I have been an asthmatic all my life, but have only ever used a Ventolin? inhaler and a nebuliser. As long as I am fit I find that my control is not too bad, but I often have to use my inhaler up to five times a day, particularly when I am exercising. I am also waking up feeling short of breath during the night. I think I should probably start an inhaled steroid, but I am worried that it will make me put on weight. What should I do?

Answer

You need to see your doctor and get your asthma sorted out immediately. If you are using your inhaler up to 5 times a day and waking up at night as well, then your control is poor enough to be potentially dangerous.

You will find that your control is better when you are fitter, but until you get yourself onto the correct medication you will never manage to get as fit as you could be!

Inhaled steroids will not make you put on weight. The newer forms such as fluticasone, marketed as Flixotide?, are thought to have virtually no effects on the body except the lungs in the normal doses which are used to control asthma. If you are waking up at night you will probably also benefit from a long-acting bronchodilator such as salmeterol, marketed as Serevent?. However, this is very expensive and you should first see if your control improves sufficiently with an inhaled steroid.

I have been on daily, full-dose inhaled steroids for many years now with no ill effects. In fact the combination of inhaled steroids and Serevent keeps me completely symptom-free as long as I keep fit.