🌿 Covid-19 and ABPA / Bronchiectasis: What Patients Need to Know

Many patients with ABPA, bronchiectasis, and asthma ask:

“If I test positive for Covid, am I at higher risk, and do I need antivirals or steroids?”
“Is Covid still a dangerous infection now that everyone has had it many times?”

Here’s what’s important right now.

🎯 Why you may be at higher risk

Having ABPA, bronchiectasis, or asthma doesn’t guarantee severe illness, but it does put you at higher risk compared to the average healthy adult. This means you are more likely to experience:

  1. More severe Covid illness – infections can trigger worse chest symptoms (wheeze, shortness of breath, cough).

  2. Secondary infections – bronchiectasis makes it easier for bacteria to grow in mucus after a viral infection.

  3. Flares of existing disease – Covid can set off asthma attacks or ABPA flare-ups.

  4. Slower recovery – fatigue, breathlessness, and extra sputum can last longer.

⚠️ Important: “Higher risk” does not mean you will definitely become very unwell. Many people with chronic lung disease still have mild Covid and recover fully at home.

✅ Current Covid treatments in the UK (2025)

  1. Antivirals / monoclonal antibodies

    • People with conditions like ABPA, bronchiectasis, or severe asthma may be eligible for medicines such as Paxlovid or Molnupiravir.

    • These must usually be started within 5 days of symptoms or a positive test.

    • Access is through the NHS Covid Medicines Delivery Unit (CMDU), often arranged via NHS 111 or your GP.

  2. Steroids

    • Oral steroids (prednisolone) are not routinely given for Covid unless oxygen levels drop, or you already take them for your lung condition.

    • If your asthma/ABPA flares, follow your specialist’s guidance on when to start rescue steroids.

  3. Antibiotics

    • Covid is viral, so antibiotics don’t treat it directly.

    • But if your doctor suspects a bacterial infection (e.g. in bronchiectasis), they may prescribe something like doxycycline.

🧾 Practical steps if you test positive

  • Call NHS 111 or your GP: Tell them you have ABPA/bronchiectasis/asthma and ask about referral for antivirals.

  • Monitor symptoms closely:

    • Use a pulse oximeter if you have one (seek help if oxygen ≤94%).

    • Watch for worsening breathlessness, chest pain, or confusion.

  • Keep safe at home: Ventilate rooms, use masks if possible, and wash hands often — though once exposed, focus mainly on monitoring and treatment.

🚨 When to seek urgent help

  • Severe shortness of breath

  • Oxygen levels ≤92–94%

  • Chest pain, confusion, or sudden collapse
    → Call 999

❓ Is Covid still dangerous in 2025?

Why it feels less dangerous now

  • Vaccination and immunity: Most people have had jabs and multiple infections, so later bouts are usually milder.

  • Variants: Current strains spread more easily but often cause less pneumonia than the original virus.

  • Better treatments: Antivirals and steroids (when needed) are widely available.

Why it can still be dangerous

  • Vulnerable groups: People with lung disease, weakened immunity, or older age are still more likely to need hospital care.

  • Exacerbations: Even mild Covid can set off asthma or ABPA flares, or worsen bronchiectasis infections.

  • Long Covid: Some people continue to develop fatigue, breathlessness, or brain fog lasting weeks to months.

  • Hospital admissions: Lower than during the pandemic, but NHS hospitals still see severe cases every winter.

👉 In summary: For most healthy people, Covid now feels like a bad cold or flu. For people with ABPA, bronchiectasis, or severe asthma, it can still be a dangerous infection — which is why monitoring and access to antivirals remain important.

✅ Key message

With ABPA and bronchiectasis, you are more vulnerable to complications from Covid. Most people still recover at home, but you may be eligible for antivirals. Steroids are only used if your underlying condition flares or if your oxygen drops. Stay alert, act quickly if symptoms worsen, and reach out for NHS support as soon as you test positive.

by GAtherton

🌿 Coping with Exhaustion When Tapering Prednisolone

Coming off prednisolone can leave you feeling unusually tired. This happens because:

  • Your body’s own adrenal glands have been “asleep” while steroids did the work.

