What Type of Asthma Do You Have?

Symptoms, causes, and treatments

There are several types of asthma, all with similar symptoms, such as difficulty breathing and chest tightness. The different asthma types vary in their triggers and underlying causes, and some may have additional symptoms. While they are similar, an accurate diagnosis is needed for optimal treatment.

Asthma subtypes include:

  • Allergic asthma
  • Non-allergic asthma
  • Cough-variant asthma
  • Medication-induced asthma
  • Nocturnal asthma
  • Viral-induced asthma
  • Exercise-induced asthma
  • Adult-onset asthma
  • Occupational asthma
  • Glucocorticoid-resistant asthma

It's possible to have more than one type of asthma, such as non-allergic and nocturnal. And most people who have asthma will experience exercise-induced bronchoconstriction at some point.

Asthma is also classified by severity, and the severity may change over time. Most asthma types can range in severity.

Your diagnosis may include the type and severity of your asthma—for example, you could be diagnosed with moderate-persistent occupational asthma or intermittent allergic asthma.

Some elements of asthma are the same across most or all types and severities:

  • Classic symptoms: Wheezing, chest tightness, shortness of breath, cough, asthma attacks
  • Causes/risk factors: Genetics and environmental exposures (like smoke)
  • Diagnosis: Pulmonary function tests (PFTs) and assessment of response to asthma medications
  • Treatment: A rescue inhaler for the treatment of asthma attacks and possibly daily inhaled or oral medications to prevent symptoms

Some asthma types have unique underlying mechanisms that require specific additional treatments.

Allergic Asthma

Between 50 and 80% of all asthma has an allergic component, which is also called extrinsic asthma. People who have seasonal allergies (hay fever) may also be diagnosed with seasonal asthma.

With allergic asthma, your immune system reacts to allergens, which trigger both allergy symptoms and asthma symptoms.

Symptom Triggers

If you have allergic asthma, it's important for you to identify your asthma triggers. 

Common triggers include:

Additional Symptoms

Your asthma symptoms will be the same as with other types, but will also be accompanied by allergy symptoms:

  • Nasal congestion
  • Runny nose
  • Scratchy throat
  • Sneezing
  • Itchy, red, and/or watery eyes

Causes and Risk Factors

Allergic asthma is believed to have a heavy genetic component combined with hypersensitivity and exposure to the substances that trigger symptoms.

Additional Diagnostic Tests

To confirm whether your asthma is allergic, and to determine your triggers, your doctor may order:

  • Skin tests: Common allergens are put on your skin to see if you react to them.
  • Blood tests: Elevated levels of immunoglobulin E (IgE) antibodies, which your body produces in response to allergens, confirm an allergic reaction.

Additional Treatments

In addition to standard asthma treatments, you may need to manage your allergies. That includes avoiding triggers when possible and possibly taking allergy medicine, such as antihistamines or immunotherapy (allergy shots).

Non-Allergic Asthma

Between 10 and 33% of all people who have asthma have non-allergic asthma, which is sometimes called intrinsic asthma. It usually develops later in life than allergic asthma.

Some research suggests that non-allergic asthma is more severe than other forms as measured by the Global Initiative for Asthma (GINA) score. Some studies also suggest a higher prevalence among women, but this hasn't been universal.

Symptom Triggers

Non-allergic asthma symptoms can be triggered by a variety of factors, including:

  • Cold weather
  • Humidity
  • Stress
  • Exercise
  • Heartburn/acid reflux
  • Pollution, smoke, or other irritants in the air
  • Respiratory infections (e.g., cold, flu)
  • Strong odors and sprays

Additional Symptoms

Non-allergic asthma isn't associated with additional symptoms.

Causes and Risk Factors

Things that may lead to non-allergic asthma include:

Conditions such as rhinosinusitis (inflammation of the nasal and sinus cavities) and gastroesophageal reflux disease (GERD) frequently affect people who have non-allergic asthma and may contribute to its development.

Additional Diagnostic Tests

While no test can specifically diagnose non-allergic asthma, you may be given skin and blood tests to rule out allergic triggers.

