Managing your asthma when you’re dealing with another health condition can sometimes be tricky. For one thing, you might forget to think about your asthma if you need to go to appointments, have tests and take medicines to treat something else. For another, you might have questions about juggling two (or more) conditions at the same time.
Look after your asthma
Whatever else is going on with your health, it’s important to do everything you can to look after your asthma. Taking your medicines as prescribed, going for asthma reviews every year (or at least once a year for a child) and getting your inhaler technique checked regularly, for instance, will help to ward off asthma symptoms and help to prevent a potentially life-threatening asthma attack.
Get other conditions treated
It’s also important to get other health conditions treated because ignoring symptoms or putting off appointments may crank up your stress levels, which can trigger asthma symptoms in some people. Some conditions can also directly affect your asthma if they’re left untreated.
Get the support you need
Even if things seem complicated, your healthcare team is there to support you. They can help you to manage all your health conditions so they don’t stop you getting on with your life.
What other health conditions are more likely when you have asthma?
Many people with asthma don’t develop other health conditions as well, but if you have asthma, you do have a slightly higher risk of developing certain other conditions. If you do, your GP or asthma nurse will help you manage the symptoms, or they will refer to a specialist if you need one. They can also talk to you about all the lifestyle changes you can make to help you avoid developing another condition in the first place.
While there’s not much evidence to say what conditions children with asthma are more likely to get, adults with asthma have a higher risk of:
- Allergic rhinitis
- COPD and ACO
- Depression and anxiety
- Gastro-oesophageal reflux disease (GORD)
- Heart disease and stroke
- Vocal cord dysfunction.
This is inflammation of the inside of the nose caused by an allergen, such as pollen, dust, mould or pets. It's a very common condition, estimated to affect around one in every five people in the UK.
Common symptoms include:
- blocked or runny nose
- constantly clearing your throat.
If you have asthma, allergic rhinitis symptoms can make your asthma symptoms worse. Having a blocked nose can also affect asthma control.
If you have, or think you may have, allergic rhinitis it’s very important to speak to your GP or asthma nurse about how you can treat it. Leaving it untreated can make your asthma symptoms worse.
If the substance that’s causing your allergic rhinitis is pollen, this is known as hay fever. Research shows that anyone with asthma who also has hay fever can significantly reduce their risk of going to A&E or being hospitalised if they treat their hay fever. This could include a nasal steroid spray, anti-histamines or anti-inflammatory eye-drops; so ask your pharmacist or GP which treatment is right for you.
Chronic obstructive pulmonary disease (COPD) is a condition where the airways become inflamed and the air sacs in your lungs are damaged. This causes your airways to become narrower, which makes it harder to breathe in and out. Common symptoms include:
- wheezing, particularly breathing out
- breathlessness when resting or active
- tight chest
- producing more mucus or phlegm than usual.
The main cause of COPD is smoking and it can also be caused by long-term exposure to air pollution, fumes and dust from the environment or your workplace. People who don’t smoke but who have poorly controlled long-term asthma can go on to develop COPD.
Asthma-COPD overlap (ACO) is the term health professionals have recently started to use if you have symptoms of both asthma and COPD.
It’s a useful term because when you have both conditions, the symptoms can be so varied, it’s sometimes difficult for a doctor to work out which medicines are right for you.
The important thing to remember is:
- if you have asthma or severe asthma and it's poorly-controlled in the long term and/or
- if you’re not looking after your asthma well and/or
- if you smoke
you’re putting yourself at increased risk of asthma attacks and COPD. Speak to your GP or asthma specialist who will be able to talk you through all the ways you can lower your risk of developing COPD.
If you have, or think you have ACO, your GP may refer you to a specialist who will help you get the right diagnosis and treatment.
According to mental health charity Mind, every year around one in four of us experiences a mental health problem, such as anxiety or depression.
- low mood
- lack of motivation and interest in doing things you usually enjoy.
- feeling tense, restless and unable to concentrate
- having a sense of dread.
People with a long-term condition such as asthma, particularly severe asthma, are more likely to experience depression and/or anxiety. It’s important to speak to your GP or asthma nurse if you’re experiencing these conditions so they can help you manage them. Leaving the symptoms untreated may mean that you’re less likely to stay well with your asthma.
