Yes, ducts can look terribly dusty. However, that dust will not become aerosolized during the normal operation of your furnace. There is an easy way to test this. Rent a particle counter and test the air flowing out of your registers before and after cleaning. You will not see any improvement in the air quality or any reduction in the airborne dust level. Think of it this way. Duct cleaning companies tell you that you need to clean your ducts when you can see a layer of dust in your ducts. Yet that very layer of dust is proof that duct cleaning is unnecessary, because that dust proves that the air movement in your furnace is not fast enough to re-aerosolize the dust.
I am NADCA Certified Air Systems Cleaning Specialist. Over the year I have learned on simple answer to this questions: there air duct cleaners and there are pretenders. There will be no benefit at all if you use on the very cheap pretender because they will not really clean anything. On the other hand if you call a qualified air duct cleaner with a NADCA Certification you will, like 99% of my customers, report improvement with your respiratory problems, you will see less dust and the job will pay for itself with energy savings and repair prevention.
I was able to get a next day appointment with them last week after multiple other providers did not have availability. The tech was on time and did a good job to diagnose and eventually replace the circuit board and get it up running again. The service itself would be 5 stars, although it did take a week to complete the job due to ordering the part.
"Customer service was great, and the price was in-line with other places, and fast service. We had a whole replacement of the outside and inside. I would have liked to see a better install for the furnace and new thermostat - the new thermostat should have gone where the old one was, and even tho the new furnace was a tight fit, they didn't offer to come back and repair the case molding, or give me a discount on the damage done, and I believe they should have put a disconnect box on the outside of the home, to make it easier for any future repairs needed. Other than that, am very happy with the cooling and heating!"