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Dr said no wheeze - no asthma

Hi all,

I am in desperate need of some advice, and hopefully someone might be able to point me in the right direction.

I have been struggling with a tight chest(often accompanied by pain) for a couple of years now, especially during evening, night and morning times. If I get a cold, I will also develop a cough that last a good couple of months after my cold has gone.

The symptoms are getting worse and worse the longer it goes. I was away on a travel for 2.5 weeks in Norway in a house with no carpet and very low air humidity- and I didn't have any symptoms of anything. I landed back on UK soil, slept one night at home and I woke up with the tight chest and feeling of being filled up with phlegm.

I have taken allergy tests at the doctor, and everything is coming up as absolutely fine. They have checked my blood oxygen levels, listened to my chest, checked pulse etc and it is all fine. So without any further tests, the doctor has now concluded that my chest tightness is due to stress.

I don't feel particularly stressed, and the pain in my chest gets ten times worse if I use an antibac spray or have candles burning (basically anything that lowers the air quality). And also since my symptoms went on my second day being away, and came back the next morning when I returned - it seems odd that this would be related to stress or anxiety?

Has anyone experienced something similar where chest tightness is triggered due to sensitivity?

I guess there is not much I can do if the GP says there is nothing wrong with me though? Maybe I need to consider going private? Or accept the diagnosis?

Sorry about the length of this post, and any guidance or advice would be very much appreciated.

24 Replies
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Hi have you ever had a peak and flow test or spirometry? The first is specifically to determine if you have asthma and the 2nd can pick up asthma and other lung issues. I presume you are at a group practise? If so I would see another doctor and ask for those tests. You can also ask for a chest X-ray too.

Good luck and let us know how you get on. x

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Thank you for your reply! I have not had a spirometry, but I have had a peak and flow test. This doesn't really indicate asthma either, just a consistently low reading(I belive with asthma it should probably change?). I can only do about 315, and the normal for my age/height is 430. I might ask for the spirometry and chest x-ray too.

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Well your peak and flow is low. I can do an average of 350 and I do have asthma. I am female in my 60's. I don't know your details so can't compare them. Go back and see a doctor and ask for the spirometry test. x

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I feel wat u saying everytime I got to an attack my chest feel like its gone cave in its hard bad I had this for almost 2years n it feels like it can only get worse

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It is possible for chemicals such as perfumes - scented candles? - etc to trigger asthma type reactions. Ditch the antibac spray. Stop using candles and see if that helps - you mention them specifically which makes me wonder if you think these might exacerbate your problems?

Chemical sensitivity isn't currently recognised by most GPs. (It was the same for alllergies 30 + years ago when I first developed them.) In medical school their training usually only covers the typical prawn / peanut/ strawberry / penicillin allergy. Allergy tests are not 100% accurate and chemicals aren't covered. My experience is that as far as you can you need to be your own detective. Do you work and if so are you better, the same or worse at work?

Finding that you were better when you were away from home suggests there is something which is at the very least exacerbating, if not causing your symptoms, at home. What allergies were you tested for? Dust mite, moulds, or just food allergies and pollens? Ask your doctor (or GPs secretary) for a copy of your results. They are usually limited in scope and may have missed something. Stress related? It doesn't sound like it. If you only react at certain times or in certain environments (to certain triggers) then the tests may well be normal at the GPs surgery but not at other times.

Hope you find the cause - it does make a big difference! A second opinion might help. Phone Asthma UK helpline and ask for more infomration if you think you are being fobbed off.

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Thanks for a very considered and detailed reply :) Yes, they definitely trigger my symptoms - especially antibac spray which I stopped using yesterday. Will also continue to eliminate anything with perfume in to see if it makes a difference.

Will also ask for copy of my test results.

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I don’t wheeze and have never wheezed and I have an asthma diagnosis, however my peak flow was very varied to begin with. It’s all over the place again now but I’m dealing with that myself. Change GP or maybe see if you can get an appointment with a local asthma nurse? It doesn’t sound like it would be stress, but don’t let them continue to fob you off

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I agree with the others - it sounds like you have some specific triggers and that the doctor.does not understand much about asthma and thinks it's all allergic. A consultant once told me that reaction to scents etc is not due to allergy, but a respiratory irritant - different mechanism. I do often say I am 'allergic' to sprays though as it's just easier to explain that way.

Very cynically, I think that while stress and anxiety can mimic asthma and also can trigger it, I also think many drs just use it as a get out when they don't know enough. I have been 'diagnosed' with anxiety by someone I.met a minute ago who hadn't even talked to me! (It was an asthma attack.)

Besides the fact that whatever some drs think, a wheeze is not needed for asthma, you would probably not wheeze anyway if you are fine when they listen! As someone else said, you will probably seem fine if your specific triggers are not present when you see the dr. They are meant to listen to the history too as asthma is variable and doesn't necessarily present itself at your appt time!

