Skip to main content

Why Do Doctors Recommend a Steroid For Asthma?

Title Image
Why is my doctor recommending a steroid medicine for asthma instead of albuterol?

Why is my doctor recommending a steroid medicine for asthma instead of albuterol? Aren't steroids more dangerous? Well, with asthma, there's really two main components. Asthma is a chronic condition of the lower airways hallmarked by recurrent episodes of reversible bronchoconstriction. So the airways become real tight. The muscles surrounding them are very twitchy. So that's what causes the symptoms of asthma. But there's also inflammation inside the airways. And for people who have more persistent symptoms or more severe symptoms, that inflammation often needs to be more adequately treated. And that's when we use good anti-inflammatory medications like inhaled corticosteroids.

Now, these are not the same things that, you know, weightlifters and people who use anabolic steroid use to make their muscles really big. And the reason that we deliver steroids through an inhaler is because we can significantly limit the side effects. Yeah. If we give somebody oral steroids every day, they're not going to be very happy because the major side effects that can cause suppression of their adrenal glands, it can cause stomach ulcers and cataracts and brittle bones and things like that.

So if we give a micro dose of that of a similar steroid through an inhaler and deliver it right to the lungs, it can adequately calm down the inflammation and better control somebody's symptoms if they have persistent or severe symptoms due to asthma.

We want to make sure we use proper technique. So for meter dose inhalers that you push down and it sends a little puff out, we want to use a spacer attachment on the end of that that allows the liquid in the inhaler to turn into a nice mist that you can then breathe deep inside the lungs. Otherwise, most of the liquid ends up in the mouth and you swallow it into your belly. There are also dry powder inhalers that don't require spacers. So regardless of what inhaler is prescribed by your physician, please make sure you understand how to properly use it because the technique varies greatly based upon the inhaler that you use.

So steroids are very important for those who have persistent asthma. They're very safe to use long term. We always want to, you know, weigh the benefits versus the risks. So what are the risks of poorly controlled asthma? Well that puts somebody at risk of having severe exacerbations, needing emergency room care and needing oral steroids, which is a much higher dose of the steroid than you get through using very small doses in the inhaler.

And lastly, steroids work very differently than albuterol. Albuterol doesn't treat the inflammation. It's a very, it's a quick reliever. So, it alleviates your symptoms when they're occurring because it helps loosen the tightening of the muscles in the lower airways. So often times these are used in conjunction with each other. And there's actually several combination inhalers that combine the use of both an inhaled steroid and a long lasting albuterol type medication, which can be very effective for people to use.

So, if you have concerns, there's a lot of misconceptions about steroids and steroids side effects. Please talk to your personal doctor and hopefully, they can answer all your questions.

Asthma, Medicines
Answered by

David Stukus, MD, is a Professor of Clinical Pediatrics in the Division of Allergy and Immunology, Director of the Food Allergy Treatment Center, and Associate Director of the Pediatric Allergy and Immunology Fellowship Program at Nationwide Children’s Hospital and The Ohio State University College of Medicine. He is board certified in allergy/immunology and pediatrics.

Dr. Stukus has devoted his career to communicating evidence-based medicine and best clinical practice to colleagues, medical professionals of all backgrounds, patients, and the general public. In addition to providing clinical care for children with all types of allergic conditions, he participates in clinical research, quality improvement, patient advocacy, and medical education.

Reviewed and Answered

Add Comment

Comments (0)

Link copied to your clipboard.