Why am I so out of puff?

[Stuckinarut100]

I’m fit, I exercise, not overweight.
I use an inhaler.
Don’t smoke or vape.
Ive had my iron levels checked.
I’ve had a lung x ray.
yet whenever I go upstairs I get out of breath. It’s worse at home. I do have a Dr appointment to ask about it again but what could it be. I’m sat here now trying to get my breath.

How old are you? Any dizziness, especially when you stand up?

A blue inhaler is a reliever inhaler (Ventolin/salbutamol) to relieve asthma attacks. Do you use a brown steroid one to build up your lungs as well? How often are you using the blue inhaler?

46 no don’t think I’ve had any dizziness

No I don’t use a brown one I use the blue one when I feel wheezy or out of breath.

Have you had your thyroid levels checked. When I was first diagnosed with Graves Disease (hyperthyroidism), I realised it was one of the first symptoms - but I hadn't recognised it as such because I knew nothing about it!

What is your peak flow OP?
Have you even got a peak flow meter?
It sounds like you need a thorough asthma overhaul, with a respiratory nurse.
I'm surprised you're only on a reliever ( blue) inhaler, it's quite outdated treatment.

Also, have you had a recent cold/ viral illness in the last 2-3 months?
Sometimes quite quiescent asthma can be triggered by a virus.

Sounds like it's asthma related. Others with more knowledge have given their advice/thoughts on that.

Just to mention, and not to scare you, but I had a lot of breathlessness especially going up hills and steps/stairs. No history of asthma or lung issues etc. Turned out I had Atrial Fibrillation! That was a big surprise to me as I had no other symptoms, but was tired more than usual along with the breathlessness.

So yep, after all the usual stuff was ruled out with bloods and x rays etc., a 48 hour Holter monitor caught the irregular heartbeat. All good now and while I get the occasional flutter here and there, I'm fine. Just keep it at the back of your mind if nothing else shows up. But I hope it's just something simple like an asthma review as already suggested.

How many times in any given 24hr period are you reaching for your blue inhaler and does it help, ie relieve your breathlessness/wheeze/cough?
Are you waking at night with cough or wheeze and is your breathlessness exacerbated by exertion, like climbing stairs, moderately fast walking, cold air?
Sorry for so many questions but these are the questions the nurse should be asking at your asthma review.
You'll need to be prescribed a peak flow meter and taught how to measure it and record it diligently twice daily and in the midst of a breathless attack.
Your inhaler technique should also be observed and tweaked by the nurse if they think it's inadequate.
All the best OP.

Sorry, just to add, you may need to do a Feno test ( Fractional Exhaled Nitric Oxide).
Most surgeries have one of these now and it can be v useful.

Unfortunately, in many cases, too many people were thrown an asthma diagnosis, sometimes years ago, or as a child. And it may be an erroneous diagnosis, with suboptimal pt. information and treatment/management. There can be a lot of laziness associated with asthma.
I'm hoping this isn't the case with your practice; some surgeries can be great though.

So if you are fit and exercise without feeling breathless it's probably not a health problem?

Our bodies take a little while to adjust to strenuous exercise (such as going up stairs). The quickest adaptation it can make to increase the oxygen available to muscles is to increase our breathing (get more oxygen in). As we continue to exercise our blood vessels dilate, heart pumps more etc. but in a 10-30 second trip up one or a few flights of stairs it's only your breathing that you'll notice

@Gymbunny2025, that's really interesting! I guess it should be obvious but I've never thought of it like that before.
OP, hope you get sorted soon.

Hi so an update, I went for an asthma review and they said I don’t actually have asthma but no one had told me??? So even more of a mystery, back to the GP next week.

Seconding the over active thyroid - its a very common symptom and easy to check.

Thanks I have had my thyroid checked before but will mention it again.

Oh that's interesting, maybe sadly, not surprising. Robust diagnosing a few years ago, include a detailed history, serial peak flow measurement and often a trial of treatment with follow-up and sometimes spirometry.
Unfortunately, often, it was a lazy diagnosis if these tests weren't competently done.
Nowadays it needs a blood test ( to measure eosinophil count) and a Feno test ( most GP surgeries should have one, it really should be done before handing out an asthma diagnosis) along with the other tests. No wonder your blue inhaler makes no difference... and that your symptoms are not exacerbated by exercise...how did they tell you you didn't have asthma? (See my post 25/2/25 19.07)

They said - you don’t have asthma!

Just that!?

Look up pulmonary sarcoidosis and see what you think. It could show as the slight scarring on your lungs. Do you have any rashes, sores on shins or sore eyes? Do you have any autoimmune or skin conditions?

Yep! According to the tests I’d done.

Nope not got any of those

It's just that these are sometimes seen in patients with pulmonary sarcoidosis but not always, so still worth looking it up.