Cold air is triggering my asthma

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.

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.

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.

I hope you live in a warmer place. Any air temp.change causes severe coughing for me. Docs took out my tonsils when I was 4, didn't help. 80 years later, my best med is Fisherman 's Friends cough lozenges. Lots of good menthol without inhaler side effects.

Good morning,
It is interesting that your symptoms are triggered by the cold. I feel like my asthma is triggered by the cold - but it took a long time to diagnose it as "asthma". When I first went to my pulmonologist they didn't think I had asthma because while I had low lung volume in one lung my spirometry was normal. However, when I went to do the methacholine challenge it turns out I have severe asthma (which he says is triggered by allergies) but I have stopped going to cold places if I can because it triggers my asthma. I have a nebulizer that I use with asthma medicine at least three times a day if I am in cold weather. Have you tried doing that? Also has your doctor tested you EOS count or done the methacholine challenge test? I used to get sick and bronchitis and cough all the time especially in the cold. I am now much better after we did the testing and found the right combinations of inhalers. Plus if your eosinophils in your blood count are high there are different medicines that might help - at least in my case they did. I don't have RAD to my knowledge but I do know it took us a long time to identify the type of asthma I have which is eosinophilic asthma. I am not really familiar with RAD so not sure if that is helpful but just thought I would share my story in case it helps. Hope you find a solution. I would wake up coughing for years and was sick all the time in cold weather - took until the age of 42 to get officially diagnosed with this. I take spiriva and symbicort. I also do bi-monthly injections of Fasenra which has made a big difference. I had to stop using albuterol because it gave me hand tremors so everyone is different in what works for this. Just sharing my experience in case it helps.

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