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Can you really 'grow out' of asthma?
Asthma is a lifelong condition that can be highly disruptive to everyday activity. However, those diagnosed with milder symptoms in childhood can find their symptoms lessen or 'disappear' over time and subsequently stop using medication. We investigate if it really is possible to grow out of asthma and whether abandoning your inhaler puts you at risk.
As someone who is prone to allergies, resulting in seasonal hay fever and eczema, it was unsurprising that later into childhood I developed asthma. After a couple of mild asthma attacks when I was 10, I was prescribed preventer and reliever inhalers and sent on my way.
Reliever inhalers open up the airways. They work quickly to relieve symptoms and are often needed only when you have symptoms, but they don't stop flare-ups. Preventer inhalers, by contrast, work largely by reducing inflammation and need to be taken regularly to work properly.
Time went on and I later found my symptoms were not overly disruptive to my day-to-day routine, so I slowly phased out my asthma pumps without consulting my parents or GP.
Fast-forward to adulthood and I notice that strong smells in my surroundings, such as perfume, cigarette smoke and even freshly laid tarmac, cause me chest tightness and wheezing. When it comes to regular exercise, I struggle with stamina during cardio and high-intensity workouts, due to shortness of breath.
Was I wrong to stop using my medication even though I felt I didn't need it?
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Can you really grow out of asthma?
"If you have asthma your airways are inflamed and sensitive to triggers such as cold air, pollution, cold and flu viruses or allergies that set off your asthma symptoms (for example, hay fever, dust mites, or food)," says Dr Andy Whittamore, clinical lead at Asthma UK.
"For some children diagnosed with asthma, the condition might improve or disappear completely as they get older but for many people, asthma is a lifelong condition," he adds.
However, it may not always be asthma causing the problem. Asthma-like symptoms can be down to allergies, which is why it may appear that a child has outgrown their asthma.
"True asthma does not go away, just as diabetes or hypertension don't go away," states Dr Thomas Antalffy, inventor of the Smart Peak Flow device.
If you feel your asthma symptoms are relieved, it may simply be lying dormant so it's important to be vigilant.
"There may be periods where your symptoms do not affect your day-to-day life and these periods could last years or even decades. However, asthma symptoms can be triggered again by a change in circumstances, such as a new workplace, stress, or hormonal changes during pregnancy or menopause," says Whittamore.
"If you're taking your asthma medicines as prescribed and feeling well, this is a sign that they are working," so don't assume you no longer need treatment, he warns.
If symptoms do come back, it's vital that you don't ignore them and that you speak with your GP.
Conversely, just because you have not been diagnosed with asthma as a child does not mean you never will be.
"Asthma is often diagnosed at a later age and is nonetheless dangerous. The National Review of Asthma Deaths shows that the median age of being diagnosed with asthma is 37 years," Antalffy reveals.
Minimising your risk of an attack
It may seem obvious, but the best way to decrease your chance of an asthma attack is to use your medicines if you start having symptoms.
"If you no longer take medicines because you have 'grown out' of asthma, but notice symptoms such as breathlessness, coughing at night, a tight chest or wheezing flaring up, make sure you see your doctor to discuss whether you might need to go back on asthma medicines again," urges Whittamore.
"Your preventer inhaler (usually brown) reduces the inflammation in your sensitive airways over time so you are less likely to react if you come into contact with an asthma trigger, reducing your chance of having an asthma attack or flare-up," he explains.
Common asthma symptoms include shortness of breath, a tight chest and wheezing. All can put you at risk of a life-threatening asthma attack.
Depending on the severity of your asthma, treatment usually goes as follows:
"The most basic treatment calls for a reliever inhaler to be used as symptoms appear. When the reliever inhaler is used more than twice a week, it is recommended to move the treatment to step two," says Antalffy.
"Step two calls for a preventer inhaler, usually used twice a day regardless of symptoms, in addition to the reliever inhaler on standby."
If your asthma is still poorly controlled after these measures, sometimes a third drug will be prescribed alongside inhalers.
"It is important to take your asthma medicines as prescribed and speak with your GP or asthma nurse if you wish to make a change," implores Whittamore.
"Attend your annual review to keep your GP or asthma nurse up to date with your circumstances and health and they can help you adjust medication if appropriate," he adds.
Know your triggers
Spend time observing your condition to detect what triggers your asthma, and note it down. This can range from household dust or mould, weather conditions, infections and even things like alcohol and stress.
"Avoiding these triggers and taking appropriate measures when they are unavoidable is a big step towards achieving control over your asthma," advises Antalffy.
As well as attending your annual review, the best way to keep track of your asthma is to have a written action plan and keep a peak flow diary. Not only is this handy for you, it's a great way to illustrate any changes to your GP.
Technological advances are making this even easier to keep track of on the go. If you’re willing to splash out, the Smart Peak Flow is a medically certified device that plugs into your smartphone and tracks your peak flow through an app. It can even accurately predict when an asthma attack is likely up to seven days before it happens.
Something in the air?
The fact is, we don't know what causes asthma, and there is not enough data to know why there are more people being diagnosed than ever before.
"The proportion of people with asthma is rising worldwide, and pollution has an adverse effect on asthma but there is no simple direct connection between the two," Antalffy admits.
"There is evidence to suggest that air pollution plays a part in causing asthma. We know that children's lungs are stunted by exposure to pollution, which means they are more likely to develop the condition," Whittamore explains.
"We do know that air pollution also affects people with asthma and triggers symptoms for 3.3 million people with asthma in the UK. Exposure to high levels of pollution can put people at risk of a life-threatening asthma attack."
As air pollution is almost unavoidable, especially for those who live in cities, taking your brown preventer inhaler is the best way to minimise this as a trigger.
"If your asthma is affected by pollution, it may help to avoid hotspots like junctions and bus stations and stick to back streets where pollution levels are lower," suggests Whittamore.
Remember, before changing or stopping asthma medication for yourself or your child, always speak with your GP; otherwise, you could be caught short - of breath!