Asthma vs Anaphylaxis

By age 3 our son had achieved the hat-trick. We had an official diagnosis of eczema (6 months), food allergies (11 months) and asthma (~2.5). I spent one birthday sleeping on a couch in the children’s hospital checking on him every hour.

Since this is a topic that confuses a lot of people, it’s a good time to discuss how asthma and anaphylactic allergies are, and are not, similar.


In both an asthma attack and anaphylaxis, the airways tighten. Mucus develops inside the airway to battle irritants, further restricting space. In both cases, you may see wheezing, short or labored breathing, or coughing as the person tries to open their airways. To make things more confusing, about half of asthma issues are thought to be caused by allergies to things like dust, mold, and pollen.

However, in chronic asthma or adult onset asthma, runny nose or “hay fever” type symptoms are common. On the other hand, a clear sign of an anaphylactic episode is swelling of the face, hives on the skin, vomiting or other digestive systems. These acute symptoms are very uncommon with asthma alone.

We can usually use context clues to tell the difference. Did he have a cold or runny nose? When was the last time he ate something? Are we seeing any hives on his neck or arms?

Asthma vs Anaphylaxis

If you have known allergies and have acute onset issues in your airways, doctors recommend using your epinephrine first, because issues related to allergies can only be cleared with epinephrine. A fast-acting bronchodilator will open up the airways for asthma, but it won’t work if it’s anaphylaxis.

Unfortunately, as we’ve learned, the key is preventing the episodes all together. Anytime our son has a cold we start medications to make sure the asthma attack doesn’t happen. We are diligent about food and always carry epinephrine, no matter where we go.

There are great resources from the Asthma and Allergy Foundation, the CDC, and the American Academy of Allergy Asthma and Immunology to create action plans and stay ahead. Until there’s a cure that’s the best we can do.



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