Roughly 26.5 million Americans suffer with asthma (that’s approximately 20.4 million adults and 6.1 million child patients). The most common triggers for asthma are smoke, dust, pollution, pet fur or dander, or mold, however, food may also trigger asthma symptoms, particularly if the patient also suffers from a food allergy. In fact, studies from the National Institutes of Health indicate that about 27.5% of asthma patients have a sensitivity to at least one food.

Symptoms of asthma triggered by food may include redness, swelling, itching, hives, and rash, as well as nasal congestion, sneezing, running nose, itchy nose and throat, and postnasal drip. Food allergies may include hives, stomach cramps, vomiting or nausea, and wheezing. The top trigger foods for asthmatics include the following:

1. Dairy
Casein is a protein found in dairy products and is usually the culprit of a dairy allergy. If your body mistakes casein as a threat to your body your immune system will begin to react. You may develop hives, rashes, wheezing, severe pain, food malabsorption, vomiting, breathing problems, or anaphylaxis. A casein allergy is a common problem for children and infants with asthma, although it may be outgrown. Anaphylaxis can be deadly so if you suspect a dairy allergy and also have asthma you should seek a doctor’s care.

2. Shellfish
Shellfish has a protein that the body sometimes mistakes as a threat. If you already have asthma, you may notice symptoms show up in your airways, sinuses, nasal passages, digestive tract, and skin. Most reactions happen within minutes of ingesting shellfish or fish but could appear hours later. Symptoms could include tingling in the mouth or lips, Stomach pain, nausea, diarrhea, or vomiting.

3. Wheat
Headaches, nasal congestion, itchy throat, breathing difficulties, bloated stomach, lightheadedness, vomiting, hives, pale skin, diarrhea. and anaphylaxis, can all be indicative of a trigger to wheat. The wheat can be inhaled or ingested. The symptoms range from mild to possibly deadly (if an allergy is present) and can happen within minutes or hours after exposure. Suspicion of an allergic reaction to wheat should be followed by seeking a doctor’s care immediately.

4. Nuts
Common nuts that trigger asthmatics or those allergic to nuts often come from tree nuts like almonds, cashews, and walnuts. If eaten or even touched their proteins cause your immune system to release histamines. A major symptom could be anaphylaxis, which can cause death. Other symptoms may include severe itching including the mouth, throat, eyes, or skin, stomach pain, diarrhea, nausea, nasal congestion or a runny nose, and vomiting. Peanuts may cause the same symptoms.

5. Eggs
Asthma signs and symptoms such as coughing, wheezing, chest tightness or shortness of breath may also occur when egg white is consumed. In fact, egg white allergies or sensitivities are one of the most common triggers for children with asthma. Reactions usually happen a few minutes to a few hours after ingestion. Symptoms of egg allergies can be mild or severe and rarely cause anaphylaxis. Other symptoms include rash, hives, nasal congestion, vomiting, and other digestive problems. The severity of symptoms can change each time eggs are consumed so if you notice an allergic reaction that you believe may be related to eggs you should seek medical help. Seeing a doctor while the allergic reaction is still happening could help in making a diagnosis. Both egg whites and the yolks contain proteins and either, or both could be a trigger.