Do steroids work on everone?
Question:
– Hide quoted text — Show quoted text -> > *There is a small per cent of asthmatics who don’t respond to steroids. > > It’s called steroid-resistant asthma. > Very interesting posts. I was going to post a similar question when I > noticed this thread. > Every winter I get colds that end up as asthma. I have very few asthmatic > problems during the rest of the year. Right now I have had 2 weeks of > relatively mild asthma following a cold. Since the doctor is seeing my > pattern now for a couple of winters, she gave me a sample of Advair 100/50 > to try for the winter. I took it twice (24 hours total use) and stopped. > It was almost as bad as prednisone for me, and that is *bad*, regarding > side > effects. But most puzzling to me was that I had a big increase in my > asthma > during that 24 hours. Wheezing and coughing. When I reached 12 hours > after > the final dose, there was a noticeable improvement as it wore off. > I called and she put me on Singulair instead. Now, 2 hours after my first > dose, my asthma is getting bad again. Same result as the Advair, except > no > side effects noticeable. > Singulair is not a steroid, right? > Albuterol helps, although 2 puffs makes me jittery so I ususally limit it > to > 1 puff. > So, what is the course of action I should ask the doctor to look at? I > have > not really had thorough testing for asthma. > Has your doctor tried you on Nasalcort?
Rhinocort, which is probably very similar? I stayed with the Singulair and it seems to be helping. Time will tell.
Response:
Right, Singulair is not a steroid. Interesting it would give you that response in only 24 hrs. As for the albuterol, take the two puffs as ordered you’ll feel no more shakey with two than one and it does go away. Also, two puffs are required for effective relief. It is not good to play doctor especially with asthma meds.
– Hide quoted text — Show quoted text -> *There is a small per cent of asthmatics who don’t respond to steroids. > It’s called steroid-resistant asthma. > Very interesting posts. I was going to post a similar question when I > noticed this thread. > Every winter I get colds that end up as asthma. I have very few asthmatic > problems during the rest of the year. Right now I have had 2 weeks of > relatively mild asthma following a cold. Since the doctor is seeing my > pattern now for a couple of winters, she gave me a sample of Advair 100/50 > to try for the winter. I took it twice (24 hours total use) and stopped. > It was almost as bad as prednisone for me, and that is *bad*, regarding side > effects. But most puzzling to me was that I had a big increase in my asthma > during that 24 hours. Wheezing and coughing. When I reached 12 hours after > the final dose, there was a noticeable improvement as it wore off. > I called and she put me on Singulair instead. Now, 2 hours after my first > dose, my asthma is getting bad again. Same result as the Advair, except no > side effects noticeable. > Singulair is not a steroid, right? > Albuterol helps, although 2 puffs makes me jittery so I ususally limit it to > 1 puff. > So, what is the course of action I should ask the doctor to look at? I have > not really had thorough testing for asthma. > Thanks!
Response:
> It was almost as bad as prednisone for me, and that is *bad*, regarding side > effects. But most puzzling to me was that I had a big increase in my asthma > during that 24 hours. Wheezing and coughing. When I reached 12 hours after > the final dose, there was a noticeable improvement as it wore off. > I called and she put me on Singulair instead. Now, 2 hours after my first > dose, my asthma is getting bad again. Same result as the Advair, except no > side effects noticeable.
It IS possible to be allergic to steroids and Singulair. I am. Joan Joan Marie Verba http://www.sff.net/people/Joan.Marie.Verba
Response:
– Hide quoted text — Show quoted text -> *There is a small per cent of asthmatics who don’t respond to steroids. > It’s called steroid-resistant asthma. > Very interesting posts. I was going to post a similar question when I > noticed this thread. > Every winter I get colds that end up as asthma. I have very few asthmatic > problems during the rest of the year. Right now I have had 2 weeks of > relatively mild asthma following a cold. Since the doctor is seeing my > pattern now for a couple of winters, she gave me a sample of Advair 100/50 > to try for the winter. I took it twice (24 hours total use) and stopped. > It was almost as bad as prednisone for me, and that is *bad*, regarding side > effects. But most puzzling to me was that I had a big increase in my asthma > during that 24 hours. Wheezing and coughing. When I reached 12 hours after > the final dose, there was a noticeable improvement as it wore off. > I called and she put me on Singulair instead. Now, 2 hours after my first > dose, my asthma is getting bad again. Same result as the Advair, except no > side effects noticeable. > Singulair is not a steroid, right? > Albuterol helps, although 2 puffs makes me jittery so I ususally limit it to > 1 puff. > So, what is the course of action I should ask the doctor to look at? I have > not really had thorough testing for asthma.
