Uncontrolled asthma can lead to emergency room visits, hospitalizations and even premature death, according to allergist Myron Zitt, MD, past president of the American College of Allergy, Asthma, and Immunology (ACAAI).

If you have <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/video-different-types-asthma">asthma</a>, it is critical that you take your medication as directed, see your pulmonologist regularly and avoid allergy triggers to ensure you don&#39;t struggle to breathe. Here are some common missteps to avoid:

Not taking your symptoms seriously 
If you have symptoms more than two days a week that cause you to reach for your fast-acting relief inhaler&mdash;or find yourself waking up at night wheezing&mdash;see your doctor to discuss other asthma control options, such as inhaled corticosteroids, which may help address the airway inflammation that occurs with asthma.

Ignoring allergies 
<a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/video-how-common-allergic-asthma">Allergens</a> are an asthma trigger for many people, and Zitt recommends undergoing allergy testing to learn what sparks a reaction and gain guidance in avoiding these allergenic triggers.

Not using your medication preventatively 
Patients who are prescribed a daily medication for asthma must take their medication every day. Yet when symptoms appear to be under control, some patients may skip doses or forget doses. Unfortunately, non-adherence to a treatment plan can lead to poorly controlled symptoms. Zitt stresses that it&#39;s always best to take your medicine regularly to prevent attacks rather than waiting until your symptoms hit and then trying to deal with them.

Not using your inhaler properly 
Many asthma patients do not administer the medication from their inhalers properly, which means they aren&#39;t getting the full benefits of the medicine, Zitt admits. &quot;Using inhaled medication requires instruction and practice to learn how to get it into the lower airways,&quot; he explains. Your doctor or pharmacist can review the technique with you. If you can&#39;t get the timing right, inquire about using an inexpensive device called a spacer, which may make the process easier to coordinate.

Not having a current asthma action plan in place 
The National Heart, Lung, and Blood Institute guidelines indicate that doctors should give each patient with asthma an individualized written plan. The plan should spell out the patient&#39;s triggers, his or her control medications and dosage, the warning signs that an <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/video-what-is-asthma-attack">attack</a> is impending and detailed directions on how to respond, such as increasing inhaler frequency, using a nebulizer or taking an oral steroid.

Not taking care of your health 
Part of controlling asthma is staying healthy. Take precautions to avoid getting sick. Get your annual flu shot as well as a pneumococcal vaccine, wash your hands frequently and steer clear of germy places. If you do become ill, you&#39;ll need to be on the lookout for asthma symptoms and respond by increasing your asthma medicines according to your asthma action plan.

Not working with your healthcare provider 
Understanding asthma and working as a team with your healthcare providers is vital to managing asthma. The good news is that with proper planning and communication, asthma can be managed.

Medically reviewed in May 2018.

7 Mistakes That Sabotage Asthma Control

Allergic asthma is a type of asthma where symptoms are triggered by contact with allergens, and it is the most common type of asthma. Watch Chandler D. Patton, MD, discuss the symptoms and management of allergic asthma in this video.

Medically reviewed in May 2018.

What Is Allergic Asthma?

Asthma comes in a variety of different types. Watch pulmonologist Harish Murthy, MD, discuss how allergies, infections, cigarette smoking, exercise and acid reflux can all cause asthma.

Medically reviewed in December 2020.

What Are the Different Types of Asthma?

Genetics and the environment are two causes of asthma, says <a href="https://www.sharecare.com/doctor/dr-clifford-bassett">Clifford Bassett, MD</a>. In this WisePatient video, he discusses those and other culprits.

Medically reviewed in April 2018.

What Causes Asthma?

Allergic rhinitis and asthma are both common conditions. While exact numbers are hard to pin down, it is estimated that 25 million adults and children in the United States have allergic rhinitis and another 25 million have asthma.

While they are different conditions, there is overlap. Many people who are diagnosed with <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/what-you-need-to-know-about-asthma">asthma</a> also have allergic rhinitis, and the most common type of asthma is allergic asthma, where allergens act as triggers for asthma symptoms.

What are allergies? 
An allergy is an immune system reaction to a harmless substance. Normally, the immune system reacts to get rid of germs and heal injuries. You sneeze to rid your nasal passages of germs. Your eyes water to keep harmful particles out. A sprained ankle swells as the area is flooded with fluid and white blood cells. All of these things are appropriate immune responses.

