I have been referred for spirometry testing due to some symptoms which the cause is unclear (sinus polyp issues/acid reflux/chest tightening)
However my peak flow has always been low. Even though I am only 5ft 1 for many years whenever I have had my peak flow tested in college lessons etc it has never been more than 300. I have tried at home to develop a good technique but still can’t get more than 310. There is not much 24 hour variability I am usually between 270 - 300. I have been a runner in the past and done sport with no issues - though I remember during a distance race several years ago a stranger asked if I was asthmatic as apparantly I was wheezing.
Anyway I was wondering if I have always had a low peak flow won’t my spirometry show up as low too? What will it reveal that peak flow won’t?
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Blueforest23
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My peak flow has always hovered around 150 at its best for 40 years thats been normal for me. I never needed any medication until my 50s but think always had asthma from a child I wheezed. Spirometry basically tells you how your lungs are working, air in and out. Age height weight etc is taken into account. Its more accurate than peak flow. Its painless takes about an hour. I had my first one last year I'm in my 60s. I worried that I wouldn't be able to breathe. I shouldn't have. Go for it and see you'll be fine.
It will show low similar to your peak flow, but it also looks at the inspiratory pattern, and can see if theres possibly an altered breathing pattern, e.g breathing in obstruction/ dysfunctional breathing pattern. It looks at breathing volume in a different way as peak flow is just one way which is called forced expiratory volume, the spiromitry looks at forced vital capacity and can also do whats called a flow volume loop which is looking at the whole breathing in and out phase. Hope this helps.
Spirometry is much more detailed than just peak flow. It will highlight any obstruction and whether it’s fixed or reversible, then you can get the right treatment if necessary. Hopefully, you won’t need any, but it’s useful to check because asthma is reversible and would help your sport (a well-known example would be Bradley Wiggins) and fixed small airways obstruction is controllable.
I was diagnosed with late-onset asthma and fixed small airways obstruction at 65 after years of incessant winter colds (my only symptom at the time!), so it’s not always obvious even though I only had 53% lung function - I’d never smoked. Lung function tests aren’t routine in the UK (possibly because there is a lot of redundancy in lungs and a good pair would keep you going until you’re 130!), so it’s probably a good idea to have the test if offered as it might pick up something which would otherwise be hidden for years. I certainly wish I’d found out earlier because I suspect I might have avoided some of the damage.
Yea maybe the low peak flow is ok for my height/size though according to the charts I should be 420, my 290/300 is not even on some of the charts I googled lol so that’s what makes me think it is strange. Even though I have always been this low.
I have had recent chest tightness which was scary but this is in keeping with an acid reflux/Globus condition I have recently developed, salbutamol did not seem to help.
I did a mini reversibility test on myself and after 2 puffs of salbutamol my peak flow did rise to 340, unless this improvement can occur in non asthmatics maybe it shows some narrowing. Yet last year my gp did a steroid inhaler trial for 1 month but there was no improvement to peak flow
Part of me suspects there must be some sort of lung deficiency as I have had rhinitis/polyps for years, so has my my dad and he diagnosed with asthma/bronchitis as an adult.
Just a question .. obviously with lung issues it takes weeks and months to find answers/wait for tests and to get sorted but I do get worried when I feel my breathing is compromised for whatever reason. I have anxiety but don’t like mentioning it because then people/doctors just put everything down to this and I feel I am taken less seriously. It has happened twice I have felt tight chested (I think due to the reflux issue) give to the walking centre and they have said it’s a panic attack (I am sure it wasn’t but there was no point arguing with them).
So far when I have felt changes in my breathing I have been reassuring myself by telling myself my respiratory rate is normal, there is no wheeze (though I sometimes get it from the reflux) and peak flow hasn’t changed . Would you say these are 3 reliable objective markers of indicating that you are not in any real trouble with breathing? If not what objective markers could I use to either reassure or indicate that I should seek help?
As others have said, spirometry is more detailed. Your peak flow may well just be lower than average. The predicted is an average for the population of people who are the same height, age and sex as you. However sometimes it's misunderstood as being 'you must have this value' - nope, it's just there as a guide until you learn your own best. This post may help re peak flow: healthunlocked.com/asthmauk...
