Can asthma med cause hoarseness and hunger?


Q: Since using Trelegy for my asthma, my voice has been hoarse. I am also hungry more often. Are other Trelegy users complaining about these issues?

A: The strong corticosteroid (fluticasone) in Trelegy is known to cause hoarseness (dysphonia) as a relatively common side effect. (In addition to fluticasone, Trelegy contains umeclidinium and vilanterol.)

You’re not alone. Other readers also report hoarseness with inhaled steroids: “Since I’ve been using the Trelegy Ellipta inhaler, I’ve been hoarse every day. It is definitely to blame. “

Other inhalers associated with hoarseness due to the inhaled corticosteroid are Advair (fluticasone, salmeterol), Breo (fluticasone, vilanterol), and Symbicort (budesonide, formoterol).

Another common complication from inhaled steroids is thrush. This yeast infection can occur in the mouth and throat. Corticosteroids can also increase appetite.

Q: I take metoprolol, isosorbide, and losartan for high blood pressure. Nobody warned me that my eye drops (timolol) might increase the blood pressure lowering effects of these medicines. I can barely function after taking my BP medication and then applying my eye drops. I almost passed out several times. Is this combination risky?

A: Yes! You are taking a beta blocker (metoprolol) to lower blood pressure along with other antihypertensive drugs. The timolol in your glaucoma eye drops is also a beta blocker. This can lead to low blood pressure, dizziness and falls (BMJ, April 22, 2006).

Ask your ophthalmologist to show you the tissue compression method for applying your eye drops (Clinical & Experimental Ophthalmology, January 2020). After applying the drops, close your eyes and press a wrinkled cloth over the eye for a few seconds to absorb excess liquid. This will reduce the amount of timolol your body absorbs.

The best way to solve this problem is to avoid taking two beta blockers. There are other options for high blood pressure and glaucoma. Talk to your doctor and see if someone is willing to switch you to a different medication.

Read our eGuide to Blood Pressure Solutions to learn more about blood pressure medication and non-drug approaches. This online resource can be found under the Health eGuides tab on

Q: When I read your column on putting your legs up to reduce going to the toilet at night, I found it ridiculous. I’m a skeptic by nature and home remedies don’t appeal to me.

On the other hand, I don’t enjoy getting up three times at night to urinate. So I thought what the heck! I have now conducted my own clinical study on this question. If I spend an hour or so with my legs up before bed, I won’t have to get up that often at night. Why does it work?

A: As far as we can tell, there have been no scientific studies of this low-cost, low-tech technique. Raising your legs is to prevent fluid from building up in them. Some doctors recommend compression tubing as another means to the same end. Doctors suggest that doing this can help you get rid of excess fluids before bed, rather than overnight.

Q: I have type 2 diabetes. My doctor prescribed me metformin, but I found it caused terrible neuropathy in me. I had sharp pains in my legs and numbness in my feet and ankles.

After doing some research online, I decided to stop taking metformin and started taking Ceylon cinnamon instead. I use a water extract. I haven’t had any problems with neuropathy since making this change. My last test result showed that my HbA1c is 5.6 and my blood sugar is usually around 110. What do you think?

A: Be sure to tell your doctor what you are doing. Ask him or her to check your vitamin B12 levels, as metformin can decrease your absorption of this important nutrient. Small amounts of vitamin B12 can affect nerves and contribute to symptoms of neuropathy.

Cinnamon can help control blood sugar levels (Clinical Nutrition, April 2019). You are taking the safest approach to medicinal use of this spice: you have chosen Ceylon cinnamon, which is naturally low in coumarin, and you are using a water extract. This technology leaves the coumarin behind.

Coumarin is a compound that occurs naturally in the cassia cinnamon bark. Overdosing can damage the liver, so we recommend an approach like yours. tested cinnamon products and found that a water-based extract, Swanson Cinnulin PF, met its standards for low coumarin and high proanthocyanidins.

To learn more about cinnamon and other natural methods of controlling blood sugar in type 2 diabetes, you can read our eGuide to Preventing and Treating Diabetes. This online resource can be found under the Health eGuides tab on

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