completely normal, I also had severe eczema, as I got older my asthma and eczema mostly went away, however, when I run still I have trouble breathing, the inside of my lungs feel as thought they burn, and I cannot run very far without having the onset of restricted lung utilization. My question is, what could be causing this? as I do not have high IgE levels, and it is only induced by excercise, to me it seems there must be some sort of metabolic disorder or acidosis occuring, what could be the potential cause?

Doctor

A:   Your asthma may not have completely resolved yet. In some individuals, asthma gradually then completely resolve as they get older. In some unfortunate ones, it stays for a lifetime. The IgE levels are not specific for asthma which means it is less important in diagnosing asthma; it is more important, however, in the setting of eczema. Bear in mind that asthma has a lot of triggers: stress or intense emotion, pollen, animals, exercise, some drugs, smoke, etc. Also, cold weather can worsen an asthma attack. Cold has the effect of constricting the airways. So one may have a mild asthma attack (starts to constrict the airways) with no apparent symptoms but when exposed to cold air or weather, the attack can progress to a moderate one (worsens airway constriction). This is also the reason why asthma attacks are more common at night when it is usually colder. These triggers should be avoided as much as possible. You may need some controller meds (puffers or inhalers) for the asthma to improve the “restricted lung utilization” you have been experiencing. You may have mild asthma without you knowing it but the symptoms only become apparent when an increase in oxygen (e.g. exercise) is needed. I strongly suggest you see your doctor as soon as possible because a severe asthma attack (which can happen if controller meds are not given) can potentially kill. I do hope I have answered your question. Take care always.   

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