NRAS
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Shortness of breath?

My RA is still active since I just was diagnosed over the summer and have only been on Leflunomide about 6 weeks.

I’ve been having shortness of breath this last week. It feels like I’m not taking deep enough breaths, when I’m just sitting there. I then breath deep. It doesn’t hurt and I’m fine but the feeling of not breathing deep enough returns.

I went into after hours yesterday. Lung X-ray was clear. They gave me albuterol.

Has anyone ever had this? I’m not sure it’s even related to my RA.

17 Replies
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It might be a good idea to contact your rheumy and mention it as soon as possible just as a precaution darling.xxxx

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I did call him but he wanted me to go into after hours to rule out pneumonia or the start of the flu (both negative).

Thanks for the advice, I should call him again though, if I still continue to have problems. My next appointment isnt until the beginning of December.

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Albuterol is something a friend of mine with asthma has to help her breathe. I think it's also used for people with lung problems.

But lungs are important, so do follow up with your rheumy to check it's not a side effect of the Leflunomide. And also maybe go see your GP. You could ask about seeing a lung specialist if this doesn't improve?

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Hi I am on them pill and have been out of breath sins March, been for x-ray, asthma test both ok and ra nurse was not interested. Some day feel ok.

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Hiya cheshcat. Even though the lung X-ray was clear I would still report your symptoms to your Rheumy team as the disease itself can cause lung issues (as opposed to the meds we take). That said LEF is one of the meds I take, I was asked to have the pneumonia jab before I started it & checked why. There's a slight risk but nevertheless a risk it can leave us more open to infections, particularly chest infections so it seems sensible to have it. Albuterol is a med prescribed usually prescribed for asthma, but because it relaxes the muscles from spasming allowing your airway open more this is probably why you've been prescribed it, not because they think you have asthma. Again let your rheum team know you've been prescribed Albuterol. I hope it helps ease the shortness of breath.

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The other thing that can cause this is being anxious and breathing too shallowly. I know! Practising slow breathing counting in and out helps me. But get it thoroughly checked that there isn't anything else going on.

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Yes i had this with mthx and Humira the rheumy doesnt think it is that BUT I DO have had a ct scan on lungs last week see rheumy next week keep u posted xxx

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Hi Ceshcat

I am sorry I can't help you but would be interested of your outcome.

I have asthma.

I've been on lefluomide since April this year swapped from sulphasalazine as ineffective.

In June my cough began after a lung XRAY and 4 lots of antibiotics which helps for a short while.

Hope you are able to find the reason for your shortness of breath.

Best wishes

Matilda x

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Hi chestcat

As one of your reply’s as stated being on mex has a side effect of shortness of breath that is why you must insist to the chest clinic or rummy you want a lung test and then another one on six months later. I am on oxygen now because l now know my hospital has a different approach to lung tests that being if you do not have shortness of breath on the first appointment then the odds are you will be okay l am one of the odds that did not fall on the right side of side effects l hope all go’s well for you please ensist on the test good luck

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Hi Cheshcat, I'm getting over pneumonia and my breathing sounds like yours, I had this the last time had pneumonia so I'm thinking it's just goin to take time but you keep trying to take deep breaths to help it. I have a great respiratory consultant which ive had since I was in hospital last year with pneumonitis. He consults with my rheumy who was the one to send me for another chest X-ray. I had one two weeks prior to this and took a flare after I saw him. The rheumy doc pinged my new X-ray to him and it showed a nodule on my lung. I'm going for a ct scan on Monday as it wasn't on the first X-ray. My RA seems to attack my organs more than pain altho I do have some mostly on my hands. I'd go back to your doc as its not right, it took me bout 9 weeks to get rid of this breathing prob, just rest and take it easy. X

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In case you haven't already seen this Leflunomide (LEF) capsulised summary, cheshcat, here's the infographic that may help place this DMARD treatments in context. ("Shortness of breath" is a "possible complication" to be aware of & to keep your rheum. 👩‍⚕️ 👨‍⚕️ informed of.)

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Managing Patients Taking DMARDs

(Disease Modifying Anti-Rheumatic Drugs)

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🛅 INFOGRAPHIC (pdf): bmj.com/content/bmj/suppl/2...

A visual summary of the 4 most frequently used DMARDs, including recommended monitoring & conditions that may interfere with treatment:

1 • Methotrexate (MTX)

2 • Leflunomide (LEF)

3 • Sulphasalazine (SSP)

4 • Hydroxychloroquine (HCQ)

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"Symptoms of inflammatory arthritis are often controlled in the long term using DMARDs (disease modifying anti-rheumatic drugs).

