Pulmonologist or Asthma Specialist?

By Theresa Cannizzaro, Respiratory Therapist

2 min read

What's the difference between a pulmonologist and an allergy and asthma specialist?

Allergy and asthma specialist

An allergy and asthma specialist is a doctor that specializes in just that: allergies and asthma. Generally if you have allergic asthma, this is the ideal doctor for you. They are board-certified in allergy and asthma and have had years of extra training to treat both issues. If you need to have environmental or food allergy testing it will mostly likely take place in an allergists office.

Lung function testing can also be done in most allergists' offices. An allergy/asthma specialist can help come up with a treatment plan for your allergies and asthma, such as mediations and ways to avoid and treat allergy symptoms, especially those that set off your asthma.

Pulmonologist

A Pulmonologist is a specialty doctor that specializes specifically in lung conditions and respiratory diseases, including disorders of the respiratory system. These disorders may affect the lungs, upper airways, the thoracic cavity, and chest wall. This also includes other parts of the body that affect the lungs and their function. Some examples include asthma, COPD, emphysema, cystic fibrosis, lung cancer, pulmonary hypertension, and sleep disorders to name a few.

Pulmonologists are classified under the Internal Medicine sub-specialty. After being board certified in internal medicine and receiving additional training specifically in pulmonary medicine, they take the exam to become board certified in pulmonary medicine. Pulmonologists are the ones who can perform complete pulmonary (lung) function testing as well as diagnostic bronchoscopy as needed.

Is a pulmonologist or asthma specialist right for me?

If you are finding that your asthma isn't being adequately controlled with the help of your primary care doctor, you should consider being referred to an asthma specialist or pulmonologist. If you are needing to use your rescue inhaler more than twice a week, or are needing more than one or two courses of oral steroids in a year, a Pulmonologist or asthma specialist may be beneficial for you. For people with allergy-driven asthma, an allergist is the way to go. They're the experts on how to help you gain control over your allergies that set off your asthma.

If the asthma diagnosis is in question or not determined completely yet, a Pulmonologist has the tools and capabilities for complete lung function testing and other tests (such as a methacholine challenge) that can better confirm or rule out asthma.

I am a firm believer that most asthmatics should be followed by a specialist. There are many amazing primary/general practitioner doctors out there that are equipped to handle mild intermittent asthma; however, in my opinion, an asthma specialist or Pulmonologist is a better choice. I was followed by my primary care doctor for many years until my asthma started being more bothersome and my doctor referred me to a Pulmonologist.

Both specialists are highly trained in the diagnosis and treatment of asthma. If your asthma is classified as more than mild intermittent, I would highly recommend being referred to a specialist.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Asthma.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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rolandh Member
I am 65 and have had exercise induced asthma for around 50 yrs. My airways always feel somewhat constricted but close up with vigorous exercise. I have tried all of the known inhalers which have not helped but have never used a nebulizer. I have always noticed that I breathe somewhat better when it's humid and also if I'm by the ocean. Could there be connection to the fact that there is more moisture in the air that benefits me and might this mean that a nebulizer could be beneficial in delivering the medication I need ?
1. Leon Lebowitz, RRT Moderator & Contributor
 Hi RolandH and thanks for your post. It's interesting that after all these years, you've never had the opportunity to use a medication nebulizer. You may want to speak with your physician about that. In my professional experience, there are patients who prefer to use the nebulizer as a matter of routine, but use their inhalers for convenience, time and when they are mobile. For your breathing to feel better in the humid air and/or when you are by the ocean speaks to your specific condition. We often say that asthma affects everyone differently and so, this type of humid air may be something that is of benefit to you. What do you think? Leon (site moderator)
John Bottrell, RRT Moderator & Contributor
Great article, Theresa. This will be very helpful for community members. Personally, I have seen both a pulmonologist and allergist in the past. But, after reading your article, I would think an allergist would be best for me considering it's allergic. All the best. John. <a href='http://Asthma.net' target='_blank'>Asthma.net</a> Site Moderator.
johnep Member
I am age 75 and have asthma since childhood. It was relatively mild until about 10 years and I was referred to a pulmonologist and I see him every year. He gives me a breathing test and there has been no notable change in the test. He diagnosed me with mild COPD. He has me on QVAR, singulair and rescue inhaler. Recently my asthma has worsened and I am taking more of the rescue inhaler. My biggest issue is that I often wake up in the middle of the night with restricted breathing. I took an allergy test in my 20s and I was allergic to many things including foods, dust, pollen, etc. The doctor had me avoid certain foods, control my home environment better and after about 6 months I gradually reintroduced many of those foods into my diet. I take allegra for my allergies and they seem well managed except for possibly its affect on my asthma. Does it make sense to see an allergist to determine what things could be causing my worsened asthma? Is it possible that allergies are the root cause of my problem? Thanks, John
davel317 Member
My 13 year old daughter has breathing issues when she plays soccer. She never has any breathing issues outside of that. She has never had any allergies of any kind. So, this sounds like exercise induced. She does not have chest pain; she has shortness of breath, and she feels like her throat is restricted some. She says it feels totally different than when you are just winded from running a lot. So, I'd like opinions on whether I should see an allergy specialist or a pulmonologist. I don't think she has any allergies. Thanks.
1. davel317 Member
 Leon - thank you very much for the reply. Yes, my daughter has never had anything allergy related - hardly ever sneezes. I did have the typical seasonal allergy symptoms of my own as a kid, but she has never had anything. So, if I have to choose pulmonologist vs. allergist, sounds like pulmonologist may be the place to start. Some neighborhood folks have suggested starting with my daughter's pediatrician, saying that we might end up with an Albuterol inhaler if it's exercise induced. Do you think it is worth going to the regular doc, or do you suggest I just skip that step and go straight to a pulmonoligist/allergist?
2. Leon Lebowitz, RRT Moderator & Contributor
 Hi again, davel317, and thanks for your reply and explanation. My feeling is you are going in the right direction. Since your daughter has a pediatrician who knows the family and is familiar with her medical condition, that might be a good place to start. If the pediatrician can manage this now (and often times, pediatricians are extremely well versed in these conditions), it may be prudent to begin with the child's doctor. Again, the choice is really up to you. Please do check back and let us know how this all works out for you (and your daughter!). Good luck! Warm regards, Leon (site moderator <a href='http://asthma.net' target='_blank'>asthma.net</a>)

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