I often encounter such asthma patients in the clinic. The doctor has prescribed a drug to regulate asthma. However, the condition does not seem to improve. What is the patient? The patient often replies that the doctor’s drug contains hormones, so he did not dare to use it. So, do asthma patients really get fat with hormonal drugs?
Distinguish systemic hormones and inhaled hormones
Glucocorticoids are indeed the most effective drugs for asthma treatment, but hormones are available in three major dosage forms: oral, intravenous and inhaled. Among them, intravenous hormones directly into the blood are very effective in controlling acute asthma attacks and can quickly control the symptoms of asthma.
Oral hormones have a similar effect, due to the need to be absorbed into the bloodstream through the gastrointestinal tract, the effect is slightly slower than intravenous hormones.
Both hormones go through the blood circulation and reach the lungs. Therefore, we refer to intravenous hormones and oral hormones as systemic hormones.
While systemic hormones exert their therapeutic effects, hormones in the blood circulation can also reach various organs of the body, thus causing adverse reactions.
Long-term use of systemic hormones can lead to decreased patient resistance, osteoporosis, elevated blood sugar, central obesity and other adverse reactions, and adverse reactions are not just obesity.
In order to not only play the role of hormones in the treatment of asthma, but also avoid the adverse reactions that systemic hormones are difficult to avoid, so there is an inhaled hormone.
Inhaled hormones deliver the drug directly to the inflammation site of the asthmatic patient, the lungs, without the need for blood circulation, thus greatly reducing the adverse effects of hormones.
Several current inhaled hormones are used in combination with bronchodilators (such as beta-agonists) to further reduce the amount of hormones used.
Why are asthma patients so afraid of inhaled hormones?
This is because they confuse intravenous hormones, oral hormones and inhaled hormones, thinking that inhaled hormones also have adverse reactions using systemic hormones.
Inhaled hormones have low systemic adverse reactions
At present, more use of Formoterol dry powder, the amount of hormone per 1 adult dose is 160 micrograms per day, 2 times a day, so the total amount of one day is 320 micrograms.
20%-40% of the dry powder is inhaled into the lungs, and the rest is scattered in the mouth and throat. The hormones in these parts can be removed as long as they are carefully smeared, so as to avoid local adverse reactions such as oral cavity. Ulcers, etc.
The rest is swallowed into the gastrointestinal tract. These hormones go through the catabolism of the liver (medically known as the 'first pass effect') before entering the blood circulation, so the amount of hormone that is eventually absorbed into the blood circulation may cause adverse reactions. Very few!
This result has been confirmed by the clinical practice of countless patients. Although they inhale hormones every day according to doctor's advice, the incidence of systemic adverse reactions is extremely low.
If patients are eager to end, because they are afraid of gaining weight, do not follow the doctor's advice, and pin their hopes on the use of systemic hormones, this not only wastes medical resources, but more importantly, long-term application of systemic hormones hurts the body!
Moreover, in order to further reduce the adverse effects of inhaled hormones, doctors should use the lowest dose of hormones (including other drugs, such as beta-agonists, montelukast, etc.) to control asthma symptoms.
Therefore, asthma patients must follow the doctor's advice and adhere to standardized asthma treatment. Not only can asthma be completely controlled, but the adverse reactions of drugs will be minimized, so there is no need to worry about getting fat.