Has your doctor tried you on Nasalcort? I’ve found that one puff in each nostril twice a day does a lot to control my asthma. Steroids do work for me, although I hate the side-effects; the mood swings, the joint pain, the headaches. GERD also causes asthma and I’m on prilosec for that. All in all, I have a heck of a time taking all these pills and the only thing that keeps me straight is one of those big pill organizers. I am on Singular which must be taken at night and I see little benefit from it. Currently I’m coming down from a bad episode that resulted in an ER visit and steroids. I’m hoping that I’ll be out of here before spring hits. Sue – Hide quoted text — Show quoted text -> Thanks!
Response:
> *There is a small per cent of asthmatics who don’t respond to steroids. > It’s called steroid-resistant asthma.
Very interesting posts. I was going to post a similar question when I noticed this thread. Every winter I get colds that end up as asthma. I have very few asthmatic problems during the rest of the year. Right now I have had 2 weeks of relatively mild asthma following a cold. Since the doctor is seeing my pattern now for a couple of winters, she gave me a sample of Advair 100/50 to try for the winter. I took it twice (24 hours total use) and stopped. It was almost as bad as prednisone for me, and that is *bad*, regarding side effects. But most puzzling to me was that I had a big increase in my asthma during that 24 hours. Wheezing and coughing. When I reached 12 hours after the final dose, there was a noticeable improvement as it wore off. I called and she put me on Singulair instead. Now, 2 hours after my first dose, my asthma is getting bad again. Same result as the Advair, except no side effects noticeable. Singulair is not a steroid, right? Albuterol helps, although 2 puffs makes me jittery so I ususally limit it to 1 puff. So, what is the course of action I should ask the doctor to look at? I have not really had thorough testing for asthma. Thanks!
Response:
– Hide quoted text — Show quoted text -> I have intermittent asthma. I’m 35 years old and have tried inhaled steroids > at least three times in my life. Each time I gave the steroids at three > months to kick in. And I have never noticed any perceptible improvement. I > am now on 4 puffs – twice a day (220 flovent). I am aware that steroids are > preventers (anti-inflamatory) and are not meant to provide instant relief > like albuterol. > I just read your Nov 18th article: "Asthma Guidelines Revised to Reflect > Best Scientific Knowledge" and it reaffirmed "unequivocally that inhaled > steroids are the ‘gold standard’ of asthma treatment". My doctors all look > at me like I’m crazy when I tell them steroids don’t work for me. > My symtoms come and go. I have had long stretches symtom free. And long > stretches symtom-full. In both cases, steroids never seem to help. Also, > earlier this year I had a very bad few weeks with asthma and my doctor gave > a steroid pill. It had no effect. > I HAVE had noticible improvements from long and short acting brinodilators > (serevent and albuterol) and Singulair seems to help. > A few other things that seem to be contrary to the asthma norm: > 1. I don’t have alergies – I had scratch and shot tests and they all came > out negetive. > 2. My symtoms are almost always between 3:00 PM and 11:00 PM. I never wake > up in the middle of the night from asthma. > 3. Colds and flues seem to make myasthma better – not worse. > So my question is: is there some small percentage of asthmatics that don’t > respond to steroids? Do I maybe have something other than asthma? > "We are each an experiment of one." – Dr. George Sheehan > Just do what works for you – take Singulair, take Serevent, and see if > being on those all the time takes care of your symptoms.