  • As the dose drops, your body needs time to start making its own cortisol again.

  • Tiredness and low energy are the most common symptoms during this adjustment.

✅ Tips that may help

1. Pace yourself

  • Don’t expect full energy straight away.

  • Break tasks into smaller chunks, with rests in between.

  • Use a “little and often” approach for activities.

2. Prioritise rest and sleep

  • Listen to your body: extra rest is part of recovery, not weakness.

  • Try to keep a regular bedtime routine to support natural hormone rhythms.

3. Gentle movement

  • Light activity (walking, stretching) can actually boost energy and mood.

  • Avoid pushing too hard — overexertion can worsen fatigue.

4. Balanced diet

  • Aim for regular meals with protein, whole grains, fruit/veg.

  • Stay hydrated — dehydration makes fatigue worse.

  • Limit caffeine or sugar “quick fixes” that lead to energy crashes.

5. Monitor stress

  • Emotional stress increases your body’s demand for cortisol.

  • Try calming activities: breathing exercises, mindfulness, or gentle hobbies.

6. Stay in touch with your team

  • If exhaustion is severe, worsening, or you develop dizziness, faintness, low blood pressure, or nausea → contact your doctor urgently.

  • These can be signs your body is struggling with adrenal insufficiency, and your taper may need adjusting.

⚠️ Important reminders

  • Never stop prednisolone suddenly unless your doctor tells you to.

  • Carry a steroid card or alert bracelet if you are tapering — in case of emergencies.

  • If you get unwell (infection, surgery, severe stress), you may temporarily need a higher steroid dose.

👉 Key message:
Tiredness during tapering is very common. Self-care, pacing, and staying in close contact with your healthcare team can help you get through this phase more smoothly.

by GAtherton

🧾 A Patient’s Guide: How to Raise Concerns About Possible Vitamin or Mineral Deficiencies

🌱 Why this matters

People with chronic lung conditions such as aspergillosis, asthma, bronchiectasis, or ABPA often feel fatigued, weak, or run down. Sometimes these symptoms are partly caused by a vitamin or mineral deficiency (e.g. iron, vitamin D, B12). But testing is not automatically offered in the NHS unless there are clear reasons.

Knowing how to raise the concern makes it more likely your GP will take it seriously and order the right tests.

🩺 Why GPs won’t “just run a full panel of tests”

  • Cost and resources: Lab tests are expensive. Panels covering 10+ nutrients aren’t routinely funded.

  • Evidence-based practice: Guidelines (like NICE) advise testing only if there’s a clear clinical reason — not just curiosity.

  • Safety: Too much of certain vitamins (like iron or vitamin D in sarcoidosis) can be harmful if taken unnecessarily.

So rather than asking for “a panel,” it’s best to highlight specific risks or symptoms.

🔍 How to suggest you may have a deficiency

  1. Link to your symptoms

    • Fatigue, pale skin, shortness of breath → ferritin (iron)

    • Muscle weakness, bone pain → vitamin D & calcium

    • Tingling, memory issues → B12 & folate

    • Frequent infections → vitamin D, iron, zinc (though zinc is rarely tested on the NHS)

  2. Refer to your condition or treatment

    • Steroid use: raises risk of osteoporosis → vitamin D & calcium testing often justified.

    • Antifungal medication: can affect liver function & absorption → may influence nutrient status.

    • Sarcoidosis: special caution with vitamin D → specialist testing sometimes needed.

    • Kidney/liver disease: changes how nutrients are processed.

  3. Use guideline evidence

    • NICE, BNFC or patient charities often recommend when a test is justified.

    • Bringing a leaflet (e.g. SarcoidosisUK on vitamin D) can support your case.