With an allergy, your immune system reacts to things that normally do not trigger any kind of immune response. People are allergic to all sorts of things, including foods, bites and stings from insects, materials and medications. Anything that causes an allergic response is called an allergen.

Allergic rhinitis is inflammation of the nasal membranes that results from allergic reactions. Its symptoms are what we typically call &ldquo;allergies,&rdquo; and include nasal congestion, sneezing and irritated eyes, as well as a sore or scratchy throat, coughing, hives and headaches. Common allergens for allergic rhinitis include pollen, mold spores, pet dander and <a href="https://www.sharecare.com/health/allergy/article/eliminate-dust-mites-stop-sneezing">dust mites</a>. You may also hear allergic rhinitis referred to as seasonal allergies, hay fever or indoor and outdoor allergies.

What is asthma? 
Asthma is a chronic condition in which the lungs and the airways&mdash;the tubes that carry air to and from the lungs&mdash;become inflamed. This inflammation causes the airways to spasm, and also causes an excess amount of mucus that blocks the airways. This makes it difficult to breathe normally.

Wheezing, coughing, tightness in the chest and feeling out of breath or shortness of breath are all symptoms of asthma. These symptoms can range from mild to severe. An asthma attack (also called an exacerbation or a flare-up) occurs when asthma symptoms become severe.

Asthma can be triggered by a variety of things&mdash;physical exercise, cold air, tobacco smoke and stress can all trigger asthma symptoms. Many people have more than one asthma trigger.

How are asthma and allergies connected? 
The most common type of asthma is <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/how-manage-allergic-asthma">allergic asthma</a>; approximately 60 percent of people who are diagnosed with asthma have allergic asthma. With allergic asthma, allergens trigger asthma symptoms. This includes skin and food allergens as well as allergens like pollen, pet dander, mold and dust mites.

Though they are different conditions, both allergic rhinitis and asthma are inflammatory disorders, and both involve similar immune responses in the body. It is common for people diagnosed with asthma to also have allergic rhinitis, and allergic rhinitis is a risk factor for developing asthma.

If you have symptoms of allergies, asthma or allergic asthma, or have been diagnosed with any of these conditions, it&#39;s important to work with your healthcare provider to get an accurate diagnosis and come up with a treatment plan to address your symptoms.

It is also important to understand that conditions like these can change over time and increase your risk for things like sinus infections, bronchitis and pneumonia. See your healthcare provider anytime you start to experience new symptoms, your symptoms worsen or your symptoms are not responding to treatment.

Medically reviewed in July 2018.

Is It Asthma, Allergies or Both?

Did you know half of all asthma cases are related to allergies? Learn more from Robin Miller, MD, in this video.

Medically reviewed in May 2018.

The Link Between Allergies and Asthma

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition where breathing becomes difficult due to a diminished function of the lungs and airways. It occurs in two main forms: emphysema and chronic bronchitis. With emphysema, the elastic tissue that aids exhaling air, as well as the walls between the tiny air sacs in the lungs, become damaged and no longer function properly. With chronic bronchitis, the walls of the bronchial tubes become inflamed and thickened, and produce excess mucus. Most people with COPD have a combination of these two conditions.

Tobacco smoking is the leading risk factor for COPD, and the majority of COPD cases are attributable to cigarette smoking. However, there are other risk factors, including genetics and exposure to <a href="https://www.sharecare.com/health/health-society/article/pollution-kills-millions-each-year-finds-study">pollution</a>, fumes and chemicals, and there are people with COPD who have never smoked. Some research also suggests that excess bodyweight and a lack of physical activity are associated with COPD symptoms.

The research looked at self-reported data taken from more than 113,000 participants in the National Institutes of Health-AARP Diet and Health Study, which began in 1995. While none of the participants reported COPD-like symptoms at the start of the study, 3,648 participants reported having COPD symptoms in the follow-up years between 1996 and 2006. The researchers discovered that obese people&mdash;as measured by <a href="https://www.sharecare.com/health/wellness-healthy-living/article/can-you-be-overweight-and-healthy">body-mass index (BMI)</a>&mdash;accounted for a greater percentage of those who reported COPD symptoms than did slimmer people.

