As suffers from Respiratory Disorders, most of us make a 'trade-off' (be it an unconscious one) by accepting the risks of both Oral and Inhaled Steroids in order to reduce some of the breathing difficulties experienced with our condition.
Having recently become aware that 'Inhaled' Steroids can give rise to the very same issues as Oral Steroids, I think this is a topic worthy of discussion and consideration.
Because the pathway for Inhaled Steroids is said 'not to be' systemic, many assume that they can therefore discount the types of systemic issues that occur with Oral Steroids but - from what I've been looking at - it seems to be the case that even doses of Inhaled Steroids that are 'not' consider 'high' can - when taken regularly - bring about the same problems as Oral Steroids.
Inhaled Steroids and / or the co-factors that manufacture's need to include in the Inhaler, can also sometimes irritate the lungs, possibly triggering or contributing to Respiratory Difficulties.
There are some Respiratory suffers that Steroids (Inhaled and Oral) seem to do little or nothing to help (because they are Steroid Resistance) - but who end up taking them anyway, often because the simplest and most cost effective approach from a treatment perspective is the 'suck it and see' one.
I don't know if there's a Test you can ask for that will categorically disclose 'up front' whether you are a 'steroid resistant type' -and whether steroids (i) cannot help you, (ii) can only help you a bit, or (iii) will only be of use at very high dosages - but I for one, would like to know 'to what extent' Inhaled Steroids are capable of reducing my symptoms - and to have such a 'Test' to address that question if it's feasible to do so.
It's tempting to jump to the conclusion that if (for 'example' only) you are on an Inhaled Steroid Inhaler, and are feeling 'better', that the Preventer Inhaler must therefore be contributing to the ease of your symptoms. While, undoubtedly, that will be an 'accurate' assessment for many suffers, here's 'just one' example (there may well be others) where things are not quite that straight forward .
Consider Duel Inhalers, that contain both an Inhaled Steroid and a Breathing Relief Drug, i.e. Long Acting Beta Agonist (LABA) which give you around 12 Hours of Respiratory Aid.
If you're taking such a Drug (typically) twice a day, you're getting 24 hour 'round the clock' breathing assistance from the LABA Component - so how do you know if the Inhaled Steroid Component of the Inhaler (which the LABA is combined with) is actually helping at all - or whether it's possibly even hindering? My understanding is that, for safety issues, you 'cannot' be prescribed a LABA Inhaler without an Inhaled Steroid Drug being included in the Inhaler Device, which means that you can't simply switch to a 'LABA Only' Inhaler to see if you feel just as good without the Inhaled Steroid that's always included.
I fully accept that Steroids (Inhaled and Oral) have a vital role to play in many people's treatment regimes, but it's important to be aware of the risks posed by these drugs, and to establish:
a) if they are actually helping (and to what extent)
b) protocols for getting down to the absolute minimum dosage
c) what, if anything, can be done - in advance - to preempt the impact on adrenal function
d) what Tests to expect and ask for regularly, to asses any damage steroids are doing
e) what regular medications, vitamin supplements, diets, exercise regimes, life-style strategies etc, are the most important for mitigating some of the negative effects of steroid use (whether inhaled or Oral)
Steroids make many lives bearable that would otherwise be intolerable, but non of us can afford be indifferent or lazy about acquiring a thorough understanding of the 'negatives' of taking them, nor about seeking guidance and assistance from medical professionals to ensure everything reasonably possible is being done to protect against the downside of a medicine regime that includes steroids in any form.
All thoughts welcome (and thanks in advance for sharing your views).