Inhaler problem

[Iris Kraft]

I am newly diagnosed with Asthma and find the Simbicort (gluten-free) is creating sore throat, inflamed vocal cords and upsetting mouth Flora. Has anyone else experienced same and how did you solve problem? Also use Albuterol as my rescue inhaler (gluten-free). 

[trents]

Welcome to the forum, @Iris Kraft!

Are you remembering to rinse your mouth out with water after using these inhalers?

[Iris Kraft]

Yes, I rinse my mouth twice, brush tongue, and gargle twice after using the inhaler.

[trents]

Maybe you are allergic to the Simbicort. I would suggest talking to your physician about an alternative inhaler medication.

Edited April 2, 2025 by trents

[Guest]

I have the exact same symptoms for a couple of wks now but I've been taking Symbicort for quite awhile at this point. I read you can get yeast infection in the vocal cords so I may ask my Dr. for antifungal meds cos I cant wait for an ENT exam. Also read on this site the connection between Vit D and K2 deficiency and asthma...doesn't apply to me cos mine is from mold in a house years ago but still might try and see if my asthma improves. I am Celiac and gluten causes the same symptoms but it says this inhaler is gluten free and it only started acting up so that option is out. I use Ventolin on occasion but using that for many many years. For me I will see if can switch inhalers to a brand that doesn't affect vocal cords as much, Advair is NOT one of them, plus will try the supplements. Do not suck on menthol lozenges cos menthol dries out cords more...sleeping elevated and sucking on ice chips gets the swelling down...at night this can really help especially. I can't continue like this so will get on everything this coming week.  

[Iris Kraft]

I do not use menthol lozenge, but I have found a brand of oral probiotics that has same ingredients as Prodentim but without spending $50  bottle. I bought Naturewise Oral probiotics from Amazon at $29 a bottle for 50 chewables instead of the 30 qty. The Simbicort upset the bacteria is my mouth, had white tongue and created a dental problem with a tooth, plus the inflammation in throat, vocal cords. Used the chewable and rested it along the gum where tooth hurts 4 x on Monday. Tuesday, went to dentist and she looked at what I thought was my problem tooth and she said all looked pink and happy. No problem.  Also, I spoke with my Allergist and he said instead of two puffs am and pm, try one puff only in am.Can always add one puff in PM if needed. Rinse mouth twice and gargle twice, and brush tongue. Use the Rescue inhaler Albuterol if needed (which I didn't need to). Know that Flucasolone, Simbicort, Advair are interchangeable.

[Guest]

1. I would not use Advair at all, it is clinically shown to cause vocal cord side effects... saw this on a music website where a singing teacher posted the most problems re inhalers are with Advair & when checked with pharmacist it was true...I don't have coverage for it anymore anyway so i don't use it anymore...but it is not good for vocal cords. 

2. My gluten symptoms are not gastrointestinal, they're the same symptoms you're describing....vocal cord swelling, throat clearing, white stuff on tongue, sore throat...mine has little white  bumps & red areas...these symptoms happen after I eat gluten & I'm thinking now I've been eating pasta the last while that prob I'm allergic to even though it says gluten free. I also can't eat oats, barley, some gluten free flours, or grocery/bakery gluten free products. Some food industry professionals say that it's not the gluten that's the problem it's what they're spraying on crops...which would explain why I'm allergic to so much...sprays are used for almost everything. You may want to think about what you're eating...are there things labeled gluten free you're consuming? Cos they may be causing the reaction...gluten free breads, crackers, pastas? Barley or oats? Even some buckwheat flour I can react to...Cornflakes have barley malt in them so do some ice creams, a swiss chocolate bar i bought I reacted to because the label had gluten on it.  You really have to be careful. I would take things out of your diet if you're eating them & see if things improve.

[trents]

I don't mean to be an ogre but this thread would seem to be unrelated to gluten/celiac/NCGS issues. Is there another health-related online community that might be more appropriate and more helpful to those experiencing these reactions to inhaler use?

[Guest]

It's totally related....move on if don't like it. Sheesh. 

[Guest]

I am off the charts celiac and I have the same symptoms as the post who is asking. We are talking about celiac, food allergies, celiac symptoms & inhalers. Some inhalers are possibly not gluten free...our comments celiac related & don't get your PROBLEM so pls move on. 

[trents]

Are you saying you believe there is gluten in the inhaler products? I mean you talk a lot about reacting to foods that are supposed to be gluten free but this thread is about inhalers. 

[trents]

There could be other reasons you are reacting to the inhalers. There is no concrete evidence to believe they contain gluten. Anecdotal experiences can be misleading do not establish fact.

