If you have asthma it’s kind of like your respiratory system won an undesirable lottery. Asthma symptoms typically include shortness of breath, coughing, wheezing (a whistling sound when you breathe), and chest tightness, so, it’s not exactly a party.
Having this health condition can spark a serious case of “why me?!” and make you wonder what causes asthma in the first place. The answer isn’t entirely clear-cut, but doctors have some ideas.
Let’s do a quick refresher on how asthma works so you can better understand what may cause it.
There are various types of asthma, but they all have the same effect on your respiratory system. Asthma affects your airways, which go between your nose and mouth and your lungs. Your airways have the incredibly important job of carrying air in and out of your body, but triggers can inflame them to the point of malfunctioning, the National Heart, Lung, and Blood Institute (NHLBI) says.
This inflammation can make your airways swell up, causing the muscles around them to tighten. That often makes it hard to get air in and out. At the same time, your airways might also make more mucus than normal, adding to the factors that make it hard for you to breathe. That’s how you wind up with asthma symptoms.
Asthma triggers include pet dander, pollen, mold, cold air, cigarette smoke, exercise, and respiratory infections like colds, among others. Though these things can be pretty harmless in people who don’t have asthma (or allergies and other related health conditions), if you do have asthma, your body perceives these substances as threats and way overreacts in response, Raymond Casciari, M.D., a pulmonologist at St. Joseph Hospital in Orange, California, tells SELF.
Doctors don’t entirely understand why some people develop the immune oversensitivity that leads to asthma, but it could be a mix of your genetics, environment, and more.
While there’s a lot that isn’t clear, the American Lung Association (ALA) says certain factors can increase your risk of developing asthma:
Your genetics: Asthma usually runs in families, the ALA points out. If your mom or dad (or both) has it, the odds that you’ll have it climb as well.
A personal or family history of allergies: This can include seasonal allergies as well as allergic skin conditions like atopic dermatitis (eczema), Ronald Purcell, M.D., an allergist and immunologist at the Cleveland Clinic, tells SELF. This is because of something known as the atopic march, he says, which is a group of allergic conditions that may progress during different stages of a susceptible person’s life.
Typically (but not always) the atopic march involves having eczema as a kid, then issues like asthma and allergies as you get older. Experts aren’t sure why the atopic march happens, Dr. Purcell says, but it may simply be that your immune system tends to overreact to triggers as a whole, and it manifests differently as you age.
Respiratory infections as a child: Well, obviously every kid gets a respiratory infection at some point, lovable little germ machines that they are, and not everyone will wind up with asthma because of it. But when you were a baby and young kid, your lungs were still developing, so respiratory infections could have caused inflammation and damaged the lining of your lung tissue. This kind of damage can lead to an increased risk of developing asthma in the future, the ALA says.
Your environment: This is kind of a mix of the above factors, but it’s worth noting that if you were exposed to allergens, irritants, or viral infections as a baby or young child when your immune system wasn’t fully developed, you’re at an increased risk of developing asthma, the ALA says. There isn’t one set reason why this happens, but it could simply be because all of these tend to be inflammatory and potentially harmful to your lung tissue, Dr. Purcell says.
Coming into contact with various chemicals and substances at work is an environmental factor that can increase your chances of winding up with adult-onset asthma, the ALA notes. (There’s an entire subset of asthma called occupational asthma, which happens because of excessive workplace exposure to those irritants.)
If you have asthma, it’s important to make sure you seek treatment and keep it under control.
“Get it treated, because it’s going to affect your life,” Dr. Purcell says. “If you don’t treat it, it could become harder to treat later.” Letting asthma go for too long can create something known as airway remodeling, which is a permanent change in your airways that can make it harder to breathe all the time, not just during asthma flares, Dr. Casciari says.
“The vast majority of patients should never end up anywhere near that,” Dr. Purcell says. “We have good medications and treatments, and it’s important to use them.”
If you talk to your doctor, they can help you determine which asthma treatment may be right for you. That might involve fast-acting drugs you can breathe in through an inhaler to open up your airways if you’re having asthma symptoms, preventive drugs to generally reduce airway inflammation, or both.
Once you’ve landed on the best treatment for you, you and your doctor can hammer out an asthma action plan, which is essentially a written document that explains exactly how to handle your asthma based on how much it’s acting up. So, even though you may not know the exact cause of your asthma, you can figure out exactly how to combat it—and that might feel even better.