Additional Treatments

You shouldn't need treatments beyond what's generally prescribed for asthma treatment.

However, people with non-allergic asthma are less likely to improve with inhaled corticosteroids (ICSs), which are used as daily preventive medication for moderate-to-severe asthma.

You may need to take additional or alternative medications to prevent asthma attacks, such as:

Cough-Variant Asthma

With cough variant asthma (CVA), a dry cough is the main symptom. The cough may remain your sole symptom or you may go on to develop other symptoms, especially if your asthma isn't adequately treated.

Symptom Triggers

Because a dry cough doesn't usually make people think they have asthma, symptom triggers are an important part of figuring out you have the condition.

Watch for bouts of coughing that:

  • Wake you up
  • Come on after exercise
  • Worsen in cold, dry weather
  • Worsen with hay fever or other things you're allergic to

Additional Symptoms

Cough-variant asthma doesn't have additional symptoms.

Causes and Risk Factors

Cough-variant asthma may be an early symptom of emerging asthma; children have it more often than adults. Even so, only about 30% of people with cough-varient asthma ever develop classic asthma.

Additional Diagnostic Tests

Cough-variant asthma is difficult to diagnose. In addition to standard asthma tests, your doctor may order a sputum test to look for eosinophils, a type of white blood cell that is often increased with asthma. Sputum is a type of mucus that you would cough up from your lungs.

Additional Treatments

Treatment for cough-variant asthma is generally the same as for other types of asthma.

Asthma Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Old Man

Medication-Induced Asthma

Several medications have been found to induce asthma for some people who haven't been already diagnosed with asthma and to worsen attacks for some people with pre-existing asthma. Aspirin was the first such drug identified as having this effect and, as such, this condition is often called aspirin-exacerbated respiratory disease (AERD), aspirin-induced asthma, or drug-induced asthma.

Many people who have this condition have symptoms of asthma and chronic sinusitis/nasal polyps even if they avoid the causative medication.

The most common causative drugs are non-steroidal anti-inflammatory drugs (NSAIDs) and beta-blockers. Asthma attacks linked to these drugs can be fatal.

Reactions can occur with other drugs as well, but these two are the most common.

Symptom Triggers

NSAIDs are typically used to treat pain that's caused by inflammation and to lower fevers. Those that have been linked to this type of asthma include:

  • Aspirin (acetylsalicylic acid)
  • Motrin/Advil (ibuprofen)
  • Aleve (naproxen)
  • Voltaren/Cataflam/Cambia (diclofenac)

Other NSAIDs may cause symptoms as well, especially in people highly sensitive to those listed above.

Corticosteroids that are commonly used to treat asthma relieve inflammation in a different way than NSAIDs and are not linked to drug-induced asthma.

Any beta-blocker can trigger asthma symptoms for people who are sensitive to them. Beta-blockers are typically used to treat heart conditions, high blood pressure, and migraines.

Common beta-blockers:

  • Corgard (nadolol)
  • Inderal (propanolol hydrochloride)
  • Normodyne (labetalol)

Most people who have asthma react to non-selective beta-blockers.

Additional Symptoms

Symptoms of this asthma type are the same as symptoms of classic asthma, but they're more likely to be severe.

Causes and Risk Factors

The cause of medication-induced asthma isn't known, but researchers suspect that the causative drugs may contribute to oxidative stress in some people or set up a complicated chain reaction that leads to asthma symptoms.

About 30 to 50% of adults who have asthma and also have nasal polyps are sensitive to aspirin and other anti-inflammatory drugs.

Alternative pain relievers that are typically safe include:

  • Tylenol (acetaminophen)
  • COX-2 inhibitors
  • Corticosteroids

Additional Diagnostic Tests

No additional tests are used to diagnose medication-induced asthma.

Additional Treatments

The primary treatment for this type of asthma is standard asthma medications and avoiding the triggering drugs.

Nocturnal Asthma

Nocturnal asthma, as a diagnosis, is usually added to a pre-existing asthma diagnosis. If you have marked nighttime symptoms, you might have nocturnal asthma or it could be that your asthma is not well controlled.

