So, I’ve had three posts on asthma treatment on the medical end of things. This post and the next post will be on lifestyle factors that the literature strongly supports: Namely trigger avoidance and exercise.
Asthma triggers are things that provoke asthma symptoms. Some things are very common, while others are a bit weirder. I’m going to talk a bit about how to find out what your triggers are, the most common triggers, and then talk about steps you can take to avoid them.
There are two main ways that triggers can be discovered: The first is through self-monitoring of symptoms and looking for patterns in your asthma flareups. The single most beneficial way to self-monitor symptoms and look for patterns is through keeping an asthma diary. An asthma diary is a place where you record your peak flow (if you have a peak flow meter), how often you’ve needed your inhaler, and anything you think might’ve had something to do with your symptoms that day. If you notice that the same thing keeps popping up in your diary, try avoiding that thing and see if your diary entries after avoiding it show improved control. If the improvement is substantial, then it’s probably a trigger. Your asthma diary can either be a hard copy or be electronic. A number of asthma apps exist if you like mobile record-keeping. Personally, I like using a spreadsheet – a bit less user-friendly, but I can include everything I want on it.
The second way you can try to figure out what triggers you is through allergy testing. Most people with asthma who also have allergies find that their allergies trigger their asthma, so avoiding things you’re allergic to is a good way of helping out your asthma control. There are five different types of allergy testing: Skin prick testing, intradermal testing, oral challenge, patch testing, and blood testing. What type of test is used depends on the type and severity of the allergy suspected. All allergy tests except blood tests carry the risk of anaphylaxis, a type of very serious and potentially life-threatening allergic reaction, and so in people with a history of anaphylaxis to the suspected allergen, blood tests are usually preferred.
Asthma triggers fall into two general categories: Inflammatory triggers and symptom triggers. People with non-allergic asthma are only bothered by symptom triggers while people with allergic asthma are usually bothered by both symptom and inflammatory triggers, though the exact set of triggers will vary person to person.
Symptom triggers include:
- Smoke – including wood smoke, tobacco, and incense
- Cold air
- Car exhaust
- Strong scents
- Chemical fumes
- Air pollution
- Intense emotions
- Certain food additives, including sulphates and nitrates
Common inflammatory asthma triggers include:
- Dust and dust mites
- Viral infections (especially upper-respiratory tract infections)
- Certain air pollution
- Food allergies
Note that these lists of common triggers are by no means exhaustive. I’ve met people for whom laughter is an asthma trigger, and others who find that foggy days or bad weather trigger them – if a trigger isn’t on these lists, that doesn’t mean it doesn’t trigger a person’s asthma. It just means that it’s a bit less common a trigger.
How you avoid triggers will depend on the trigger in question. For pollen and air pollution, look up your region’s pollen count and air quality. In Canada, air quality is measured through the Air Quality Health Index. Other countries have their own monitoring systems. Once you’ve found what the air is like that day, decide accordingly: On high-pollen and/or low air quality days, I don’t exercise outside. If it’s medium, I might exercise with premedication, and then change clothes and have a shower when I get inside.
Where animals are concerned, the most effective way of avoiding the trigger is to avoid the animal. I had to give away my pet cats. On that note, there is no such thing has hypoallergenic pets. If you don’t want to give away your pets, this website has a list of ways to reduce pet dander.
Where dust is concerned, make sure you clean regularly and wash bedding and curtains weekly in hot water.
For other triggers, strategies for trigger avoidance can be found online, but in general it all boils down to: avoid it where possible, and take steps to mitigate it if it’s impossible to avoid.