Diabetes is a condition where a person’s level of sugar in their blood becomes unstable. About 90 per cent of people with diabetes have Type 2 diabetes.
Common symptoms include:
- going for a wee a lot, especially at night
- being really thirsty
- feeling more tired than usual
- losing weight without trying to
- genital itching or thrush.
Having asthma doesn’t increase your risk of diabetes, but the long-term use of steroids to treat severe asthma, especially if you’re taking high doses, has been linked to an increased risk of developing Type 2 diabetes. Also, being overweight is one of the risk factors for diabetes, especially if you have a large waist.
Uncontrolled diabetes can cause serious long-term health problems. Your GP or asthma nurse will keep an eye on your blood sugar levels if you’re taking high doses of steroids by arranging blood tests and by testing your urine for glucose. They will also talk to you about all the lifestyle changes you can make to help lower your risk of Type 2 diabetes. If you do develop it, you will be prescribed medicines to help manage your blood sugar levels if you need them.
This is a common condition where acid from the stomach leaks out of the stomach up into the oesophagus (a long tube of muscle that runs from the mouth to the stomach).
Common symptoms include:
- heartburn – burning chest pain or discomfort that happens after eating
- acid reflux – an unpleasant taste in the mouth, caused by stomach acid coming back up into your mouth
- pain when swallowing and/or difficulty swallowing.
If you have asthma and GORD, your asthma symptoms may get worse as a result of stomach acid irritating your airways and causing inflammation. For this reason, it’s very important to tell your GP or asthma nurse if you’re getting any GORD symptoms. They will probably talk to your about your diet (and losing weight if you’re overweight). They may also prescribe medicines.
Coronary heart disease is the term used to describe what happens when your heart's blood supply is blocked by a build-up of fatty substances in the arteries - the tubes that carry blood to the heart.
Common symptoms include:
- chest pain (angina) – a painful feeling of heaviness or tightness, usually in the centre of the chest, which may spread to the arms, neck, jaw, back or stomach
- heart palpitations
- breathlessness, especially if it comes on suddenly or for no obvious reason.
If they’re not treated quickly, these symptoms may lead to a heart attack – when the arteries become completely blocked and the blood can no longer reach the heart. If this happens, you need to dial 999 immediately as it can be life-threatening in some cases.
A stroke is a serious, life-threatening medical condition that occurs when the blood supply to part of the brain is cut off. The main symptoms can be remembered with the word FAST:
- Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have dropped.
- Arms – the person with suspected stroke may not be able to lift both arms and keep them there because of arm weakness or numbness in one arm.
- Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake.
- Time – it is time to dial 999 immediately if you see any of these signs or symptoms.
Research suggests that people with asthma are at higher risk of heart attack or stroke, but it’s not yet known why.
If you have asthma and heart disease, your GP, asthma nurse and/or consultant(s) will help you treat both conditions. They will also talk to you about all the medicines you need, as well as all the lifestyle choices you can make to help you stay well, such as giving up smoking, keeping active and eating a healthy diet.
Vocal Cord Dysfunction (VCD) is a condition where the vocal cords (or voice box) do not open correctly, making breathing difficult. This rare condition is more common in women than men. It’s sometimes confused with asthma because some of the symptoms and triggers are similar.
Common symptoms of VCD include:
- tight chest
- tightness in throat
- changes in voice
- high-pitched breathing.
Some people with asthma also have VCD, making diagnosis difficult. Often VCD is only diagnosed when the usual treatments for asthma aren’t working.
The best way to diagnose the condition is through a procedure known as a laryngoscopy, where a practitioner uses a thin tube with a tiny camera at the end to look at the back of your nose, throat and voice box. Ideally this should be carried out when you are getting the symptoms of VCD. This will then show whether the vocal cords are working normally or not.
Giving your GP or specialist a detailed description of your symptoms and when you experience them will also help to pinpoint the cause of the problem.
Although no-one really knows what causes VCD, there are effective treatments to manage the condition, including:
- Speech therapy - You will be taught a range of techniques to help relax your throat muscles. These can significantly improve symptoms as well as prevent future symptoms. Ask your GP or specialist to refer you to a speech therapist.
