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inhaler shaped like muscular arm and steroids dispense when the arm flexes

Corticosteroids for Asthma

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 aren’t 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 doctors 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 taking it every single day regardless if you are experiencing breathing issues. The amount of steroid 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?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Asthma.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • VioletVixen
    4 months ago

    Is Symbicort a good choice of inhaler…have been advised by doctor to try it but am 76 yrs. old and after reading the plethora of its bio, no
    studies have been made on age 65 and older as to side effects and reactions, etc. , am very
    “paranoid” and afraid to try it…any experiences or thoughts on this would be greatly appreciated…thank you..

  • Lyn Harper, RRT moderator
    4 months ago

    HI VioletVixen – It’s great that you’re being your own health advocate. I certainly can’t speak specifically to whether or not Symbicort is good for you, although your doctor must feel it’s worth a try if it was prescribed.
    As you know, it contains two drugs to help control asthma symptoms; an anti-inflammatory and a long-acting bronchodilator. As with any new drug it’s good to monitor any reactions you may have or the effectiveness of it. Of course, this is different with every person.
    Have you been on one of these types of combination inhalers in the past? If so, how did you feel it worked. That may give you some indication of how you’ll react to this.
    Please let us know what you decide to do.
    Best, Lyn (site moderator)

  • Mary Ann
    5 months ago

    I take breo ellipta 200/25. I started it because of wheezing. I’ve been on it for about 7 months. It does help. It just seems to make my voice a little raspy.

  • Leon Lebowitz, RRT moderator
    5 months ago

    Hi Mary Ann, and thanks for sharing with the community the success you’re having using this medication. If your voice has changed and this persists, you may want to bring it to your doctor’s attention. Do you rinse, gargle and spit after each use? Leon (site moderator)

  • Leon Lebowitz, RRT moderator
    5 months ago

    Hi again, Mary Ann, and thanks for your response and explanation. As long as you are gargling, rinsing and spitting, that is the proper technique following the use of this medication. However, if the symptoms you described (raspy voice) persists – you may want to see your doctor to make certain nothing else is going on. Warm regards, Leon (site moderator)

  • Mary Ann
    5 months ago

    Yes I do gargle and rinse every time I use Breo. I just don’t want to have to change to anything else. I always worry about starting something new. It took me a week to start using this after I got it.

  • Shellzoo
    5 months ago

    Nice article! Symbicort has worked very well for me and I remain hopeful one day I can get on the lower dose.

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