[Guest]

Re food,  I said the gluten free thing isn't necessarily about gluten itself, but chemical sprays they use on GRAINS which cause allergic throat & vocal cord issues regardless of the inhaler you're using.  Your issue may not be the inhaler but eating gluten free food that still will bother you because they have been sprayed with certain chemicals. Barley & oats cause vocal and throat issues with me as well as gluten free flours. We didn't have gluten issues in the world yrs ago...the food changed somehow or they're using sprays that cause reactions in some people. 

Re inhaler: Symbicort is registered as gluten free but companies can change their ingredients at any time so you may want to check with the company who makes it and get an ingredient list. 

I don't believe I'm reacting to the inhaler...I believe it's a gluten free pasta I've been eating so I'm taking it out of my diet. I've used the inhaler for over 1 year and no problems up until now so I suspect it's the pasta. 

[trents]

On 4/6/2025 at 10:04 PM, Guest said:

Re food,  I said the gluten free thing isn't necessarily about gluten itself, but chemical sprays they use on GRAINS which cause allergic throat & vocal cord issues regardless of the inhaler you're using.  Your issue may not be the inhaler but eating gluten free food that still will bother you because they have been sprayed with certain chemicals. Barley & oats cause vocal and throat issues with me as well as gluten free flours. We didn't have gluten issues in the world yrs ago...the food changed somehow or they're using sprays that cause reactions in some people. 

Re inhaler: Symbicort is registered as gluten free but companies can change their ingredients at any time so you may want to check with the company who makes it and get an ingredient list. 

I certainly agree with all that. However, you also mentioned cornflakes with barley malt but that would obviously not be gluten free since barley is a gluten-containing grain. And the chemicals they spray on grains would affect everyone, not just those with gluten disorders. I'm just trying to figure out what this thread has to do with the main subject this online community is focused on. Is the point of this thread that having a gluten disorder makes someone more susceptible to reacting adversely to inhalers? That could be but it may have nothing to do with the inhaler having gluten. It could have to do with, say, having higher systemic yeast counts because the celiac community generally suffers from gut dysbiosis. So it would be easier for celiacs using inhalers to develop thrush.

[Guest]

Not everyone will be allergic to whatever they're using in food. There is another forum re people who are posting they have vocal cord & throat issues after they eat breads & pastas which stopped after they removed those foods from their diets. Same as me...gluten doesn't react as gastrointestinal it reacts orally. Which is why I'm saying ensure all your food isn't what you're having a reaction to. 

...& I used Cornflakes as an example because some gluten free people would assume it's gluten free but if they're allergic to barley they will have a reaction...nothing to do with their inhaler.  You're missing my points a lot & frustrating so I'm done commenting. You really need to ensure your food isn't what's causing the issue. I am checking with symbicort manufacturer to check their ingredients. 

[trents]

Guest, thanks for the clarification. I think I understand your point now. Yes, I realize gluten can produce non Gi Reactions. Let us know if you find out that there is gluten in these inhalers. I have my doubts but gluten does show up in strange places. It could also be manufacturer dependent of these inhaler products are generic.

[Iris Kraft]

Gluten shows up in Anesthesia, anti- inflammatory meds, pain meds. That's from a real experience because I had dental surgery and Dentist didn't know. I couldn't hold food or water down for over 24 hours.  Eventually it wore off but was scary. The point made that because trace amounts of gluten is deemed acceptable, the impact to some of us can be huge when you take foods or meds with these trace amounts that become cumulative. 

[Scott Adams]

So there can be gluten in pain meds, but I've never heard of it in anesthesia before. Do you have any more info on this claim, perhaps a link to a source?

[Guest]

I never said anesthesia. Medical companies can of course change their ingredients at anytime. What may be listed as gluten free on a website may not be updated so always good to check with pharmacy or the medical company itself. 

[Guest]

My POINT trents, was actually related to food more than inhalers causing your issue. My POINT is that even though gluten free food is supposed to not cause a reaction it does and can in some people so think about what you're eating...premade foods labeled gluten free like breads, pastry, cookies....whatever you're consuming....may be causing the reaction. I can't eat any gluten free breads from stores & certain pasta is a no too...others are OK. You may want to eliminate certain foods and see if your problem clears up. 

2. Check with the inhaler manufacturer to ensure it's gluten free. Other than those two points if it continues a throat scope by an ENT may be needed to rule out other things. 

[Iris Kraft]

I have alerted surgeons that they need to check with manufacturers and labs to vet the anesthesia. My hands surgeon did that and I was ok so reconstruction surgeon called her to use same anesthesia. They certainly wouldn't have taken just my word.

[knitty kitty]

Hello,  

The medication in these inhalers can cause a thiamine deficiency if used by someone already low in thiamine.  We don't absorb sufficient amounts of vitamins and minerals due to the inflammation and damage done to our villi in Celiac Disease.  Even a long term strict gluten free diet may not provide sufficient amounts of vitamins and minerals. 

