Expert: Marc Rubin, RPh Asthma Educator - 6/5/2008

Question
I have had Asthma since I was very young and have always had a problem with low energy.  Outside of Asthma attacks, is it possible that someone could have some type of chronic airflow issues that could effect blood oxygen levels?  If so could this be a potential source for chronic low energy?

Answer
Hi Michael,

You don't indicate your age, so to address the question broadly, yes. Chronic asthma may lead to changes in the lining of the airways forming tissue scarring and COPD (Chronic Obstructive Pulmonary Disease).

Smoking increases the inflammation, as well as other environmental triggers such as ozone, and workplace chemicals.

There is a basic guideline for assessing severity of asthma called the "Rules of Two"
1)Use of rescue medication 2 or less times per week while awake, OR 2 or less times overnight (where you are awakened due to breathing issues, e.g.: shortness of breath, coughing, wheezing)> you have intermittent asthma, which only requires rescue medication (albuterol)
2)If you are above this threshold, then you need to be taking a controller medication on a DAILY basis. Controller medications like inhaled steroids, Singulair, Accolate or Zyflo, etc.

Following an "Asthma Action Plan" which is a treatment program created by working with your doctor, your therapy is then modified based on your control over the last 3 months. With proper control, you should be able to have what we call a "near normal" life. "Near normal" in the sense you can do almost anything you want to, but understand your disease, and take appropriate action to prevent attacks. As your lung function improves (and it can take a full 6 months of inhaled steroid to reach maximum reduction in lung inflammation), you will see your oxygen levels rise, as well as your energy levels. Keep in mind that up to 15 of Olympic athletes have asthma and win medals. It is all about gaining knowledge, following your therapy, and taking control.

Bottom line...it is up to YOU! :)

If you have only been followed by your primary physician, I strongly suggest you be evaluated by an allergist/immunologist or pulmonologist to get a solid grasp on where you currently stand. This is not a knock against primary practitioners, it is just the fact that the NHLBI Asthma Guidelines are only 1 set out of over 400 guidelines of therapy to the human body, and a generalist cannot be expected to be the expert on all.

Sincerely,

Marc