How could COPD, a disease of the lungs, be associated with being overweight or obese? Carrying excess weight can impact breathing and exacerbate the symptoms of respiratory conditions, including COPD. Obesity can also contribute to inflammation, according to Gundula Behrens, PhD, a researcher in the department of epidemiology and preventive medicine at the University of Regensburg in Germany and co-author of the study. Cells in the immune system secrete proteins called cytokines, and one type of cytokines, known as pro-inflammatory cytokines, cause an inflammatory response in the body.

&quot;The fat tissue that is most active in the production of pro-inflammatory cytokines is visceral fat, which is found in the <a href="https://www.sharecare.com/health/obesity-overweight-condition/article/bad-body-fat-omentum-definition-causes-prevention">abdomen</a>,&quot; Behrens says. &quot;Those pro-inflammatory cytokines circulate through the body, and increased levels of those cytokines may stimulate COPD-related processes in the lung.&quot;

If you have been diagnosed with COPD, there are a number of steps you can take to slow the progression of the disease. At the top of this list is to quit smoking (if you smoke, and you haven&rsquo;t already quit). Exercising and adopting a healthy diet can also help. Speak with your healthcare provider about pulmonary rehabilitation&mdash;a treatment program that utilizes exercise, counseling, nutrition and breathing techniques to help people with respiratory illnesses improve lung function, manage symptoms and improve quality of life.

How Being Overweight Affects COPD

If you feel short of breath while exercising, or you&rsquo;re prone to fits of coughing, you may be wondering if asthma or COPD could be to blame. Asthma and <a href="https://www.sharecare.com/health/copd/article/what-you-need-know-copd">chronic obstructive pulmonary disease (COPD)</a> are often confused or lumped together because they share some of the same symptoms.

&ldquo;Both conditions cause wheezing and shortness of breath,&rdquo; says <a href="https://www.sharecare.com/doctor/dr-nicholas-roy">Nicholas Roy, DO</a>, a pulmonary, internal medicine and critical care specialist from Lourdes Health System in Camden, New Jersey. &ldquo;But not everyone who wheezes has asthma, nor do they necessarily have COPD&mdash;it takes a little more investigating to figure out which condition it is.&rdquo;

Here are some key similarities between the two conditions and how to tell them apart.

What are asthma and COPD? 
Asthma is a chronic lung disease that often appears during childhood. It may be reversed over time, but many people have <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/what-you-need-to-know-about-asthma">asthma</a> for life. &ldquo;It causes airway tightening, inflammation and constriction in the lungs. The small airways actually narrow, leading to shortness of breath, coughing and wheezing,&rdquo; says Dr. Roy.

These symptoms become especially severe during asthma attacks. Asthma attacks may be brought on by a number of <a href="https://www.sharecare.com/health/asthma-causes/causes-of-asthma">triggers</a> such as allergies, exercise, irritating fragrances and lung infections. Attacks can be life threatening, but they&rsquo;re usually treatable at home with rescue inhalers like albuterol.

&ldquo;COPD is a group of chronic lung diseases, which are almost always caused by&nbsp;smoking and don&rsquo;t typically appear until after age 40. These diseases include chronic bronchitis and emphysema,&rdquo; says Roy.

<ul>
	<li>Chronic bronchitis is an ongoing cough, which produces large amounts of mucous.</li>
	<li>Emphysema involves the damage and scarring of tiny air sacs in your lungs, called alveoli. When alveoli are destroyed, it&rsquo;s harder for your lungs to take in oxygen and release carbon dioxide.</li>
</ul>

There are treatments for COPD, but there&rsquo;s no known cure. Many of the same triggers that cause asthma attacks could also lead to COPD exacerbations, or symptom flare-ups. Exacerbations can be serious and require a hospital stay; with each flare, COPD tends to become a little worse.

Are COPD and asthma diagnosed the same way? 
Some of the same tests are used to diagnose both asthma and COPD. For example, your lung specialist will ask about your symptoms, listen to your heart and lungs and have you to complete a pulmonary function test (PFT).

A PFT involves taking a deep breath, and then exhaling as long and hard as you can into a special tube. The tube is attached to a computer, which measures your lung strength and capacity, or the amount of air you&rsquo;re able to exhale. If you don&rsquo;t score well on your PFT, your doctor will give you an inhaled medication to help open up your airways, and then let you redo the test. People with asthma typically score better after taking the medication, while those with COPD show little or no improvement.

Your lung specialist may also order blood tests, as well as a chest X-ray to determine if another condition like pneumonia could be causing your symptoms.

