Your asthma may be uncontrolled if you experience frequent symptoms that can affect your daily life. Uncontrolled asthma may require changing your treatment plan to avoid health complications.

    Uncontrolled asthma is when you experience frequent or bothersome asthma symptoms, even with a treatment plan. Uncontrolled asthma can happen if your asthma is mild, moderate, or severe.

    The Centers for Disease Control and Prevention (CDC) estimates that about 60% of all U.S. adults and 50% of children with asthma don’t have their symptoms under control.

    Getting asthma under control is usually possible with a review of current treatments and lifestyle factors. Your doctor can help you make changes that can help you reduce symptoms, although it may take several weeks to see improvement.

    Not controlling asthma can lead to chronic health conditions that affect you mentally and physically, such as lung infections, anxiety, depression, and life threatening asthma attacks. You may want to consider seeing a doctor if asthma symptoms disrupt your daily activities.

    Many people with asthma accept their symptoms as part of having the condition. But if your asthma is under control, your symptoms have a minimal impact on your daily life.

    People with uncontrolled asthma may experience frequent, often daily, symptoms that include:

    Your asthma may be uncontrolled if you:

    • use at least two puffs of your rescue inhaler every week
    • refill quick relief medication two or more times yearly
    • wake up with asthma symptoms two or more times a month
    • visit an emergency department frequently
    • stay in the hospital because of asthma symptoms
    • have frequent flare-ups and attacks
    • regularly miss school or work due to asthma symptoms
    • want to withdraw from daily activities because of your symptoms
    • are unable to be physically active
    • rely heavily on caregivers
    • experience adverse effects on relationships with friends and family
    • rely more on relief medication than control medication
    • experience chronic fatigue, inability to walk up stairs, or breathlessness
    • develop conditions like chronic sinusitis or obstructive sleep apnea
    • experience medication side effects like weight gain or mood changes

    What can trigger an asthma attack?

    Asthma attack triggers differ among people. Common triggers include:

    • respiratory infections like a cold or flu
    • weed, grass, or tree pollens
    • pet dander
    • dust mites
    • mold
    • smoke
    • chemical fumes
    • cold air
    • dry or windy weather
    • exercise
    • stress

    In some people, beta-blockers can cause lung airways to tighten (bronchospasm).

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    Uncontrolled asthma and severe asthma are not the same. Still, it’s possible to have severe asthma that is also uncontrolled.

    If you have mild or moderate asthma and your current treatment plan isn’t working, your asthma is uncontrolled. Discuss your symptoms with a doctor. They may recommend changing your treatment plan. Changes may include adding:

    If these added measures don’t improve your symptoms after 3–6 months, your doctor may diagnose severe asthma. They may also refer you to a specialist who can perform further tests for biomarkers, such as those in eosinophilic asthma. They may recommend other treatments, such as biologics.

    Severe asthma is often more challenging to treat than mild or moderate asthma. If you recently received a diagnosis of severe asthma, you may still experience uncontrolled asthma, even with treatment.

    You should consult a doctor if you have bothersome asthma symptoms or if your asthma interferes with daily life.

    The American College of Allergy, Asthma, and Immunology recommends knowing the “rule of twos.” Speak with a doctor if you encounter any of the following:

    • experience asthma symptoms twice a week or more
    • use a quick relief medication twice a week or more
    • wake up at night with asthma symptoms twice a month or more
    • need to refill a quick relief medication canister twice a year or more

    Feelings associated with your asthma can also cause distress. Consider discussing your asthma with a doctor if you experience:

    • fear, frustration, or anger because of asthma
    • fear of medication side effects
    • problems taking medication the right way
    • medication side effects such as mood changes or irritability

    You may want to see a doctor if you take controller and relief medications and still have symptoms. You may have severe asthma and might benefit from additional therapies.

    Asthma Control Test

    The Asthma Control Test is one of the most common self-assessment tools to determine whether your asthma is under control. The test is for people 12 years and older, but there’s a separate test for children ages 4–11. Though you can take the test on your own, you should discuss your results with a doctor.

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    If your asthma is uncontrolled, your doctor may take several steps. These may include:

    • assessing your lung function with a spirometry test
    • identifying your triggers with a symptom questionnaire or asthma diary
    • checking that you’re using your inhaler properly

    Then, your doctor may recommend managing or eliminating risk factors for asthma which can include:

    Finally, your doctor may want to adjust your medications. This may include adding an inhaled controller medication or starting a systemic medication, like a biologic.

    It may take several weeks or months to see whether these changes bring your asthma symptoms under control.

    Uncontrolled asthma can lead to complications such as:

    • lung infections
    • delayed growth or delayed puberty in children
    • excessive fatigue
    • stress
    • anxiety
    • depression
    • life threatening asthma attacks

    Asthma symptoms can also make daily life more challenging, possibly limiting you physically and affecting your daily activities.

    Uncontrolled asthma can lead to severe medical complications such as life threatening attacks and lung infections. Your asthma may be uncontrolled if you have frequent symptoms, even if you are on a treatment plan. A doctor can help determine whether you can control asthma with a change in medication and a reduction of risk factors.

    Consider taking the Asthma Control Test to assess and track your asthma control.