How to Tell if It's Asthma or COPD

Both conditions have similar symptoms like wheezing and shortness of breath.

Medically reviewed in February 2022

If you feel short of breath while exercising, or you’re prone to fits of coughing, you may be wondering if asthma or COPD could be to blame. Asthma and chronic obstructive pulmonary disease (COPD) are often confused or lumped together because they share some of the same symptoms.

“Both conditions cause wheezing and shortness of breath,” says Nicholas Roy, DO, a pulmonary, internal medicine and critical care specialist from Lourdes Health System in Camden, New Jersey. “But not everyone who wheezes has asthma, nor do they necessarily have COPD—it takes a little more investigating to figure out which condition it is.”

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 asthma for life. “It causes airway tightening, inflammation and constriction in the lungs. The small airways actually narrow, leading to shortness of breath, coughing and wheezing,” says Dr. Roy.

These symptoms become especially severe during asthma attacks. Asthma attacks may be brought on by a number of triggers such as allergies, exercise, irritating fragrances and lung infections. Attacks can be life threatening, but they’re usually treatable at home with rescue inhalers like albuterol.

“COPD is a group of chronic lung diseases, which are almost always caused by smoking and don’t typically appear until after age 40. These diseases include chronic bronchitis and emphysema,” says Roy.

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

There are treatments for COPD, but there’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’re able to exhale. If you don’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’t prevent asthma, but you can limit the number of attacks you experience by:

  • Avoiding triggers
  • Getting your annual flu shot
  • Taking your daily, or maintenance inhalers

Smoking can’t cause asthma, but it can trigger attacks, make it harder to fight lung infections and increase your risk of developing COPD. “People with asthma are actually more likely to damage their lungs with cigarette smoke,” says Roy. “It puts them a slightly higher risk for COPD than the average person.”

Can asthma cause COPD?
Asthma doesn’t cause COPD. However, people with severe asthma whose symptoms don’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:

  • Call the national Smokefree Hotline at 1-800-QUIT-NOW (1-800- 784-8669)
  • Visit Sharecare’s quit smoking page for tips and support
  • Reach out to an addiction specialist for personalized help

Asthma and COPD also share some—but not all—medications. “There's often a crossover between inhaler therapies for both conditions,” explains Roy. “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's often confusion between the two conditions.”

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’s find a doctor tool to make an appointment with a lung doctor near you.

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