  4. Frame it as safety, not curiosity

    • Instead of “I’d like a full vitamin panel,” try:
      “I’ve had ongoing fatigue and a self-test showed my ferritin was low. NICE guidelines mention testing ferritin in these situations. Could we check that?”

🛒 What about over-the-counter (OTC) tests?

You can buy some blood spot kits privately from Boots, Superdrug, or online (Thriva, Medichecks, Forth). These can give helpful information — but they’re not a replacement for GP care.

Test Available OTC? Notes
Ferritin (Iron stores) ✅ Widely available Good first check if you have fatigue or anaemia risk.
Vitamin D (25-hydroxy) ✅ Widely available Most popular; bone/muscle health.
Vitamin B12 / Folate ✅ Available online Useful if you have fatigue, memory issues, neuropathy.
Magnesium, Zinc, Selenium ⚠️ Some private labs only More expensive; less reliable finger-prick accuracy.
Omega-3 index ⚠️ Niche Measures fatty acid balance.
Calcium ❌ Not OTC Needs venous blood in hospital.
Active vitamin D (1,25-dihydroxy) ❌ Not OTC Needed in sarcoidosis; specialist only.

⚠️ Important:

  • OTC kits vary in quality; stick to UKAS-accredited labs.

  • GPs may not act on private results unless they cross NHS thresholds.

  • Self-supplementing without medical oversight can be risky — e.g. iron overload, or vitamin D worsening sarcoidosis.

⚖️ Why this approach matters

  • Helps your GP match your request to clinical guidelines.

  • Reduces the chance of being dismissed as “just worried.”

  • Protects you from the risks of self-supplementing without knowing your true levels.

✅ Key Takeaways

  • Don’t ask for “everything” — focus on the nutrients most relevant to your condition, treatment, and symptoms.

  • Use published guidance or patient resources to back up your request.

  • OTC tests exist for iron, vitamin D, and B12, but they’re not a substitute for GP advice.

  • Testing is about patient safety (avoiding both deficiency and harm from unnecessary supplements).

by GAtherton

Winter 2025–26: Flu & Other Respiratory Viruses. Bad Flu Season coming?

Information for people living with aspergillosis (ABPA, CPA and related conditions)

What the evidence says right now

Signals pointing to a tougher flu season

  • Southern Hemisphere “preview.” Australia saw higher-than-usual flu notifications in early 2025 compared with 2024, which often foreshadows a busier winter in the UK and Europe. That doesn’t guarantee the same for us, but it’s a warning sign. ausvaxsafety.org.au

    • By September 2025 the numbers of cases in Australia had reached similar levels to those seen in 2024 www.health.gov.au

  • Co-circulation of viruses. In recent winters, influenza, RSV and COVID-19 have circulated together, increasing pressure on people at risk and on health services. WHO continues to flag this pattern in seasonal updates. World Health Organization

  • UK picture (late Sept 2025). UKHSA reports flu and COVID-19 at baseline/low levels for now. Activity can rise quickly as weather cools and schools/universities return. GOV.UK

  • Vaccine effectiveness (VE). Last season’s European interim VE against influenza A was ~32–53%, which is moderate—helpful at preventing severe illness and hospitalisation, especially in higher-risk groups. Effectiveness varies by age, strain and match. PMC

  • Timing. After Southern Hemisphere signals and based on past seasons, an earlier start (late Oct–Nov) with a Dec–Jan peak is plausible, though not certain. Local surveillance will confirm if that pattern emerges.

Why forecasts are uncertain (and what can improve outcomes)

  • Vaccine uptake. Higher uptake = smaller peaks and fewer hospitalisations. GOV.UK

  • Strain match. If circulating strains stay close to vaccine strains, protection is better; drift reduces it. PMC

  • Public behaviour. Ventilation, masks in crowded indoor spaces, and staying home when unwell still reduce spread. NHS Covid

  • Population immunity & health-system readiness. Recent infections and prior vaccines help; NHS readiness also matters.

