Still don’t really know if I have asthma or not

[Blueforest23]

Hi, I know I’ve posted similar to this before but I suppose it’s because I don’t know where I stand in terms of breathing/ asthma status

I do also have anxiety which I’ve received help for but I still feel on edge with the whole I might have asthma thing. I have had tests which haven’t revealed anything but then I know that asthma is hard to diagnose unless it’s obvious. Sorry if this seems a bit pathetic but it might be easier if I list some Fors and againsts why I think I could have it and hopefully it will make sense why I’m still anxious.

For

I have always had a low peak flow - my best is 320 (260 at the gp’s which has a larger mouthpiece). I remember back at school it was this low.

I have chronic rhinosinusitis with polyps - only mild to moderate apparently but it’s there and up to 60% with this condition develop asthma.

Family history - my dad developed asthma/nasal polyps in his 40’s

Blood eosinophils have always been on the high side (0.5 or 7%) All allergy tests were negative though

I have had occasional symptoms years ago. Once after a run in hot weather I suddenly felt dizzy, sick, anxious and like I was breathing through a straw for about 1 minute. It was very scary. Over the past year after a covid infection I have had times where I felt I wasn’t taking in enough oxygen - though this has eased off quite a bit now

Often when I get colds I can get a cough which lingers for weeks and sounds horrid - people have made comments that I have a chest like a smoker/asthmatic

On a cross country run once a girl ran past me and asked if I was ok/if I had asthma as I was wheezing. This was 5 years ago I went to my gp about it he gave me salbutamol but I never felt I needed it

I did a mini trial myself - I took 2 puffs of my blue inhaler and my peak flow went from 310-350

Against

My breathing is mostly clear I don’t have classic symptoms of asthma (much has been linked to anxiety)

Spirometry normal (I know it can be normal with asthma)

I trialled a brown steroid inhaler for 4 weeks my gp then retested peak flow and it didn’t change

I have been measuring my peak flow variability it is always within the 290-320 range. I have measured it after exercise still no change

I can exercise intensively and my breathing recovers quickly as expected. Though before exercise I am often a bit wary (likely anxiety)

This may sound sad but I’m just being honest. I just find it difficult to have confidence in my breathing with having the rhinitis/polyps

[Chip_y2kuk]

I'm in a similar boat but it's been decided at the minute that .... I do have asthma.

It's taken lots of tests... ive had two bronchial challenges in different hospitals (methacoline and mannitol) to definitively prove asthma (I didn't react)

My peak flow is always a little on the low side

I don't wheeze often (and if I do it's normally not good)

However the asthma team has also decided that I likely have a "mucus asthma phenotype" (it was written in one of the letters) and my biggest symptom is the mother of all coughs (because of all the mucus)

I've had my symptoms blamed on anxiety (they aren't anxiety for me)

What im really getting at is you can "be out of the normal" and still have asthma (the issue normally is convincing doctors that your breathing issues are breathing issues and not other things, some doctors are really good at listening and others are shocking)

[Patk1]

Sorry I can't help except to say there is a condition,and many people here with breathing probs develop it- health anxiety.anxiety of any kind is tough on breathing.there is a technique called " controlled pursed lips breathing".if u feel anxiety affects Yr breathing,its v helpful,and also if Yr out of puff or breathless.read up on it on aluk website and practise it, so u remember to slip into it whn needed.let us know how u get on x

[Dilly1958 in reply to Patk1]

Excellent advice

[ellamental]

I think anxiety can cause asthma but then if you can't breath that is very stressful/anxiety making so it is a hard one to measure. Can anything be done to help your rhinitis/polyps? Def worth keeping an eye on your Eosinophil count as if your asthma continues to be hard for you... you could be considered for the biologic injections. I am on fasenra and it has been life changing for me. Good luck with it all.

