Non-allergic asthma reacting to something on a high pollen day...

[Lysistrata]

How much of a freak am I? High grass pollen, lungs are reacting a lot today.

Thing is, I don't have allergic asthma (total IgE and specific IgEs normal, most triggers are not allergic eg scent, weather/humidity, viruses, smoke etc. No eosinophilia either.

Twist is I *do* have hayfever and take fexofenadine and Avamys which generally control it - so how correct are those tests, I wonder? Have done some reading, and it seems hayfever plus non-allergic asthma is possible. My consultant is sceptical of the hayfever because my asthma is not allergic, suggested it was viral infections but it gets worse outside and improves with the hayfever medication.

Going to guess weather and/or pollution (London) responsible for today's fun and games, but equally my lungs can decide that they don't like Wednesdays and they're going to act up, so who knows?

Just wondering if anyone else has this confusing mix of non-allergic asthma but possibly with some allergic bits/hayfever?

Even my specialist clinic thinks I'm a freak - would be nice to have some company

[CindyID]

I do have allergic asthma but I'm not allergic to pollen, however I've really struggled on these high pollen days. An asthma uk nurse suggested that, as my lungs are currently hyper reactive, pollen could irritate them even without the allergy. Not sure if this helps you though! Hope you feel better soon

[Lysistrata Administrator Community Ambassador in reply to CindyID]

Thanks! Hmm that could be it - I did once have an attack after moving and the respiratory dr in hospital suggested it could be the dust I kicked up in the process. I said I wasn't allergic to dust and he pointed out it is still an irritant, which makes sense. Most of my triggers are more irritant than allergic so stuff floating around could be doing it, had never considered that!

Hope you also feel better soon

[CindyID in reply to Lysistrata]

Cool, glad to help. Have a fab afternoon

[Lysistrata Administrator Community Ambassador]

I got hayfever about 5 years ago for the first time and have always had negative skin and blood tests - but seem to react to certain plants/trees when I walk past.

I just did a quick google on the allergy/irritant thing as I wasn't 100% sure of the different mechanisms. Very briefly, it seems that an allergy is where the substance triggers cells that recognise it (through specific IgE) and then lead to the release of histamine and leukotrienes and various other things. An irritant is where the substance acts directly on receptors on nerve cells (in the airway in this case, but could also be skin). (Anyone with greater knowledge, please feel free to correct or add to this as I didn't exactly do a full review...).

This is interesting, if bizarre, because I think it's related to the types of challenge test - have you had one? I had what I think was a methacholine challenge, but may have been histamine, a few years ago. That was normal though I had a lot of reversibility afterwards. I think it was because I didn't stop meds for long enough. These two tests are meant to be 'direct' challenge tests ie directly acting on the airways.

A couple of years ago I then had a strong reaction in the mannitol challenge test which is indirect - this leads to a 'cascade' that is set off leading to histamine release, and you need to stop montelukast (which I was on) for several days beforehand because it is a leukotriene receptor antagonist and it interferes with this process (ie how it's meant to help with asthma).

I am very glad I had this reaction in the test as I kept getting 'maybe you don't have asthma and it's dysfunctional breathing', but then it seems I was responsive to having this kind of indirect reaction triggered. (Ugh that test was not fun...the physiologist kept reminding me it was the cons's idea not his lol, and we were both relieved it didn't take too long for me to react enough to stop).

Also my cons stopped montelukast last year as he said it only really helps allergic asthma, but if I was reacting in the test and leukotrienes were being triggered...? Montelukast definitely helped me before but have read it can become less effective for some reason.

Anyone who knows more about this please do jump in.

[Superzob]

My wife doesn't usually get hayfever, but has been suffering this year. I think regardless of whether you are actually have an allergy, any significant pollutant can affect your breathing, as the lungs defend themselves with mucous and restricting the small airways.

[Lysistrata Administrator Community Ambassador in reply to Superzob]

Yes, and if twitchy then won't take much!

[Wheezycat]

Hi, me, too, I also think I can react to high pollen - can’t think anything else that could cause more reaction in my lungs a couple of days ago - but I don’t have hay fever.

More to the point, a couple of years ago, when I got bad enough to end up in hospital for some days, I think it was high tree pollen count that was the major blow. Last year I expected to react on pollen but I never did.

My asthma is far from as bad as yours, but my reactions are irritants not allergens. Most recently a rather powerful burning scented candles collection.

[Lysistrata Administrator Community Ambassador in reply to Wheezycat]

Scented candles are the devil's work! Also those shops that have scents floating around inside. I kind of understand that if they sell scented items but a clothes shop doing it was a bit much! I tried to hold my breath and look but my friend removed me as she said we had plans that did not involve an afternoon in A and E.

Does sound like others have this odd pollen thing too - it has always confused me so the idea of pollen.as an irritant does make sense. Hope your lungs have recovered from the candles.

[Wheezycat in reply to Lysistrata]

My lungs are fine! I think I had the sense (for once) to act quickly, rather than my usual self, which is to deny the problem, and calling myself a whimp for paying any attention to the irritation

[Lysistrata Administrator Community Ambassador in reply to Wheezycat]

Good to hear! I'm the same with denial - didn't help to also have consultants denying it was an issue for ages.

I have managed to persuade myself it's not in my head though because I don't react to eg synthetic versions of floral, like cheap lavender shower gel with no real lavender. Also, lol, I can handle most expensive perfume just fine. It used to be a joke at my last job that only Chanel would be permitted in the office.

