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

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

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 %.

  1. Could this mean my asthma control is poor despite medication?

  2. Should I be shifting to a different combination inhaler or adding oral medicine?

  3. I also experience breathlessness, mostly at night. Does that indicate allergy or reflux-related asthma?

  4. Would allergy testing or peak flow monitoring at home help to identify what is triggering these flare-ups?

Kindly suggest.
Answered by Dr. Amandeep Singh Arneja

Education:

MD RESPIRATORY MEDICINE

Professional Bio:

I am Dr. Amandeep Singh Arneja, a dedicated Chest Physician and Senior Resident in Pulmonary Medicine at Jawaharlal Nehru Medical College (JNMC), Wardha, with extensive training in the management of complex respiratory and critical care conditions. I completed my M.B.B.S. from Universal College of Medical Sciences, Tribhuvan University (2016) and M.D. in Respiratory Medicine from Shri Shankaracharya Institute of Medical Sciences, Bhilai (2025), where I gained hands-on expertise in managing ICU patients, performing advanced diagnostic and therapeutic procedures, and conducting research in pulmonary diseases. My areas of expertise include: Management of asthma, COPD, tuberculosis, and interstitial lung disease Critical care management (ICU care, mechanical ventilation) Pulmonary function testing (spirometry, DLCO) Interventional procedures (thoracentesis, ICD insertion, bronchoscopy) Sleep medicine and polysomnography Research, academic writing, and clinical presentations I hold certifications in Good Clinical Practice and Biomedical Research. I am a proud member of the National College of Chest Physicians (NCCP). Alongside my pulmonary expertise, I have also completed a CPCDM Fellowship in Diabetes from RSSDI, enabling me to provide holistic care for patients with respiratory diseases complicated by diabetes. Currently, I am also pursuing a Fellowship in Critical Care Medicine, which further enhances my ability to manage critically ill patients with respiratory and systemic illnesses. With multiple research publications, conference presentations (NAPCON, SSIMSCON), and a strong academic background, I strive to combine evidence-based medicine with compassionate patient care. My mission is to provide comprehensive, high-quality care to patients suffering from respiratory and lifestyle-related diseases.

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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.

Medically reviewed by iCliniq medical review team
Published At December 28, 2025
Reviewed At December 28, 2025

Education:

MD RESPIRATORY MEDICINE

Professional Bio:

I am Dr. Amandeep Singh Arneja, a dedicated Chest Physician and Senior Resident in Pulmonary Medicine at Jawaharlal Nehru Medical College (JNMC), Wardha, with extensive training in the management of complex respiratory and critical care conditions. I completed my M.B.B.S. from Universal College of Medical Sciences, Tribhuvan University (2016) and M.D. in Respiratory Medicine from Shri Shankaracharya Institute of Medical Sciences, Bhilai (2025), where I gained hands-on expertise in managing ICU patients, performing advanced diagnostic and therapeutic procedures, and conducting research in pulmonary diseases. My areas of expertise include: Management of asthma, COPD, tuberculosis, and interstitial lung disease Critical care management (ICU care, mechanical ventilation) Pulmonary function testing (spirometry, DLCO) Interventional procedures (thoracentesis, ICD insertion, bronchoscopy) Sleep medicine and polysomnography Research, academic writing, and clinical presentations I hold certifications in Good Clinical Practice and Biomedical Research. I am a proud member of the National College of Chest Physicians (NCCP). Alongside my pulmonary expertise, I have also completed a CPCDM Fellowship in Diabetes from RSSDI, enabling me to provide holistic care for patients with respiratory diseases complicated by diabetes. Currently, I am also pursuing a Fellowship in Critical Care Medicine, which further enhances my ability to manage critically ill patients with respiratory and systemic illnesses. With multiple research publications, conference presentations (NAPCON, SSIMSCON), and a strong academic background, I strive to combine evidence-based medicine with compassionate patient care. My mission is to provide comprehensive, high-quality care to patients suffering from respiratory and lifestyle-related diseases.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Amandeep Singh Arneja
Dr. Amandeep Singh Arneja

Pulmonology (Asthma Doctors)

Education:

MD RESPIRATORY MEDICINE

Professional Bio:

I am Dr. Amandeep Singh Arneja, a dedicated Chest Physician and Senior Resident in Pulmonary Medicine at Jawaharlal Nehru Medical College (JNMC), Wardha, with extensive training in the management of complex respiratory and critical care conditions. I completed my M.B.B.S. from Universal College of Medical Sciences, Tribhuvan University (2016) and M.D. in Respiratory Medicine from Shri Shankaracharya Institute of Medical Sciences, Bhilai (2025), where I gained hands-on expertise in managing ICU patients, performing advanced diagnostic and therapeutic procedures, and conducting research in pulmonary diseases. My areas of expertise include: Management of asthma, COPD, tuberculosis, and interstitial lung disease Critical care management (ICU care, mechanical ventilation) Pulmonary function testing (spirometry, DLCO) Interventional procedures (thoracentesis, ICD insertion, bronchoscopy) Sleep medicine and polysomnography Research, academic writing, and clinical presentations I hold certifications in Good Clinical Practice and Biomedical Research. I am a proud member of the National College of Chest Physicians (NCCP). Alongside my pulmonary expertise, I have also completed a CPCDM Fellowship in Diabetes from RSSDI, enabling me to provide holistic care for patients with respiratory diseases complicated by diabetes. Currently, I am also pursuing a Fellowship in Critical Care Medicine, which further enhances my ability to manage critically ill patients with respiratory and systemic illnesses. With multiple research publications, conference presentations (NAPCON, SSIMSCON), and a strong academic background, I strive to combine evidence-based medicine with compassionate patient care. My mission is to provide comprehensive, high-quality care to patients suffering from respiratory and lifestyle-related diseases.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality
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