I'm very new to this and haven't been diagnosed as asthmatic yet - although reliever and preventer inhaler do seem to be improving my symptoms (cough, wheezing, tight chest, difficulty taking deep breaths).
I have also had what I've assumed to be an allergy for about 10 years now, which gives me a very itchy throat and lip, and sometimes will cause my nasal passages to become so inflamed they totally close. I've never been able to identify a trigger for this, it seems to be caused by many different things multiple times a day/night - from temperature and mood changes to certain foods and smells. I've noticed taking ventolin for asthma symptoms seems to give immediate relief of these allergy-type symptoms, which is very strange!
I know allergic asthma is a thing, but I'm confused about why ventolin would stop the apparent allergy symptoms (rather than just treating the asthma)?
I just wondered whether anyone has experience with similar symptoms and if this could be linked to asthma? If I could finally know a cause of my allergy symptoms and be able to manage them more effectively, that would be incredible!
Thanks!
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LoopyLux
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Ventolin is a bronchodilator and, in essence, relaxes smooth muscle allowing airways to open. As an inhaler it’s more a direct effect in your lungs, meaning it mainly works on the area that absorbs the drug (ie your airways), then takes time to be absorbed and ‘spread’ by the blood stream.
This is why having good technique is needed as all the salbutamol going into your tongue/back of throat will do little to nothing as there aren’t the right receptors there. IV salbutamol can be pushed straight into your blood system and that will have a more global affect and work on more than just the resp system. This works on β2 adrenergic receptors to dilate your blood vessels - which then allows your body to ‘send’ whatever it needs around the body quicker, as well as being a bigger dose to have a more ‘dramatic’ affect on the airways.
Ventolin technically doesn’t work on the cause of the inflammation, so in anaphylaxis (for example) it will have little to no effect if the airway has completely closed, and if it’s still open it won’t stop the allergy developing.
Allergic swelling is typically caused either by histamine or mast cell release/‘exploding’. In asthma/in the lungs, this can then have a ‘small’ amount of swelling which is why in mild allergic issues vent can work as the airways are still open enough for the salbutamol to reach where is needed.
Normally/naturally β2 adrenergic receptors would absorb adrenaline to work. Adrenaline is used in anaphylaxis - maybe for you ventolin is allowing your body’s natural adrenaline to work more efficiently so calms the extreme swelling that way?
There is also confusion however between an allergy and a trigger in asthma. Some people will think all their triggers are allergies but (usually) this is not the case. For example personally I am not allergic to exercise (I do not get rashes and other symptoms like runny nose and watery eyes and sneezing), however it does trigger my asthma, I am allergic to cats (I sneeze etc) which can trigger my asthma, but I’m also allergic to real Christmas trees (contact rash and hives) however I can’t remember if they’ve ever triggered my asthma!
From the sounds of it your having a more anaphylactoid issue than an asthma issue, however as your airways are remaining open your body is still able to absorb the ventolin which can then have a positive knock on effect.
Plus bodies be weird 😉. Don’t forget you are also taking a steroid inhaler now. That builds up in your system and is a major anti inflammatory- steroids are a treatment for swelling caused by allergy etc. It could be a combined action of both the steroids already working to ‘fix’ the problem more easily, and the ventolin dilating things slightly again speeding up recovery 🤷♀️🤷♀️
Have you seen/been investigated regarding the random swelling/allergy thing? Have you been suggested any treatments like regular and ‘emergency’ antihistamines? It does sound like it could be a form of idiopathic angiodema (random swellings of things like face (lips/ears/nose etc) throat, genitalia, palms and soles usually - I have angiodemia 😅), but it’s good to make sure it’s not something else like MCAS that’s developing (random anaphylaxis- a friend has this).
Anyway... hopefully this has helped a little?? 😅 but if you haven’t mentioned to your doc yet about the swelling please do - I’d advise you to take a photo of it at it’s worse so they can ‘see’ what happens during flares (you can offer to email it to them if it’s a phone consult). Hope things calm for you soon.
Thanks so much for this! Really interesting, I'll definitely mention it in my next appointment. I've been to the doctor before for the allergy-type symptoms, but they didn't find a reaction to any common allergens. I was subscribed fexofenadine years ago but didn't get on with it and no longer take it. Good idea to take a photo of the swelling, I will do that!
Do you take any other antihistamines? Some people get on better with the likes of chlorphenamine than fexofenadine. I know of someone who has tried all sorts but went back to this and it was really helpful for them.
Thank you - yes, I've just been taking piriton (which is chlorphenamine) when symptoms are especially bad and it does give some relief. I'd love to get it sorted properly, it just always seems like such a weird/vague problem and GPs haven't seemed at all interested in the past. Should probably try again!
Maybe try it regularly for now? Or try a once a day one like cetirizine. Keeping things at bay might help - a bit like regular painkillers are better for ongoing pain than waiting for it to "be bad" and then having more to tackle.
Thank you for your question and the answers you got - I have similar problems and have never really got to the bottom of it. I’ve seen loads of experts over the years who reckon it is a mast cell response to a variety of allergens including chemical ones like perfume but the biggest help has been asking to talk to the ‘asthma nurse’ at my doctors. For one thing they have the time to listen and for another they do really know their stuff. I hadn’t realised just how many different inhalers there were. Mine put me on Duoresp which has made all the difference.
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