Asthma testing

[Kjm83]

Has anyone been diagnosed with asthma but had a good lung function score (on a good day) and then had a negative challenge test? (Mannitol used) I have a family history of asthma, eczema and allergies.

I had coughed for over a year and a half, been in hospital over night when I couldnt breath during an upper respiratory infection. My highest peak is 400 but usually around 350 and drops as low as 220 when I have a cold which I keep catching. Feel worse with dust, paint, perfume etc

They tried me on stomach tabs for a month before starting inhalers to rule that out and it made no difference to cough.

Waiting on my consultant app with test results which I know are negative but worried they are going to stop my inhalers which I won’t manage. I’m on seretide, ventolin, mucodyne caps, montelukast tabs, fexofenadine, and mometasone nasal spray

Thanks for any help

[Lysistrata Administrator Community Ambassador]

Hi, i had a negative challenge (histamine I think) in 2012 but still had strong reversibility after it. A confirmed severe asthmatic who was there at the same time had a negative as well but definitely had asthma - her first challenge test was positive.

In 2016 I had a fairly strong response to mannitol challenge. This was because I did my own research beforehand about what medications to stop when and didn't rely on what I was told to do, which turned out not to be accurate. It seems hospitals, even specialist ones, give really poor instructions about this a lot of the time - not long enough and all medications for the same period. That can really affect the results! It was very hard stopping mine but worth it for the result.

The thing which jumped out at me from you post is that you are on montelukast. That works on the pathways that mannitol also acts on, and based on the reading I did, you cannot just stop it 24 hours before a challenge.

Of course you may have been told it all correctly and it is hard stopping meds, but it is very much something to consider and to point put to the consultant when you see them. If meds aren't stopped correctly it may test how well your meds work but it shouldn't be taken as a test of underlying asthma! I also don't think they would necessarily ask or record what you did stop so the consultant may assume you were off things unless you tell them.

Also asthma is variable so yes can definitely get a good score on a good day - assume you were off meds briefly before that.

[Kjm83 in reply to Lysistrata]

Thanks, I did stop all meds except ventolin for a full week before test as like you I had a read up on the test on the web. It was tough not having ventolin on the day and had chest pain on the bus on the way there as someone behind me had just been smoking before getting on.

My work had a refit about month before and I felt so ill the full 3 weeks of it with low peaks from the dust etc so just don’t understand the result. I was coughing and wheezing during test but wasn’t affecting the numbers enough. Obviously don’t want asthma but want answers and to stop being ill all the time.

Iv had 3 antibiotics since my first lung test in August and prob should be on them just now as cold is going into my chest. 😞

Thanks for reply, hope u are doing well at the mo

[Lysistrata Administrator Community Ambassador in reply to Kjm83]

That's frustrating! For your sake I was hoping it would be the med stopping issue. Did they do reversibility afterwards?

I totally understand about wanting answers and the concern about meds plus frustration with being ill. It is odd though I was totally convinced my second test would be negative so read up on it, and it seems a negative test is positive with asthma if it is an indirect one like mannitol - it may be that your asthma is not coming from that pathway, although in that case the montelukast would be unlikely to work (does it help you? Or were you put on it to try?)

I hope you get some answers as it is not a fun place to be. Maybe try the AUK nurses? They may have more ideas and suggestions re your appt.

[Kjm83]

The hospital changed me to a low strength symbicort from beclometasone when I was admitted, which wasn’t enough. So one gp wanted to try monte b4 upping a steroid. It helped at night but by 3pm I would be coughing non stop again. So then put on seretide while waiting on resp app. I didn’t have enough reversibility after first lung test but she done it immediately after giving it to me but read u were suppose to wait a bit before testing. Consultant put me on mucodyne coz I have a chest cough yet people think it sounds dry. They tested me for 6 allergies with the blood test but only dust mites were positive. He thought it could be my new horse I got but had her 6 months before problems started and cat and dog came back fine so assuming my girl is good too. I’m worse at work anyway so believe it’s the air con/dry heating unit

[Spanners]

Hi,

I've had some recent success using HEPA filter and dehumidifier (40%).

Houseplants are also good for improving interior air quality (check out a recent study by NASA).

Have you heard of using macrolides to treat asthma? Apparently, in a subset of cases, asthma symptoms are caused by a chronic lung infection which the immune system is unable to clear, but which creates inflammation whilst trying to do so.