Are both conditions preventable? 
COPD is largely preventable since smoking causes 80 percent of cases. You can&rsquo;t prevent asthma, but you can limit the number of attacks you experience by:

<ul>
	<li>Avoiding triggers</li>
	<li>Getting your annual flu shot</li>
	<li>Taking your daily, or maintenance inhalers</li>
</ul>

Smoking can&rsquo;t cause asthma, but it can trigger attacks, make it harder to fight lung infections and increase your risk of developing COPD. &ldquo;People with asthma are actually more likely to damage their lungs with cigarette smoke,&rdquo; says Roy. &ldquo;It puts them a slightly higher risk for COPD than the average person.&rdquo;

Can asthma cause COPD? 
Asthma doesn&rsquo;t cause COPD. However, people with severe asthma whose symptoms don&rsquo;t improve with treatment are considered to have a type of COPD. People with poorly controlled asthma as children are more prone to this condition as adults.

How asthma and COPD are treated 
Quitting smoking is the number one treatment for COPD and a key part of controlling asthma symptoms. For help quitting tobacco:

<ul>
	<li>Call the national Smokefree Hotline at 1-800-QUIT-NOW (1-800- 784-8669)</li>
	<li>Visit Sharecare&rsquo;s <a href="https://www.sharecare.com/health/quit-smoking">quit smoking page</a> for tips and support</li>
	<li>Reach out to an <a href="https://www.sharecare.com/find-a-doctor/specialty/addiction-medicine">addiction specialist</a> for personalized help</li>
</ul>

Asthma and COPD also share some&mdash;but not all&mdash;medications. &ldquo;There&#39;s often a crossover between inhaler therapies for both conditions,&rdquo; explains Roy. &ldquo;Inhalers include bronchodilators, or drugs that help open up the airways to allow better air flow in and out. Both conditions may also require steroid inhalers, although people with asthma tend to respond a little better to steroid treatments. This is a major reason why that there&#39;s often confusion between the two conditions.&rdquo;

Visit your lung specialist at least once a year to determine which medications are right for you and to update your med list as symptoms change. Individuals with both asthma and COPD often need a combination of inhalers, which may vary from season-to-season or depending on how advanced your condition is. Use Sharecare&rsquo;s <a href="https://www.sharecare.com/find-a-doctor/specialty/pulmonary-disease">find a doctor tool</a> to make an appointment with a lung doctor near you.

Medically reviewed in April 2018.

How to Tell if It's Asthma or COPD

Some of the clues are a little surprising, but if you&nbsp;know what to look for, you&#39;ll be better prepared for your next attack

5 Weird Warnings of an Asthma Attack

Watch Keren Bakal, MD, from Summit Medical Group discuss why having an asthma action plan is an essential part of asthma management, plus her recommendations for her patients.

Taking Control of Your Asthma

There was a killer stalking the Brown family of Exeter, Rhode Island, in the late 19th century. After the deaths of a mother and two daughters, locals thought the culprit was clear&mdash;one of the deceased Browns was a vampire, and if they didn&rsquo;t find out who, the lone remaining son, Edwin, would soon perish. To root out the vampire, townspeople exhumed the deceased Brown family members and declared the youngest daughter, Mercy, to be the perpetrator. Sadly, this revelation did nothing to help Edwin, who passed shortly thereafter.

This tragic family tale was one of the most sensational stories to come out of the New England Vampire Panic of the 19th century. The real killer throughout this era and beyond had nothing to do with the mythical undead, and was instead caused by a very real and still very deadly infection: tuberculosis.

Then known as consumption, tuberculosis (TB) isn&rsquo;t just a threat from a bygone era. &ldquo;It&#39;s still the leading infectious disease cause of death. It kills more people than AIDS, it kills more people than yellow fever or malaria across the world,&rdquo; explains Elizabeth MacNeill, MD, chief of the Tuberculosis Control Branch for the Hawaii Department of Health (DOH).

According to estimates by the World Health Organization, one in four people around the world has TB and it kills around 1.6 million people annually. In the United States, the numbers are far less drastic. Nationally, there are 2.8 cases of TB per 100,000 people. Some states, however, have higher rates of infection, such as Alaska, Hawaii, Texas, New York and California. Immigration from parts of the world where TB is still common may be a reason why these states have more cases. In 2017, 70 percent of TB cases in the US were in foreign-born individuals.