What this means if you have aspergillosis

People with ABPA/CPA or bronchiectasis can have more severe or longer-lasting symptoms from flu, RSV, or COVID-19. Practical steps:

  • Get your vaccines when invited.

    • Flu vaccine (annual) and the autumn COVID-19 dose if you’re eligible. These don’t eliminate risk but reduce severe illness and hospitalisation. Flu  Covid

  • Act early if you become unwell.

    • Watch for fever, sore throat, cough, breathlessness, increased sputum, chest pain, or a fall in home SpO₂. NHS Covid  NHS Flu

    • Seek medical advice promptly—early antivirals (for COVID-19, and occasionally for flu in high-risk people) are time-sensitive.

  • Keep your baseline care tight.

    • Continue airway clearance, inhalers/other prescribed medicines, and your personalised action plan.

    • Ask about a rescue plan (who to call, when to test, when to increase treatments).

  • Reduce exposure where you can.

    • Improve ventilation, avoid poorly ventilated crowded spaces during peaks, consider masking indoors when rates rise, and hand hygiene.

Bottom line

  • Many experts anticipate a busier-than-average flu season in the UK/Europe this winter, but outcomes are not fixed. What we each do—vaccination, early help if ill, and sensible precautions—can make a big difference.

by GAtherton

🧾 Vitamins & Minerals in Aspergillosis: What Patients Should Know

Living with aspergillosis (ABPA, CPA or other forms) and its treatments can affect your body’s levels of certain vitamins and minerals. Some of these nutrients are important for bone strength, energy, and the immune system.

But ⚠️ taking supplements without advice can be harmful. Always check with your doctor or specialist team before buying or using vitamins or minerals.

🌟 Common Deficiencies in Aspergillosis

1. Vitamin D & Calcium

  • Why important: Strong bones, healthy immune system.

  • Why low: Long-term steroids and less sunlight.

  • Problems if low: Weak bones, higher risk of fractures, tiredness.

  • ⚠️ Too much can cause kidney damage — only take on medical advice.

2. Magnesium

  • Why important: Muscle strength, energy, nerve function.

  • Why low: Some antifungal or reflux medicines reduce levels.

  • Problems if low: Muscle cramps, weakness, tiredness.

  • ⚠️ High doses can upset the heart and kidneys — medical supervision is essential.

3. Iron

  • Why important: Carries oxygen in the blood.

  • Why low: Chronic illness, poor appetite, blood loss.

  • Problems if low: Tiredness, breathlessness, pale skin.

  • ⚠️ Aspergillus uses iron to grow — taking iron when you don’t need it can make infection worse.

4. Zinc

  • Why important: Healing, immunity, skin health.

  • Why low: Chronic illness or poor diet.

  • Problems if low: Slow wound healing, infections, taste changes.

  • ⚠️ High zinc can block copper absorption and damage health.

5. B Vitamins (B12, Folate, B6)

  • Why important: Energy, blood health, nerve function.

  • Why low: Poor absorption, weight loss, some medicines.

  • Problems if low: Fatigue, pins and needles, anemia.

  • ⚠️ Over-supplementation can also cause problems — needs testing first.

6. Vitamin A

  • Why important: Keeps lung lining healthy.

  • Why low: Poor diet, chronic illness.

  • Problems if low: Weaker lung defences, more infections.

  • ⚠️ Too much vitamin A can be toxic (especially to the liver).

7. Vitamin K

  • Why important: Normal blood clotting.

  • Why low: Gut bacteria disruption from antibiotics/antifungals.

  • Problems if low: Easy bruising, bleeding gums, nosebleeds.

  • ⚠️ Vitamin K can interfere with warfarin and other blood thinners.

🩺 Safe Steps for Patients

  • ✅ Ask your doctor about vitamin D and calcium checks (especially if on steroids).

  • ✅ Routine blood tests can check iron, B12, folate, magnesium, zinc.

  • ✅ Take supplements only if prescribed — many interact with antifungal medicines.

