9 Surprising Reasons You Can’t Get Your Asthma Under Control

2. Strong Emotions Can Trigger Asthma Symptoms

In people with anxiety disorder, a panic attack can trigger an asthma attack because of the hyperventilating that often occurs, Otsu notes.

But even strong emotions that don’t belong to any particular disorder can also contribute to asthma symptoms. These include being upset or stressed, or even laughing hard or crying.

It’s not always possible to avoid these emotions and reactions, of course, but it can help if you take steps to reduce stress through adequate sleep, lifestyle modifications, relaxation techniques, and exercise.

3. Misconceptions About Your Pet

For both cats and dogs, “there are breeds out there that are sold as hypoallergenic,” says Otsu. “But if you ask an allergist, they’ll tell you that there’s no such thing.”

It’s true that certain dog breeds don’t shed, and that certain cat breeds produce less fur and dander. But you can still develop allergic and asthma symptoms from exposure to these animals.

That’s because allergens are still found in the saliva and skin of cats and dogs. “Unless you have a dog that doesn’t salivate or has no skin, hypoallergenic is a misnomer,” Otsu says.

4. Changes in Weather

Going from warmer to colder air or from drier to humid air can trigger asthma, says Otsu. This can happen when you go outside from a controlled environment, or simply as the weather changes on its own each season.

While you can’t control the weather, you can try to limit your time outdoors when the weather could be a trigger. For example, if heat and humidity are triggers for you, try to stay inside in an air-conditioned environment whenever possible.

And when it’s cold out, cover your nose and mouth with a scarf when you go outside to help warm up the air you breathe into your lungs.

5. Changes in Hormones

Going through hormonal changes at different stages in life — namely puberty, pregnancy, and menopause — can aggravate asthma in women, says Otsu.

But this doesn’t apply to all women, and some women even experience improvement in their asthma during pregnancy, according to Otsu.

Doctors don’t fully understand the role hormones play in asthma, but if you’re going through a period of hormonal change, it’s worth considering the possible effects this may have on your asthma control.

6. The Medications You’re Taking

The most common example of a drug interfering with asthma control is a beta-blocker, which is prescribed to treat certain cardiovascular conditions.

That’s because albuterol — a widely prescribed drug to treat asthma symptoms as needed — is a beta-agonist, which means its action can be directly blocked by beta-blockers, Otsu notes.

There may also be lower-level interactions between drugs for asthma and other conditions, so it’s important for every doctor you see to know about your asthma and what medications you’re taking to manage your symptoms.

7. The Foods You Eat

Food allergies can trigger asthma in some people, although they more commonly trigger anaphylaxis — a potentially life-threatening reaction that can cause breathing difficulties as well as hives, vomiting, diarrhea, and abdominal cramping.

But even if you don’t have any food allergies, you may be sensitive to sulfites, a preservative found in certain foods and medications that can trigger asthma symptoms.

Common sources of sulfites include wine, beer, shrimp, dried fruits, wine vinegar, and maraschino cherries. If you suspect that the food you eat may be triggering your asthma symptoms, talk to your doctor about keeping a food and symptom diary to help you determine which trigger foods to remove from your diet.

8. You May Actually Have a More Severe Type of Asthma

If you can’t adequately control your asthma, it may have simply gotten worse — or it could have been more serious than was originally recognized all along.

“People can have asthma that appears pretty straightforward, but in reality, it’s really severe,” Otsu notes. This may be because of inadequate treatment earlier in the course of the disease, which can lead to permanent damage in the lungs.

In these cases of asthma, “instead of reversible disease, it’s become more chronic and fixed,” says Otsu. “The traditional asthma medications aren’t going to help as much.”

It’s possible you may also have a more severe type of asthma, such as eosinophilic asthma, which can be more difficult to control. If you’re having trouble controlling asthma symptoms, be sure to talk to your doctor, who can perform a simple blood test to see if you have this type of asthma, which can be treated with newer asthma medications.

9. Your Symptoms Aren’t Actually Caused by Asthma

It’s common to think you’re having an asthma flare, but in reality, the symptoms are not due to asthma, according to Otsu.

“A lot of patients have symptoms of chest tightness and wheezing, and think that these symptoms must be an asthma flare,” Otsu says. But it’s possible for these symptoms to be caused by another respiratory or throat ailment, she says, such as vocal cord dysfunction.

Especially when someone is diagnosed later in life, Otsu notes, a patient might never see an allergist or pulmonologist for the right kind of testing, and simply be diagnosed with asthma by a primary care doctor based on symptoms.

In these cases, if it’s not actually asthma, treating with a daily inhaler won’t be effective. And sometimes, “more medication gets added onto their original medication because [doctors assume] their asthma must be severe,” says Otsu.

If you’re doubtful about your asthma diagnosis, ask to be referred to an allergist or pulmonologist, who can help you pinpoint the cause of your symptoms.