How TB spreads 
TB is a bacterial infection spread through the air from someone with an active infection to a non-infected person. Usually it infects the lungs causing a severe cough and possibly even coughing up blood. Casual contact such as shaking hands, or even sharing food or a toothbrush, will not spread the infection.

&ldquo;The people at greatest risk of catching TB from a patient are those folks who are living with the TB patient. Then on average only about one in five will acquire the infection. Infectiousness varies quite a bit from patient to patient, and usually it takes close, prolonged contact with the TB patient to acquire the infection,&rdquo; says Dr. MacNeill.

While the TB infection itself doesn&rsquo;t discriminate, unfortunately minorities have disproportionately higher rates of the disease. Native Hawaiians and Pacific Islanders, Asians, Hispanics and Latinos and African Americans all have higher rates of TB disease than white Americans in the US.

Two types of infection 
There are two types of TB infection: Latent TB infection (LTBI) and TB disease. People with LTBI have the TB bacteria living in their bodies but aren&rsquo;t sick. They also aren&rsquo;t contagious but usually will test positive for TB. They may or may not go on to develop TB disease. According to MacNeill, &ldquo;nine out of ten people with latent TB will never get sick.&rdquo; Some risk factors of LTBI developing into TB disease include age, HIV status, substance abuse, diabetes or other medical conditions that may weaken your immune system.

It&rsquo;s impossible to say exactly how many cases of LTBI there are in the US today. Different factors can lead to a person developing TB disease from LTBI, including a weakened immune system. People with LTBI should consult with a doctor to go over possible risk factors of developing TB disease and treatment options.

TB disease is an active infection. People with TB disease are very sick and can pass the infection on. Some of the symptoms of TB disease include:

<ul>
	<li>Persistent cough that lasts more than three weeks</li>
	<li>Chest pain</li>
	<li>Coughing up blood or phlegm</li>
	<li>Fever</li>
	<li>Lack of appetite or weight loss</li>
	<li>Fatigue or weakness</li>
	<li>Chills</li>
	<li>Night sweats</li>
</ul>

It&rsquo;s important to note though that not all cases of TB disease will affect the lungs. &ldquo;TB can go to almost any place in your body: your eyes, your brain, your bones, your reproductive organs, your intestines, the sac around the heart,&rdquo; says MacNeill. That means not all cases of TB will include a cough.

Testing, treatment and prevention 
A vaccine is available for TB called Bacille Calmette-Guerin (BCG), but it is not always effective and generally not administered in the United States. In developing countries where TB is more common, infants and young children may receive BCG to ward off an infection.

There are two types of tests available to screen for TB&mdash;a skin test and a blood test. People who have received the BCG vaccination may have a false positive skin test and require further screening. There are two FDA-approved blood tests for TB in the US. People who have received the BCG vaccine or have had a positive skin test will likely have to get the blood test to confirm either LTBI or TB disease.

After a person has had a confirmed positive TB test, a doctor will evaluate them to see if they have LTBI or TB disease. Doctors will take a medical history, perform a medical exam, take a chest x-ray and may run additional lab tests to make an accurate diagnosis.

Treatment for TB disease can take six to nine months. People with TB disease will work with their doctors to determine the right combination of medications to treat the infection.

Not all cases of LTBI require treatment. Only 5 to 10 percent of people with LTBI will go on to develop TB disease, and a variety of risk factors can help physicians determine if someone with LTBI is likely to get TB disease. Risk factors can include age, HIV status, substance abuse, diabetes and medical conditions that weaken immune systems. Treatment for LTBI can be shorter than for TB disease at three or four months total. Treatment plans are determined by a physician on a case-by-case basis.

While TB remains a global threat, it is thankfully not the mysterious killer that once plagued the US, fueling superstition and fear. It has a name and treatment plan that will hopefully one day make TB something that truly is a bygone disease.

Medically reviewed in April 2019.

What You Need to Know About TB

Add these into your diet to help prevent attacks.

The Best Foods for Asthma

There was a killer stalking the Brown family of Exeter, Rhode Island, in the late 19th century. After the deaths of a mother and two daughters, locals thought the culprit was clear&mdash;one of the deceased Browns was a vampire, and if they didn&rsquo;t find out who, the lone remaining son, Edwin, would soon perish. To root out the vampire, townspeople exhumed the deceased Brown family members and declared the youngest daughter, Mercy, to be the perpetrator. Sadly, this revelation did nothing to help Edwin, who passed shortly thereafter.

