Corticosteroids for Asthma
Last updated: April 2022
What do you think of when you hear the word “steroids?”
For people without lung disease or breathing difficulties they more than likely think of anabolic steroids which are the ones that are taken to boost physical performance and strength. If that were the case for corticosteroids then all of us who take asthma steroids would be big, buff bodybuilders! But it’s not.
Corticosteroids have become center stage in the treatment and prevention of asthma exacerbations. They come in three forms: oral, inhaled, and intravenous (IV).
What are corticosteroids for asthma?
While many people are prescribed corticosteroids for asthma, whether inhaled or oral, they often times are not sure what they are for nor what they actually do. In short, corticosteroids lower the inflammation in the body and, specifically for asthmatics, in the lungs. Corticosteroids mimic the hormones that are produced naturally in the body (more specifically the adrenal glands). When the dose is more than what the body naturally makes, it suppresses inflammation.
The SET mnemonic for asthma
When providing education for asthmatics, in the respiratory field we use the SET mnemonic. SET stands for Swelling, Excess mucus, and Tightness. These are the three main things that happen during an asthma flare-up or asthma attack. Inflammation in the lungs is what causes the swelling which makes it difficult to breathe. Mucus production is increased and when combined with the swelling and tightness, causes wheezing. Tightness happens from both the swelling and bronchospasm. These three things create a perfect storm when you are exposed to a trigger.
Inhaled corticosteroids (ICS)
Inhaled corticosteroids (ICS) are the first line of asthma control management. These are inhalers (and sometimes nebulizer form) that you take every day (usually once or twice a day depending on the inhaler and doctor's recommendation) regardless if you are experiencing asthma symptoms or not. It is very important to continue taking your ICS even if your asthma is not acting up because it will continue to keep the inflammation down in the lungs and keep you breathing easy.
Oral corticosteroids (OCS)
When our asthma is flaring up and our daily maintenance ICS aren’t enough to keep asthma symptoms at bay, your doctor may put you on an oral corticosteroid for a short period of time to decrease the amount of inflammation in the lungs. The OCS are the ones that tend to come with more side effects such as weight gain, bloating, insomnia, headache, and mood swings just to name a few. Not everyone will experience the same side effects and some might not experience any at all. You will have to weigh the options with your doctor and decide what is the best course of action for your specific asthma.
While the side effects may be unpleasant, not being able to breathe is far worse. Being able to keep your asthma controlled without excessive use of OCS is ideal. However, in rare cases, there is a need for long-term daily OCS due to asthma severity. Long-term use of OCS can lead to some serious problems including decreased bone density, diabetes, and adrenal fatigue.
What has your experience been with corticosteroids for asthma?
If your doctor has put you on an ICS as part of your asthma action plan and treatment take it every single day regardless if you are experiencing breathing issues. The amount of steroids in the ICS is far less than OCS. With the help of your doctor, finding a daily inhaled ICS is imperative to help achieve and maintain asthma control.
Have you spoken with your doctor recently regarding using corticosteroids for asthma treatment?
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