  • ✅ Don’t buy “high-dose” vitamins or minerals online or in shops without advice.

  • ✅ Ask your team about a dietitian referral if you are struggling with appetite or weight.

  • ✅ Bone scans (DEXA) may be needed to monitor steroid-related bone loss.

📌 Key message

People with aspergillosis are more likely to have low levels of vitamin D, calcium, magnesium, iron, zinc, and B vitamins.
These can affect your energy, bones, and immune system.
👉 Supplements can help — but only when checked, prescribed, and monitored by your healthcare team.

by GAtherton

🌟 Biologics and the Future: A Toolkit for Severe Asthma, ABPA & Beyond

Many people with severe asthma or Allergic Bronchopulmonary Aspergillosis (ABPA) now have access to biologic medicines — treatments that block very specific signals in the immune system. For some, the results can feel miraculous. For others, the effect may fade or never fully take hold. But the exciting news is that science is building a toolkit of biologics that can be matched more closely to each person.

✨ Why biologics sometimes stop working

  • Biologics like tezepelumab (which blocks TSLP) can give dramatic improvements, but in some people the benefit doesn’t last.

  • That may be because the immune system “switches pathways” — other signals (like IL-5 or IL-13) start to dominate.

  • It doesn’t mean treatment is over — it means we need to try a different tool in the kit.

🧰 The current toolkit

Each biologic blocks a different “messenger” (called cytokines) in the immune system:

  • IgE blocker (omalizumab): helps in allergy-driven asthma/ABPA.

  • IL-5 / IL-5R blockers (mepolizumab, benralizumab, reslizumab, and soon depemokimab): reduce eosinophils (a type of white blood cell) that cause inflammation.

  • IL-4 / IL-13 blocker (dupilumab): controls type-2 inflammation, also helpful in eczema and nasal polyps.

  • TSLP blocker (tezepelumab): targets an “alarmin” high up in the pathway, useful across many asthma types.

  • IL-33 blockers (in development): another upstream “alarmin” that could help in the future.

🚀 What’s new and coming soon

  • Depemokimab: a long-acting IL-5 treatment, given only twice a year.

  • Inhaled anti-TSLP: same target as tezepelumab, but in inhaler form.

  • IL-33 blockers: still experimental, but promising because IL-33 is involved in fungal allergy and ABPA.

💡 What this means for ABPA

  • ABPA involves allergy (IgE), eosinophils (IL-5), and other signals like IL-33.

  • That’s why some patients respond to omalizumab, others to mepolizumab/benralizumab, others to dupilumab, and some to tezepelumab.

  • In the future, doctors may be able to choose the exact biologic (or even combination) that best matches your immune profile — just like targeted cancer treatments today.

🧩 The Biologic Toolkit (summary table)

Target Signal Biologics How it Helps Relevance to ABPA
IgE (allergy antibody) Omalizumab Calms allergic reactions Useful when IgE is high and fungus/allergy is a trigger
IL-5 / IL-5R (eosinophils) Mepolizumab, Benralizumab, Reslizumab, Depemokimab (6-monthly) Reduces eosinophils that damage lungs Helpful in many ABPA patients with high eosinophils
IL-4 / IL-13 (type-2 inflammation) Dupilumab Reduces mucus, inflammation, and steroid need Good in patients with eczema or nasal polyps alongside ABPA
TSLP (alarmin, upstream trigger) Tezepelumab, Inhaled anti-TSLP (in trials) Blocks an “early alarm” that activates many asthma pathways Early evidence: big improvements in some ABPA patients
IL-33 / ST2 (alarmin) Itepekimab, Astegolimab (in development) Switches off another early “danger signal” IL-33 is strongly linked to fungal allergy → promising for ABPA

🫁 COPD, Bronchiectasis & Mucus Plugging

  • COPD: Some biologics (like anti-IL-5) show benefit in patients with high eosinophils, and IL-33 blockers are being tested. Not yet routine NHS use.

