Before and after thunderstorms, Cynthia Lucking often experiences asthma symptoms, which she used to think was related to heavy humidity and steam coming off of hot roads.

Lucking, a 55-year-old outside sales representative who lives in Mount Pleasant, has both asthma and seasonal allergies, which get worse in the summer when the grasses, flowers and weeds are in full bloom. But thunderstorms also make her lungs tighten and breathing labored.

"This past week (after a string of storms earlier this summer), I found myself using my nebulizer, much more than usual. I can feel my lungs tighten up before and particularly after a storm."

Research in recent years is showing that in some people, allergy and asthma symptoms do get worse after storms. Reactions aren't widespread, after all more than 23 million Americans have asthma, but it's enough to get researchers to start studying the matter more.

Thunderstorms causing allergy and asthma symptoms do not follow conventional wisdom. After all, rain washes pollen away.

The culprits may be the electricity, updrafts and downdrafts generated by the storm.

Cause unknown

In 2012, the British medical journal, QJM, published an overview showing that thunderstorms set off asthma attacks, causing a spike in emergency room visits and ambulance calls around the world. The phenomena has been followed primarily in Australia, the United Kingdom and Italy.

Four years earlier, the British Thoracic Society's "Thorax" published an analysis of 12 years of data by Atlanta researchers that found three percent more emergency room visits for asthma attacks in the 24 hours after thunderstorms compared to days without such storms.

The study's co-author Stephanie Ebelt Sarnat, an assistant professor of environmental health at Emory University, said the scope of thunderstorm asthma might well be broader because the emergency room figure doesn't include individuals who might have self-medicated or seen their personal physicians in the wake of a storm.

But the exact cause or mechanism is not yet known.

"The phenomenon exists ... it's not entirely predictable," says Elizabeth Matsui, an associate professor of pediatrics, epidemiology and environmental health sciences at the Johns Hopkins Children's Center in Baltimore, in an interview with The Washington Post earlier this summer.

Dr. Bruce Ball of Charleston Allergy & Asthma says the likely causes for thunderstorms triggering acute asthma or allergy symptoms may be due to "the picking up and redistribution of pollens."

Heavy thunderstorm winds create updrafts that lift pollen and mold particles from the ground. Beating rain saturates and bursts the particles into tiny pieces. A downdraft then spreads those small particles into the environment and the air we breathe.

"It is also suspected that the electrical thunderstorm may break the pollen into smaller pieces making it easier to inhale larger-than-normal pollens, making you more symptomatic," says Ball, noting that these tiny particles are more likely to stick in the lungs when inhaled.

Ball adds that thunderstorms set off symptoms that may be a warning flag.

"If your asthma or allergies are exacerbated by something as simple as a thunderstorm, that is an indicator that your symptoms are not controlled. The major takeaway is that if a minor trigger such as a thunderstorm creates issues for you, then you need to see a board-certified allergist to get help."

Some experts cited in the recent Washington Post article say they think some of the upsurge in ER visits related to thunderstorm asthma can be traced to the fact that people with mild asthma or hay fever may not carry rescue inhalers and are therefore unprepared for the impact of the storm.

Summer to fall

Meanwhile, allergy sufferers will start to experience the change of seasons soon, according to Ball.

"Grasses are the main contributing factor for allergy symptoms in the summer. We are starting to see weeds as a secondary contributor. In the late summer months, you begin to see grasses fade and ragweed take over."

Ball adds that there is a new form of oral immunotherapy available for grass and ragweed. Oralair is the first and only FDA-approved oral allergy immunotherapy that is provided to the patient in the form of a daily slow dissolve tablet, says Ball.

The drug is to treat patients from age 10 to 65 years with grass pollen-induced allergic rhinitis. It treats any of five grass species: sweet vernal, orchard, perennial rye, timothy, and Kentucky blue grass.

Reach David Quick at 937-5516.