Can inhalers cause obstruction?

I hope this is an okay question. If you are reading this please do not stop taking your medication without direct advice from your doctor! I would never stop taking my medication suddenly either.

I’m a 28M, 5 pack year smoking history, and have been having breathing difficulties for around 7-8 months now.

Looking back, I no troubles breathing and probably a sore throat from reflux, until I started on the symbicort inhaler prematurely at the suggestion of my GP. After starting the inhaler, I developed wheezing and problems breathing. I took a Spirometry test which showed FEV/FVC = 70% which went up to 77% post bronchilator.

Then I went onto a Breo inhaler and symptoms improved for a couple of weeks and got worse again, after increasing the dosage it improved, then got worse. After a few months I repeated the Spirometry, FEV/FVC = 68% with no change post bronchilator.


Now I am trialing a COPD inhaler (spiolto), I noticed a massive initial improvement in my peak flows. Again after 1-2 weeks my peak flow has dropped and symptoms are getting worse.

I understand inhalers are meant to clear obstruction, not create it. But I understand that paradoxical bronchoplasm can be a side effect of all of these inhalers.

Taking that further, can long term inhaler use ever show up as obstruction in Spirometry?

I still suspect it is COPD (although my pulmonologist does not think so due to my age and only very brief smoking history), I have a clear CT and no genetic factors. But I am still looking for answers and each inhaler is the main factor that has made symptoms worse.


Thank you!!