Expert: Marc Rubin, RPh Asthma Educator - 7/15/2008

Question
A few months ago I had been taking a steroid called Anadrol ( oxymethalone), I was doing this in order to build up some muscle mass. Within a couple weeks of taking it I started having a very hard time breathing and so I immediately stopped. I had only been taking it once every other day. Since however, I have had a lot of trouble breathing on a regular basis, especially when I work out. At first they thought it was pleurisy, but my pulmonologist diagnosed me with asthma. However, the symbicort he has me on is providing minimal results and I feel like my albuterol inhaler and xophenex hfa are doing nothing. Do you have any advice for me? I've been in and out of the Doctors office for the last few months now and I don't see much improvement.

Answer
Hi Mike,

Treatment failure may be due to a number of problems. I don't believe the Anadrol is necessarily related to your present problem. BTW, don't even think of going there again if you value your health.

There are three specific issues involved in asthma control:
1)Proper drug therapy, 2) environmental control, 3) knowledge.

1) The choice of drug therapy is guided by the degree of impairment (how bad your lungs are at the point of evaluation), and the level of risk that you will suffer further attacks. That said, it is imperative that you follow the therapy that the doctor prescribed. Symbicort is a combination of an airway dilator (like Xopenex) plus a steroid to reduce the inflammation in the lungs. You will not see inflammation improvements for a few weeks, and the maximum effect takes ~ 6 months...so don't skip doses. Have your physician or an asthma educator visually observe and review your device technique. many times, drug failure is due to the improper use of the inhalers. Also,you should have a peak flow meter to self-monitor your lung function. You may need a short course of oral prednisone (3-7 days)to get the inflammation under control. NOTE: the steroids used in asthma are NOT related to the anabolic steroids used (illegally) in weightlifting.

2)If the environment you live or work is unhealthy, your lungs are not having a chance to get better, because they are constantly under attack. Did the pulmonologist test you for allergens? If not, I'd suggest changing over to a board certified allergist to guide your therapy. If you have mold in your residence, own pets, live in an area with high pollen levels, smoke, ozone, etc., there are steps that can be taken to decrease the impact. If your work environment has these issues, or if there are industrial chemicals there, these can also be a problem. And the gym where your work out? Many have high humidity levels and subsequently...mold. Nasty trigger for attacks.

3) Knowledge: go to http://www.AAAAI.org http://www.chestnet.org, the American Lung Association web site, etc. to learn as much as you can about asthma. Therapy is a balance of controlling your environment and proper drug therapy. Drugs help, control of your surroundings help, to achieve the greatest success you need to address both. 15% of Olympic athletes have asthma, and obviously compete at a very high level. You need to learn about the disease so you can take control. There aren't any shortcuts to success. That also applies to weightlifting> the price you pay for that shortcut (impotency, emotional rages, cancer, etc.)are inescapable. Don't cheat yourself out of a full, healthy life.

Good luck!

Marc