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Methacholine Testing
Last week I had a follow up appointment with my local Pulmonologist, who brought up something a little unusual. For the most part, my appointment went well and showed some stabilization reflected in my Pulmonary Function Tests (PFTs) and some decline. Unfortunately, the highest decline was 8% on one test, which has me a little concerned but we talked about what I will need as a result of this decline and I feel a little better with a plan in place.
For now it doesn’t seem as though I will be adjusting my supplemental oxygen needs, even though this was offered, as I don’t really feel like its necessary. I’m currently managing well on my prescribed amount of oxygen, and don’t want to increase how often I need to use my tanks/POCs. I am to call my doctor directly if I ever feel as though I’m not getting enough, and he said he will adjust it right away. I am content with this!
One thing he did bring up though, which I thought was odd was a Methacholine test. Have any of you been offered, or taken this test following your diagnosis of IPF/PF? As far as I understand, this is a test to confirm asthma. I asked why he wanted to order a test that is focused on asthma, and he said it was to better understand how my airways react to certain allergins, likely contributing to the chronic, dry cough that I have consistently. I voiced that I thought this cough just came with IPF, and my doctor confirmed that it does but that sometimes other triggers can cause it and if those additional triggers can be treated, then there is a chance I’d be able to reduce the amount of coughing. From what I understand, I guess it would be like two things triggering an illness side effect and while one can’t be treated/reduced, another possible trigger can be, thus reducing the overall intensity of the side effect. Does this make sense to anyone else?
I wasn’t really sure what to say so I allowed my doctor to proceed with ordering this test, which will be set up within a few weeks. I guess it doesn’t hurt to try it out and see what it reveals, right?
Have any of you ever had this done?
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6 Replies
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Hi Charlene,
My pulmonologist has ordered this test too, but in my case it’s to figure out if the shortness of breath might have another cause than the fibrosis. He said it was to rule out occult asthma. I haven’t had the test yet, but will let you know what happens when I do.
Interested to hear what you find too.
Josie
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Hi Josie,
Thanks so much for contributing your experience to this topic thread – I was kind of worried no one else had any experience with Methacholine testing, which then left me questioning why my doctor wants to do it. Your sharing helps me understand a bit better, and feel a bit more comfortable that my Pulmonologist isn’t the only one taking this approach. The approach your doctor is taking might be the same one mine is. He is interested in finding out the cause of the chronic cough, as the amount of coughing I do isn’t consistent with the PFTs or scans of my chest. I guess I cough more than I “should be” so there may be a secondary cause? I haven’t heard of occult asthma but I’ll look it up for sure! Please let me know when you do the test and how it goes and I’ll do the same. I’m to have mine scheduled soon, but no one has reached out yet with any appointment. Stay tuned!
Thanks again,
Charlene. -
Hi Charlene and Josie, I am wondering how the tests went and if it was a good thing. I have a methacholine challenge test booked for March. The respirologist ( Pulmonologist in the US) I saw told me she did not think the amount of fibrosis I have was the cause of my symptoms of cough and SOB. I don’t agree with her as I have tried Ventolin puffers and my PFTs state “no changes with bronchodilators” so why proceed with this test? Did you find it beneficial? I am having another opinion in the end of January and I will ask that doctor but wondered about your input.
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Hi Charlene,
Although I have never heard of, or been offered, this test for allergy induced asthma, it makes sense to try it if it is non-invasive and no other “downsides”. Seems to me that any allergy induced restrictions/narrowing of the bronchial airways would aggravate the decline in blood O2 SAT rates of fibrosis or COPD patients. Seems to me that any narrowed bronchial tree would restrict both volumetric and DCLA (diffusion) measurements in a PFT. One responder mentioned it should not be necessary for her as her pft volumetric numbers did not improve with the administration of abuterol during testing. Maybe that could be true if there would no allergens present at or about the time of her pft. Best of luck and will look for you continued info on this test. Jim Knox -
Hi Nan,
I did have this test done, though it didn’t reveal any significant/important results. Some doctors still say I have some “adult-onset asthma” while others disagree and believe fully that the SOB is the fibrosis. I also don’t really improve with Ventolin though I have a million (it feels that way, Ha!) repeats of the inhaler on my prescription record. It isn’t a painful test, though it does trigger some significant coughing which is unpleasant. Ask Toronto about it, and whether or not they think it is necessary – if it is scheduled after your visit with them. Let us know, but ultimately no, I didn’t find anything revealing from this test. Char.
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Hi Jim,
Thanks for writing, and you’re completely right: the test didn’t really have any downsides or invasive measures associated with it, so I did take it early last year. It didn’t reveal anything significant but my doctor did it to rule something out in his mind, so I was satisfied with that. It did induce some unpleasant coughing, but with IPF, that can feel relatively normal. Glad I did it now, and can advise others on what to expect from it, even though it didn’t yield any significant findings for me. Happy New Year!
Charlene.
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