Afrezza inhalable insulin side effects (coughing & wheezing, trouble breathing)
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After weeks of fighting with my insurance company and getting HHS Managed Care involved, I got the inhalable insulin, Afrezza, my doctor prescribed, approved. I was looking forward to trying this new formulation of insulin because the injectable insulins were causing swelling and burning in my fingers and toes, even though I injected the medication into the small amount of fat in my hips. The injectable insulins were also causing severe neuropathy. My circulation got so bad that certain fingers and toes turned gray, which could have led to an ER visit and amputation.
(To watch a video on this topic instead of reading this post, scroll to the bottom of this page to play the YouTube video below that I created to show how to remove the cap on the insulin inhaler, how to insert the insulin powder cartridges into the inhaler, how swollen my fingers and toes looked like when I was taking injectable insulin, why I tried Afrezza, and what my short-term, immediate side effects were while taking Afrezza inhalable insulin).
I picked up the prescription the afternoon it came in, but I waited until the next day to try it, just in case I had a severe reaction. If Afrezza made me severely ill, I’d rather go to the doctor in the morning than end up waiting in the emergency room with a bunch of sick people in the evening.
The next morning, my blood sugar was 87, an excellent glucose reading, even for a non-diabetic. Before I took the first dose of inhaled insulin, I ate my first hearty carb meal in over three months. I ate a half of a sweet potato topped with ¼ cup of black beans with some diced red onions. I also ate one dark red cherry, ½ ounce of raw walnuts, three stalks of celery, ¼ cup of TVP soy protein sprinkled with pumpkin pie spice with a tiny amount of monk fruit. I estimated the total carbs to be around 55 grams.
I took the powder insulin out of the refrigerator to let it warm up to room temperature for at least 10 minutes as recommended by the manufacturer. Inhaling cold powder is more likely to lead to coughing. After letting the insulin sit out on my kitchen counter for 20 minutes, which should have been sufficient time for it to warm up, I inhaled three of the cartridges, which is their recommended one-dose. Immediately I started coughing, but that wasn’t the worst part. I could not breathe normally or take in full breaths. I started to wheeze, which turned into a mild asthma attack. It took 15-minutes before I was able to breathe optimally again.
My blood sugar reading, three hours later, was 88. The inhalable insulin seemed to be working well, and the three cartridges appeared to cover approximately 60 grams of carbs for me.
Even though I ended up coughing, wheezing and had trouble breathing for a short period of time this morning after inhaling Afrezza, I thought my body may just needed to acclimate to the new medicine, so I gave it a second go. I took the 4-unit dose of the three cartridges. The same side effects occurred: coughing, wheezing and difficulty breathing for 15-minutes.
My next meal, lunch, consisted of a smoothie. I put a ripe banana in a blender cup with ice, water, 1 teaspoon of ground flax seeds, 2 teaspoons of ground chia seeds, ½ teaspoon of cinnamon, blended it, and topped it with cacao nibs. It was delicious! I haven’t had a whole banana in four months. I couldn’t believe how sweet the banana was. Since I was eating such a small amount of fruit because I was off insulin, my taste buds adjusted and fruit tasted like a delicious dessert, it was divine! I ate a spinach salad in between sips of my banana-cinnamon-chocolate drink, to blunt rising blood sugars.
A few hours later, I started feeling light-headed, shaky, dizzy, and had trouble concentrating. My blood sugar was low at 60. If my blood sugar dips below 80, I can’t function properly. Since I haven’t taking any insulin in over two months, I’ve been on a low-carb, high-fat diet, my blood sugars stayed fairly level, and never went too low. With synthetic insulin in my body, I forgot how awful hypoglycemia feels.
To correct my blood sugar, and because it was time to eat an early dinner, I ate 1 large apple, 1 small kiwi, 1 small tangerine, ½ medium sweet potato with ¼ cup of black beans. I didn’t know if my blood sugar was going to dip down further, so I made the mistake of taking only 1 of the cartridges.
