Information from AAFA’s Ask the Allergist is not a substitute for a consultation with a health care professional. Always talk with your own doctor before making changes to your asthma or allergy management plan.

Q: Is it common for asthma to develop very suddenly? I am a 30-year-old, Caucasian female and I have had intermittent shortness of breath for 11 months, but have had everyday attacks for the past 3 months. My allergist and pulmonologist are having a hard time managing my asthma. My spirometry is always “normal” but my methacholine challenge test was stopped after level 3/5. I am really struggling with this!

A: There are many causes for shortness of breath and I agree with a close follow-up from your allergist and pulmonologist. Asthma can occur at any point in time. It may even occur during adulthood. It is also possible for you to develop new asthma triggers, and the development of allergy can change the severity of asthma.

Spirometry is a test of large airways. It is possible to have uncontrolled asthma with a normal spirometry. A methacholine challenge that is negative would make asthma unlikely. But a positive methacholine challenge does not necessarily mean that the problem is asthma. These tests provide clues to help your doctors determine the best or most likely diagnosis. There are many new and exciting treatments available for asthma. But the first and most important step is the correct diagnosis. I recommend continued close follow-up to discuss your symptoms and work on achieving an accurate diagnosis. 

Dr. Douglas Johnston is our Ask the Allergist columnist. Dr. Johnston is a board-certified allergist/immunologist with Asthma & Allergy Specialists, P.A., in Charlotte, North Carolina. He obtained his D.O. from New York Institute of Technology College of Osteopathic Medicine. He completed his residency at Winthrop University Hospital in Mineola, New York. Dr. Johnston grew up with both allergies and asthma. He decided it would be exciting to help people with these conditions. His passion about food allergies also comes from having a child with a peanut allergy.