This tragic family tale was one of the most sensational stories to come out of the New England Vampire Panic of the 19th century. The real killer throughout this era and beyond had nothing to do with the mythical undead, and was instead caused by a very real and still very deadly infection: tuberculosis.

Then known as consumption, tuberculosis (TB) isn&rsquo;t just a threat from a bygone era. &ldquo;It&#39;s still the leading infectious disease cause of death. It kills more people than AIDS, it kills more people than yellow fever or malaria across the world,&rdquo; explains Elizabeth MacNeill, MD, chief of the Tuberculosis Control Branch for the Hawaii Department of Health (DOH).

According to estimates by the World Health Organization (WHO), one in four people around the world has TB and it killed around 1.6 million people in 2017. In the United States, the numbers are far less drastic. Nationally, there are 2.8 cases of TB per 100,000 people. Hawaii, however, has three times the national average. In 2018, there were 8.4 cases per 100,000 residents, the second highest TB rate in the country. Other states with relatively high TB rates include Alaska, which had the highest TB rate; California; Texas; Washington, DC; and New York.

How TB spreads 
TB is a bacterial infection spread through the air from someone with an active infection to a non-infected person. Usually it infects the lungs causing a severe cough and possibly even coughing up blood. Casual contact such as shaking hands or even sharing food or a toothbrush will not spread the infection.

&ldquo;The people at greatest risk of catching TB from a patient are those folks who are living with the TB patient. Then on average only about one in five will acquire the infection. Infectiousness varies quite a bit from patient to patient, and usually it takes close, prolonged contact with the TB patient to acquire the infection,&rdquo; says Dr. MacNeill.

In 2018, 88 percent of all infections diagnosed in Hawaii were from foreign-born individuals who likely acquired the infection before arrival. The majority of cases were from people born in the Philippines (58 percent), but there were also a significant number of cases from the Federated States of Micronesia (8 percent) and the Republic of the Marshall Islands (8 percent). Nationally, minorities have disproportionately higher numbers of TB disease, with Native Hawaiians and Pacific Islanders reporting the highest rate of infection of any ethnic group in the country. There were 120 total cases of active TB in Hawaii in 2018, with an average of 121 cases annually since 2009.

Two types of infection 
There are two types of TB infection: Latent TB infection (LTBI) and TB disease. People with LTBI have the TB bacteria living in their bodies but aren&rsquo;t sick. They also aren&rsquo;t contagious but usually will test positive for TB. They may or may not go on to develop TB disease. According to MacNeill, &ldquo;nine out of ten people with latent TB will never get sick.&rdquo; Some risk factors of LTBI developing into TB disease include age, HIV status, substance abuse, diabetes or other medical conditions that may weaken your immune system.

It&rsquo;s impossible to say exactly how many cases of LTBI there are in Hawaii, but current estimates are between 70,000 to 100,000 residents with LTBI. Different factors can lead to a person developing TB disease from LTBI, including a weakened immune system. People with LTBI should consult with a doctor to go over possible risk factors of developing TB disease and treatment options.

TB disease is an active infection. People with TB disease are very sick and can pass the infection on. Some of the symptoms of TB disease include:

<ul>
	<li>Persistent cough that lasts more than three weeks</li>
	<li>Chest pain</li>
	<li>Coughing up blood or phlegm</li>
	<li>Fever</li>
	<li>Lack of appetite or weight loss</li>
	<li>Fatigue or weakness</li>
	<li>Chills</li>
	<li>Night sweats</li>
</ul>

It&rsquo;s important to note though that not all cases of TB disease will affect the lungs. &ldquo;TB can go to almost any place in your body: your eyes, your brain, your bones, your reproductive organs, your intestines, the sac around the heart,&rdquo; says MacNeill. That means not all cases of TB will include a cough.

Testing, treatment and prevention 
A vaccine is available for TB called Bacille Calmette-Guerin (BCG), but it is not always effective and generally not administered in the United States. In developing countries where TB is more common, infants and young children may receive BCG to ward off an infection.

There are two types of tests available to screen for TB&mdash;a skin test and a blood test. People who have received the BCG vaccination may have a false positive skin test and require further screening. There are two FDA-approved blood tests, one of which is available in Hawaii. People who have received the BCG vaccine or have had a positive skin test will likely have to get the blood test.

