How do I identify the triggers of my asthma?

How to Identify Your Asthma Triggers

Keep a detailed symptom diary tracking when your asthma worsens and what you were exposed to in the hours before symptoms began—this pattern recognition combined with allergy testing for perennial indoor allergens is the most effective way to identify your specific triggers. 1

Start with Pattern Recognition Through Self-Monitoring

The cornerstone of trigger identification is documenting the relationship between exposures and symptom onset. You should:

• Record peak flow measurements twice daily (morning and evening) along with symptoms to identify patterns of airflow obstruction that correlate with specific exposures 1
• Note the timing and severity of symptoms including wheeze, shortness of breath, chest tightness, and cough, particularly if they worsen at night or with specific activities 1
• Document all potential exposures in the 2-24 hours before symptoms appear, including locations visited, activities performed, foods eaten, and medications taken 1

This systematic approach reveals temporal relationships that point to specific triggers, which is more reliable than memory alone.

Common Triggers to Systematically Evaluate

Based on established guidelines, focus your investigation on these categories:

Environmental Allergens

• Indoor allergens: House dust mites, cockroach allergens, cat and dog dander, and mold (especially Alternaria species) are the most common culprits 1, 2
• Outdoor allergens: Pollens from trees, grasses, and weeds that vary seasonally 1
• Occupational exposures: Chemicals, dust, or fumes in your workplace 1

Irritants

• Environmental tobacco smoke is one of the most important modifiable triggers 1
• Air pollution, strong odors, paint fumes, and cleaning products 1, 2

Medications

• Aspirin and NSAIDs (ibuprofen, naproxen) can trigger severe reactions in susceptible individuals 1, 3
• Beta-blockers (including eye drops for glaucoma) can worsen asthma 1, 3

Other Triggers

• Viral respiratory infections are extremely common triggers, especially in children 1, 4, 2
• Exercise, particularly in cold air 1
• Emotional stress and strong emotions 1

Get Objective Testing for Allergic Triggers

If you have persistent asthma requiring daily medications, you should undergo allergy testing for perennial indoor allergens. 1 This recommendation is explicit in guidelines because:

• Skin prick testing or specific IgE blood tests definitively identify which allergens you're sensitized to 1
• Knowing your specific allergens allows targeted avoidance strategies rather than guessing 1
• Testing is particularly important if you have a personal or family history of atopic conditions (eczema, allergic rhinitis) 1

The British Thoracic Society emphasizes that irritant or allergen sensitivity should be determined by your exposure and symptom history first, then confirmed with testing—not the other way around 1.

Implement Systematic Exposure Challenges

For suspected triggers that aren't confirmed by testing:

• Exercise challenge: Perform vigorous activity for 6-8 minutes and measure peak flow before and after to document exercise-induced bronchospasm 5
• Workplace exposure assessment: Note if symptoms improve on weekends or vacations, suggesting occupational asthma 1
• Food diary: If you suspect food triggers, though these are less common than environmental triggers 6

Critical Pitfalls to Avoid

• Don't assume triggers based on single episodes—patterns over weeks are more reliable than isolated events 1
• Don't overlook medication triggers—always inform healthcare providers about asthma before starting new medications, especially aspirin, NSAIDs, or beta-blockers 1, 3
• Don't ignore nighttime symptoms—these often indicate inadequate control and may point to bedroom allergens like dust mites or pets 1
• Don't forget that multiple triggers often coexist—most people with asthma have more than one trigger 6, 4

When to Seek Specialist Evaluation

Consider referral to an allergist or pulmonologist if:

• Your asthma remains poorly controlled despite avoiding suspected triggers 1
• You need help interpreting allergy test results or implementing avoidance strategies 1
• You're considering allergen immunotherapy for confirmed allergic triggers 1
• Occupational asthma is suspected, as this requires specialized evaluation 1, 6