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Asthma UK community forum
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Low peak flow reading

Hi. I'm 52 and had asthma for years. Been worsening. Peak flow was 450 two years ago and now it's 250 max. My lung function tests are normal which baffles me a bit. Strong family history of asthma and Mum has COPD. Anyone any ideas or experienced this themselves?

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450 to 250 is a big drop in 2 years. What does the GP say? Or Asthma Nurse? Have you been looking after yourself? By that I mean not smoking, eating a good diet and exercising those lungs, taking you medication as advised, Including your preventor meds?

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Asthma nurse didn't seem concerned as lung test ok. I don't smoke and never had, eat healthily, have an active job . Family history of a connective tissue disorder though so trying to work out if there's aconnection or whether this is a normal drop.

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Accurate diagnosis of Asthma, Chromic Bronchitis, COPD, Asthma / COPD Cross-over etc will be important, as the degree of airway blockage reversibility that's possible will usually be linked to that diagnosis as well as to the extent of airway remodelling which has occurred. The usual Spirometry Tests and / or evaluations using courses of Oral Steroids to ascertain by what, if any, degree airway blockage reversibility might be possible, should have been carried out - or be ongoing.

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Nurse did say to ask for referral re connective tissue disorder rather than referral for lungs.

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Are we talking about JHS or EDS here? I'm interested in this as I was diagnosed with JHS/EDS hypermobilit type a couple of years ago (like you I'm in my 50s). I must admit I've wondered whether my lungs have been affected by the condition but so far no one has made any suggestion that it might be. I am, however, currently under investigation for digestive tract issues that might well be connected to it.

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The top docs believe JHS and EDS3 are the same. Digestive problems are likely to be connected. My son is under Royal Lindon for his gastro/ bowel problems. I think there's been research that doesn't show definetly lung probs are more prevelant in EDS community than other people but do t think enough research has to been done to be definite.

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I once asked a retired consultant cardiologist, who was teaching me anatomy as part of a teaching qualification in dance at the time, what caused exercise induced Asthma (this was about eighteen years ago). His response was that it wasn't really understood, but he wondered (and he stressed that this was his personal opinion) whether the autonomic nervous system might be involved. Given that it's well understood that JHS/EDS can affect the autonomic nervous system I do wonder whether there is a connection.

Of course the problem for the researchers is that EDS isn't that common to start with, although the hypermobility type is the most prevalent variant of the condition. And then again, like asthma, EDS hypermobility type can vary quite a bit from individual to individual, which is going to make it difficult as well.

Perhaps coming from the other direction might be an interesting starting point. Has there, for example, been much research on the role of the autonomic nervous system in asthma?

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How do you feel in yourself? What do you mean by the Asthma Test was OK? Did she do a proper Spirometry test, and if so, what was your FEV? Did the nurse confirm you have Restrictive Airways Disease (Asthma)? I can't comment about connective tissue. I can tell you that in 3 years I have gone from 300 to 180 - 200, but then I have had Severe Asthma all my life, and now have Lung Obstruction as well as Lung Restriction. They are now realising that in Severe Asthmatics there is an overlap between Asthma Restrictive Lung Disease and the remodelling of the airways due to all the infections resulting in Bad Asthma Attacks causing Obstructive Airway Disease (COPD), which is why Severe Asthma comes under the Umbrella of COPD now. I hope some of that makes sense and is helpful? I am in my late 50s. There are loads of different meds out there nowadays to control Asthma, so if you are still having difficulty, go back and ask for a referral to the Asthma Clinic or Respiratory Team.

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