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How to know if I need steroids?


I'm new here, unfortunately I'm not new to asthma. I have been diagnosed with mild-moderate asthma since young childhood, I don't have mild asthma attacks, or even moderate asthma attacks, I have severe-hospital-admission type of attacks for no apparent reason.Like a lot of asthmatics, I am struggling with the hot weather, my chest is near enough constantly tight and painful. I'm getting short of breath a lot easier than normal. I take salbutamol and seretide inhalers. I have upped my seretide as directed by my resp. consultant and I'm taking my salbutamol 3-4 times a day, for a few hours afterwards, my chest feels better but once it has worn off, it feels worse than it started. I haven't needed prednisolone since this time last year when the weather was hot and causing issues. I have upcoming surgery which won't be performed/will need rearranging if I need any steroids between now and then so I'm not wanting to take them if I don't 100% need them. my peak flow is around 70-80% of my personal best at the moment, getting up to around 90% after taking salbutamol.

If you have managed to read all of this - how do I know if I need steroids?

Thank you.

4 Replies


And welcome!

I got an action plan telling me when i need steroids and also i can ring the respiratory nurse or the gp or a walk in centre . Cannot really say u need steroids or not. But to me i get given steroids any time i see any dr as my peak flows are generally low and salbutamol only brings it up for a while and cannot keep using that much salbutamol the whole day every day its dangerous ?. (the cons shouted at me for taking too much salbutamol!) but maybe ask someone. I take steroids when my peak flow falls to 70% and below according to my plan. But i am a brittle asthmatic so my peak flow is up and down so i only start on it at home if it stays like that for a day .

Hope this helps

And that you get better



Thanks for your reply; I've spoke to my doctor and have got an appointment at 5:20pm today.


Hi Emma, why would your surgery be cancelled?

If it's because of adrenal suppression, you/they should be aware that patients on high doses of seretide often have adrenal insufficiency anyway.

I had a fairly major op around 4 weeks after one of the worst exacerbations I've ever had - and they just gave me extra steroid cover for the procedure. Though if my chest had been bad during the week of the op obviously they would have delayed it.

I think you would be better off to get the steroids in, get your chest sorted and go from there - starting an op with a tight chest isn't going to work very well, so the op may end up being cancelled even if you don't take the steroids.

I hope your GP is helpful,



The nurse who did my pre operative assessment said with my history (repeated A&E visits and hospital admissions from attacks), the anaesthetist may not be happy doing the surgery as a day case even if I behave myself, I was told that it's almost certain I won't be allowed to have it done as a day case if I end up on steroids/in A&E/admitted to hospital. I've been waiting forever to get it done, I really really don't want to get it cancelled because of stroppy lungs.


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