Is the doctor right?: Hello i had a... - Asthma Community ...

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Is the doctor right?

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Hello i had a check up today and when i asked to have my adrenal gland and calcium levels checked as i have been on steriods for 2 years he told me 'we do not check these routinely on the NHS as the steriod inhalers are minimal in your blood stream, so we dont check anyones' is he right? im sure i saw on the forum somewhere last year recommended to get them checked?

he also told me that he didnt know where i could for food allergy testing, it would have to be private... i asked if he could recommend some and said he didnt know but he woulds find out... maybe he ahd an off day?!

Kel xx

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I have been told before that the inahled steroids are very low level in your blood. Not sure if its different for people who also take tablets on a regular basis as I only usually need these a few times a year

Steroid inhalers are in extremely low concentrations in your blood stream, unless you're on very high doses (>1200mcg beclomethasone equivalent per day) for long periods of time. Even on this dose, it's unlikely to cause adrenal suppression. As a reasoned approach, unless I had reason to suspect adrenal suppression for other reasons, I wouldn't worry about checking for adrenal suppression in people on inhaled steroids.

As for food allergy testing, unless you have specific symptoms to tie an allergy to a foodstuff it can be a true fishing trip to try to identify allergies via blood tests. I would be wary of commercial testing for ""food intolerances"" as these can be quite different from allergies. The best way to identify allergies is via careful tallying of ingestion of foodstuffs against symptoms, then a blood test for that specific thing may be able to identify positively or negatively an allergen. However - even specific IgE testing does not necessarily correlate well with actual symptoms (many people will tell you about coming up as being allergic to cats/dogs etc on these tests but not actually having any problems from exposure to cats/dogs), so some may argue it is a fairly futile exercise...feel free to discuss!

adrenal gland and calcium levels...

I'm allergic to steroids; they cause oedema, heart problems, arthritis, and funnily enough crumbling bones (Osteoporosis) due to calcium deficiency. It's not what dosage of steroids are in the inhaler that you need to worry about, it's what they are doing to you. So I have the blood tests done every three months unless I have to up my inhaler dose, then the bloods are checked monthly.

Those nice little inhalers have changed me from an athlete (hill walking, rugby, hockey, cross-country and track racing) into a walking-stick wielding Mr Blobby, who has difficulty walking 30 metres. ;oD

If your GP won't fully check your bloods then DEMAND to see your Consultant - you should have one.

Hi kelwoo

Just seen your post and would say i would disagree with two peoples replies.

I would say if you want to be tested for allergies as your GP to refer you to an immunologist. A good way to locate your nearest one is to ring allergy uk (google them) and ask them for your nearest NHS one, for there name, there hospital and there secretaries number. Following this ring the secretaries number see where the consultant immunologist does consultations. Then go back to your GP and ask to be referred to see them. This was exactly how i did it and i am on waiting list to see one. You cannot be too careful with asthma and allergies that was words of allergy uk.

Also steriod inhalers are really low and do not cause damage in very many people, only a few unlucky ones. If you take prednisolone tablets reguarly (ie daily for a year) then they will test you but they wont do it before. I have only been tested for the first time this year.

Plumie

adrenal gland

Hi,

I would insist on having your adrenal gland and calcium levels checked. They thought I was anorexic for years before by accident they checked my adrenal gland and found out it was not working because of all the high dose steroids I was on. I could have died I was so thin and the doctor said that if they hadn't caught it in time I could have collapsed and died. Also I have osteoporosis because of the steroids. I'd definately go back to the doctors.

Good luck

Helen

Change your GP

Sadly, some, not all GP’s have a ‘blind spot’ when it comes to Asthma, back pain and some mental illnesses etc – Find one who cares!

I just want to clarify a few things.

This post is about normal dose steroid inhalers, not high-dose, and not steroid tablets. However, if you have needed more than three courses of steroid tablets in the past year, then you may be more at risk of steroid side-effects.

Grafxart, you obviously have significant problems with steroids, but these really are the exception, not the rule. Also, most people with asthma are managed well within primary care and it is only the more severe patients who require consultant input. Of course, that is not to say that if you wish to see a consultant you shouldn't be able to - of course you should. But many people with asthma do not have, or require, consultant care.

Cath, I think the problem comes from having a disproportionate numbers of people with difficult to control asthma. Certainly when I was just a bog standard blue inhaler girl I did not know of these forums existed. It is easy to assume if you are not being seen by a consultant something is going wrong, as you point out the vast and I think we really are talking vast numbers of asthmatics are managed very well by their GP surgery. I have 7 immediate members of my family all of whom suffer from asthma and I am the only one who is under the care of a consultant. I suspect my eldest son should be he uses far too much ventolin for my liking but he is 21 just got a new flat, is doing well in work so apart from me he is too busy enjoying life with his GF. Hopefully at some point a GP will pick up how many inhalers he gets through now he has moved away he can't just pinch is brothers and sisters so I think he trip an alarm at the new GP's surgery soon.

Hugs

Bex

Good point, Bex. By its very nature this message board is more likely to attract those at the more severe end of the spectrum. The suggestion that all asthma sufferers should be under a consultant is just plain wrong.

Looking at the meds Kelwoo says she's on in her profile, her asthma should be more than adequately managed in primary care - although as mentioned by one of the other posters below, not all primary care is equal!

Hey all,

Yes do not have a consultant as my asthma is controlled. Doctor is perfectly good for me! he is going to call me back today anyhow as I have a few things he needs to check (my acid reflux being the worst for now) it gets complicated at what to look at at what time...

im sure if you are on high level steriods you will have a consultant that will know what to check for...

many thanks!

kel xx

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