What could be the reason for steroids not working ?

[Hannah125]

Hi everyone,

I've been using Seretide 250 (two puffs twice a day) for 2 months now and I still feel the same (using around 20 puffs of ventolin everyday, nebs 3 times a day). My symptoms are still there almost all the time : tight chest and struggle to breathe. The intensity of the symptoms vary throughout the day but it's always there.

I've had two short courses of prednisolone (40mg for 5 days) and it didn't change anything either. I was hoping it would put an end to this flare up and get rid of the inflammation in my lungs but it didn't work. I know there are certain types of asthma that do not respond to steroids but I thought it was rare. This is all new to me as I never had to deal with severe persistent asthma. Compared to now, I used to live like someone that didn't have asthma and never needed any medication! And all of a sudden because of a viral infection I find myself living the life of a severe asthmatic and no matter what drugs I take my symptoms are still the same. So now I'm wondering why it didn't work ? What can possibly be preventing the steroids (both oral and inhaled) from working ?

Thank you!

[MrsCMK]

I’m in the exact same situation as you (except that I don’t need nebs) and I really feel your frustration. I’m hoping I’ll have some answers on Thursday when I see my specialist for the first time. I’ll share anything that I learn 👍

[Junglechicken]

Hi Hannah. You have my full sympathy. I’m not sure what to suggest other than keep seeking answers from your medical team and keep control as best you can. I had two rounds of steroids which did nothing to help my latest pneumonia fuelled flare. I’ve now been taking Seretide 500 for 10 weeks and just this week I started to feel some relief and my peak flow is starting to level out at 90%. It had been jumping from 60% to 70% but I’m still taking my blue once or twice a day (obviously you are in a lot more distress than I am) I hope you manage to find some answers as you are obviously very poorly.

[Js706]

Hi Hannah,

Sorry to hear you're still struggling - have you got another appointment with your specialist booked?

Have you ever seen respiratory physio or tried pulmonary rehab? They can be really good for teaching tricks and exercises (either breathing exercises with physio or physical exercises and education with pulm rehab) that help to manage the symptoms on an everyday basis! It might be something worth asking about to try and help you deal with the daily symptoms while you try to get more control of things with your specialist?

[twinkly29]

It might be worth trying regular Gaviscon (as in 4 times a day for a week) to see if it improves. I'm not at all saying it's not your asthma but would be worth seeing if there's some reflux, silent or not, going on as well which could be causing the symptoms that aren't going away with asthma treatment.

Anxiety can also cause those symptoms and it would be understandable in your situation - concerned it's not improving/worse/etc which of course then exacerbates things. But I don't know how one would check that out.

[Ghoulette]

I'm sorry you're struggling Hannah. I can't really offer any advice as I am still learning, but I just wanted to wish you well and hope you get some answers and start to feel better soon x

[Autie1]

Hi it may be that you are like me. Im one of the pain in the backside to all medical people who don't respond to the combination inhalers. They actually make my asthma ten times worse. Where i live we are lucky to have a reseach group that do genotype testing on all asthmatic patients. It might be worth asking for an inhaler that isn't a combination one. I take qvar, montelukast and theophyllin which manage my asthma quite well.

[WheezyNanma]

Hi Hannah. Sorry to hear of your problems. I've been in that position - colds and viruses always made the asthma much worse. It took 2 months, prednisone and Fostair twice two times a day to eventually get relief. Ventolin did nothing for me (according to spirometry made it worse!).

Have you tried Fostair? I'm on the 200/6 (stronger steroid component).

I'm sure things will work out - it's just a case of trial and error and working out what's best for you.

I also agree that reflux might be exacerbating everything. I recently wrote a post on here about everything going well, then the cough/tightness/wheezing came back after just one episode of reflux. And remember, reflux can be 'silent'. You're not always aware it's happening. The give away is the relentless cough and wheeze. Asthma and reflux and allergies, PND and nasal congestion are ALL linked in many ways.

[Hannah125 in reply to WheezyNanma]

Thank you for your message! Yes, I've tried Fostair but I had to stop it after 4 days because it made my breathing worse. I think it was because of the powder which irritated my airways more. However, I'm also thinking that Fostair might be responsible for the two "real" asthma attacks I had just one week after I had last used it.

I've been thinking about reflux so I started taking Gaviscon but so far no results. I did have reflux before but it never triggered asthma exacerbation like that before. That's why I'm also thinking that there may be something else on top of that.