Cold air is triggering my asthma

Posted by bears @bears, Oct 20, 2021

I have asthma or RAD. Does anyone else have bronchospasms when the outdoor air temperature is 69 or even 70 degrees Fahrenheit?? My spirometry test is normal, however I have become extremely sensitive to air temperature! My chest tightens and it is difficult to breathe. I have no problem with air in mid 70 to 80 degree (or warmer) degree range. My pulmonologist says I am a unique case in her experience and thus she has no advice to give me. Thanks!

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Profile picture for zebra2022 @zebra2022

Back in September 2022, I was diagnosed with cryoglobulinemia, and ever since then I have had issues with breathing. Both of my pulmonary doctors say the issue is asthma. Yes I've had asthma in the past but when I have my flare ups none of my inhalers work to help my breathing. I've been on 4 so far. The Albuterol used to help with my episodes prior to my September diagnosis. Now my triggers have been cold air, I get shortness of breath and then sometimes chest pains. I never had that problem before, now its everytime I'm in cold air (whether air conditioned rooms, fridge/freezer areas, fans, even cool breeze). One doctor thinks it's really strange. All my tests come back normal. The only thing I've found that helps is wearing a mask.Even with the mask, back in 2020 when we all had to wear masks, it used to trigger my asthma, now it helps my breathing. It's weird.

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@zebra2022 - If you'd like to connect with others talking about cryoglobulinemia, you might check out this Mayo Clinic Connect discussion:

-Cryoglobulinemia: Want to connect https://connect.mayoclinic.org/discussion/cryoglobenemia/

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I haven't had an asthma attack in about 25 years. Used to go to the hospital 4 or 5 times a year when I was little. I went on Flovent in 1994, and it changed my life. I continue to get it in Canada since the US stopped manufacturing it. I was born with severe asthma. I used to stay stopped up a good part of the year when I was little, so I became a mouth breather. During the winter, I only breathe through my nose for the first 5 minutes of being outside. It does the trick for me. Any kind of cold air breathing through my mouth or air blowing on me directly in the face triggers a coughing attack. Which, in turn used to trigger an asthma attack. I have learned to avoid those situations by breathing slowly through my nose until the air warms up and then hits my lungs. BE - Bronchiectasis. I am normally on the Infectious disease section of Mayo Clinic. Picked up MAC (Macro Avium Complex) in 2012. It's a bacterium found in the dirt. Turns out gardening is not a good hobby after all! People with asthma and COPD are more prone to these bacteria as we get older. It was once called Lady Windermere syndrome. Skinny, old, white women got it. It's harsh, and if I contract it again, that will mean 3 years of 3 different antibiotics every other day. The BIG 3 they call it. So I take Azithromycin 3x a week for the rest of my life to avoid contracting it again. This is only 1 of approximately 164 bacteria that are called NTM (Non-Tuberculous Mycobacteria). Turns out they are in our water supply as well. Because of so many infections over the years, I was diagnosed in 2021 with Bronchiectasis which is a widening of the tubes in the chest, making it hard to clear mucus. I have no cilicia anymore because they have either been destroyed or deformed. This makes it almost impossible to clear the mucus. Who knew that mucus was so important! It picks up bacteria if you can't clear it. Thank God my asthma is totally under control because I had exercise-induced asthma for many years. Now with BE it is super important to move. Exercise helps our breathing immensely. I think there about 500,000 of us in the US with BE right now and it is growing.

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Welcome to Mayo Clinic Connect, @lafieldeparunu. I believe that @sueinmn had some helpful information about cold air as an asthma trigger.

Have you talked to your doctor about this reaction? If so, what did they say?

@1fancydancear - as there are a number of medical terms with the initials "BE," I wanted to be sure to understand which one you meant. Will you expound on that?

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Profile picture for Sue, Volunteer Mentor @sueinmn

Hello, and welcome to Mayo Connect. You are presenting an unusual set of circumstances, but temperature sensitivity with reactive airway disorder (RAD) is quite common.
How long have you had the diagnosis of RAD? Did it begin as an exercise-induced situation? When did the unusual temperature sensitivity begin? What do you do to manage it?

The reason I am asking specifically is that for many years, I had exercise-induced RAD and asthma in high-temperature/high humidity situations. My doc at the time had "never heard of high-temperature RAD" and I'm sure she believed it was psychosomatic. But use of my albuterol rescue inhaler resolved it.

Then my daughters, both of them with mild asthma, began cross country skiing competitively, one had intermittent RAD at very low temperatures (and more severe, persistent asthma), the other NEVER skiied a race without an attack until her 5th year of competing. Curiously, inhalers resolved her attacks, and she reacted less as the season progressed each year.

Now for the interesting part - last year, for the first time in 10 years, I spent the winter in the cold climate of Minnesota. As part of coping with the pandemic, I took my grandsons out to play in the cold every day while their Mom worked from home (daycare was closed.) At first, because none of us was vaccinated, we wore masks full-time, even outdoors. After vaccine, we decided to forego masks, and I began to experience bronchospasm on any day when it was dry or windy - but it went away if I put on my mask!

Is it possible you have been wearing a mask so much, keeping the air to your lungs warm and moist, that a normal 70F, low-humidity day is causing them to perceive cold and to spasm? What happens if you wear a mask outdoor when it is cool?

Curious to hear from you.
Sue

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I know that this is an old post. I discovered when I was about 10 years old that I tend to be a mouth breather even at night. I was born with asthma. In the winter, when I went out to play, it would hurt my lungs to breathe. So I tried breathing through my nose. It worked. I asked my doctor about it, and he said that breathing through my nose gives the air time to warm before hitting my lungs. It has worked for me in winter for many years. Also, any air, from a ceiling fan, car air conditioning, or even a regular fan blowing directly on me, will cause me to start coughing. I avoid direct air blowing on me. My asthma has been under control for many years using Flovent. However, have developed BE and now I HATE SUMMER in Georgia. The humidity gets me this time of year. My best time of year for breathing has become winter.

