Low peak flow reading, how concerned should I be?

[AVeryBigHouse]

I'm being investigated for asthma and have been given a peak flow monitor to record my readings for the next 3 weeks.

Based on my age and height, I should be blowing around 480. Currently I'm blowing 275, with 300 as an absolute maximum.

I'm breathless and exhausted.

I think that, if you have asthma, you may find your readings are lower. Or they are until you use an inhaler. I may not be correct in that though.

I know it's a cliche, but I think you should phone 111 for advice.

I think you should go see a doctor or asthma nurse today. My good peak flow target is 450 (I go up to 520) and I've been told if it drops below 320 I need to get seen asap. You're at increased risk of asthma attack with low peak flow like that and need urgent medication.

My peak flow (asthmatic since childhood and I'm 60 now) has never been measured at over 250. But I'm never breathless or exhausted at normal activity or resting - in fact if they hadn't measured I'd never know it was so low!

So what I'm saying is, if you are breathless and exhausted, I'd say that whatever the numbers say, things are definitely not right and hopefully there are steps that can be done to improve matters. Please get yourself seen, it's horrible to feel breathless.

If you are breathless and exhausted now, you should go back, not wait 3 weeks.

Have you been given any form of treatment or just the peak flowmeter that would be v odd?

Essentially you have no idea what your normal peak flow is because you are ill at the moment and in 3 weeks time, all you are going to know is you are still ill, probably more so.

Go back to GP and get some treatment.

Thanks all. Tried to get an appointment today but no luck so will try again tomorrow.

I went into the chemist and asked the pharmacist for some advice. He said the same as you Hulder ans thought it strange I'd not been started on some medication already.

Peak flow was 250 this morning (I know it's naturally lower in the mornings).

Managed to get in at the Drs this morning. She didn't seem concerned about my low readings but has given me a ventolin inhaler which has definitely eased my tight chest and breathlessness.

Glad you got an appointment. In a sense the numbers don't matter for now (until you know your target area) whereas how you feel does so great that it's helping. Do you have to do the peak flow before using the inhaler and about 15 mins after it?

Call asthma uk - they really helped me when I discovered I had asthma. It was In The process of discovering! A blue inhaler is not what you need. Ideally, they need to do a test where they test peak flow, give you a blue inhaler, then test 15 mins later. If the increase in peak flow is above a certain percentage (irrc 10% But I’d check with asthma uk) then you need to start a brown steroid inhaler. That takes 2-3 weeks to really kick in. Then your blue use should be infrequent.

Most gp practices have an asthma nurse now who has the up to date knowledge. The gps don’t really know, but until you’re diagnosed you don’t get to see them. I ended up on asthma uk advice (and two nurse friends) to talk to the asthma nurse who then made an appt to do the test . Then I started a brown. I developed it at 39 though I think I’ve always had leanings to it.

I simply couldn’t get over a cough and only oral steroids had any affect. Which should have been a red flag to the gp I now know. But it’s not really their area now.

Which is why the pharmacist questioned the fact you’re not on medication.

Glad you have something and are feeling better.

However as Ekphrasis says, the point of asthma medication is to have a preventer to stop you getting breathless in the first place (usually a brown inhaler) - not to rely continuously on a blue reliever inhaler.

The blue inhaler does make you feel better but it doesn't stop the inflammation happening in your lungs so ultimately doesn't make you better. And relying on blue alone can be dangerous as your lungs can be getting worse while you just take more puffs of the blue inhaler.

Asthma UK is a great source of info.

You now need another appointment with a GP to say 'yes I feel better but I have to take my blue inhaler x times a day to do so' 'Do I have asthma? I would like to see the asthma nurse and have a written asthma plan.'

If you can show your peak flow readings pick up after your blue inhaler, this is pretty diagnostic.

Like Ekphrasis I got diagnosed with asthma as an adult age mid 30s but with hindsight I'd had it since childhood - lots of coughing at night and unable to exercise much with being v short of breath and coughing.

In well controlled asthma you shouldn't need your blue inhaler more than three times a week. More than that and you should at least be on an inhaled steroid too. There is scope for stepping up further to a combination inhaler if still struggling.
Spirometry would provide a more accurate diagnosis. It looks at your breathing patterns before and after salbutamol (not just peak flow). A significant improvement after would indicate asthma. You neeed to go back.