I agree with others that you should try another GP in the practice if possible till you get one who is more familiar with asthma and listens to what you say. Also agree that the AUK nurses are very helpful.

EDIT: forgot to say all my allergy tests were negative and I do have asthma. Also hayfever so possibly also allergy tests are not 100% accurate, or don't cover everything even if you do also have allergic triggers.

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Yes, candles and antibacterial spray, and any other household perfumes trigger my asthma. I burn unscented candles occasionally, but still need an air purifier running, Hope you find a more knowledgeable and sympathetic GP very soon.

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Thank you. Air purifier sounds like a good idea and something I will look into.

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Yes stress can create chest tightness and difficulty in breathing. However the phlegm could be due to an allergy. Animal hair, dander from their fur, air sprays, perfume etc are known to cause allergies, but sometime we can be allergic to some odd things that we never dream would cause us problems. Sinus infections (even mid ones) can cause phlegm, post nasal drip at night can drain down to the lungs so when you awake you cough up the residual. Has your GP checked for sinus problems? May be worth checking it out.

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It wouldn't harm to investigate further. My friend has cough variant asthma which is similar to asthma without a wheeze. Chest pain with the tightness should be investigated alone. You can get chest pain which is called chostocondritis around ribs due to coughing. If I was you I would stop anything that is perfumed that may irritate you and persistent with your GP.😊

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Hi! Reading through some of the responses, one thing, other than spirometry, that comes to mind, is this thing with peakflow. I am approaching seventy, and my normal good is 350 and up a bit, so yours sounds low.

1. Do you check it first thing, just when you have woken up? And then later in the day, say 4pm or so? If not, try some version of that. The very first thing in the morning is important, the later one perhaps less important for exact timing.

2. Peakflow only records when your major airways are affected. If your small airways are, but thmajor one’s not so much, peakflow may not register.

Since my asthma became a thing to be reckoned with I react on loads of scents, not to the point of having an attack, but I do find them uncomfortable and want to get away. Likewise with anything that produces smoke, like scented candles etc, etc. Outside is easier to manage.

Why not talk to Asthma UK nurses. They are wonderful! And really helpful.

Also, consider damp, causing moulds. It is prevalent in the U.K., less so in Scandinavia, where people are ‘on the case’ much faster if it happens.

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i have severe chest tightness. my peak flow, spiro. and oxygen level are normal. I don't wheeze. There is a test that only pulmonologist and maybe allergists have that is called a FENO test, which is the only external evidence of my asthma. It measures inflammation in the lungs. If you have no inflammation, then it's less than 25. mine is always between 90 and 200. The doctor said the only thing it could be is asthma.

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Yes this is similar to mine. You can have a tight chest no wheeze called silent chest. Also you can have ok peak flows mine are not that bad. I was breathing ok as I am fit normally. I took a while to get diagnosed. I have allergy. My spirometry was normal but so ill during spirometry the nurse was worried. 76% of asthma patients the spirometry is normal. I am now on 4 puffs Brown qvar 2 a day and salbutamol and now just started on montelukast. If the readings indicate a difference between before and after asthma meds then you got asthma no matter what the peak flow is.

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Thank you so much for everyone who has replied! I feel much more clear on what I need to do, and if I don't get anywhere with the GP practice - I will ring the helpline and I might go privately.

Interestingly, after writing my post yesterday I realised that I hadn't been using any cleaning sprays when I was in Norway. So I haven't touched them since and my pain when I breath in and out has definitely gotten better. (My chest still feels a bit painful, but not tight.) Another clear trigger is if I use the washer/dryer in the kitchen(??). I will start a diary and list anytime I feel symptoms and what I did/where I was and also bring requests for some more tests.

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I would change gp. This is what I had to do and I'm a nurse! There is some poor knowledge out there. Speak to asthma UK before you do.

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Changing GPs is easier said than done. My view of GP surgeries is pretty low. (Its their appallingly unwelcome appointments systems, bossy receptionists (or in my surgery these are now called "Care Navigators"!!) and the lack of communication or even point blank refusal to provide copies of reports or even to bother to inform patients about *their* health issues. The message I'm getting from my surgery lately is "We don't want to see anyone."

And I've had these general experiences from 3 different surgeries.

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Hi Seri,

You may also need to consider that it isn’t asthma you’re struggling with, but another type of lung condition.

You said you get a tight chest which can be painful. That could be COPD or something else.

Have a look at the British Lung Foundation’s website too (www.blf.org.uk) as there’s lots of information on there about all the different type of lung conditions. They too have a helpline you can phone for advice.

Your GP may or may not be right in that it isn’t asthma, but he/she was wrong to fob it off as stress.

Ask for a second opinion. Ask for a spirometry. And ask them to check for lung conditions besides asthma.

Good luck.