More than 50% of adults with asthma have nocturnal asthma. About 10% of children with asthma have this form as well.

Symptom Triggers

With nocturnal asthma, you may experience nighttime symptoms several times a week or even every night.

Environmental symptom triggers can include irritants like pet dander or dust in your bedroom or sleeping with the window open.

Additional Symptoms

The symptoms of nocturnal asthma are the same as classic asthma symptoms. They just happen to be more prominent at night.

The sleep interruptions associated with nocturnal asthma can leave you tired during the day. You may notice that you are waking up several times overnight, but many people fall back to sleep quickly and don't recall waking up.

Nocturnal asthma can increase your risk of serious complications, including heart disease, respiratory arrest, and asthma-associated death.

Causes and Risk Factors

Nocturnal asthma is believed to be caused by changes in your body that occur at night.

Your circadian rhythm, which is your internal body clock, contributes to nocturnal asthma by causing nighttime shifts in:

  • Muscle control
  • Airway resistance
  • Inflammation
  • Hormones

Additionally, obstructive sleep apnea, a sleep disorder that interrupts breathing during sleep, is common among people who have asthma and the conditions can exacerbate one another.

Additional Diagnostic Tests

Testing your breathing during the day isn't helpful in the diagnosis of nocturnal asthma, so your doctor may instruct you to test your breathing at home, closer to your bedtime.

Depending on your specific symptoms, your doctor might also send you for a sleep study.

Treatment Changes

Nocturnal asthma is treated with the same medications as classic asthma, but it may require adjusted timing of your medication. For example, rather than taking a daily control medication in the morning, your doctor may prescribe it for use in the afternoon or early evening.

Some researchers also have suggested time-release tablets for treating this type of asthma.

Viral-Induced Asthma

Viral-induced asthma is caused by a respiratory tract infection, such as the common cold, flu, or COVID-19. An estimated 50% of acute asthma attacks have a viral trigger.

A viral respiratory tract infection can cause asthma:

  • In people who've never had asthma symptoms before
  • In adults who outgrew childhood asthma
  • By being an exacerbating factor to other types of asthma

Symptom Triggers

The respiratory tract infection is the symptom trigger in this asthma type.

Additional Symptoms

Viral-induced asthma can cause asthma attacks even if your symptoms typically are well-controlled. So while it doesn't cause additional symptoms, it can exacerbate those you already experience.

Causes and Risk Factors

It isn't known why certain respiratory tract infections trigger asthma in some people and not in others.

The primary viruses responsible for new-onset or worsening asthma are:

Rhinovirus causes 60 to 70% of cases, with flu and RSV causing the majority of the rest.

Other viruses linked to a small percentage of viral-induced asthma cases include:

Additional Diagnostic Tests

Your doctor may consider that you could have viral-induced asthma if you have your first asthma symptoms during a respiratory illness or if symptoms suddenly appear after a period of excellent control.

Viral-induced asthma tends to result in significantly worse outcomes.

If you haven't previously had asthma, your doctor will likely send you to a pulmonologist for more extensive testing to confirm an asthma diagnosis.

You may also get a viral test to confirm the presence of a certain virus, such as RSV or the flu.

Additional Treatments

For viral-induced asthma, the viral infection may need to be treated. Asthma is treated with standard asthma medications, although if your symptoms are worsened, you may need to add or increase your asthma medications.

Doing what you can to avoid respiratory infections can help prevent this type of asthma.

If you have asthma, had it as a child, or have a strong family history of asthma, talk to your doctor about a flu vaccine, avoid people with respiratory infections, and practice social distancing, handwashing, and other virus-avoidance strategies.

Exercise-Induced Bronchoconstriction

Exercise-induced bronchoconstriction (EIB) used to be called exercise-induced asthma (EIA). Up to 90% of people with any type of asthma may have symptoms triggered by exercise, but many people with EIB don't fulfill the diagnostic criteria for asthma.

