Should I reduce or stop my running? - low peak flow and low oximetry readings recently & after running

[atreeon]

I've recently been running more and more in preparation for a half marathon. However, my peak flow has dropped and I've been taking more ventolin and more becotide inhalors. I'm male 5'7'' 44yo and my good peak flow is about 450 but the best I've blown in the last year is about 430. Good for me is blowing consistently over 400 and not using my ventolin at all.

The last couple of months, as training has increased, I've seen my peak flow average 360 and only managing 320 a few times. After I go on a longer run my peak flow seems to be worse the night and day afterwards. I have been using an oximeter.

kinetikwellbeing.com/respir...

and that has also been showing low spO2 results especially in the night and in the mornings when I wake (sometimes I see 85 briefly but mostly around 90-94). Once I'm up and walking around it is usually back up to 95-98ish. When my peak flow is in that good state of being consistently above 400 then the spO2 reading is usually consistently high too even when I wake up.

My question is, should I stop running? Reduce the amount? Or continue? I'm thinking I should really reduce the kms I've been doing and maybe just run 4-5km a couple of times a week and go very slowly. My heart rate during running rarely goes above 160bpm and usually averages 140bpm so I'm not pushing myself too much.

I don't smoke, avoid all known allergens, try to avoid walking on polluted roads (although I do live just off an A road in the middle of a city), I take my peak flow regularly, take my inhalers regularly, use a spacer, wash my mouth out, I eat healthy foods and even do yoga a couple of times a week.

I spoke to my GP, he said to continue running but I should see my asthma nurse for a checkup although there are no appointments in the next month (I don't think he really listened to my problem though). When I have seen an asthma nurse they tell me to double my inhalors but if I take more than four puffs of becotide a day I seem to always get a really bad sore throat so I am influenced by this to not take more.

[twinkly29]

Using your recent best of 430, your usual of 360 is still 84% of that 430 best, so well in to your green/safe zone. Even the occasional 320 is 74% which isn't hugely concerning as a one off. If you are symptomatic when this happens then use your reliever inhaler and that should help. If you then redo your peak flow 15 mins after doing so you should see an increase (if the symptoms are asthma related).

With the oxygen, I would ignore it to be honest. Oxygen levels are not reliable as a tool in asthma - the readings can easily be wrong, they can remain good when someone isn't well, they vary naturally anyway, they drop naturally at night, and all sorts of other things. So I would ignore those (as in not worry about those but go on symptoms/peak flow instead).

However, I do think it would be a good idea to get am appointment when you can with the nurse for a review as it sounds like you're needing your reliever to exercise so they may tweak your preventer meds so you don't need to do this. In the meantime it's ok to use it afterwards if you need it or to use it beforehand. With asthma being niggly (or even after an exacerbation) it's common for people to have to moderate what they do according to how they feel - at the time, immediately after and in the next day or so. But I guess you can only go on how you feel - maybe have more rest days or do something less intense when you need to. Do you check your peak flow afterwards because you're symptomatic? If you're not symptomatic I would just leave it and go on how you feel for training. Sometimes over-tracking things doesn't help (not saying that's you but I know of people who track sats and sleep and all sorts and it just becomes the focus).

With the becotide, do you use a spacer? If not this might help the sore throat. Other things that help are rinsing the mouth or gargling after using it.

Not sure if any of that is helpful!

[Nmstoday]

The other thing I would add to Twinkly's comments is do you have hayfever/react to pollen at all as your peak flows look as if they start deteriorating around the time the pollen started rising. Is it worth trying an antihistamine to see if it makes a difference?

[Jodu]

I used to get quite wheezy during running even beyond the hayfever season. I kept going to my asthma nurse and they put me on a combination inhaler with preventer and long acting reliever. I'm on Relvar ellipta but there are others. Initially the lower dose but then higher dose. This did settle my symptoms and now I use my reliever 15-20 min before running and I'm usually ok throughout.Definitely see the asthma nurse.