[Wheezycat in reply to Lysistrata]

I am not keen on any perfume now. Or after shave. Or air fresheners. Or hair spray. And so on. It didn’t send me into an attack, just irritation and extra coughing. I am not having your level of problems. But I have had to ask a couple of clients to reduce perfume and after shave. Embarrassing. And I still haven’t told the circle dance teacher about the scented candles, and why I left early. I do feel a whimp!

[Lysistrata Administrator Community Ambassador in reply to Wheezycat]

I am a wimp too, learning to be better! I don't get a full on attack with scents mostly but it leaves me feeling rubbish for the rest of the day and can be a bit loud and scsry for others. I have won a victory at work by insisting on removal of the.air freshener burst dispenser in one toilet - a few years ago I might have downplayed and not mentioned it.

[Wheezycat in reply to Wheezycat]

Yes, the dreaded air fresheners! I complained when our local hospital installed them. I don’t get full attack either, but it is unpleasant, and once after some inscence I felt under the weather for a week! I had to learn. A second time when I encountered a very mild one, I took an extra dose of inhaler then forgot about it, it was that mild. But I suffered the consequences the day after. So more learning is needed.

I was once so whimpish/in denial/unaware/feeling one mustn’t give in, that I in the end ended up in hospital for four days. I was new to all this then. Thankfully I am not that badly affected that that has happened again. Long may it remain that way.

[Doodles65]

My lungs don’t like Wednesdays either! Sent home from work - well a mutual decision - went straight to docs and put on nebuliser, now n steroids. I don’t have allergic asthma, but I am sensitive to lots of things. Think the high pollen count got the better of me despite steroid inhalers, montelukast and fexofenadine! Feel shattered today! Hope the pollen count goes down soon as much as I like the warmth and sunshine. Hope you feel better soon

[Lysistrata Administrator Community Ambassador in reply to Doodles65]

Thanks, hope you also feel better! Working from home and brain dead as they are still at it today - not very productive and wishing I had just called in sick. I wish I got on better with steroids. In a kind of limbo where I know that the GP would either tell me no wheeze = fine or pass the buck to hospital, but it isn't quite at that point for me yet (my scale for that is very individual I should add, and has taken a while to work out). I'd text the asthma nurse but they always want me to come in for assessment. Fair enough but exhausting and then if FENO normal as it often is, they can't/won't do anything as steroids not helpful - wish they offered nebs at least for the journey to be worth it!

Sorry for ranting- the joys of asthma and freakishness. Hope things settling down for you and weather improves.

[Doodles65]

No probs re the ranting we need to get it off our chest sometimes ( pun not intended!)

I am hoping just one course will sort it as last year I was on slow reduction which was a nuisance. I had hoped after seeing the consultant in October and being given extra inhalers that I would not be like this how daft was I? Still think positive there are lots worse off than me.

Here’s hoping for a lower pollen count and a better weekend. Take care.

[Cb28]

Hiya I’m new to all this but I have exactly the same reaction ...July last year I had an asthma attack aged 54 no asthma or any chest problems beforehand ... allergy tests say no to all pollens ... Wednesday coughed all day, wheezed, bad head ( first symptom of asthma coming on but apparently no ones ever heard of this ) sore raw chest and breathless . Docs yesterday after a bad night and today I’m off work exhausted 24 hr headache again but breathing has eased. Started doxycycline anc prednisone for the 7th time since last July . Before the asthma attack I had nasal drip etc symptoms of hay fever .. I take like you fexofenadrine, avamys, montelukast carbacystine, fostair, salbutamol and spiriva .. Resp nurses don’t know what brings it on and neither do I but been researching humidity levels and might be getting somewhere ... I find it all very confusing like you and convince pollen affects me but they’ve said no ... I hope you feel better soon x

[Lysistrata Administrator Community Ambassador in reply to Cb28]

Thanks, hope you feel better soon! Seems there are a few of us with similar reactions. The weather is a huge one for me - especially storms as lungs don't like the pressure drop. Also changes from warm to cold.

[mas7656]

I have just been diagnosed with asthma aftet having suffered for the past 5 years without a diagnosis. All I kept being told was that I have sensitive airways. I even ended up in hospital with severe breathing issues. I was asked if I was asthmatic, got a chest xray done and bloods done then sent home!!! I think that was the start of my breathing problems.

I too am very sensitive to smells, even if my son is frying food, it starts me coughing. Scented candles, plug ins, cleaning products even strong smelling washing powder or conditioner sets me off.

Ive not had any allergy tests done yet but have been told thst they're expensive and might not get them done.

[Lysistrata Administrator Community Ambassador in reply to mas7656]

Are you outside the UK (as you mention cost of tests)? Sounds like you do react more to irritants than allergies but the tests may be useful if you can. Chest x-rays and bloods in hospital aren't going to tell much other than rule things out like infection! I assume someone has done more appropriate tests since then like spirometry. Have you been started on treatment?

If possible I advise giving the AUK nurses a call - they are very friendly and helpful. It's horrible suffering without a diagnosis - I went for a while like that too and kept being told it was in my head, even though I had childhood asthma, it came back after swine flu and I have a family history of asthma. I don't present very typically though (no wheeze, peak flow may not drop to expected levels) which is hard for everyone.

[mas7656]

Hi, Im in Scotland. I was at an asthma nurse for the first time a couple of weeks ago. I asked her about going swimming she said I would be ok. I queried chlorine as Im sensitive to chemicals and she still said I would be ok. I left the surgery with no confindebce in anything she said to mr.

I had a spurometry test done 2 years ago which was fine and has not been repeated.

Can I ask if any of you have arthritis or aches and pains in your bones.

I havr osteoarthritis in my hands and wide spread psin throughout my body. I wondered if it wad any way linked to having asthma/breathing problems.