I am a long term asthma sufferer (12 years +) my current medication is Fostair 200/6, (2 puffs first thing in the morning and 2 puffs last thing at night) Fexofenadine 180g, (1 tablet at night) Mometasone nasal spray (1 dose in each nostril at night). I feel that my asthma is generally well controlled.
I do of course avoid all of my asthma triggers, NSAIDS, paint smells, etc.
Just recently I seemed to have developed an intolerance to alcohol. Although not a big drinker I am now not able to tolerate a small bottle of beer, or small glass of wine. Within 20 minutes I suffer a reaction of painful blocked sinuses, streaming nose and eyes, tightening of the chest and sneezing fits.
I have always suffered from a dust mite allergy which gives me a similar reaction.
It does seem that alcohol contains high level of histamine, along with other foodstuffs and I am wondering whether I have developed some sort of histamine intolerance. My Fexofenadine anti histamine doesn't seem to be enough at the moment.
Has anyone else suffered similar symptoms and wether there are any suggestions for treatment.
Any advice would be appreciated.
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Paul_1962
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Both beer & wine contain sulphites and are definitely triggers for some asthmatics. I feel like I'm coming down with a chest infection if I even have a sip of sparkling wine (toasts ). I also avoid preservatives so rarely eat processed foods.
If you Google "Sulphites Wine Beer", then you'll see all the latest advice and some websites suggest alternatives.
I recently wondered the same thing! "What if my athsma has more to do with digestive stress than environmental factors?" Research revealed that HISTAMINES can be in food. How could I have had so many doctors and lifelong athsma, and no one mentioned that? How did I not know that? I printed out lists of foods, good to eat, bad to eat, etc. Easier to rememember that all that is very fresh is low in histamines. Even cheeses: More fresh, wet cheeses and less delicious , old cheeses. Sigh. I also bought a "histamine blocker" supplement, but have yet to really commit to it. I'll have to get back to you on my experiments...: ) DK
Asthma is very complex, both causes and triggers, and can vary between people. While histamines may be a trigger for some people with asthma, they aren't the whole picture, and 'histamine blocker' supplements aren't licensed for asthma. Obviously it's up to you what you take, but please don't share or recommend unproven treatments for asthma (or anything else).
I am eading your comments with interest. I have had asthma since childhood and in my late 50's started having anaphylaxis reactions. swelling of tongue and lips causing difficulty in breathing.
After several episodes and visits to a&e I was referred to an allergy consultant who said I had an intolerance to histamine and when the levels are high it causes a anaphylactic reaction. Diagnosed as spontaneous angioedema.bi now have to take 4 antihistamine tablets a day in order to reduce the number of reactions . I still get reactions but not as frequent. Has anyone else had similar experiences.
Hi Welshtoffee, sounds like your reaction to alcohol is worse than mine. I spoke to my doctor today who was not a great deal of help. Looks like I am going to have to go down a similar path to you and find an allergy specialist. The doctor has previously referred me to the EN&T consultants but the next appointment is almost 2 years away and in another city to where I live. I am currently trying to book privately.
I also have reactions without drinking any alcohol. The reactions happen at any time without warning. I can wake up in the middle of the night struggling to breathe as my tongue is swollen,on walks in countryside, watching football.(wonder if it is stress causing it!) Just to name a few. Have to carry antihistamines steroids with me in case of a reaction.I was lucky managed to see the consultant in two months and he did various tests to confirm what he said it was spontaneous angioedema.
Yes, I had very similar to this - I was told I was having an allergic response ‘to stress’ aged 19 and told to 'take it easy' after a few anaphylactic events. Terrifying. Same allergic responses and hard to pin down to food or environmental factors. I was given epi pens and had a restricted diet with no peanuts or additives and packaged foods. I'd had asthma as a child, then it went, then came back in my late 20s. I’d had allergy tests at a few points, at 19 (positive) at aged 30 (positive for most things), then 34 (mixed but mild for most) but it took a while longer, more testing but I was diagnosed after an extended stay in the gastro ward and a brilliant gastroenterologist confirmed EDS (Ehlers-Danlos Syndrome) and there was a lot of discussion about histamine and mast-cell activation. I was 38. That all made sense and linked together rheumatology, dermatology, gastroenterology, gynaecology, pain, neurology, cardio and pulmonary services. Not everything is the EDS but I’m better and more confident now about not being fobbed off or railroaded. Today I was told by a consultant in another speciality that EDS ‘only’ affects ‘the joints’ and he seemed to have gleaned his knowledge from his general studies a few decades ago. It can affect the lungs and the whole respiratory tract – last year I suggested my current sudden worsening of ‘asthma’ symptoms that weren't responding to asthma treatment might actually be gastric in nature and the specialist nurse recommended gastro protective omeprazole and bingo my stomach and reflux settled and my ‘asthma’ symptoms like husky voice and cough improved like magic. Sometimes symptoms are assigned to another or pre-existing condition which might be similar or mask others. I take antihistamines or increase the dose when I am flaring up or to control symptoms.
