A surprising number of adults diagnosed with asthma may not actually have the disease – but stopping asthma medication without knowing for sure can be dangerous.
Asthma inflames and narrows your airways, causing wheezing, chest tightness, shortness of breath, and coughing during an attack. About 25 million Americans have the condition, which can range from mild to life-threatening, according to the National Heart, Lung and Blood Institute.
However, a new study found a surprising number of adults who were told they had asthma actually didn’t have the lung disease — and they were taking drugs they didn’t need.
Researchers looked into the cases of 613 patients in 10 Canadian cities who were diagnosed with asthma over the past five years. Medical records available for most of the research subjects showed half of those diagnosed with asthma had never been given airflow tests required by medical guidelines to determine if a patient has asthma. Instead, their doctors had based an asthma diagnosis solely on the patients’ reported symptoms.
After the study participants were given a series of detailed breathing tests and a consultation with a lung specialist, there was no evidence a third of these patients had asthma at all.
Side effects of drugs
"It's impossible to say how many of these patients were originally misdiagnosed with asthma and how many have asthma that is no longer active," said lead author of the study Shawn Aaron, MD, a lung disease specialist at Ottawa Hospital and University of Ottawa professor. "What we do know is that they were all able to stop taking medication that they didn't need — medication that is expensive and can have side effects."
The study found a few of the patients who were determined to be asthma-free had other, mostly minor, health problems — such as heartburn and allergies — that accounted for their coughing and other asthma-type symptoms. Only two percent who had been misdiagnosed with asthma had serious conditions, including pulmonary hypertension and heart disease, and those patients went on to receive proper treatment.
If you think you might have been misdiagnosed with asthma or wonder if you can stop taking your prescription drugs for the condition, it’s foolish and potentially life-threatening to self-diagnose yourself and change your treatment.
“Asthma can be deadly, so patients should never go off their medication without speaking to a doctor first," Aaron said.
How do I know if I have asthma?
There are ways to find out for sure if you have asthma, according to allergist and immunologist Marissa Shams, MD, an assistant professor in the Emory University School of Medicine.
“An accurate diagnosis can be made after evaluation by an allergist and pulmonologist (a physician who specializes in respiratory care) and performance of pulmonary function testing (PFT) that reveals airway obstruction and reversibility and bronchial hyper-responsiveness,” said Shams.
It’s crucial that PFT testing is undertaken to find out if a person has asthma or another breathing problem, accorded to Shams. “Many respiratory diseases share similar symptoms (such as cough, sob, and wheeze) but are managed differently,” she explained.
How is asthma treated?
Allergists and pulmonologists may perform additional pulmonary function tests, too, to zero in on a diagnosis and the severity of asthma. For example, your doctor may opt for exercise testing, bronchoprovocation testing (which involves inhaling a specific substance to see if it triggers asthma), measurement of FeNO (short for fractional exhaled nitric oxide) to assess allergic inflammation within the airways, and a chest x-ray to evaluate for chest abnormalities.
“Anyone with a diagnosis of persistent asthma should undergo allergy evaluation to rule out allergic triggers, too,” Shams said. “Depending on your testing results and symptoms, your allergist or pulmonologist will prescribe a tailored treatment regimen to best optimize and preserve your lung function and minimize symptoms.”
Although asthma is a chronic disease, occasionally some patients with rare, intermittent symptoms are able to wean off their medication — or at least taper to a lower dosage, according to Shams. However, reducing or stopping your medication should be attempted based only on your doctor’s advice and instructions.
Bottom line: If you have asthma, it’s crucial to have your condition managed with regular evaluation by your allergist or pulmonologist and routine pulmonary function tests to assess how well your asthma is being controlled, Shams added.
March 03, 2020
Janet O’Dell, RN