Change in peak flow after salbutamol is actually used as part of the diagnosis for asthma - a change above about 12% with salbutamol is usually considered to be asthma. Yours is 13% (difference of 40 divided by the initial number) so that does suggest asthma. Steroid inhalers can take 6-8 weeks to kick in so a month is not really long enough for a trial.
Sometimes your symptoms may not be asthma but that doesn't mean they must be panic or anxiety - it could be breathing pattern dysfunction, which is common alongside asthma. Unfortunately some healthcare professionals think that's the same as panic which is unhelpful and confusing - they are not, though anxiety or panic can also change your breathing. This post may help there: healthunlocked.com/asthmauk...
In terms of reassurance about your breathing, a wheeze isn't a particularly useful sign as you can have asthma without a wheeze (you may get told that it's needed but it isn't, this just isn't always well understood). And as you've noticed you may get a wheeze with something that isn't asthma. Peak flow might be, but it can depend on the person as it's less useful for some. You might find it useful to practise these breathing exercises and use those:
You could also try taking your reliever inhaler when you feel that sensation (but try to avoid the day of your spirometry test as it may skew the results!) If you do have asthma, remember most people are able to control it pretty well on the right medication. This forum is full of people who have trouble with their asthma, but that's not representative of most people with asthma.
Thanks, I do try the reliever inhaler it doesn’t help much to be honest. My symptoms are just so confusing I don’t know what to put down to anxiety or genuine issues anymore. At several times throughout the day I can feel more resistance in my breathing, which makes me feel anxious as I don’t know why. I measure my peak flow during these times and it is what it usually is - 300. My resp rate is also the same.
I am looking for an objective marker of when my symptoms become serious as with anxiety I do get sensations which I can sometimes hyper focus on - air hunger, throat/chest tightness, feelings of increased breathing resistance and noisy/whistly breathing (from my throat and nasal disorder)
So I suppose if I go off respiratory rate this is pretty reliable at indicating that breathing is non concerning (assuming you are calm)? As with anything serious you would expect resp rate to increase wouldn’t you?
Your resp rate would probably also increase if you were anxious though, and also with breathing pattern disorders, as both of these could make you hyperventilate - but then as you say with asthma you might also breathe faster! So probably not the most reliable guide.
I don't know if it helps to think that even if it is asthma you have tools to address it (the reliever and finding the right preventer)? This post may help as it gives you tips on how to know if you might need to do something more - even if something is asthma, you still have methods to handle it, and you may find it helpful to know when you are ok to handle it: healthunlocked.com/asthmauk...
It may help to try the breathing exercises above and try them when you're not feeling anything so you can practise to use when you have these sensations (obviously you can also use your reliever if you need it). And have a look at the post I linked to before about asthma Vs anxiety Vs dysfunctional breathing, if you haven't already, as that may help with telling the difference.
Thanks Lysistrata, that’s very helpful I have had a look at the links and the breathing exercises I tried a few last night I was surprised to learn that breathing pattern disorder can also cause chest tightness. It is always good to have some sort of objective plan I find it calms any worrying.
My issue is the information states to treat asthma with any symptoms but at the moment I don’t know the source of the symptoms. For example I am feeling slight resistance with my breathing, hearing whistling noises and throat tightness due to several issues going on - my sinus issues and potential reflux. Plus of course anxiety leading to being over cautious. If I was to take salbutamol at every symptom I would be using it all day. Do you see what I mean? Or am I thinking in the wrong way.
I get what you mean and it is difficult! Partly it's just experience - you do tend to learn which is which (if I'm remembering correctly, chest tightness with breathing pattern issues is in a different place and feels different from asthma - I think it's more upper chest and more at the front. But that is from memory and may be incorrect - don't rely on that, especially as people can experience it differently and not everyone gets chest tightness with asthma or with breathing pattern disorder).
I suggested the breathing exercises partly because it's usually ok to try those even if you do have asthma symptoms, before salbutamol - with the understanding that you then take the salbutamol if needed.
It's also worth remembering that nothing terrible will come of taking salbutamol you didn't need while you're working things out. The reason there are warnings about taking too much is because it can show you aren't well controlled. If you do have asthma then you will need a preventer that works for you and to be allowed to try it for more than a month!
It could be worth giving the asthma nurses here a call to talk it all through: 0300 2225800 or WhatsApp 07378 606 728 Monday-Friday 0915-5pm. They're very knowledgeable and have much more time to listen than GPs etc.
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