On/off exercise induced asthma diagnosis

[PrincipalPenguin]

I'm very confused about what is happening with my running and hoping someone might have an insight for me.

About a year ago I was diagnosed with asthma after I suddenly stopped being able to run more than 2km without gasping for air. Previously I'd been a pretty regular runner with no issues and took part in 10k races so the breathing problem was not related to fitness.

The GP asthma nurse immediately gave me brown and blue inhalers which helped a bit but were not a miracle cure then i did spirometry and peak flow tests a few weeks later.

The asthma nurse looked at the results and said these are normal results so you don't have asthma so I stopped using the inhalers. Just to say i did these tests in normal conditions not under exercise conditions.

Six months later I still can't run more than 2km. I am also very susceptible to colds and coughs at the moment being on my 3rd in 3 months.

My question is if i was actually on the brown inhaler when doing all the peak flow tests, how can that reliably rule out asthma?

Surely if you're being medicated for something and then they test for it, that is not a very helpful test as the brown inhaler could have been successfully treating the asthma, hence normal results?

I'm just really confused and fed up with it all. Would be grateful to hear from anyone whose had a similar experience.

What happens if you have a couple of puffs of salbutamol using a spacer about 10 mins before you go running?

I did that for a while (not with spacer though) and it helped a little, but not loads ie still needed to take blue inhaler after about 15 minutes of running.

But i no longer use the inhalers as I don't officially have asthma, but still have the symptoms if you see what I mean.

This is a bit like something I have ongoing too - can do hills/speed work, and anything up to about 8k with no issues. Over 8k though, start to get tight and wheezy, and about 10 mins after I stop get really dizzy.

Someone suggested to me that it could be allergy related - longer runs are always first thing in the morning, everything else is done in the evening - or menopause related. Could either of those things be causing yours?

Sounds similar except mine hits at 2km.
It could be menopause related, I'm on HRT though.

Is your heart okay?

Yes, my heart is fine and im pretty healthy otherwise.

Thank you everyone for your posts.

I've decided to get the peak flow monitor out again and do loads of readings and go back to the Dr about it.

My main confusion is why did they come to a negative diagnosis from readings that were post medication? This is what I don't understand. It seems obvious that you will get good peak flow readings if the asthma is under control through the brown inhaler. Or have i missed something? I'm just baffled by way they went about it, ie medicate first then test and base diagnosis off post-medication tests.

Proper hospital lung function tests require you to be off medication and then they test again after giving an inhaler to see if your readings improve. That is a big part of an asthma diagnosis, because if your readings do not respond much to a bronchodilator then asthma is not the problem.

I think your peak flow plan sounds good.

You couldn't have caught covid without noticing could you?

A few years ago I was running in the winter and got really wheezy, diagnosed with asthma, prescribed blue inhaler.

But after a couple of months it went away. I put it down to a combination of cold damp air, and log fires.

I did switch to gentle swimming for a bit. My point is that maybe your body needs some time.

Thanks everyone, I'll do the peak flows and see how I get on

@PrincipalPenguinHow are you getting on? I really struggle with this and have similar issues to you. Hope all is well!

I had exercise induced asthma years ago and it turned out to be caused by low Vitamin D. Went away completely once I got my level up

Very interesting. I just realised I should update this thread. I ended up getting rediagnosed with asthma a few weeks ago after a nasty virus gave me a wheeze. I am now on symbicort inhaler which has really helped my running. I am just a bit miffed though that I was undiagnosed on the basis of tests that were done when my asthma wasn't triggered so I wasted nearly a year trying to work out why I couldn't breathe when I ran.

Anyway, I am slowly building back up my running and really happy about this.

I'm pleased to hear this OP.

As a PP said, I think you should have had 'reversibility' testing, ie, testing with spirometry, then giving a dose of broncho-dilator, for example Salbutamol ( blue inhaler, taken via a spacer), then repeat spirometry BEFORE you were given a 'brown', ( Preventer) inhaler. This is part of the diagnostic process. Unfortunately, robust testing, diagnosis can be hit and miss, often.

They now offer a FENO test, ( should be available in all GP surgeries...This is a"Fractional Exhaled Nitric Oxide" test.

New Asthma guidelines recommend treatment with a combined Steroid, ie Budesonide and a long-acting broncho-dilator leading to much, much better asthma control and treatment, also leading to a much reduced need for SABAs ( short-acting broncho-dilators, ie Sabutamol.

All the best with your running. X

Thank you. Mine is a combined inhaler I think and it is much better than the blue/brown combo I was originally given. I'm glad they are improving diagnosis processes.