  • Bronchiectasis: Biologics mainly help when asthma/ABPA overlap is present. Airway infections remain the bigger challenge.

  • Mucus plugging: Dupilumab can reduce mucus production. Other biologics may help indirectly, but airway clearance techniques remain essential.

💷 Why new medicines are expensive

  • Developing a new drug takes 10–15 years and can cost over £1 billion.

  • Most drugs fail — profits from a few successes must cover all the failures.

  • Patents give companies a period of exclusivity to recover costs, after which cheaper copies (generics or biosimilars) appear.

📊 Open market vs NHS

  • In the US (open market), companies set prices, and insurers or patients decide if they can pay → faster access, but very high costs and inequality.

  • In the UK (NHS), the system is funded by taxpayers. NICE weighs up cost vs benefit before approving drugs → slower access sometimes, but once approved, everyone gets it fairly.

🧬 Rare diseases and fungal infections

  • For rare diseases like ABPA and CPA, the market is too small to attract big pharma on profit alone.

  • Organisations like GAFFI (Global Action for Fungal Infections) and DNDi (Drugs for Neglected Diseases initiative) work with universities, charities, and governments to develop antifungals.

  • Examples:

    • Olorofim (F2G, UK biotech): a brand-new antifungal class, developed with public and charity support.

    • Rezafungin: a long-acting antifungal supported by government and public funding.

  • Without these partnership models, fungal drugs for ABPA/CPA would likely not exist.

🌈 The takeaway

  • Biologics are transforming treatment for asthma and ABPA — and new ones are coming.

  • If one biologic doesn’t work, others may.

  • COPD, bronchiectasis, and mucus plugging may also benefit in future.

  • New drugs are costly to develop, but the NHS negotiates to keep access fair.

  • For rare diseases like ABPA/CPA, partnerships and advocacy are crucial to get new drugs developed at all.

 

📖 Glossary of Acronyms

ABPA – Allergic Bronchopulmonary Aspergillosis
A lung condition caused by allergy to Aspergillus fungus, leading to inflammation, mucus plugging, and lung damage.

CPA – Chronic Pulmonary Aspergillosis
A long-term lung infection with Aspergillus fungus, usually in people with existing lung disease.

COPD – Chronic Obstructive Pulmonary Disease
A group of lung conditions (like chronic bronchitis and emphysema) that cause breathing difficulties.

NHS – National Health Service
The publicly funded healthcare system in the UK.

NICE – National Institute for Health and Care Excellence
The body that decides which treatments the NHS should fund, based on cost and benefit.

QALY – Quality-Adjusted Life Year
A way of measuring the benefit of a treatment: how much it improves both the length and quality of life.

IL – Interleukin
A type of messenger protein (cytokine) used by the immune system to trigger inflammation. Different ILs have numbers (IL-4, IL-5, IL-13, IL-33).

IgE – Immunoglobulin E
An antibody linked to allergies. Very high IgE levels are common in asthma and ABPA.

TSLP – Thymic Stromal Lymphopoietin
An “alarmin” (early danger signal) that tells the immune system to start reacting. Blocked by tezepelumab.

ST2 – Suppression of Tumorigenicity 2
The receptor for IL-33. Drugs like astegolimab block this pathway.

GAFFI – Global Action For Fungal Infections
A non-profit organisation pushing for better care, awareness, and research into fungal disease.

DNDi – Drugs for Neglected Diseases initiative
An international group that develops treatments for rare or overlooked diseases (including fungal infections).

EAMS – Early Access to Medicines Scheme
A UK programme that allows patients to use promising medicines before full approval.

FDA / EMA / MHRA – Food and Drug Administration (US) / European Medicines Agency (EU) / Medicines and Healthcare products Regulatory Agency (UK)
The agencies that approve and regulate medicines.

by GAtherton

Steroid Use and Your Eyesight: What Patients Need to Know

Steroids (such as prednisolone, inhaled corticosteroids, eye drops, or steroid injections) are important medicines for conditions like asthma, allergic bronchopulmonary aspergillosis (ABPA), and other inflammatory illnesses. But they can also affect your eyesight — sometimes in subtle ways day-to-day, and sometimes with long-term risks.

