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Medical Forum / Diseases and Disorders / Asthma / August 2003

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inhaled steroids

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Mia - 07 Aug 2003 20:39 GMT
Hello, I'm not quite new here, but I am returning to mostly lurking after a
very long gap.

I would appreciate any comments and opinions about new and/or current
thinking on long term effects of inhaled steroids.

I have never liked taking them though sometimes I'd get fed up enough with
asthma I'd start them again. I used to find that there was not much
improvement either, until a year or so ago one doctor I saw said it wasn't
worth taking anything less than (if memory serves me correctly) 800mcg of
beclomethasone per day.

I must admit this did help a lot but I worried about long term effects and
the fact that I knew it just was masking symptoms. I keep thinking or
hoping, optimistically that my asthma might just go away one of these days.
Sometimes it does fade away a bit of its own accord but inevitably
returns... disappointingly.

I have taken up running over the past three years and  although I'm slow and
find it hard work (lots of walk breaks), I have completed the London
Marathon twice (and raised ?1800 for the National Asthma Campaign in 2001!)
It is running that really makes me consider taking the steroid inhalers all
the time because otherwise I use up my normal reliever (salbutemol) too
quickly. In addition I've now started to find that the ventolin is less and
less effective and my running is no longer so enjoyable as I just spend the
time too knackered to do anything except walking slowly.

I apologise for the 'sorry for self' ramble, I know that many of you on this
NG have asthma a lot more severe than me, but it gets to me all the same now
and again even after all these years.

Opinions appreciated.

Mia
miasarosi01@ntlworld.com
Chris Owens - 08 Aug 2003 14:27 GMT
You need to distinguish between inhaled and oral steriod
treatment.  The effects of oral steroids are systemic, and there
are many side effects.  The effects of inhaled steroids occur
primarily in the lungs -- quelling the inflammation that causes
asthma attacks -- and have remarkably few side effects.  IOW,
inhaled steroids are one of the safest treatments around.
Further, they do not mask symptoms, as do brochodilators, they
actually TREAT the underlying inflammation.  IME, if you're an
adult with asthma, it's not going to just go away on it's own . .
. accepting that some level of life-long treatment will be needed
is part of securing the long-term benefit of good health.  One of
the very difficult things for people with asthma to accept seems
to be that they need to remain on medication even when they don't
feel ill . . . it's like the roof in your house:  you don't get
wet when it rains because the roof is there; you don't HAVE the
asthma attacks because you are taking the medication.  Finally,
not taking appropriate medication when one is an adult asthmatic,
particularly if one has exercise-induced asthma attacks or
exacerbations, is just about as idjit as it comes; in the US the
#1 killer of adult asthmatics is fatal attacks during exercise.

Chris Owens

> Hello, I'm not quite new here, but I am returning to mostly lurking after a
> very long gap.
[quoted text clipped - 31 lines]
> Mia
> miasarosi01@ntlworld.com
None Required - 08 Aug 2003 16:47 GMT
Chris's comments are good.

Inhaled steroids are generally pooly abosrbed into the body and therefore
have pretty minimal side effects. Their beneficial effects are significant.

Most side effects that they have are related to oral deposition and
swallowing, therefore getting into the body. Make sure to get a good valved
holding chamber (spacer), and make sure you know how to use it right. This
minimizes oral deposition and maximizes lung deposition. Then always gargle,
rinse, and spit right after use to further remove any from your mouth.

With the above process you can potentially lower your dosage to the lowest
effective level. You need to work with your Dr. to figure this out as it
varies from person to person and may well very over time and seasons.

FM RCP
Asthma and Allergy Foundation
 
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