Clenil and potassium

[Birch_]

Hello everyone, I’ve just picked up a new inhaler (fostair) and haven’t taken it yet but have read the leaflet. It says something about risk of low potassium which made me wonder if my clenil inhaler has also got a similar risk but I haven’t seen anything specifically about it. I’ve had lots of muscle cramping lately including being woken up in the night about 2 weeks ago with really bad cramp in my calf and also had foot cramp a lot over the past few weeks, I think the increase in cramps does match up with having my clenil dose doubled a month ago (200 mcg 2 puffs twice a day).

I already have an appt booked with my GP in 2 weeks and plan on bringing it up but want to rule out other things 1st and am interested to hear if anyone else has had the same problem, especially as I’m anticipating my GP saying it’s unrelated or not a big issue etc and would like some evidence to give her.

Thanks in advance 🌻

[twinkly29]

It can be but it's easily remedied by eating foods rich in potassium - bananas is the one people always mention but actually other things have higher potassium in them, such as baked potatoes, peanuts/peanut butter, dark chocolate, yoghurt, dried fruits (especially dried apricots), salmon, greens and orange juice is good too I think.

Hope things are ok after yesterday 🙂

[Birch_ in reply to twinkly29]

Interesting! Thank you. I don’t need an excuse to eat more dark chocolate 😂 I do eat a banana every day anyway but now I know to look out for it I will look at how much I’m getting in my diet and see if the cramps go away with more potassium.

[twinkly29 in reply to Birch_]

Hopefully it'll do the trick!

I suffer at times - never did on just a steroid inhaler but on steroid inhalers, daily oral steroids and nebulisers it can be low.

Actually should have said salbutamol can lower it too so if you've needed extra ventolin in this time that may have added to it. And you may need extra ventolin for the next few weeks as your Fostair will take a while to kick in properly (hopefully not the full time needed though, which is approx 8 weeks, because you're on Clenil already and the steroid is the same in both inhalers so hopefully less adjustment time!)

[Birch_ in reply to twinkly29]

Good to know, thank you. I have been using a lot of salamol so that might be contributing too.

[MissCS in reply to twinkly29]

Twinkly29....you are always helpful and always offer knowledgeable and comforting advice. God bless 🙏

[Carlmw]

I have suffered from twitching and cramps for a over a 18 months and the doctors and asthma nurse refuse to believe that it is due to low potassium and my fostair inhaler. They won’t give me a blood test for low potassium although I have requested it. They keep on saying it in neurological even though I am not presenting any other symptoms and want me to see a neurologist. I will be interested to see how you get on and what they find.

[twinkly29 in reply to Carlmw]

A blood test probably won't help as potassium levels can vary anyway and by the time your result came back a couple of days later the level would be different. Plus if low the advice would probablybe to increase potassium rich foods as they work best. It's unlikely that potassium would be dangerously low from just a steroid inhaler. Eating foods high in potassium really does help (unlike with vitamin D where you can't really increase it that way).

[Poobah in reply to Carlmw]

I would give your GP & AN a copy of the Fostair patient leaflet, which highlights the potential potassium issue; "Your doctor may wish to measure the potassium levels in your blood from time to time especially if your asthma is severe. Like many bronchodilators Fostair can cause a sharp fall in your serum potassium level (hypokalaemia). This is because a lack of oxygen in the blood combined with some other treatments you may be taking together with Fostair can make the fall in potassium level worse." However, I agree with Twinkly, in that blood tests aren't always conclusive in measuring potassium levels in the body. Going by symptoms can be a good indicator things aren't right. I started my potassium journey after seeing a Dr Berg vid youtu.be/q2vPQYP0dpI(Not working as expected?)

I wish I'd stumbled across this much earlier as I could have prevented the side effects of my inhalers. NB Dr Berg is not an MD but is a qualified nutritionist (I think he's considered a Dr in the US).

[Poobah]

Been there and got the t-shirt. Spiriva was my achilles heal but I'm on Fostair now so continue to eat a potassium rich diet. Avocados and dried apricots (without sulphur dioxide) are high in potassium. Blood tests aren't conclusive because of the way we store potassium and levels in the blood aren't indicative of our true levels. Symptoms of low potassium are muscle cramps/twitches, hypertension, tachycardia; the lower the potassium levels the more symptoms will develop over time.

According to the Fostair patient leaflet, "Your doctor may wish to measure the potassium levels in your blood from time to time especially if your asthma is severe. Like many bronchodilators Fostair can cause a sharp fall in your serum potassium level (hypokalaemia). This is because a lack of oxygen in the blood combined with some other treatments you may be taking together with Fostair can make the fall in potassium level worse."

[Chip_y2kuk]

No clenil won't normally cause foot cramps but lots of salbutamol/ventolin and the formoterol in fostair are known potassium leaches and low potassium can cause all kinds of issues including terrible leg cramps and believe it or not breathing issues

Chip