Brief Answer:
Add inhaled corticosteroids, life style changes

Detailed Answer:
Hello,

Thank you for asking at HCM.

I went through your history and can understand your concern.

I have gone through your reports and would like to make suggestions for you as follows:

1. Were I treating you, I would also suggest you regular montelukast and levocetirizine tablets. In addition, I would suggest you to use salbutamol inhaler on as-and-when-needed basis for wheezing or breathing difficulty symptoms.

2. As you have mentioned that despite using these medications you are having some problems, in that case, I usually suggest my patients regular inhaled budesonide for at least 6 weeks in addition to above.

3. Your spirometry is very much normal, but it looks like a single spirometry study. I would suggest you to do pre- and post-bronchodilator spirometry study, which helps to identify asthma.

Also, I would also suggest you to have a spirometry as a post-exercise study also to identify exercise-induced bronchospasm. This is more important for you as you are a cyclist.

These additional spirometry studies would help to identify your lung problem more specifically as in general, your spirometry study is very much normal and does not suggest you definitely have asthma.

4. Allergy report is also not helpful to your diagnosis. I would suggest you to consult an allergist who will perform allergy skin testing which is more specific and reliable as compared to blood allergy testing. If skin testing identifies some allergens, avoidance of allergens would help you.

5. Please take plenty of fluids during day to maintain hydration.

6. Regular breathing exercises, including practices like Yoga & Pranayama will also help you in a longer run by improving your lung capacity and immunity.

7. A diet rich in vitamins, minerals and anti-oxidants and a healthy, stress-free life style is also very important for maintaining immunity.

8. In general, please try to avoid exposure to dusts, smokes and air pollution as much as possible.

Hope above suggestions will be helpful to you.

Should you have any further query, please feel free to ask on follow-up. I will try my best to help you with best of my knowledge and efforts.

Wish you the best of the health ahead and a bright career.

Thank you & Regards,

Dr Parin N Parmar

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