Based on the epidemiology of TB, childcare workers, school employees, healthcare employees and children entering schools are no longer required to get a TB skin test, and instead get TB clearances. Individuals &ldquo;only need to be tested if they have a risk factor, and the biggest risk factor is being born or spending time in a country where TB is more common,&rdquo; says MacNeill.

After a person has had a confirmed positive TB test, a doctor will evaluate them to see if they have LTBI or TB disease. Doctors will take a medical history, do a physical exam, perform a chest x-ray and may run additional lab tests to make an accurate diagnosis.

Treatment for TB disease can take six to nine months. People with TB disease will work with their doctors to determine the right combination of medications to treat the infection.

Not all cases of LTBI require treatment. Only 5 to 10 percent of people with LTBI will go on to develop TB disease and a variety of risk factors can help physicians determine if someone with LTBI is likely to get TB disease. Risk factors can include age, HIV status, substance abuse, diabetes and medical conditions that weaken immune systems. Treatment for LTBI can be shorter than for TB disease at three or four months total. Treatment plans are determined by a physician on a case by case basis.

While TB remains a global threat, it is thankfully not the mysterious killer that once plagued the US, fueling superstition and fear. It has a name and treatment plan that will hopefully one day make TB something that truly is a bygone disease.

Medically reviewed in April 2019.

What You Need to Know About TB in Hawaii

If you have <a href="https://www.sharecare.com/health/asthma-respiratory-problems">asthma</a>, maybe you&#39;ve given up on exercise. Knowing that you won&#39;t be able to breathe while talking a brisk walk, playing sports or doing other activities might have turned you off to physical fitness. Unfortunately, exercise is a common trigger for asthma attacks. But that doesn&#39;t mean you have to write off getting in shape.

Symptoms and triggers 
Signs of exercise-induced asthma include coughing, wheezing, shortness of breath or chest tightness during or after exercise. These symptoms typically peak 5 to 10 minutes after stopping the exercise, and they usually clear up in another 20 to 30 minutes.

This type of asthma is most common during longer periods of exercise, and is especially triggered by breathing in cold air. But it can also be triggered by chlorine in pools, chemicals at ice rinks and air pollution.

Prevention 
There are some simple things you can do to help prevent an asthma attack while exercising:

<ul>
	<li>Warm up for at least 10 minutes before physical activity.</li>
	<li>Cover your mouth and nose in cold weather.</li>
	<li>Avoid exercising outdoors if you have seasonal allergies (including fall allergies).</li>
	<li>End your workout by cooling down slowly.</li>
</ul>

Treatment 
While symptoms usually go away in an hour, most doctors recommend taking medicine&mdash;both for <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/top-five-asthma-treatments">prevention and treatment</a>.

Using certain inhalers before you exercise can help prevent symptoms. Short-acting beta-agonists&mdash;what&#39;s probably inside your rescue inhaler&mdash;usually begin working in 15 to 30 minutes and last for two to three hours. But daily use of these is not recommended. Inhaled ipratropium can also relax the airways in your lungs and may work for some people as a preventive step.

But to get at the root of the problem, you should think about your long-term control meds. Exercise-induced symptoms often mean that asthma is not under control. Make an appointment with your doctor to talk about how to better <a href="https://askmd.sharecare.com/askmd/condition-management/asthma-management">manage your asthma</a>, whether that means stepping up your dose or a trying different drug therapy. Together you can find a way for you to breathe easy and get moving again.

Medically reviewed in April 2018.

What Is Exercise-Induced Asthma?

According to the Centers for Disease Control and Prevention (CDC), 1 in 13 US adults have <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/what-you-need-to-know-about-asthma">asthma</a>, a chronic lung condition that inflames the airways in the body.

People who deal with the disorder on a regular basis are probably familiar with the types of activities and environmental factors that could up their risk of an asthma attack. Things like exercise, smoking, pollution and stress can all trigger a flare-up, and symptoms like coughing, wheezing, shortness of breath or chest tightness can all be signs of an episode. But what&#39;s actually going on inside those airways and lungs once asthma kicks into high gear?

Inside your chest 
When an attack hits, it affects your body&#39;s airways&mdash;in other words, the tubes that take air from your mouth and nose to your lungs. As you breathe, the airways change in size. When the attack starts, the airways get inflamed, and it becomes difficult to breathe easy through the smaller space. As the airways flare up, the surrounding muscles become tight, creating an even smaller space for breath to push through.

