Do you have ‘asthma in disguise?’

Perhaps you find it hard to breathe in spring, and have always wondered why.

You may have put your symptoms down to a change in seasons or household dust, but it could be that you have a more serious condition, one that affects one in nine Australian adults and children: asthma.

This week’s Asthma Week 2019 (September 1-7) is themed ‘Asthma in Disguise’ and aims to highlight to symptoms of asthma that are commonly overlooked by adults.

As National Asthma Council Australia CEO Siobhan Brophy told MedAdvisor, around four out of five people with asthma also have allergies such as pollen-related hay fever, resulting in watery eyes and sneezing.

“Both conditions can result in significant health problems, particularly when experienced at the same time,” Ms Brophy says.

“As spring starts, many people will experience worsening symptoms due to an increase in triggers such as grass and other pollens in the air and it’s crucial that health professionals advise patients of the connection between allergic rhinitis (hay fever) and asthma.”

Of course, experiencing hay fever doesn’t always mean that you have asthma, but there is a strong link. What is more, hay fever and asthma sufferers are particularly at risk of thunderstorm asthma — defined as an asthma attack in response to spring thunderstorms on days of high pollen count.

“By football grand final weekend, you should be taking your hay fever nasal spray, asthma preventer, or both,” Ms Brophy says.

“And don’t stop until New Year’s Day as most adults with asthma need to take a preventer all year, not just in springtime.”

New cases of adult-onset asthma can occur at any age, however, asthma is commonly misdiagnosed in older people, according to Ms Brophy.

 “An estimated 7 to 15 per cent of Australians aged 65 years or over have asthma, similar to asthma prevalence in the general adult population,” she says.

“The diagnosis is unrecognised in an estimated 50 per cent of people with asthma aged over 75 years.”

Untreated asthma is especially risky for older people as it can make lung function worse, Ms Brophy says.

“The best way to ascertain if a person has asthma is to take a careful history to identify symptoms and triggers, and to undertake a physical examination and perform spirometry (a lung test),” she says.

“Getting breathless shouldn’t be considered a normal part of getting older.”

 In addition to being under-diagnosed, asthma is also a commonly misunderstood disease, with many myths and misconceptions.

“In the past, it was thought that children typically outgrew asthma due to maturation of the autonomic and central nervous systems under the effect of sex steroids during puberty,” Ms Brophy says.

“However, there is little evidence to support this assumption. Puberty does not predict remission of asthma and almost two-thirds of children with chronic asthma have persistent symptoms throughout puberty.

“Adults may feel they have grown out of asthma, but as the number of people with childhood asthma affected during thunderstorm asthma event demonstrated, a residual sensitivity remains.”

Ms Brophy recommends that asthma sufferers book in for an asthma review with their GP when they are feeling ok — not when their asthma is flaring up.

“This is so you can discuss and review your asthma symptoms and management with a GP and see whether your regular treatment can be stepped down or needs to be stepped up,” she says.

Ms Brophy also recommended patients talk to their GP to ensure they are taking their medications the right way and at the right time, as well developing a personalised written asthma action plan with the GP.

Asthma Australia has compiled the follow advice on preventing the impact of pollen on asthma or allergy symptoms during spring time:

• Take your preventer medication as prescribed to reduce the likelihood of asthma symptoms and flare-ups.
• Carry your reliever medication with you at all times, even when you are feeling well.
• See your doctor to ensure your medication and asthma plan is up to date.
• Stay indoors whenever possible during peak pollen season when there are high or extreme pollen days, windy days or during thunderstorms.
• Turn air conditioners to recirculate when pollen levels are high.

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This story was written by Johanna Leggatt. Johanna is an Australian journalist with more than 15 years’ experience in both print and online. She has worked across a wide range of subject areas, including health, property, finance, interiors, and arts.