- Stress management - Because strong emotions and stress can often trigger VCD, learning to manage your stress levels is important. Talk to your GP about the best relaxation techniques for you, such as meditation, cognitive behavioural therapy, biofeedback or psychotherapy.
- Physiotherapy – This can also help you manage your anxiety levels, through a range of techniques that slow down your breathing.
Your questions answered…
How can I get my GP or asthma nurse and specialists to talk to each other to check all my treatments are safe to take at the same time?
Keep a record of all your medicines, listing each name, what condition it’s for and the name and contact details of the doctor who prescribed it. Take this with you to every appointment so you can talk to your different specialists, GP or asthma nurse about what you’re taking. You can review the list together and go through any concerns.
How do I know a new medicine for another condition won’t interfere with my asthma medicines?
If you’ve taken your list of medicines to your appointment, your GP will be able to cross-check all your different medicines and make sure any new medicines are safe to take alongside the others. If you have any questions or concerns, don’t be afraid to ask your GP or pharmacist by saying something like, “Can I check this new medicine is safe to take at the same time as XX?”
What medicines am I taking, and why?
If you’re not sure why you’ve been prescribed a certain medicine or how it’s helping you, then make an appointment with your GP or asthma nurse to discuss it. It may also be useful for you to see your pharmacist for a Medicines Use Review. Your GP, asthma nurse or pharmacist will be only too pleased to answer any questions you have about your medicines. If you understand why you’re taking them, how often you need to take them and the best way to take them, you can make sure you get the maximum benefits from them.
Is it safe for me to take over-the-counter medicines for any of my conditions?
It’s really important to get advice from your GP or pharmacist before taking any over-the-counter medicines, including cold and flu remedies, vitamin supplements and herbal remedies.
Some over-the-counter medicines can cause problems if you take them with your asthma medicines. For example, aspirin and non-steroid anti-inflammatories (which include common medicines such as ibuprofen) may make your asthma symptoms worse.
Is it a waste of my doctor’s time if I ask about different conditions they’re not responsible for treating?
No – your doctors are there to help you. It’s okay to ask lots of questions. If a health professional can’t answer something, about a condition they’re not familiar with for example, they’ll be able to help you find somebody who can. Most doctors encourage questions because the more you know about your conditions and treatments, the more likely it is you will stay well. If you don’t have enough time during your appointment to ask all your questions, make another appointment.
If I’m taking lots of different medicines, am I more likely to get side effects?
Medicines affect people differently. Always ask your GP, asthma nurse, consultant or pharmacist if you have any concerns about the treatment, and tell them about any side effects. They may be able to change the prescription, adjust the dose or look at other ways to reduce the risk of side effects, such as taking the medicine at a different time of day.
If I’m taking lots of medicines, is it safe for me to have a general anaesthetic?
Before you have an operation, your doctor and anaesthetist will talk to you about your medical history. This will include finding out what medicines you’re taking so they can decide on the best anaesthetic for you. Don’t be afraid to mention any questions or concerns you have. During the operation, you will be rigorously monitored to make sure everything goes as planned.
Sometimes I want to give my body a break – does it matter if I stop taking my asthma medicines for a month or two?
Don’t stop taking your asthma medicines. If you’re worried about the effects of all your medicines on your body, talk to your GP or asthma nurse, or call our Helpline. To gain the best results from your medicines and to manage your asthma and other conditions well, you need to take your medicines exactly as prescribed by your GP or asthma nurse.
All your medicines have been carefully prescribed for you, taking into account each of your conditions and your medical history. It can be dangerous to stop taking a medicine or altering a dose without talking to your GP, asthma nurse or consultant first.
And remember – your preventer inhaler for your asthma has a protective effect that builds up over time and works away in the background to help prevent inflammation and swelling. If you stop taking it, the protection it gives your airways will start to reduce and raise your risk of symptoms and of a potentially life-threatening asthma attack.
If you have any questions about your asthma and how it relates to other health conditions, you can call our Helpline on 0300 222 5800 to talk to our asthma nurse specialists (Mon – Fri; 9am - 5pm).
Last updated August 2016
Next review due August 2019