An episode may cause your body to produce more mucus than usual in the area, clogging things up even more and making you gasp. Pretty scary!

How it&#39;s diagnosed 
Asthma can be <a href="https://www.sharecare.com/health/allergy/article/know-before-you-go-allergist">diagnosed</a> by various tests performed by a medical professional. Your doctor may conduct a pulmonary function test or spirometry, which measures how much air you can move in and out of your lungs and how quickly, as well as collect any family history of breathing issues.

In addition to these tests, the doc may also perform general allergy tests, blood tests and chest and sinus X-rays. Not only does it give them a snapshot of your major respiratory areas, but it also helps them rule out other inflammatory conditions, such as allergies, that could be causing inflammation.

Treatment options 
Asthma has no known specific cause or cure, but thankfully there are options for <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/how-manage-allergic-asthma">treating and managing symptoms</a> to help avoid an attack. A good treatment, or asthma action plan, will help maintain quality lung function and allow you to get more uninterrupted sleep.

People with asthma should also avoid any known triggers&mdash;except exercise. Although working out can increase your risk, it&#39;s beneficial to your health to stay active. Work with your doctor to find a healthy balance between asthma management and movement in order to stay healthy.

Long-term medication for asthma can come in many forms, including inhaler, injection and pill. These treatments help lower inflammation in the airways, whereas short-term fixes work to relax tight muscles when the asthma attack is happening. They do not help lower inflammation; they give immediate but temporary relief from an episode.

Medically reviewed in July 2018.

What's Really Happening During an Asthma Attack?

Asthma is a common respiratory condition that affects over 26 million adults and children in the United States. Here&#39;s a look at how the respiratory system works and how asthma impacts the respiratory system.

Upper respiratory tract 
The main parts of the upper respiratory system include the nose, mouth, throat and voice box. When you breathe in through your nose, the nasal cavity warms the air to keep it from irritating your sensitive airways. Cilia and mucus in the nasal passages trap germs and allergens. Once air is warmed and purified, it travels from your nose down to your throat and voice box and into the lower portion of your respiratory system.

Lower respiratory tract 
The lower respiratory tract is made up of the windpipe and lungs, including the bronchi, bronchioles and alveoli. The air moves down through your windpipe and into the bronchi. Airways that branch off into the lungs have cartilage embedded in their walls to keep the bronchi open. Inside the lungs, these airways then move into smaller passages called bronchioles. These are susceptible to swelling and constriction because there is no cartilage to hold them open.

The bronchioles end in air sacs called alveoli. These sacs change the carbon dioxide in your blood into oxygen, which then goes to your heart and through the rest of your body. The remaining carbon dioxide is removed when you breathe out. Your diaphragm, located beneath your lungs, helps facilitate the process by pumping air in and out of the lungs.

Asthma and the respiratory system 
When <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/video-different-types-asthma">asthma</a> kicks in, this chronic condition can cause swelling in the lining of the bronchial tubes. Excess mucus can form and clog the air passages. The smooth muscle that surrounds your airways can also tighten or go into spasms.

Avoiding the impact of asthma 
These simple steps can help you keep your respiratory system healthy:

<ul>
	<li>Avoid triggers. Triggers can include air pollution, illness, indoor and outdoor <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/video-how-common-allergic-asthma">allergens</a>, cigarette smoke, fumes, respiratory illnesses, cold air and physical activity.</li>
	<li>Use medications as directed. Your fast-acting relief inhaler is essential to reverse the tightening and spasms that occurs with an asthma flare, but in order to prevent <a href="https://www.sharecare.com/health/asthma-respiratory-problems/article/video-what-is-asthma-attack">asthma attacks</a> from occurring, you must be using your long-acting control medicines as directed.</li>
	<li>Monitor your symptoms. Pay attention to how you&#39;re feeling, and use a peak flow meter (a plastic tube that measures your breathing capacity) to get an idea of how well your lungs are functioning.</li>
	<li>Reduce stress. Practice deep breathing exercises such as yoga or meditation and engage in regular cardiovascular exercise to increase your lung capacity.</li>
</ul>

Medically reviewed in May 2018.

Your Respiratory System and Asthma

Nix these from your diet to help prevent attacks.

The Worst Foods for Asthma

Get an up-close look at your lungs to learn how air travels and how to care for them in this 360-degree virtual reality video.

Medically reviewed in May 2018.

Lung Health