Adrenal suppression

[Blackknight66]

I’ve been using Fostair 200/6 and Spriva Respimat for around 15 months. Recently went to see GP for an unrelated issue which required blood tests. Results indicated very low cortisol levels. I’ve been referred to local hospital for further investigation. In the meantime my research has revealed a causal link between Fostair use and Adrenal suppression.

I should also add that the blood tests revealed that testosterone was right at the bottom of the ‘normal’ range.

I feel tired and anxious a lot of the time and struggle to sleep, All in all pretty lousy.

Any thoughts, experiences or contributions welcome!

[Hil101]

Hi Blackknight,

Sorry to hear that you’ve been feeling so under the weather. I don’t have an answer to most of your questions but I am also on Fostair 200/ 6 and it is on my radar that this strength of inhaler is not benign. I have been on it for just over a year following the sudden onset of eosinophilic asthma (never had asthma in my life and took forever to diagnose, by which point I was extremely ill). It started with a severe cough in 2022, for months, which faded eventually then came back a few months later and after a while turned into this horrible condition. I’m sorry to say that, both times, the cough onset was not long after a mRNA covid jab and, given an already overactive immune system, I fear this was the cause. (I never actually had covid and was having regular tests for work). I’m now also on biologic medication which I hope will enable me to lower/drop the Fostair if it starts to be more effective. I’ve had 3 jabs of biologic.

Last year, while struggling to get back to normal living with the asthma, I went to a functional medicine doctor who checked my hormones and found that they were all extremely low. I’m a menopausal female so different from you, of course. After a lot of tests and risk assessment, the doctor started me on bio-identical HRT and it has been life-changing. I sleep far better and feel much more clear headed and energetic. I actually feel like doing things. I know it’s possible for men to have replacement hormone therapy if the benefits outweigh the risk. I’m assuming it’s an endocrinologist you’ve been referred to? I hope they will be helpful in identifying the causes of your low hormones and addressing them.

I should also say that part of the rationale of the hospital for pushing me towards the biologic was because of the long-term profile of the Fostair corticosteroid combined with periodic short courses of prednisolone which would put my bones and adrenal function at higher risk.

I’d be interested to hear what the consultant says. Sorry this response looks very long-winded!

[Homely2]

I have been on fostair 200 plus spiriva for four months or so, plus frequent pred courses when fostair 100 was not sufficient.

I am aware that it is very easy for consequences to arise from all these drugs so am working hard to control my asthma triggers to reduce my need for them.

I am also keen to look at biologics, but they will not do this until they have redone my spirometry, which they will not do until I have three months off prednisolone