I’d check my environment thoroughly to find out exactly is different between 3 pm and 11 pm and the rest of the time. Don’t rule out allergies. Those tests are merely for certain specific common allergins. You might be reacting to something that’s not at all on the tests. Where are you and what are you doing differently between 3 and 11 and even shortly before that? For some of us, almost nothing works. I’ve been on every asthma medication known to man and right now am back on prednisone. Sue
Response:
- Hide quoted text — Show quoted text – > I have intermittent asthma. I’m 35 years old and have tried inhaled steroids > at least three times in my life. Each time I gave the steroids at three > months to kick in. And I have never noticed any perceptible improvement. I > am now on 4 puffs – twice a day (220 flovent). I am aware that steroids are > preventers (anti-inflamatory) and are not meant to provide instant relief > like albuterol. > I just read your Nov 18th article: "Asthma Guidelines Revised to Reflect > Best Scientific Knowledge" and it reaffirmed "unequivocally that inhaled > steroids are the ‘gold standard’ of asthma treatment". My doctors all look > at me like I’m crazy when I tell them steroids don’t work for me. > My symtoms come and go. I have had long stretches symtom free. And long > stretches symtom-full. In both cases, steroids never seem to help. Also, > earlier this year I had a very bad few weeks with asthma and my doctor gave > a steroid pill. It had no effect. > I HAVE had noticible improvements from long and short acting brinodilators > (serevent and albuterol) and Singulair seems to help. > A few other things that seem to be contrary to the asthma norm: > 1. I don’t have alergies – I had scratch and shot tests and they all came > out negetive. > 2. My symtoms are almost always between 3:00 PM and 11:00 PM. I never wake > up in the middle of the night from asthma. > 3. Colds and flues seem to make myasthma better – not worse. > So my question is: is there some small percentage of asthmatics that don’t > respond to steroids? Do I maybe have something other than asthma?
*There is a small per cent of asthmatics who don’t respond to steroids. It’s called steroid-resistant asthma. *Yes, this reaction to steroids, as well as your symptom history, raises some doubt about your asthma diagnosis. Asthma is diagnosed using spirometery; lung function measured before and after adminstering a bronchodilator; a significant improvement postbronchodilator, say 12%, tends to support an asthma diagnosis. If in doubt a methacholine challenge test may be given. Note that steroids, including steroid inhalers, should be used in the minimum dose to control the problem, due to side effects. If they don’t help they shouldn’t be used. Whether they help depends on peak flow readings and symptom control. You may want to seek a 2nd opinion from a teaching hospital with a good pulmonary dept. Links: http://library.nationaljewish.org/MSU/13n2MSU_StRe_Asthma.html Steroid-Resistant Asthma Excerpt: "Steroid-resistance Inhaled glucocorticoids have become the mainstay of asthma therapy. Treatment with oral glucocorticoids is the most potent therapy available for acute asthma regimen for patients with severe disease. Unfortunately, however, a small fraction of asthmatics are steroid resistant and do not benefit from standard treatment. Obviously it is critical to identify these patients as soon as possible. Patients who do not respond to low steroid doses are often placed on higher doses, which in steroid-resistant (SR) asthmatics can cause significant adverse effects without providing significant benefit. In addition, because steroids patients is a challenging medical problem. There are no definitive statistics on the prevalence of SR asthma, but a rough estimate is that it occurs in less than 5% of the asthmatic population. The differential diagnosis includes sinusitis, gastroesophageal reflux, congestive heart failure, an anatomic abnormality, immunodeficiency, interstitial lung disease, and bronchopulmonary dysplasia. Other conditions that could masquerade as SR asthma include poor patient compliance with therapy, drug interactions with glucocorticoids, abnormal glucocorticoid absorption or elimination, food sensitivity, environmental factors, and psychosocial factors."