Symptom Triggers

In EIB, your bronchial tubes (airways) narrow and you develop asthma-like symptoms when you exercise. It's believed that the loss of heat and/or water from the airways due to the rapid breathing of exercise is the actual culprit. The bronchial tubes become dehydrated, which leads to constriction.

Typically, symptoms begin during exercise but may continue getting worse for 10 to 15 minutes after you stop exercising before they clear up on their own (typically within 30 minutes). It's safest to use your rescue inhaler, though, rather than waiting to see if you improve without it.

When combined with exercise, certain factors may make EIB especially likely, including:

  • Cold weather or a cold environment (such as in a skating rink) because cold air is drier than warm air
  • Hot air (such as during hot yoga)
  • Chlorine in swimming pools
  • Air pollution or other airborne irritants
  • Recent respiratory infection or asthma attack
  • High pollen count (especially if you also have allergic asthma)
  • Odors such as perfume, paint, cleaners, and new carpet/exercise equipment

Low-intensity activities (walking, hiking) or sports with short bursts of exertion (baseball, wrestling, gymnastics) are less likely to trigger EIB.

Additional Symptoms

EIB can come with a few symptoms not common in asthma, including:

  • Decreased endurance
  • Upset stomach
  • Sore throat

Causes and Risk Factors

If you have asthma, minor irritation or dehydration from exercise may cause EIB. In this case, the cause of EIB is underlying asthma.

For people who don't have asthma, repeated exposure to cold, dry air or airborne irritants while exercising may cause bronchial tube damage that leads to EIB. This may explain why EIB is especially common in cold-related sports such as ice hockey and skiing and among competitive swimmers (due to chlorine fumes).

People with environmental allergies, or who have close relatives with environmental allergies, have a higher risk of developing EIB.

Additional Diagnostic Tests

Whether or not you've been diagnosed with asthma, your doctor may test your breathing before and after exercise to determine whether you have EIB.

Your forced expiratory volume (FEV1), which measures how much air you can force out of your lungs, will be tested. Then you will exercise on a treadmill or stationary bike while being supervised, and then your FEV1 will be measured again. A decrease of 15% or more generally leads to a diagnosis of EIB.


If you're also diagnosed with asthma, preventing bronchoconstriction will be part of your overall treatment plan.

You may be able to prevent symptoms of EIB by:

  • Warming up for 10 to 15 minutes before exercising
  • Covering your face with a mask or scarf while exercising
  • Avoiding exercise in areas where you're exposed to pollutants or allergens

Your doctor may recommend that you use a rescue inhaler or a long-acting inhaler before exercising to prevent attacks and a rescue inhaler when an attack occurs.

Adult-Onset Asthma

Adult-onset asthma (AOA) is any type of asthma that develops during adulthood, but it does have some features that distinguish it from types of asthma that more commonly develop in children. It also has multiple subtypes.

Typically, AOA doesn't require any special diagnostic tests, but some subtypes do. Some subtypes are treated differently. Avoiding triggers may be more beneficial than standard asthma medications.

Symptom Triggers

Symptom triggers for AOA that are not identified as a specific subtype tend to be the same as those of other asthma types. While allergies are less likely to be involved, cat dander is the biggest trigger.

Additional Symptoms

People who have AOA often take an especially long time to recover from chest infections, such as colds.

Compared to childhood-onset asthma, AOA typically:

  • Is less likely to have periods of remission
  • Involves constant breathing problems
  • Leads to more rapid declines in lung function
  • Is more difficult to treat
  • Is less likely to be associated with allergies

Causes and Risk Factors

Possible causes of AOA include:

  • Female sex hormones
  • Allergies
  • Chronic sinus problems
  • Respiratory infections
  • Workplace or environmental exposure to pollutants and irritants
  • Certain medications, especially aspirin
  • Obesity

AOA is more common in women.

Occupational Asthma

Some jobs expose you to substances that can lead to occupational asthma (OA), a subtype of AOA. This may account for about 15% of asthma cases in the U.S.

