Could I Have Severe Asthma?

If you're doing everything your doctor has recommended but are still experiencing the daily burden of uncontrolled asthma symptoms, you may have severe asthma. But you're not alone. Talk to your doctor about getting tested—together, you can make it more manageable.

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What Is Severe Asthma?

People with severe asthma experience symptoms throughout the day, often have their sleep disrupted at night, may need their rescue inhalers multiple times a week (sometimes daily), and might have to put limits on their daily activity. Asthma attacks can be common, and may require urgent care, ER, or hospital visits and treatment with oral steroids.

Severe asthma can also remain uncontrolled despite sufferers consistently following their prescribed medication routine.

Did you know?

It’s estimated that 5-10% of people with asthma have severe asthma.

Types of Severe Asthma

There are two common types of severe asthma: allergic and nonallergic. Allergic asthma is caused—and triggered—by exposure to allergens, whereas nonallergic is asthma is caused by factors other than allergens.

Allergic Asthma
  • Occurs in 50-80% of people with asthma and in about 50% of people with severe asthma
  • Caused by inhaling allergens such as pollen, pet dander, and mold—among others
  • Triggers produce an allergic reaction in the body that results in airway inflammation
  • Symptoms are persistent wheezing, coughing, itchy/watery eyes, sneezing, and in severe cases, anaphylaxisAnaphylaxis is a serious allergic response that often involves swelling, hives, lowered blood pressure and in severe cases, shock. If anaphylactic shock isn’t treated immediately, it can be fatal.
  • Common for sufferers to also be diagnosed with allergic rhinitis (hay fever)
  • May require medications such as biologics
Nonallergic Asthma
  • Occurs in 10-33% of all individuals with asthma, not just severe asthma, and has a later onset
  • Common types can include neutrophilicNeutrophils are white blood cells that are important for protection against infections. They fight against infection by releasing chemicals such as hydrogen peroxide to kill germs or clean up wounds., adult onset, asthma with obesity, and asthma with reduced lung function
  • Can also be caused by an excess of white blood cells called eosinophils—often called eosinophilic asthma
  • Often triggered in patients by irritants in the air, exercise, stress, and weather changes
  • Can also be triggered by recurring respiratory infections
  • Symptoms are similar to allergic asthma
  • Can be more severe than allergic asthma
  • May require medications such as biologics

Eosinophils and Asthma

Approximately 50% of severe asthma patients have elevated levels of eosinophils. Eosinophils (ee-uh-sin-uh-fils) are normal white blood cells that help regulate the immune system and fight off infections and disease. People with eosinophilic asthma have high numbers of eosinophils that can cause chronic lung inflammation and lead to the development of asthma.


How Eosinophils Affect Asthma

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Eosinophils may react to some common asthma triggers

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Active eosinophils can gather in your airways and inflame bronchial tubes

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This inflammation can lead to asthma symptoms and attacks

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Testing for Severe Asthma

To get tested for severe asthma your doctor will likely refer you to an asthma specialist, such as a pulmonologist or allergist. They will discuss your medical history with you, review your current asthma plan, perform a physical exam, and test your blood, skin, and/or breathing for signs that indicate severe asthma. The signs can help your doctor identify what's causing your airway inflammation and note the type of severe asthma you might have.

Testing for Asthma

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Treating Severe Asthma

If you’ve been diagnosed with severe asthma, your asthma specialist will develop a treatment plan that best addresses your type of severe asthma. This typically includes a daily regimen of inhaled steroids and other regular long-term controller medicines. Additional oral corticosteroids and/or biologic medications may be necessary.

Asthma Medications

Effects of Oral Corticosteroids

You and your doctor may decide that oral corticosteroids are necessary for managing your asthma. While corticosteroids can be life-saving in the event of an asthma attack, they come with some risks. Do not stop or start any medications without talking to your doctor.

Short-Term Effects
  • Elevated eye pressure (glaucoma)
  • Fluid retention
  • High blood pressure
  • Weight gain
  • Moodiness
  • Problems with memory and behavior
Long-Term Effects
  • Changes in bone health (osteoporosis)
  • Decreased growth in children
  • Cataracts
  • Infections
  • High blood sugar levels in patients with diabetes
  • Bruising
  • Slower healing process for wounds
  • Organ damage

Severe Asthma & Uncontrolled Asthma

Severe asthma is often uncontrolled, but uncontrolled asthma is not the same thing as severe asthma. Uncontrolled asthma is generally defined as having very frequent symptoms that interfere with sufferers’ daily lives. Risks of long-term uncontrolled asthma that goes unchecked can lead to more asthma attacks and damage to your lungs.

Uncontrolled asthma could look like:

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Poor Symptom Control
Even when regularly taking medication, your symptoms are frequent and difficult to manage

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Two or More Severe Asthma Attacks in a Year
Needing 2 or more courses of oral steroids due to worsening symptoms over the past year

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Multiple Hospital Visits
If you’ve had more than one hospitalization due to an asthma attack in the past 12 months

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Recurring Nighttime Flare-ups
You're awakened by your asthma symptoms

Take the Asthma Control Test™

The best way to find out more about your particular asthma is to ask your doctor. The more you know about the symptoms, the more treatment options you can consider for finding relief. To help you better understand how well your asthma is controlled, take the Asthma Control Test™.

Take the Test


Asthma Control Test is a trademark of QualityMetric Incorporated.

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