I have asthma. Can a peak flow meter help me identify triggers?

Question

Hello doctor,

I have been having asthma since my school days, but lately, my symptoms have worsened even with regular inhaler use. My FEV1 on spirometry last week was around 70 %.

Could this mean my asthma control is poor despite medication?
Should I be shifting to a different combination inhaler or adding oral medicine?
I also experience breathlessness, mostly at night. Does that indicate allergy or reflux-related asthma?
Would allergy testing or peak flow monitoring at home help to identify what is triggering these flare-ups?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

FEV1 (forced expiratory volume 1) of around 70 % predicted does suggest partially controlled asthma. The goal in asthma management is to achieve both symptom control and normal or near-normal spirometry, so yes, this FEV1 finding means your current regimen likely needs adjustment.

There are several possible reasons for worsening control. The most common one is suboptimal inhaler technique or adherence; even small errors in timing or coordination can reduce drug delivery to the lungs by 60 to 80 %.

Please make sure you are using your inhaler with a spacer, and you can watch a quick video on the internet, “correct MDI (metered-dose inhaler) with spacer technique,” to check your method.

If your technique is fine and you are already using a combination inhaler like Budesonide with Formoterol (Foracort) or another equivalent, the next step may be to increase the inhaled corticosteroid dose or switch to a triple combination inhaler if symptoms remain frequent.

Because you have nighttime breathlessness, we should also look for two important aggravating factors: allergic triggers (like dust mites, mold, pets, or pollen) and acid reflux (GERD). Both can worsen asthma at night.

Allergy testing (skin prick or serum IgE (immunoglobulin E) panel) can be helpful to identify avoidable triggers.

For reflux-related symptoms, lifestyle measures such as avoiding late meals, elevating the head end of the bed, cutting down on caffeine or spicy foods, and using an acid-suppressing medicine if needed can make a major difference in night control.

Home peak flow monitoring is an excellent tool for someone like you. With consistent follow-up and fine-tuning, your asthma control can be brought back to target.

I hope this helps you.

Thank you.