A few hours later, my blood sugar was high at 200. I inhaled two of the insulin cartridges to bring my blood sugar back down. I was hungry so I ate two ounces of pecans, 1 tablespoon of salted roasted pepitas, a large bowl of broccoli and cauliflower soup with ¼ tsp of Umboshi salt seasoning. I was still hungry, so I ate some more TVP with pumpkin spice mixed with a sprinkle of monk fruit zero calorie sweetener.
Before I went to bed, my blood sugar went down to 127. By the end of the day, I ate just under 1600 calories and consumed 135 net grams of carbohydrates, 72 grams of protein and 67 grams of fat (the pecans tipped me over my fat quota).
As I laid down to sleep at night, I had difficulty breathing again. I raised my head with another pillow, hoping that would allow me to breathe easier, but it didn’t. It took one hour to breathe normally again, and only then was I able to fall asleep, but I woke up several times during the night with my heart beating erratically and felt like I was having multiple panic attacks. It was a frightening and horrible feeling.
People with certain conditions are advised against taking inhalable insulin, such as people with chronic asthma. Per the Afrezza package insert, “Afrezza is contraindicated in patients with the following: “…chronic lung disease such as asthma…” or COPD because of the risk of breathing problems.
I’ve had asthma attacks in the past, but those asthmatic episodes occurred in very specific circumstances: if I was in a coffee shop and someone was frothing milk (I have a severe dairy allergy), if someone puts butter in a pan and the particles float into the air and I breathe in that contaminated air (butter is a dairy product), or when the air outside is of poor quality (due to a fire, or a lot of pollen). I also get asthma attacks when exposed to dust, or when I am in the same room as Asian cats (I’m allergic to their dander).
I thought it might be okay for me to try Afrezza because I mistakenly thought “chronic” meant that I get asthma attacks all the time. According to Medicine.net, when I looked up the definition of chronic, it read: “In medicine, lasting a long time. A chronic condition is one that lasts 3 months or more (1).”
Miriam Webster defines chronic as “continuing for a long time or returning often, a chronic disease. 2 : happening or done frequently…” (5).
Based on my medical history of many asthma attacks throughout my life, and the above definitions of chronic, I was never a candidate for inhalable insulin. My doctor should have looked at my records and told me that I cannot take this medication. This is the same doctor that prescribed my asthma medication!
I sent my doctor a message that read: The Afrezza inhalable insulin caused coughing, wheezing, and trouble breathing from fifteen minutes, and up to an hour. My heart rate went up at various times during the night, which felt like I was having multiple panic attacks. This medication is not a viable insulin option for me.
On the Afrezza printout it lists the some of the side effects as: weight gain, hypoglycemia (low blood sugar), diabetic ketoacidosis, anaphylaxis (a life-threatening allergic reaction), hypokalemia, fluid retention and heath failure with while taking TZDs, coughing, throat pain, throat irritation, headache, diarrhea, fatigue, nausea, bronchitis, urinary tract infection, and bronchospasm (making it hard to breathe). In addition, the insert warns, “Afrezza causes a decline in lung function over time.”
Afrezza states that type-1 diabetics still need to take their long-acting insulin, but this is not the case for everyone (5). Some people, like myself, can manage diabetes without long-acting (basal) insulin even when eating carbohydrate-rich meals. I was able to keep my blood sugars levels more stable when I stopped taking basal insulin because the background insulin caused my blood sugar levels to go too low.
If you look at the ingredient list, you’ll see polysorbate 80. This added ingredient damages the kidneys and liver, and reduces the good bacteria in your body, which means it will make it harder for your body to protect itself from disease and infections, and heal itself.
“Polysorbate 80 has been associated with a number of adverse events. In food, small concentrations of undigested polysorbate 80 may enhance bacterial translocation across intestinal epithelia, a potential explanation for an observed increase in the incidence of Crohn’s disease . In drug formulations, polysorbate 80 has been implicated in a number of systemic reactions (e.g., hypersensitivity, nonallergic anaphylaxis, rash) and injection- and infusion-site adverse events (ISAEs; e.g., pain, erythema, thrombophlebitis) [3, 35–37]. Polysorbate 80 has also been implicated in cases of renal and liver toxicity.” (2).
