6 Myths About Severe Asthma

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By Evelyn Creekmore, Healthgrades

Don’t believe these barriers to effective treatment.

Severe asthma is difficult to treat, but the challenge begins with misinformation, from who can get severe asthma to when they can get it and why. Symptoms of severe asthma can be confused with other conditions which delays treatment. Adult asthma has become the fourth leading cause of missed days at work and leads to more than 300,000 hospital stays a year. To help gain better control of severe asthma symptoms, get a better handle on the facts.

Myth No. 1: Asthma can be cured.

Unfortunately, there is not yet a cure for asthma, but it can usually be well controlled with treatment. In fact, 95% of the 20 million American adults with asthma experience good control. For those who don’t, the condition is considered severe and requires more time and attention in understanding why and exploring a range of treatment options. Treatment for severe asthma is highly individualized, so it’s important to work closely with your doctor to evolve your personal treatment plan.

Myth No. 2: Severe asthma and uncontrolled asthma are synonymous.

Your asthma may seem severe, when it’s really mild or moderate—but aggravated by other factors. Identifying and addressing these factors may help you achieve good control without severe asthma treatment. Environmental factors include air pollution and occupational exposures. Personal factors include obesity and smoking. All of the following conditions can complicate your asthma diagnosis: severe sinus disease, gastroesophageal reflux disease (GERD), frequent respiratory infections, and obstructive sleep apnea. Your doctor will take a complete medical history to help isolate the problem.

Myth No. 3: It can’t be asthma because you didn’t have it as a kid.

The truth is you can develop asthma at any age. You may hear the term “adult onset asthma” to describe asthma in those who didn’t experience symptoms before age 18. About 30% of adult onset asthma is triggered by allergens such as dust or mold. It can also be triggered by cold and flu. For women, who are diagnosed with asthma at nearly twice the rate of men, hormone changes with pregnancy or menopause can lead to adult onset asthma. Because symptoms tend to be persistent, daily treatment may be needed to help keep your asthma from becoming severe.

Myth No. 4: Steroid resistance should be a concern with severe asthma.

Mild and moderate asthma can usually be well controlled with inhaled corticosteroids to reduce swelling in the airway. The dosage may be raised for those with severe asthma, and oral corticosteroids may be added. True steroid resistance is rare. Before your doctor determines your asthma is steroid resistant, he or she will want to make sure the dose of the medication is sufficient, you’re taking it on schedule, and you know the proper technique for using your inhaler. An ongoing dialogue is needed, because it can take a few months or more to achieve symptom control.

Myth No. 5: If asthma inhalers don’t work for you, you’re out of options.

The underlying cause of what appears to be steroid resistance can be genetic. Biologic therapies are now available that use proteins made from human genes to fight severe asthma on a different level. If you have allergic asthma, your doctor may recommend a biologic therapy that blocks the antibody that causes the reaction. If you have non-allergic asthma, your doctor may recommend a biologic therapy that stops a specific type of white blood cell called eosinophil from overproducing and making it hard to breathe. Depending on the biologic therapy, it may be given as a shot or through an IV.

Myth No. 6: Only a pulmonologist can treat severe asthma.

Primary care physicians often provide treatment for severe asthma. A pulmonologist, who specializes in diseases of the lungs and respiratory system, is usually consulted if symptoms haven’t responded to treatment as well or as soon as expected. An allergist, who specializing in diagnosing and treating asthma and other allergic diseases, may also be brought into your healthcare team. Try to be patient with the process, as more information and guidance drives better treatment decisions and gets you closer to the goal of severe asthma control.

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