These are usually initiated by rheumatologists, with patients commonly taking two or sometimes three DMARDs simultaneously.

This graphic shows information about four of the most frequently prescribed DMARDs, including recommended monitoring and other conditions that could interfere with treatment."

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📰 ARTICLE: bmj.com/content/358/bmj.j32...

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[Many thanks to Man_Oeuvre 'BMJ DMARD infographic': healthunlocked.com/nras/pos... 🙏 😌 ]

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Wishing you the very best, cheshcat. 🙏 🍀 🌺 🌞

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Here's a bit on Albuterol: drugs.com/albuterol.html

If interested in Albuterol experience from HealthUnlocked (HU) form members, these HU "Albuterol" search results may be useful: healthunlocked.com/search/a...

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Thank you all SO very much!!! I don't know what I'd do without these boards.

Sorry I didn't respond before now, I had my electrical service upgraded yesterday and it ended up taking all day to install the new panel.

It does seem to be worse when everything else is all swollen up. I will call the rheumy again if it continues on and will for sure talk to him again at my next appointment.

I only have one nodule on a toe but I guess you never know what's inside. I wish he would get this disease under control.

I "over did it" by just having a full day. I did nothing really, I had a bbq for the non-profit board I am on but didn't do much, then my daughter had a birthday party I took her too. It just ended being a full day is all, not like I ran a marathon. I paid for days, my hands were swollen horribly, I had a low grade fever, and my shortness of breath got worse. That's when I went in to after hours. I just cant wait until I can get to the point that I can spend one busy Saturday and not pay for days or a week. I don't know what you all do that work full time, I'm barely holding it together with part time at home.

I am sero+ (it was high) and my rheumy said I need to get the disease under control, I just wish they were able to get the active RA to get under control a lot faster then they can.

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Ditto, cheshcat 🙀 . 🙌

Got 'under control' via diet 🥗 🍲 & lifestyle 💃🏻🕺 over time ⏳⌛️ .

( Nodules ✋🤚 , brain fog 🤤 , debilitation ♿️ , swelling 🌝 , pain 😣 , etc. down ⬇️ . Energy 🤗 , mobility 🤸‍♀️🚶 , QoL (Quality of Life) 💁‍♂️ 💁 up ⬆️ .)

[Rhem./ medical team 👨‍⚕️ 👩‍⚕️ 👨‍⚕️ 👩‍⚕️ just keep saying, "keep doing what you're doing, you're doing well . . . ". 😳 ☺️ 🙃 ]

Maybe something to consider researching 👩‍🏫 👩‍💻 📚 , exploring 🕵️‍♀️ 🔎 🗺 — if this 'type of thing' interests you? 🤔

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🙏 🍀 🌺 🌞

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Thank you ❤️❤️ yes! I’m looking at various diets right now, to reduce inflammation. Yeah, that’s basically what they telling me. Uh, doesn’t feel like I’m doing fine 🙄 I’m reducing any stress and trying to outsource more of my work. Doing self care. This whole “being sick” thing is hard! I’ve never been “not busy”. It’s an adjustment for me for sure!

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Fully understood, cheshcat 😺. 🙏 😌

Tisn't easy indeed! 😳 😖

"Being sick" 🤕 🤢 is hard work 🛠 . 😨

Possibly ponder 🤔 swapping/ re-directing 🔀 former outward-focused 'busy-ness' (of 'work life') toward inward-focused 'busy-ness' of personal, patient 😌 self-care 💆 ??

(Afterall, you are now your own 'healing project in the works' 🏗 ! 😳 😯 🤔 )

Re-directing energy ⚡️⚡️ back toward lovingly 💗 caring for oneself 👩‍❤️‍💋‍👩 is time 🕰 well spent — gently nudging ⏭ body back toward health 💃🏻🕺.

Mayn't be easy early on 😤 🤦‍♀️ , but gets easier ☺️ 💁 over time — especially as you begin improving. 😃 🙆

A time (& 'adjustment' 🔀 ) well spent, 😺 . 👍

(Reap greater & greater health rewards 🚶‍♀️ 🏃‍♀️ 🤸‍♀️ 💃🏻 , further & further down road 🛣 . )

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🙏 🍀 🌺 🌞

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I have had the same problem it started when I was on Methotrexate in August so I stopped taking. I just started Leflunomide & have been feeling like the shortness of breath has started back. I have done the chest X-rays & gone to see a pulmonary doctor. It was determined I have slight asthma. I am starting to think it’s anxiety causing it.

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Interesting. It’s been bothering me again this week. I have the inhaler now but still don’t understand. Unless it gets worse, I’ll talk to my rheumatologist in December.

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