Per the FDA, polysorbate 80 is also in a lot of foods: ice cream and many frozen desserts, pickles, vaccines, certain vitamins, canned green beans, oils, gelatin products, cottage cheese, coloring in BBQ sauce, in the water to remove the feathers from chicken and turkey and duck (3).
Per the USDA, “most common food preservatives like sodium benzoate, or polysorbate 60 and 80 are prohibited by the organic standards” (4).
If you want to limit harmful substances like polysorbate 80, choose “certified organic,” whenever possible.
As of right now, I have no insulin medication options. The injectable insulins on the market today cause me to have neuropathy, severe burning pain and swelling in my fingers and toes resulting in erythromelalgia and Raynaud’s disease. The only available inhalable insulin, Afrezza, causes multiple asthma attacks.
I’ve been managing my blood sugar with a low-carb, high-fat, plant-based vegan diet, combined with lots of exercise, but my insulin resistance seems to be getting worse, because even if I eat boiled broccoli and cauliflower, my blood sugar goes up. If I eat a few blueberries, I have to do a cardiovascular workout for at least 15 minutes.
High fat diets, even if the fat is coming from almonds, increases insulin resistance because the cells are using fat for energy. Since the cells are full with fat, any glucose is going to have trouble entering those cells, so I’ve reduced my daily fat intake from 90% to 15%, and am slowing adding more carbs from fruit, beans, and potatoes. Since I’ve reduced my fat intake, which has lowered the calories I’m consuming, I’ve lost a few pounds, which isn’t good for me, because now, I’m underweight, but my insulin sensitivity is improving, and gaining weight is easy for me to do.
If I can get my carbohydrate total to 300 grams a day, with no more than 90 minutes of exercise by the end of the day, with good glucose control, I’ll let you know what I did and how I did it.
Maybe it’s a good thing that I’m off insulin altogether; maybe my immune system will finally be able to heal itself since I’m no longer dumping chemicals and harmful animal saturated fats inside my body since I eat an oil-free, whole-food, certified organic plant-based vegan diet.
Play the YouTube video below that I created to show how to remove the cap on the insulin inhaler, how to insert the insulin powder cartridges into the inhaler, how swollen my fingers and toes looked like when I was taking injectable insulin, why I tried Afrezza, and what my short-term, immediate side effects were while taking Afrezza inhalable insulin.
P.S. This is my 875th blog! I’ve been publishing blog posts on this platform, consistently for over seven years now. I can’t believe it’s been that long. To prevent burnout, and to provide helpful, interesting, educational, unique content, I’ll be posting blogs once a week from now on instead of twice a week.
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- “Definition of Chronic.” Medicine.net. (2021, March 29). https://www.medicinenet.com/chronic/definition.htm
- Schwartzberg, Lee and Navari, Rudolph. “Safety of Polysorbate 80 in the Oncology Setting.” (2018, May 23). National Institutes of Health. US Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015121/
- “CFR – Code of Federal Regulations Title 21 – FDA” (2020, April 1). US Dept of Health and Human Services. FDA US Food and Drug Administration. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=172.840
- What should I know about using salt and preservatives in organic food? US Department of Agriculture’s Agricultural Marketing Service. https://www.ams.usda.gov/sites/default/files/media/7%20Salt%20and%20Preservatives%20FINAL%20RGK%20V2.pdf
- “Chronic.” Miriam-Webster. https://www.merriam-webster.com/dictionary/chronic
- Afressa. “FAQs – AfrezzaAssist – Your Questions Answered: Afrezza FAQs” (2021, April 23) https://afrezza.com/faqs/
“Organic: the original clean food” EWG. (2019, March 5). https://www.ewg.org/research/packagedorganic/