Allergies and Asthma: Symptoms and Treatment Options

Allergy? Asthma?

Hello Doctor: This situation has troubled me for a long time, as I have had this issue since childhood.
When I was younger, the problem was not very noticeable, so I did not pay much attention to it.
I often cough during climate changes, especially from autumn to winter; whenever the weather gets cold, my throat becomes very dry, leading to dry coughs.
Sometimes it feels like I have phlegm stuck in my throat that I can't expel.
During car rides or while exercising, inhaling cold air can trigger severe dry coughs, and I sometimes feel a bit short of breath, especially in cold weather.

It wasn't as severe in the past, but it became more pronounced during my freshman year in college when I had to run 3000 meters.
By the end of the run, I had to exert a lot of effort to breathe, feeling as if my airways were constricted.
However, I did not realize the seriousness of the problem at that time, so I did not seek medical attention.
I researched some information about asthma online and found that I have several symptoms, such as coughing and a runny nose in the mornings and evenings when there is a significant temperature difference, as well as wheezing after exercise.
However, I do not experience this while playing basketball because I drink some water to keep my throat moist.

I have a persistent cough during climate changes and long-term coughing symptoms, but it is not as severe as what is described in the literature for serious asthma.
Finally, I would like to ask the doctor whether this is related to allergic rhinitis or if I have mild asthma.
If it is asthma, will the cost of inhalers be covered by health insurance or will it be out-of-pocket? Is it curable? Thank you for your time and assistance.

zong, 20~29 year old female. Ask Date: 2004/12/17

Dr. Jian Linzhen reply Pulmonology

The most common symptoms of asthma include wheezing and chest tightness.
Sometimes, patients may experience a feeling of breathlessness and difficulty breathing.
Coughing is also a frequent symptom of asthma and may be the only symptom during an asthma attack.
Here are five types of unexplained coughs that should be considered as potential asthma indicators: 1.
A family history of allergic or atopic conditions.
2.
The cough frequently occurs at night.
3.
Coughing and wheezing occur after exercise.
4.
Coughing and chest tightness arise upon exposure to airborne allergens.
5.
Persistent coughing with every cold.
The development of asthma is influenced by two main factors: one is atopic predisposition, which is a hereditary factor, and merely having an atopic predisposition does not cause asthma; it must be combined with environmental factors.
Common triggers in Taiwan include dust mites, cockroaches, pet dander, mold, and others.
When the predisposition interacts with environmental factors, it leads to an abnormal immune response, resulting in a persistent inflammatory state in the bronchial mucosa.
When combined with triggering factors such as changes in weather, secondhand smoke, respiratory infections, paint fumes, kitchen smoke, air pollution, cold foods, psychological stress, and exercise, it can lead to an asthma attack.
Asthma treatment is covered by health insurance; while it cannot be cured, it can be effectively managed over the long term.

Reply Date: 2004/12/17

More Info

Understanding allergies and asthma is crucial for managing symptoms and improving quality of life. Based on your description, it seems you may be experiencing symptoms consistent with both allergic rhinitis and asthma, particularly triggered by environmental changes and physical exertion.

Symptoms
1. Allergic Rhinitis: This condition is characterized by symptoms such as sneezing, runny or stuffy nose, itchy eyes, and postnasal drip. It often occurs in response to allergens like pollen, dust mites, or pet dander. Your mention of coughing, especially during seasonal changes, suggests that you might be experiencing allergic rhinitis.

2. Asthma: Asthma symptoms include wheezing, shortness of breath, chest tightness, and coughing, particularly at night or early in the morning. The fact that you experience difficulty breathing and coughing during physical activities, especially in cold weather, indicates that you may have exercise-induced bronchoconstriction, a common issue for individuals with asthma.

Diagnosis
To determine whether you have allergic rhinitis, asthma, or both, a healthcare provider would typically conduct a thorough medical history and physical examination. They may also recommend tests such as:
- Allergy Testing: Skin or blood tests can identify specific allergens that trigger your symptoms.

- Pulmonary Function Tests: These tests measure how well your lungs are working and can help diagnose asthma.

Treatment Options
1. For Allergic Rhinitis:
- Antihistamines: Medications like cetirizine or loratadine can help relieve sneezing and itching.

- Nasal Corticosteroids: Sprays like fluticasone or mometasone can reduce inflammation in the nasal passages.

- Avoidance of Triggers: Identifying and minimizing exposure to allergens is crucial.

2. For Asthma:
- Bronchodilators: Short-acting beta-agonists (like albuterol) are often used as rescue inhalers to relieve acute symptoms.

- Inhaled Corticosteroids: Long-term control medications that reduce inflammation in the airways.

- Leukotriene Modifiers: These can help manage asthma symptoms and are taken orally.

Cost and Insurance Coverage
Regarding your question about inhalers and whether they are covered by health insurance, this can vary based on your specific insurance plan. Many insurance plans do cover asthma medications, including inhalers, but it’s essential to check with your provider for details on coverage and any potential out-of-pocket costs.

Prognosis and Management
Asthma is a chronic condition, but it can be effectively managed with the right treatment plan. While it may not be "curable," many individuals with asthma can lead normal, active lives by adhering to their treatment regimen and avoiding known triggers. Regular follow-ups with your healthcare provider are essential to monitor your condition and adjust treatment as necessary.

Conclusion
In summary, your symptoms suggest a combination of allergic rhinitis and possibly mild asthma. It is important to consult with a healthcare provider for a definitive diagnosis and to discuss appropriate treatment options tailored to your specific needs. With proper management, you can significantly reduce your symptoms and improve your quality of life.

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