[Dilly1958 in reply to ellamental]

There are lots of reasons behind asthma - allergic, bad chest/infections after colds, excercise induced and anxiety induced - it doesn't make it less bad.... as a child I was NEVER asked to be a bridesmaid as everyone acknowledged I would get excited and go down with an attack!! My time as Angel Gabrielle in the Christmas nativity was limited and there was always an understudy. What I am trying to say is that of course somebody may have anxiety asthma - doesn't make it less worrying or not needing care but is more easily assisted with breathing and relaxation techniques that are well known these days

[Mandevilla]

Can you try looking at it the other way? Even if you DO have asthma, you've been issued with the Ventolin, which is what you need if you do have an attack, so maybe instead of worrying about a diagnosis, keep working on managing your anxiety and on living a healthy lifestyle. If your breathing issues are only occasional and mild anyway, it's unlikely a GP would issue you with more than Ventolin even if you did get a diagnosis.

I had asthma for a good 30 + years before I was diagnosed, went to A&E multiple times and was dismissed with no treatment at all and being told I either suffered from anxiety or from a virus. But even though it took me so many decades to get diagnosed, I'm still here! I was able to live, for the most part, a normal, active life until Covid turned it from an occasional issue into a daily one.

I don't mean this to sound dismissive of your concerns in any way. Merely to point out that you probably would not receive any more in the way of medication even if you have a diagnosis. And that many people live happily for many years with undiagnosed asthma. So you really don't need to worry as much as you are doing.

[Blueforest23 in reply to Mandevilla]

Thanks, maybe I am looking for answers too much I guess seeing asthma as being more on a scale rather than something you either have or don’t don’t helps. I’m just very black and white thinker.

Yea maybe the treatment wouldn’t really change if I had an answer.

What I’ve always found odd but has been dismissed by ent/immunology is the blood eosinophil count which is always 0.5 - 0.6. From guidance and stuff Ive seen online only very few people have a count this high and over 0.3 is the cut off point for indicating either severe eosinophilic rhinitis or qualifying for biologics with asthma.

I do annoy myself (and likely others) ruminating other this but it sort of seems that you have to look out for yourself these days

[Mandevilla in reply to Blueforest23]

Have you tried calling the helpline to talk through your concerns? They may be able to advise if you need to push for more tests or if you are ok just to carry on as usual, keeping your Ventolin handy.

You're right that asthma can be on a kind of scale. Some people are unable to live a normal life even on maximum medication. Others carry on totally as normal with just a Ventolin inhaler for the odd 1-2 times a year they experience symptoms. And there's a whole range of people in between. Obviously, everyone from the most severely affected to the most mildly affected has asthma - it's just a case of what treatment they need. And if you haven't had symptoms for a long time, I doubt you'd get anything more than Ventolin. Most doctors tend to be keen on avoiding over-medication.

I know it can be helpful to 'know' what is causing symptoms, but on a practical level, if you are not getting symptoms that often, knowing is unlikely to change your life that much. So try not to worry about it.

[Blueforest23 in reply to Mandevilla]

I did contact them last year when I had issues which in hindsight were gastric reflux in nature, I just didn’t know at the time as they were new symptoms. They were very helpful I’l prob give them a call though I can imagine they will just tell me to go for further tests

What you say is right, thanks

It’s little things that make me worry, for example usually I can exercise, jump and run absolutely fine. However today my mobile started to ring and I went upstairs to answer it (11 steps) at the top of the stairs I couldn’t catch my breath enough to talk I had to ask the caller to give me 20 secs to get my breath (felt like an old woman : D) During this time my breathing was becoming more gaspy like my breath started to run away with me then the feeling of dread/anxiety kicked in. I know it’s normal to be breathless to an extent with stairs but how much so. It resolved enough to talk after about 20-30 secs and fully went away after 3 mins. All through the call I was worrying about my breathlessness

I checked peak flow as I’ve been doing it was the same as usual. It made me think of that is/or is anything like asthma it’s f***—- scary

Since then I’m worrying if there’s something going on on but then part of me tells me that I’m being stupid

It’s little things like this that get me worried it’s like I’m scared of my own shadow 😒

[Patk1 in reply to Blueforest23]

Again,anything u find that upsets Yr breathing,like stairs - prepare yourself,controlled pursed lips breathing, and..take Yr time,slow down.itll make life easier & perhaps calm Yr reactions.x

[sciencepotato]

Maybe worth asking for mannitol challenge test. Often is useful for asthma diagnosis!

Good luck!