Peek flow

[Sewquick]

Hi, does anyone else have this problem my peek flow is nearly always good but my asthma is terrible

[Lysistrata Administrator Community Ambassador]

Hi, this definitely can happen, as peak flow can be more helpful for some people with asthma than others. Mine drops in a severe attack but only really to low yellow zone, not super low.

When it has gone under 50% of best it wasn't actually my worst attack by any means - I've had worse when it was at 60% best, as it's just one measurement. I find for me it's more about how it's responding to treatment. When I'm better it responds more and stays higher for longer. If I'm really struggling then the treatment won't last or increase it much.

Do you know your best peak flow? Just asking in case you're only comparing against your predicted for your age, sex and height. Sometimes that can be similar to your personal best - but for some people, their predicted and actual best can be quite different - my predicted is 71% of my best! You definitely need to measure only against your own actual best if you know it, even if medical staff tell you different (they don't always know how it works).

You may find this post helpful with more details about peak flow: healthunlocked.com/asthmauk...

[Emaych61]

I have had this and in my case it turned out that the problem was not caused by my asthma. I spent four weeks wondering why I was having breathing issues (not serious, but definitely annoying and very tiring) when my peak flow was fine and my inhalers weren’t hitting the problem (including ventolin - or rather the ventolin did help, but only for about half an hour at most and then the breathing problems returned). Eventually, in desperation I went to my GP. There were a couple of unusual - and notable - characteristics which the doctor I saw (not actually my GP, but a locum) picked up on - and top marks to him for working out what was going on. Firstly, the breathing issues were coming on within about forty five minutes of consuming food or drink and secondly, standing up and moving about - even jogging - helped (unusual for someone who is known to have exercise induced asthma).

So what was going on? The problems I was experiencing were not caused by asthma, but by reflux which can cause very similar symptoms. As it happened I had been referred to a gastroenterologist about four years earlier because of digestive issues and the locum picked up on that. I was put on medication to help with reflux and the problem was solved.

I still get breathing issues resulting from reflux (I’m going through a difficult patch at the moment having had several months of nothing in that area) and I’m now under consultant led gastro care whilst they try to work out what’s going on. It’s annoying because it is often very difficult to work out whether it’s asthma or reflux causing the problems- at least at first. I’m getting better at working out which is causing breathing issues, but even after years of knowing it could be either, I can still get it wrong.

[The_oldman in reply to Emaych61]

I've had serious gastro issues since 2018, my consultant tells me this is one of the factors in me getting asthma, he recons it's from a combo of gastro problems, long covid and allergies. I guess it's the acidity in your breath.

[Emaych61 in reply to The_oldman]

There’s been some research going on trying to establish whether there’s a link between the two conditions: it’s not unusual for asthmatics to get reflux issues. I’ve had asthma for over five decades; the reflux began after four decades of it so the reverse of what your consultant says has happened to you.

I have had covid, but did not get long covid (thank goodness) and we know (because it’s been checked) that I don’t have food allergies (other allergies yes, but not food). There may be an intolerance to some types of shellfish (molluscs) and I’ve had an allergic response to iodine contrast dye but I’m careful to avoid the former and the iodine allergy is flagged up on my medical notes.

In my case we now know I don’t have acid reflux, but there is such a thing as non acid reflux (pepsin reflux, bile reflux) and I’m currently awaiting test results for that. Whatever it is it is getting in to my windpipe and irritating my lungs.

[The_oldman in reply to Emaych61]

Yeah I have bile reflux as well, no gallbladder to store it, I was taking a bile binder but has to stop that as it shot my triglycerides through the roof. My esophagus packed in a few years ago as well so I'm on esomeprazole twice a day, plus famotidine and shed loads of gaviscon. Just about everything irritates my lungs at the moment, I'm on 2 different steroid inhalors but they've not having much impact.

[The_oldman]

I've only recently developed asthma, at least that's what I'm told it is, my normal peak flow is around 700, and my lungs still feel like sh!t. I didn't do a test when my chest was really tight because I didn't want to aggravate it more, I got a shock when I tried it just last week and it was only 400, I thought since I can actually breath it'd not be affected that much. But my lungs can feel aggravated with a high peak flow reading.

[Patk1 in reply to The_oldman]

Have u tried adding in antihistamines

[Birthday60]

there is considerable evidence that asthma can be mistaken for acid reflux breathlessness and many asthmatics do develop acid reflux . Worth following up with this possibility. A Peak flow reading on its own isn’t helpful but is worth recording daily and noting down significant events - it’s the trend and peaks and troughs that are key. I discovered I was reacting negatively to Chinese food, orange juice and an aromatic candles through tracking. I never hit more than 75% of my age,gender, height norm when I was in full time working but when I retired and started to really push myself by walking briskly uphill I was surprised to find I got super fit and achieved a peak flow of over 110% of my norm!! I’ve had severe and brittle asthma since I wax s baby…

[My_fairy in reply to Birthday60]

how did you manage brittle Asthma? Were You able to keep it in control? Thanks I would wait for any advise or tips as my daughter has bad asthma

[Mandevilla]

When you say that your peak flow is nearly always good, do you mean compared to your good or to the standardised charts?

Mine is abnormally high for my height and age - pre diagnosis, I would have my peak flow checked at A&E and be told it was ok, but when I'm 'normal' according to the standard charts, I'm actually at the lower end of yellow or nudging into the red!

[SuziElley]

This is usually the case with me, although it will drop significantly if I have a really bad attack as well as chest infection. My asthma nurse is sensible and tells me she treats the symptoms not what that piece of equipment says.

[Hidden]

Peak flow doesn't work will all asthma, especially if it's lower half airways effected I believe it is.. this is how bad and outdated the medical system is, they should know this and not rely on a peak flow or oxygen readings

[Poshcards]

should I be worried as my peak flow is 260 max x

[Mandevilla in reply to Poshcards]

That does seem very low - is this a peak flow you have taken at home? If it is in the surgery, then they should tell you if there is a problem. If you have taken it at home, then you might not be doing it properly, or your peak flow meter might be faulty.

[Mandevilla]

Do you have an asthma action plan? That should tell you what to do if your peak flow drops below normal for you.

[JackLina]

I did and for years I kept taking the inhalers. It turned out to be a number of food allergies

[Hamscoul]

My Asthma is always like that. My peak flows don't drop but my symptoms were dreadful. My GPs would take my peak flow but base my treatment on my symptoms and what they heard when I was examined. They noted that I presented in an unusual way. I would always explain that to my GP or nurse or consultant.

[My_fairy]

how about your oxygen level? Does it drop?