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ASK THE EXPERTS

ANTHONY SZEMA, MD

Patient Question

"I can't take the cold, but I am not looking forward to the spring, because I am usually stuffed up and bothered by allergies. I am in my early 30s and as I get older, it seems that my allergies get worse and last longer. As I age, should I worry about these allergies turning into asthma?"


Anthony M. Szema, MD

Anthony M. Szema, MD

Assistant Professor of Medicine
Department of Medicine
Chief, Allergy and Clinical Immunology, Veterans Affairs Medical Center, Northport
Expert Answer

The relationship between aging and asthma is unknown. A risk factor such as cigarette smoking may change one's risk for developing adult-onset asthma and may overlap with Chronic Obstructive Pulmonary Disease (COPD). "Postviral asthma" and "fixed airway obstruction" (not responding to inhalers) are types of adult-onset asthma that are more common in the elderly. Research suggests that genetics may play a role in developing asthma.

Regardless of age, sensitivity to allergens is related to a decline in lung function. For example, if your body makes a specific allergic antibody to tree pollen (you have positive skin tests with associated symptoms), you are at risk for asthma. The more pollen you are exposed to, the worse your risk for disease.

Putting children with allergic rhinitis on allergy shots (immunotherapy) may, in some cases, prevent asthma. So, if you never had immunotherapy as a child, you may be at greater risk of developing asthma as an adult.

Over time exposure to air pollution and fire (smoke) is associated with increasing symptoms of asthma. Seasonal fall ragweed pollen is harmful to the lungs. Because of its physical and chemical properties, ragweed pollen can cause lung injury. Repeated and intense exposure to ragweed can lead to symptoms resembling asthma. Global warming is to blame, because when carbon dioxide levels are doubled, ragweed plants will produce 61 percent more pollen. Ragweed pollen counts were at their highest level on the East Coast last year. Mild winters, followed by wet early springs, then dry days, cause the release of more pollen into the atmosphere.

Symptoms of asthma are often irregular. You may have had asthma in the past, which may have gone away, but now has recurred. In adolescence, asthma is more common in boys than in girls, and later in life, it is more common in men. According to new research, estrogen may be beneficial to the lungs.

The bottom line is that you should see your primary care physician or specialist for a complete evaluation.


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