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Profile picture for bears @bears

Thanks for your comments about cold air. You are so right. I live in Northern California and the air is cool now so I am house bound. Any air below 70 degrees seems to tighten my bronchial tubes and so are thinking seriously about moving to Arizona where it is warmer year round. Also, I took your advice and tried Fisherman's Friends cough lozenges. I don't have a coughing problem but do get tickling and irritation in my throat with asthma. Perhaps FF cough lozenges could help with reducing inflammation as well. I am giving them a try! Thank you.

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Hi @bears! I’m dealing with the exact same thing now, curious how it’s worked out for you these past few years? Are you feeling better?

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Profile picture for zebra2022 @zebra2022

Back in September 2022, I was diagnosed with cryoglobulinemia, and ever since then I have had issues with breathing. Both of my pulmonary doctors say the issue is asthma. Yes I've had asthma in the past but when I have my flare ups none of my inhalers work to help my breathing. I've been on 4 so far. The Albuterol used to help with my episodes prior to my September diagnosis. Now my triggers have been cold air, I get shortness of breath and then sometimes chest pains. I never had that problem before, now its everytime I'm in cold air (whether air conditioned rooms, fridge/freezer areas, fans, even cool breeze). One doctor thinks it's really strange. All my tests come back normal. The only thing I've found that helps is wearing a mask.Even with the mask, back in 2020 when we all had to wear masks, it used to trigger my asthma, now it helps my breathing. It's weird.

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So sorry you are going through this ☹️

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Profile picture for zebra2022 @zebra2022

Back in September 2022, I was diagnosed with cryoglobulinemia, and ever since then I have had issues with breathing. Both of my pulmonary doctors say the issue is asthma. Yes I've had asthma in the past but when I have my flare ups none of my inhalers work to help my breathing. I've been on 4 so far. The Albuterol used to help with my episodes prior to my September diagnosis. Now my triggers have been cold air, I get shortness of breath and then sometimes chest pains. I never had that problem before, now its everytime I'm in cold air (whether air conditioned rooms, fridge/freezer areas, fans, even cool breeze). One doctor thinks it's really strange. All my tests come back normal. The only thing I've found that helps is wearing a mask.Even with the mask, back in 2020 when we all had to wear masks, it used to trigger my asthma, now it helps my breathing. It's weird.

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I have severe asthma (diagnosed by my pulmonologist). Yes I have problems with cold air. In fact, anything under 55 degrees is hard on me for anything more than 10 - 15 minutes.

And if it is actually freezing out, 30 degrees or below, I am only ok for 2 - 5 minutes.

But scarves help tremendously. Can easily double or even triple the amount of time I can spend outside.

A nice little life hack ---- thermos!!! Prep a thermos with boiling water. Breathe that in as you move around outside. For some reason, seems like tea or coffee is even better than just boiling water...

I also use a ski mask outside. For some reason, keeping those cheeks covered and warm helps tremendously.

I have also, actually used the old surgeon's paper masks from COVID, outside, just to breathe better. Seems to help a lot. I guess it keeps the warm air, from the breathe, closer or something???

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Profile picture for lenchiksf @lenchiksf

Have you tried albuterol nebulizer ? Suppose to get deeper into lungs.
When i am very sick, nebulizer gives me best relief (for a short time 🙂

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I have. It helps with some things but does nothing for the issues I have with the cold air.

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Profile picture for zebra2022 @zebra2022

I've been on the Albuterol inhaler, symbicort inhaler, flovent inhaler, spiriva handihlr, ipratropium bromide (nebulizer) and now sodium chloride solution (nebulizer). These are the ones I have tried. The only one I'm on now is just the sodium chloride for the nevulizer. The rest of the inhalers don't even touch my lungs when my lungs are affected by the cold. My other asthma triggers respond to the Albuterol. Just not the cold air. Unfortunately avoiding cold altogether is not really an option. Plus it wouldn't help moving to a warmer state because I would still deal with the same issue. Businesses and shopping always have fans or air conditioners. I only started having this issue after my diagnosis of cryoglobulinemia and my system did a complete flip flop. I have not been the same medically since.

Jump to this post

Have you tried albuterol nebulizer ? Suppose to get deeper into lungs.
When i am very sick, nebulizer gives me best relief (for a short time 🙂

REPLY
Profile picture for lenchiksf @lenchiksf

@zebra2022
Are you using albuterol puffer or albuterol nebulizer (ie 0.083 or 0.5 strengths). And what other meds you tried, you said 4 total.

Yes, cold weather can trigger broncospasm.
Can some of above scenarios - refrigirators and air conditioned rooms be avoided ?
My Best,

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I've been on the Albuterol inhaler, symbicort inhaler, flovent inhaler, spiriva handihlr, ipratropium bromide (nebulizer) and now sodium chloride solution (nebulizer). These are the ones I have tried. The only one I'm on now is just the sodium chloride for the nevulizer. The rest of the inhalers don't even touch my lungs when my lungs are affected by the cold. My other asthma triggers respond to the Albuterol. Just not the cold air. Unfortunately avoiding cold altogether is not really an option. Plus it wouldn't help moving to a warmer state because I would still deal with the same issue. Businesses and shopping always have fans or air conditioners. I only started having this issue after my diagnosis of cryoglobulinemia and my system did a complete flip flop. I have not been the same medically since.

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