by Dr Deborah Lee, Dr Fox Online Pharmacy
https://pixabay.com/users/meineresterampe-26089/
3 people die every day in the UK from acute asthma. And 80% of people with asthma also have hay fever, according to a 2016 survey by Asthma UK. The big problem is that many people don’t realise the link between the two conditions.
Hay fever can trigger asthma and make an acute asthma attack more likely. But better control of hay fever helps reduce the chance of acute asthma.
- What is the link between asthma and hay fever?
- What is the best way to manage hay fever and avoid an asthma attack?
What is the link between asthma and hay fever?
Asthma is a chronic lung condition, in which narrowing of the airways, results in breathlessness, chest tightness, wheezing, and cough. Asthma symptoms are often triggered by a range of factors, including cold air, exercise, infections, and allergens such as pollen. Pollen allergy is the underlying cause of hay fever.
Pollen asthma
In the Asthma UK survey, although 61% of asthma sufferers thought that hay fever worsened their asthma symptoms, 52% did not know when the pollen season was.
Tree pollen is released from mid-March to late May. Grass pollen levels are high from mid-May until July, whereas weed pollen levels peak from June to September.
Urban areas have lower pollen levels than the countryside, and coastal regions have lower pollen levels than those inland. The Met Office predicts that climate change will result in longer, hotter summers, extending the pollen season and potentially increasing pollen levels. They are also concerned that these changes could make pollen a more potent allergen. It’s vital that those with hay fever-induced asthma recognise the link and learn to manage both conditions optimally.
Bronchospasm
If you are allergic to pollen, when you come into contact with it and breathe it in, this sets off an immune reaction. Large quantities of a substance called histamine are released. Histamine causes many hay fever symptoms such as itchy eyes, runny nose, scratchy throat, and skin rashes (hives ) – but – histamine also causes your main airways – the bronchi – to constrict. This is called bronchospasm.
Once these are narrowed, the lungs need to work harder to keep your body supplied with oxygen, which means you feel breathless, and start to breathe faster. Air is now travelling through narrowed airways which gives rise to the characteristic whistling sound known as wheezing.
Experts believe that people with hay fever-induced asthma, have an over sensitivity to pollen, meaning that their airways overreact.
What is the best way to manage hay fever and avoid an asthma attack?
Here are some key points –
- Take your hay fever and your asthma medication exactly as directed every day. Don’t miss out on doses.
- Asthma UK recommends that you find out which pollen you are allergic to, so you can be aware of the pollen season when you are most at risk. This can be done by a skin prick test and/or a blood test.
- Keep a diary of symptoms for your asthma nurse or doctor. They will be able to advise you on the best non-sedating antihistamines for you, and the best time of day to use your inhalers, eye drops, and nasal spray.
- Each child and adult with asthma should have a written asthma plan, which they need to share with anyone taking care of them. This means any warning signs of an attack can be quickly recognised and action taken.
- Always carry a reliever inhaler when the pollen count is high. This contains salbutamol, which stimulates the B2 receptors in the smooth muscle of your airways, causing the muscles to relax. They are fast-acting – providing relief within a few minutes, and the effects last for 4-5 hours.
- Make sure you use the correct inhaler technique. You can watch a video of how to use a Ventolin (salbutamol) inhaler here. Don’t let your inhaler run out – always have a spare inhaler in the house.
- If you find you are not getting relief from your inhaler like you usually do, or the improvement is not lasting 4 hours and you are needing to use your inhaler more often, this means you need urgent medical help. If your asthma is out of control, the British Lung Foundation recommends you take one puff of your inhaler every 60-seconds, up to 10 times, and if you are not better and remain concerned phone 999.
- Antihistamine medication lowers levels of histamine in your body. This helps reduce the chance of your airways constricting, so you need to take these regularly. Other things can raise histamine levels, such as alcohol, so try not to drink alcohol when the pollen count is high. Certain foods contain high levels of histamine such as fermented foods such as yoghurt and sauerkraut, but also other foods including avocado, spinach, and aubergine.
- Don’t drink orange or grapefruit juice when on fexofenadine as this reduces its efficacy.
Final thoughts
Don’t let hay fever trigger your asthma needlessly. By managing your hay fever symptoms optimally, you can reduce the chances of having an acute attack of asthma.
- What could you do differently this year to manage your hay fever?
- Do you need to consult your GP or asthma nurse for further advice?