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You need a spirometry - that will indicate the reversibility of symptoms indicative of asthma. Wheezing, peak flows, etc are not sufficient to diagnose asthma. Of course, it's entirely possible that the spirometry may show you DON'T have asthma (which would be good), but at least that might prompt some more tests to get to the bottom of it.

There are a couple of other things you could do yourself: antihistamines sometimes improve asthma symptoms because they act on the results of the autoimmune response; also, I think you can buy Ventolin over the counter, in which case you can see whether your symptoms improve with it (which would indicate asthma).

Whatever you decide, it's important to stick to your guns and not be fobbed off. The important thing is to get well, and that's what the medical profession is supposed to do for you (though sometimes you get the impression they forget that!).

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Same here. No wheeze, peakflow low. After a year of hell with 3 A&E visits, I went private and have had CT scan which did show scarring which unfortunately allows natural mucus and natural bacteria to build up, particularly when having asthma symptoms and then this causes bacterial infection.

As I have a parrot and I live in an old house (15th century) allergy testing was done particularly with a view to looking for Hypersensitive Pneumonitis. This can be caused by specific things - in my case "Bird fancier lung". Happily no antigens were found for birds or anything associated with birds. I could have told them that but its now been proven not to be the case (and I don't cough when handling my bird).

No other allergens were found so theoretically I don't have allergic asthma. The formal diagnosis is "Non-Allergic Asthma" which in theory sounds better but in practice is actually not because its difficult to then find what does cause it.

I know my body and I also know that viral infections (colds and flu) are my main kryptonite. Having had respiratory infections all through my life we know these have caused scarring. It means I have to manage my asthma carefully. Despite no known allergens, I know that Perfumes, Chemicals, Cold weather, Flu/Cold infections and Cigarette/Pipe/Cigar smoke are NOT good. These will all trigger major coughing attacks.

Most of these I can avoid, except the smoke (because people think that their smoke doesn't affect anyone else) and viral infections (because people think that struggling into work sneezing and coughing all over the place is a sign of heroism).

You are at the same place I've been - doctors ignoring symptoms etc. Keep a diary of when you do get asthma tightness and if possible your environment around you. I created my own spreadsheet where I record my peak flow and have a daily "diary" with a tick list of usual symptoms and free text area where I can record observations. This then gives me an average for my peak flow (my regular best is 300-310 which is still low for my age etc, my worst is 150. If I am close to 200 then I need to use steroids to help).

If you can start to really see a pattern you might be able to start to eliminate triggers from your environment. So, see what your house is like compared to what its like in Norway. Do you have carpets? If so, think about replacing with wood floors that are easy to mop clean etc.

If I get a sore throat heralding a cold/flu, then straight onto steroids. I have them on repeat now thanks to the Consultant and I think I'll be having antibiotics on it too. These are back ups to start whilst I get to a GP (not easy as ours doesn't seem to like seeing patients).

Be prepared to kick the GP. And as others have said, PLEASE talk to Asthma UK. Without them last year I don't know what I would have done. I was in a very dark place, barely able to breath properly and my GP surgery were not taking notice. Thankfully my work have been so supportive and Asthma UK nurses were amazing and helped me understand it was not all in my mind.

For me, since I've seen my consultant, I am now off steroids and antibiotics (since Feb), I've been having huge help from Respiratory Physiotherapists which mean I've been able to relearn how to breathe again which is helping my lung health.

Good Luck. Remember you are not alone.

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Sorry you are suffering so. I have similar symtoms. I have Asthma past 12 years. Took over 2 years to get diagnosis. Not read all replies so apologies if i duplicate.

By what you say it does seem chemical reaction. Briefly i too had every allergy test they do. Nothing. No allergy test has ever found anything. Luckily i jad top allergy consultant 10 years ago and diagnosed many things.

Firstly Samters Triad a severe allergy to Aspirin and its organic form Salicates which is in sime food. Secondly water! If water/Steam goes into lining of my nose i get asthma attack. Steam in bathroom causes major attack.

I never ever have crackles etc in my chest ever. Even had double pnumonia and never knew as breathing always bad now and i have vasculitis. Only bloods showed it.

Have you had blood tests done? I was diagnosed with eosinophilic (cannot spell) eos asthma. My eos count was extremely high. Never a wheeze everon my chest. I am also allergic to lots of medication.

Yes there seems something in your environment causing this but do get bloods etc done and chest xray. Stress does cause asthma attacks but not always or i would be long dead.

Please don't give up. Took me 2 years to get diagnosis and i have had many ignored attacks since and now got bad lung damage because some doctors gp and hospital cannot understand i have no wheeze.

Good luck.

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Hello, I have cough variant asthma and very rarely wheeze! One other thought about environment, both my lung function and sense of smell improve when on holiday, especially near the sea. Back home in Leeds, both are affected by the pollution from traffic. Could that be another reason why you felt better in Norway? Good luck getting a diagnosis

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Thank you for the reply, and yes - this might definitely be a factor. Although I doubt my GP will believe that it is!

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