This guide explains what may happen, why vision can fluctuate, and what you can do to protect your eyes.

How steroids can affect the eyes

  • Cataracts
    Long-term steroids may cause a type of cataract at the back of the lens (posterior subcapsular). This can cause glare, blurred vision, or difficulty seeing in bright light.

  • Glaucoma (raised eye pressure)
    Steroids can increase pressure inside the eye, potentially damaging the optic nerve if untreated. This is more common with steroid eye drops, but tablets and inhalers can also contribute.

  • Central Serous Retinopathy (CSR)
    Fluid may build up under the retina, causing blurred or distorted central vision. Usually reversible when steroids are reduced or stopped, but it can recur.

  • Blood sugar and fluid changes
    Steroids raise blood sugar and shift body fluids. This can temporarily alter the eye lens, making vision sharper one day and blurrier the next.

  • Delayed healing and infection risk
    Steroids can make eye infections worse or delay healing after injury or surgery.

Why vision changes from day to day

Some patients notice that their glasses seem to “work” differently depending on their steroid dose. Reasons include:

  • Time of day: Vision may blur a few hours after taking a dose, when steroid levels peak.

  • Dose level: Higher doses cause more fluctuation; tapering can also make vision variable.

  • Delivery method:

    • Tablets: most likely to cause daily swings.

    • Eye drops: may raise eye pressure within hours.

    • Inhalers: usually small risk, unless high dose over many years.

  • Other factors in asthma/aspergillosis: Nebulisers, oxygen, antifungal medicines (like voriconazole), fatigue, and infections can all add to vision changes.

What patients can do

Day-to-day management

  • Drink plenty of water to help with fluid balance.

  • Eat regularly and limit sugary snacks to reduce blood sugar swings.

  • Use good lighting and take regular breaks from close work.

  • Try to take steroids at the same time each day for more predictable effects.

  • Keep a diary of when blurred vision happens in relation to your dose.

Eye care

  • Tell your optician and GP you are on long-term steroids.

  • Ask for regular eye checks (pressure and cataract screening every 6–12 months).

  • Don’t rush to buy new glasses if your prescription seems to keep changing — vision often settles once steroid doses stabilise.

  • Lubricating eye drops can help if dryness is a problem.

When to seek urgent help

  • Sudden or severe blurred vision

  • Dark spots, flashing lights, or distorted shapes

  • Eye pain, halos around lights, or redness

  • Rapid worsening of eyesight

These could be signs of glaucoma, cataract progression, or retinal changes and need prompt medical attention.

Key message

Not everyone on steroids will notice eyesight problems, but it is a well-recognised side effect. The changes are often temporary and reversible, especially the day-to-day fluctuations, but long-term use does carry risks.

By being aware, monitoring regularly, and working with both your doctor and optician, you can catch problems early and protect your sight.

by GAtherton

Autumn 2025 COVID-19 Booster – What Aspergillosis Patients Need to Know

The UK Health Security Agency (UKHSA) has updated who will be offered the COVID-19 booster this autumn. The programme is now more limited than in 2024, so it’s important to know if you qualify.

Who will be offered the booster?

You can get a free COVID-19 booster this autumn if you are:

  • Aged 75 or over

  • Living in a care home for older adults

  • Aged 6 months or older and immunosuppressed

This is a change from 2024, when everyone aged 65+ and many other clinical risk groups were included.

What “immunosuppressed” means

Many people with aspergillosis fall into this category. You may be considered immunosuppressed if you are:

  • Taking systemic steroids for more than a month

  • Receiving biologic therapy or other immunomodulatory medication

  • Living with a condition that affects your immune system

  • Having had chemotherapy, radiotherapy, or a transplant

If you’re unsure whether this applies to you, check with your GP or hospital specialist.