If you have other forms of asthma, workplace exposures that can cause asthma may cause your symptoms to get worse.

Symptom Triggers

More than 250 substances are believed to cause and trigger symptoms of OA. Typically, symptoms are only triggered by the substance(s) you're in regular contact with.

Common triggers include:

  • Animals
  • Certain types of mold
  • Cleaning products
  • Chemicals including hydrochloric acid, sulfur dioxide, and ammonia
  • Dust from wood, flour, or grains
  • Insects
  • Latex
  • Paints

Additional Symptoms

Many people who have IgE-mediated (allergic) OA develop occupational rhinitis (nasal allergy) symptoms prior to the onset of OA symptoms.

Symptoms from work-related exposures can happen right away or take years to develop.

Causes and Risk Factors

Regular exposure to fumes, gasses, dust, or other irritants causes OA. The exposure either directly damages your airways or causes sensitization to the offending substance. With sensitization, your body gradually develops an abnormal immune reaction to a substance.

You're at risk for OA if you work in/at a:

  • Bakery
  • Detergent manufacturing facility
  • Drug manufacturing facility
  • Farm
  • Grain elevator
  • Laboratory (especially those that involve animals)
  • Metal-processing facilities
  • Mills
  • Plastics manufacturing facility
  • Woodworking facility

If you outgrew childhood asthma or have a family history of asthma, you're more likely to develop the occupational type.

Additional Diagnostic Tests

If your doctor determines that you have asthma and rules out seasonal allergies as a trigger, they can start investigating work-related causes. Providing Material Safety Data Sheets for chemicals you're exposed to at work can help identify the cause of your symptoms.

If you have symptoms of OA, the next steps can include:

  • Testing for the allergen with a skin test or blood test
  • Breathing tests over the course of the workday
  • Bronchoprovocation with the suspected allergen to see if your lung function drops at least 20%.

Occupational asthma is sometimes misdiagnosed as bronchitis. If you're diagnosed with bronchitis but treatment isn't effective and symptoms tend to be worse at work than in other places, bring this up with your doctor.

Getting a proper diagnosis and treatment is important. If OA continues unchecked, it can cause permanent lung damage.

Additional Treatments

Standard asthma treatments are typically used for OA.

In addition, you'll want to take steps to avoid the problem substance(s) if possible. This may require the help of your employer in the form of Reasonable Accommodation, which is a legal requirement under the Americans With Disabilities Act (ADA).

Glucocorticoid-Resistant Asthma

While glucocorticoids are among the most potent anti-inflammatory drugs available and are normally very effective asthma treatments, they don't work well for 5 to 10% of people with asthma. This is described as glucocorticoid-resistant or steroid-resistant asthma, another subtype of AOA.

Symptom Triggers/Additional Symptoms

This type of asthma isn't associated with any unique symptoms or triggers, but it is especially likely to be severe.

Causes and Risk Factors

For most people with asthma, eosinophils are part of the inflammatory response that causes airway constriction. Steroids do a good job of treating this type of inflammation.

However, steroid-resistant asthma is associated with lower levels of eosinophils and higher levels of neutrophils, another type of white blood cell. Neutrophils are typically associated with bacterial infection, and the possible role of bacteria in steroid-resistant asthma is currently under investigation.

Several other possible mechanisms are being explored, as well.

Additional Diagnostic Tests

This type of asthma is diagnosed based on the lack of response to treatment rather than any specific tests.

Alternative Treatments

People who have steroid-resistant asthma may require:

  • High doses of steroids
  • Secondary immunosuppressant drugs
  • Disease-modifying biologic drugs
  • Anti-leukotriene medications (such as montelukast)
  • Theophylline

These drugs can be costly and come with some serious side effects that can have a significant negative impact on quality of life.

A Word From Verywell

Zeroing in on an accurate asthma diagnosis can take some time. Your precise diagnosis can have a big impact on the treatments you're given, so the diagnostic process is important.

Pay close attention to your symptoms, their frequency, triggers, and factors that may have influenced the onset to help your doctor reach the correct diagnosis and treatment plan for you.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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