Ask Dr. Etingin: Adult-Onset Asthma; Hair Thinning and Loss
I had an episode of shortness of breath, coughing, and wheezing during an exercise class. The instructor said it sounded like an asthma attack. I’m 65 and I’ve never had asthma. Is it possible to develop it now?
Asthma can strike at any age, and research shows that rates are climbing for older adults, with one study showing that 40 percent of people with asthma had their first attack after age 40. An asthma attack occurs when your airways narrow and swell and generate extra mucus. The primary symptoms of asthma are shortness of breath, a tight or painful chest, and persistent cough or wheezing. When asthma strikes at a later age, the symptoms are similar to anyone else’s—but there are a few differences: Asthma in an older person can be much more serious because it can lead to respiratory failure, even during mild episodes. Triggers that might never have bothered you before might now be a problem. Things like dust, pollen, cigarette smoke—and even stress—can induce an asthma attack.
It’s tougher to diagnose adult-onset asthma because the symptoms can mimic other conditions, like acid reflux, congestive heart failure, or bronchitis. Asthma is diagnosed in a variety of ways, including physical exam, a lung function test, and sometimes a chest or sinus x-ray. The sooner you’re diagnosed, the better, because early intervention and treatment can help prevent asthma from progressing. Schedule an appointment with a doctor to discuss your symptoms. If your doctor makes a definitive asthma diagnosis, you may be prescribed medication to help reduce lung inflammation and mucus production, as well as an inhaler to manage symptoms when they occur. Also, since about 30 percent of adult asthma is triggered by allergies, your doctor may recommend getting screened for allergies so you’ll know what to eliminate or avoid.
My hair used to be thick and full, but now I can actually see my scalp when I look in the mirror. What’s happening, and can I make it stop?
First, aging can lead to changes in hair follicles, resulting in reduced hair growth and thickness. Second, hair loss in the postmenopausal years is common due to hormonal changes. Estrogen plays a crucial role in promoting hair growth and maintaining the hair’s structure. As estrogen levels decrease, there is a relative increase in androgens (male hormones like testosterone), which can contribute to hair thinning and loss.
Other factors that are associated with hair loss in the postmenopausal years are stress, and nutritional deficiencies. Stress can exacerbate hormonal imbalances and negatively impact overall health—including the health of your hair; and poor nutrition—particularly deficiencies in vitamins and minerals essential for hair health (such as iron, vitamin D, and biotin)— can contribute to hair loss.
Some things you can do to try to reduce ongoing hair loss include employing gentle scalp care practices, such as using a mild shampoo and avoiding excessive heat styling; and engaging in regular physical activity to manage stress levels. Consuming foods high in biotin, iron and vitamin D may help, as well. Biotin, also known as vitamin B7, can be found in foods such as egg yolks and sunflower seeds. Iron is important for preventing hair loss, and good sources of iron include poultry and spinach. Foods high in vitamin D include fatty fish such as salmon and tuna, as well as cod liver oil, and fortified dairy products. To get to the bottom of your hair loss issue, see a dermatologist. They can assess your situation and identify any potential underlying causes. You may be directed to have your iron or thyroid hormone levels tested.
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