Timing of the booster

  • Boosters are usually offered at least 6 months after your last dose, including the spring booster.

  • Even if you’ve never had a COVID-19 vaccine before, you can still get one this autumn if you are in one of the eligible groups.

Why this matters for aspergillosis patients

People with aspergillosis often have weaker lungs and higher risks from infections. If your immune system is also suppressed by medication or illness, COVID-19 can be more severe. The booster offers added protection during the winter months.

💙 Key advice:

  • If you are immunosuppressed or over 75, you should be offered the vaccine.

  • If you think you qualify but haven’t received an invitation, speak to your GP or specialist.

  • Don’t delay — protecting yourself against COVID-19 is especially important when living with aspergillosis.

📌 Full details from UKHSA: Who’s eligible for the 2025 COVID-19 vaccine or autumn booster

by GAtherton

Why the NHS doesn’t use unvalidated tests (and why that’s not just being awkward)

It can feel frustrating when the NHS won’t accept private tests like mycotoxin panels, IgG food intolerance kits, or home mould testing. But this isn’t about being difficult — it’s about protecting patients and making sure care is fair, safe, and effective.

  • Safety first
    Unvalidated tests can give false positives (saying you have a problem when you don’t) or false negatives (missing something important). Acting on the wrong result could lead to unnecessary medication, restrictive diets, or missed diagnoses.

  • Evidence matters
    NHS doctors can only use tests that have been proven in research to give accurate, meaningful results. That way, they can be confident the result will actually help guide treatment.

  • Protecting patients from harm
    Many private tests are expensive and may push people toward costly supplements, detox regimes, or antifungals they don’t need. The NHS avoids recommending anything that risks harm or waste.

  • Fairness and trust
    The NHS has to provide care that is fair for everyone. That means sticking to tests and treatments that have passed strict checks for accuracy, safety, and usefulness.

💙 Key message: When the NHS says “we can’t use that test,” it’s not about being awkward or dismissive — it’s about making sure that what’s offered is safe, reliable, and genuinely helps patients.

Private companies that sell mycotoxin or food intolerance tests will naturally try to justify their services — it’s their business, after all. But before you spend money, it’s worth asking one key question: ‘Will my NHS doctor be able to use these results to guide my treatment?’ If the answer is no (and in most cases it is), then you may just be spending a lot of money without getting anything useful for your care.

That doesn’t mean your symptoms aren’t real — it just means these particular tests aren’t the right tool. NHS doctors can only act on validated results (like CT scans, Aspergillus antibody blood tests, or sputum cultures) because those are proven to be accurate and safe.

by GAtherton

Voriconazole and Sun Sensitivity: What Patients Can Do

Voriconazole is an important antifungal, but it can make your skin much more sensitive to sunlight. Some people develop mild rashes, while others can get severe sunburn even after only a few minutes outdoors.

🌞 Protect your skin every day

  • High-factor sunscreen (SPF 50+) on all exposed skin, even in winter or cloudy weather.

  • Lip balm with SPF for lips, which are often affected.

  • Protective clothing: hats, long sleeves, UV-blocking fabrics if possible.

  • Avoid peak sun (11am–3pm) and try to stay in shade when outdoors.

👀 Watch your skin closely

  • Report any new rashes, blisters, lumps, or patches to your specialist team.

  • Regular skin checks may be offered if you are on long-term voriconazole.

💊 Medication review

  • If severe reactions develop, your doctors may:

    • Adjust the dose

    • Switch you to another antifungal (e.g. posaconazole, isavuconazole)

    • Add specialist dermatology follow-up

🚨 When to act fast

Seek medical advice urgently if you develop:

  • Blistering burns after short sun exposure

  • Painful or rapidly changing skin lesions

  • Any signs of infection in damaged skin

💙 Key message for patients: Sun sensitivity on voriconazole is common enough that everyone should take precautions. Don’t wait until your skin is badly affected — protect daily, and tell your team about any changes.

by GAtherton