Thank you for your reply very interesting. Yes these anaphylaxis attacks can be terrifying .Six months ago I was admitted to hospital after going to A&E with a lot of pain in my left side. I had a CT scan and it confirmed diverticulitis another gastro problem. The CT scan also showed something on my lungs. Had a lung CT scan which showed that I also have nodules on my lungs. I am learning about the new diagnosis diviculular disease and find that certain foods cause severe acid reflux and sickness. Reading about it seems to be caused by taking steroids (on seretide 250 4 times a day plus steroids rescue packs and for my anaphylaxis.
I am so glad you got that confirmed. We're not such unusual patients after all as it turns out. I like the clinicians who think, ooh this is interesting what could it be and listen, rather than jumping to conclusions.
The number of times it was suggested I had 'anxiety' and it was a very good Psychiatrist who said it's basic clinical care to be checking if someone has other conditions, say asthma and is literally struggling to breathe (like you are) so wrote a stiff letter to say that. Turns out I had an exacerabtion and chest infection and was then told off for not coming sooner. Well, when you've been told to go away with 'it's just anxiety or low mood' and cycled through a few signposts a few times, that's a bit difficult! I know now, and it's better now being older and more confident. But still very wearing at times. I've had meninigitis and encephalitis which got me unconscious and hospitalised after a week of seeking care as they said the stiff neck pain, headache, aversion to light, temp, dizziness, vomiting and nausea was 'low mood and stress'. Huh?! Thank heavens for the young GP in training who was overruled for a lumbar puncture but said if I deteriorated my family should call 999.
My old very good gastro was superb - she explained how many are fobbed off with 'this is just stress/anxiety' but then the interactions of what is doing what or causing symptoms and to rule things in or out. I spoke to a Matron yesterday who could identify another consultant by the description that patients burst into tears with relief in many appointments as she is so good she can accurately listen and diagnose sometimes decades after symptoms started.
I've got my steroid use down to as little as I can manage with. Sorting out other issues then means I've had fewer exacerbations and haven't had to use a rescue pack for a while now (but I am now allowed to keep one in reserve for when I do which funnily enough then also reduces anxiety!). It's all a balance.
I avoid any foods with sulphites and certain preservatives eg: propionate in bread or msg. There are sulphites in many foods and drinks even most soft drinks. No doctor has ever talked to me about this. I’ve discovered through reading and personal experience.
I'd be surprised if wine or beer contain histamines. I would think it more likely that it's yeast allegy? I suffer from perpetual rhinitis, but no one has ever bothered to find out what causes it. I now take Spiriva Respimat for my asthma.
Hi Lysistrata, I have been suffering from asthma for about 5 years and my main triggers perfumes & fragrance(all sorts)& cold air, and it is affecting my life as I find it difficult to out any where i.e busses family gatherings work or even shopping because the fragrance are everywhere. So I was wondering if you could help and give me some advice on how to control these perfumes effects please. I will really appreciate your help. I am on fostair currently 200/6. I sometimes try Cetirizine when I need to go out but didn't find them much helpful.
That sounds difficult! It's often tricky to avoid triggers like that entirely - and yes sometimes it does feel like there is fragrance everywhere sadly! Cetirizine and other antihistamines probably aren't going to help much because that kind of trigger usually isn't an allergy, it's more of a direct irritant triggering your asthma.
I find I definitely can't always avoid triggers, and some scents will trigger me no matter what. However, I do find when I'm doing better and medication is helping, I can be less twitchy and less likely to respond to at least some triggers.
It sounds like if you're reacting to a lot of things, and presumably needing to use your blue reliever inhaler a lot, then your asthma probably isn't well controlled. How long have you been on the Fostair? it might be that it's not quite enough, or not right, for you. It's definitely worth discussing with your GP and asthma nurse and saying that you're struggling with a lot of triggers and you don't find your asthma is very well controlled.