There are eight B vitamins that all work together.  Thiamine deficiency often shows up first because our bodies use so much of it and it can't be stored very long. Thiamine deficiency symptoms can appear in as little as three days.  Without thiamine, the other B vitamins may not be able to function properly.  

Thiamine is needed to clear lactic acid accumulation caused by the inhalers:

Shoshin beriberi provoked by the inhalation of salbutamol

https://pubmed.ncbi.nlm.nih.gov/12951730/   

Significant Lactic Acidosis from Albuterol

https://pmc.ncbi.nlm.nih.gov/articles/PMC5965110/

Albuterol-Induced Type B Lactic Acidosis: Not an Uncommon Finding

https://pmc.ncbi.nlm.nih.gov/articles/PMC7263006/

Lessons of the month 1: Salbutamol induced lactic acidosis: clinically recognised but often forgotten

https://pmc.ncbi.nlm.nih.gov/articles/PMC6964186/

An Overview of Type B Lactic Acidosis Due to Thiamine (B1) Deficiency

https://pmc.ncbi.nlm.nih.gov/articles/PMC10731935/

 

Thiamine has antifungal and antibacterial properties.  Thiamine helps keep Candida in check.  Thiamine helps keep SIBO in check.  Thiamine helps with black mold, Aspergillis infection.  Riboflavin helps fight Candida infection in the mouth.

Riboflavin Targets the Cellular Metabolic and Ribosomal Pathways of Candida albicans In Vitro and Exhibits Efficacy against Oropharyngeal Candidiasis

https://pubmed.ncbi.nlm.nih.gov/36625571/

 

Thiamine deficiency can make ones voice hoarse and can cause localized edema.  Niacin deficiency can make ones voice hoarse.  (Niacin deficiency and Thiamine deficiency can each cause irritability, agitation, and lability.)

Hoarseness in pellagra

https://pubmed.ncbi.nlm.nih.gov/21507655/

Hidden Hunger: A Pellagra Case Report

https://pmc.ncbi.nlm.nih.gov/articles/PMC8152714/

 

Anesthesia can cause B12 deficiency.  B12 deficiency can show up as mouth sores and geographic tongue, diarrhea, and dementia.

Vitamin deficiency, a neglected risk factor for post-anesthesia complications: a systematic review

https://pmc.ncbi.nlm.nih.gov/articles/PMC11823251/

Neurologic degeneration associated with nitrous oxide anesthesia in patients with vitamin B12 deficiency

https://pubmed.ncbi.nlm.nih.gov/8250714/

Subacute combined degeneration of the spinal cord following nitrous oxide anesthesia: A systematic review of cases

https://pubmed.ncbi.nlm.nih.gov/30144777/

The Effect of Vitamin B12 Infusion on Prevention of Nitrous Oxide-induced Homocysteine Increase: A Double-blind Randomized Controlled Trial

https://pmc.ncbi.nlm.nih.gov/articles/PMC4052402/

 

 

Eating a diet that is heavy in carbohydrates can precipitate a thiamine deficiency.  As the amount of carbohydrates consumed increases, additional thiamine is needed, otherwise the carbs will be stored as fat.

 

Thiamine deficiency disorders: a clinical perspective

https://pmc.ncbi.nlm.nih.gov/articles/PMC8451766/

 

Hiding in Plain Sight: Modern Thiamine Deficiency

https://pmc.ncbi.nlm.nih.gov/articles/PMC8533683/

 

The deficiency symptoms of some of the B vitamins cause gastrointestinal symptoms that resemble the same symptoms as when being glutened.   Thiamine deficiency can present as vomiting, diarrhea and abdominal pain (Gastrointestinal Beriberi).  Niacin deficiency can present as diarrhea (Pellagra = diarrhea, dermatitis, dementia, then death ).  B12 deficiency can present as diarrhea or dementia.  Not everything is caused by hidden gluten.  Gluten free processed foods are not required to be enriched with vitamins lost in processing like gluten containing foods are.

Blood tests are not accurate measurements of vitamin levels, but do talk to your doctor and nutritionist about supplementing with the eight B vitamins, Vitamin C, the four fat soluble vitamins and minerals like magnesium.  Your physician can give you a shot of B12 before anesthesia administration.  

By the way, Celiac Disease genes have been traced back to having originated in Neanderthals.  I'm not a singing teacher on the net.  I earned a degree in Microbiology after studying nutrition because I wanted to know what vitamins are doing inside the body.  I've experienced nutritional deficiencies myself.

Hope this helps!  Keep us posted on your progress!