Response:
- Hide quoted text — Show quoted text – > I have intermittent asthma. I’m 35 years old and have tried inhaled steroids > at least three times in my life. Each time I gave the steroids at three > months to kick in. And I have never noticed any perceptible improvement. I > am now on 4 puffs – twice a day (220 flovent). I am aware that steroids are > preventers (anti-inflamatory) and are not meant to provide instant relief > like albuterol. > I just read your Nov 18th article: "Asthma Guidelines Revised to Reflect > Best Scientific Knowledge" and it reaffirmed "unequivocally that inhaled > steroids are the ‘gold standard’ of asthma treatment". My doctors all look > at me like I’m crazy when I tell them steroids don’t work for me. > My symtoms come and go. I have had long stretches symtom free. And long > stretches symtom-full. In both cases, steroids never seem to help. Also, > earlier this year I had a very bad few weeks with asthma and my doctor gave > a steroid pill. It had no effect. > I HAVE had noticible improvements from long and short acting brinodilators > (serevent and albuterol) and Singulair seems to help. > A few other things that seem to be contrary to the asthma norm: > 1. I don’t have alergies – I had scratch and shot tests and they all came > out negetive. > 2. My symtoms are almost always between 3:00 PM and 11:00 PM. I never wake > up in the middle of the night from asthma. > 3. Colds and flues seem to make myasthma better – not worse. > So my question is: is there some small percentage of asthmatics that don’t > respond to steroids? Do I maybe have something other than asthma?
Almost word for word I’ve had the same experience as you. The only difference I note is that for me the inhaled (not the pill – which did nothing at all) steroids made my symptoms worse. No question it’s asthma and ventolin works like a dream. Eventually, I got to see a consultant who simply advised that there is no point in taking steroids, if they aren’t doing you any good. Once that wisdom propagated down to my growing list of GPs, I was taken more seriously.
Response:
I have intermittent asthma. I’m 35 years old and have tried inhaled steroids at least three times in my life. Each time I gave the steroids at three months to kick in. And I have never noticed any perceptible improvement. I am now on 4 puffs – twice a day (220 flovent). I am aware that steroids are preventers (anti-inflamatory) and are not meant to provide instant relief like albuterol. I just read your Nov 18th article: "Asthma Guidelines Revised to Reflect Best Scientific Knowledge" and it reaffirmed "unequivocally that inhaled steroids are the ‘gold standard’ of asthma treatment". My doctors all look at me like I’m crazy when I tell them steroids don’t work for me. My symtoms come and go. I have had long stretches symtom free. And long stretches symtom-full. In both cases, steroids never seem to help. Also, earlier this year I had a very bad few weeks with asthma and my doctor gave a steroid pill. It had no effect. I HAVE had noticible improvements from long and short acting brinodilators (serevent and albuterol) and Singulair seems to help. A few other things that seem to be contrary to the asthma norm: 1. I don’t have alergies – I had scratch and shot tests and they all came out negetive. 2. My symtoms are almost always between 3:00 PM and 11:00 PM. I never wake up in the middle of the night from asthma. 3. Colds and flues seem to make myasthma better – not worse. So my question is: is there some small percentage of asthmatics that don’t respond to steroids? Do I maybe have something other than asthma?
Response:
- Hide quoted text — Show quoted text – > I have intermittent asthma. I’m 35 years old and have tried inhaled steroids > at least three times in my life. Each time I gave the steroids at three > months to kick in. And I have never noticed any perceptible improvement. I > am now on 4 puffs – twice a day (220 flovent). I am aware that steroids are > preventers (anti-inflamatory) and are not meant to provide instant relief > like albuterol. > I just read your Nov 18th article: "Asthma Guidelines Revised to Reflect > Best Scientific Knowledge" and it reaffirmed "unequivocally that inhaled > steroids are the ‘gold standard’ of asthma treatment". My doctors all look > at me like I’m crazy when I tell them steroids don’t work for me. > My symtoms come and go. I have had long stretches symtom free. And long > stretches symtom-full. In both cases, steroids never seem to help. Also, > earlier this year I had a very bad few weeks with asthma and my doctor gave > a steroid pill. It had no effect. > I HAVE had noticible improvements from long and short acting brinodilators > (serevent and albuterol) and Singulair seems to help. > A few other things that seem to be contrary to the asthma norm: > 1. I don’t have alergies – I had scratch and shot tests and they all came > out negetive. > 2. My symtoms are almost always between 3:00 PM and 11:00 PM. I never wake > up in the middle of the night from asthma. > 3. Colds and flues seem to make myasthma better – not worse. > So my question is: is there some small percentage of asthmatics that don’t > respond to steroids? Do I maybe have something other than asthma?
"We are each an experiment of one." – Dr. George Sheehan Just do what works for you – take Singulair, take Serevent, and see if being on those all the time takes care of your symptoms. -S-
Response:
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