The other thing I would say is that fragrances can make your upper airways twitchy as well. Sometimes that can be from a condition called Vocal Cord Dysfunction (VCD) or inducible laryngeal obstruction (ILO) which often happens alongside asthma: this link can help: asthma.org.uk/advice/manage...
VCD/ILO can be triggered by strong scents and smells, but there's also a view by some doctors that when your asthma is triggered, your upper airways can join in - the exercises you could use for VCD would also help this side though. I only react to specific scents and it acts more like an allergy, so I don't feel VCD is the main issue for me, but I do get some upper airway involvement and the exercises I learned seemed to help that side.
It's also worth calling the asthma nurses on the helpline to chat through everything - 0300 2225800 or WhatsApp 07378 606 728 Monday-Friday 0915-5pm. They can chat through it and give you some suggestions of what to discuss with your GP/asthma nurse.
Thank you Lysistrata, I don't know what to say, I spoke to my GP last year when I was having issues & they refered me to hospital as I refused to take monteluckost(given the horrible side effects). Hospital ran lot of tests and found nothing. When I asked consultant about the perfume issue in fact literally begged for help he gave appalling answer and fobbed me with respimat which didn't help at all (surprise surprise). You can't use it spacer with it you see. but never mind may be I will speak to GP about changing fostair. I have been using it since 2020. I was diagnosed with asthma in 2018 via spirometry test. pretty frustrating.
So you've definitely given the Fostair long enough it sounds like - and you use it with a spacer? Or is it the dry powder version?
With the montelukast, did you mean that when you took it you had awful side effects, or that you were worried about this happening from reading about other people? If you had side effects yourself it makes sense to stop, but if you haven't tried it because you were concerned about getting them, it may be worth a go. You often don't hear about all the many people who take it without having problems, and many of the problems, while serious, turned out to be in children and younger teenagers who were on too high a dose (the child dose is now half the adult dose). Obviously if you experienced side effects yourself then ignore what I've said, as it has to work for you!
I've sometimes found it difficult to discuss this kind of trigger too, it isn't always as well understood. I'm sorry the consultant wasn't good at discussing it, but I do understand why he prescribed Spiriva Respimat. It won't work for everyone but it can be very helpful for people with scent triggers. I take it and thought it wasn't working, but when I accidentally missed a dose or two because of a prescription mix-up, I found it really was working!
I always use a spacer for my Ventolin and any similar inhalers, but have found the Respimat is ok without one. I think it does need someone to show you how to use it though - did anyone show you how? It's not quite like the other types of inhalers and can be tricky to work out first time, so they should have shown you. If you still have one in date, it's worth asking a pharmacist if they can show you. If it still doesn't work, then you know it's not for you! But definitely speak to the GP and see what they can do - and as above, the helpline may be able to give you some other ideas to discuss with the GP.
In case it's not obvious and I'm not meaning to patronise you - I was advised to always wear a scarf by my resp consultant and wrap it right around me and keep my mouth covered fairy high up as soon as the weather got colder. I was mocked a bit by my boss for covering my face until I explained that it was to keep the air as warm as much as possible as I breathed it in (not quite rebreathing old air) and keep my neck and face warm. It really worked and I have a few. Ha ha, those colder months are sometimes six or seven months of the year in the UK...
p.s. this cold air was always a trigger running about doing field sports when I was a child but as I was always running and swimming no one made the connection of that being such a major trigger. And it's fairly hard to avoid. I am lucky to be vulnerable enough to have winter support and cold weather payments for my heating - it's a very serious issue but no more seeing the clouds of my breath as I sit with a hat in bed. Now it's central heating and the hat, but I can't risk getting that cold.
you’re not alone Paul, I don’t drink anymore either, but actually I’ve gone off it anyway, I think when you have such bad reactions to something it puts you off.
This is making me think. I too have issues with certain food and drinks triggering asthma and blocked sinuses. I have asthma and allergic rhinitis. Been given lots of different meds by GP.....with varying side effects. Some work, some don't. I tend to feel better taking antihistamines.
Hi Paul, I also have similar symptoms to you & felt for a long time that my asthma wasn't very well controlled. I recently started taking Relvar instead of Fostair and I have found that much better. I take dymista nasal spray and fexofenadine too. I tried monteleucast but it gave me bad side effects. I also worked out that I'm sensitive/allergic to sulphites so I completely avoid them now. It's in a lot of food & drink.
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