Reviewed by The Wellness Team. Last reviewed October 2026.
Asthma is one of the most common long-term conditions in the UK, and one of the most under-treated. Many people use a blue inhaler for years without ever having their control properly reviewed, and accept symptoms they do not need to live with. This guide explains the signs, what good asthma care looks like, and when to see a GP.
What asthma actually is
Asthma is a long-term inflammation of the airways. The airways become twitchy and narrow in response to triggers, which produces the classic symptoms: wheeze, a tight chest, shortness of breath and a cough that is often worse at night or early in the morning. Common triggers include colds and viruses, dust, pollen, pets, cold air, exercise and smoke.
Symptoms vary from person to person and from month to month. Some people wheeze obviously; others just have a persistent night cough and never realise it is asthma.
Signs your asthma is not well controlled
Good control means almost no symptoms. You should not be waking at night with a cough, you should not need your blue reliever inhaler more than twice a week, and exercise should not routinely trigger symptoms. If any of those are happening, your asthma is not controlled, whatever dose you are on.
Frequent blue inhaler use is the single most useful warning sign. Needing a new reliever inhaler every month or two means the underlying inflammation is untreated, and untreated inflammation is what leads to flare-ups and A&E visits. This is fixable, usually with a regular preventer inhaler taken every day.
Getting diagnosed and reviewed
Diagnosis starts with the history: the pattern of symptoms, the triggers, and any family history of asthma, eczema or hay fever. A GP may arrange breathing tests, including spirometry and a peak flow diary, to confirm variable airflow. If you were diagnosed years ago, the diagnosis and your treatment should still be reviewed at least once a year, and after any flare-up.
A review is also the moment to check inhaler technique, which goes wrong more often than people expect. Poor technique means the medicine never reaches the airways, and is one of the commonest reasons treatment appears to fail.
What treatment looks like
Modern asthma treatment is built around inhaled corticosteroids, which treat the inflammation itself. The blue reliever is for symptoms only and treats nothing underlying. Many people are now managed with combination inhalers used both regularly and for relief, an approach supported by current UK guidance for suitable patients.
The right regime depends on your symptoms, triggers and test results, and it should be written down as a personal asthma action plan so you know exactly what to do when symptoms worsen. A GP can prescribe inhalers where clinically appropriate, check your technique, arrange lung function tests and step treatment up or down with you.
To book or ask a question, message WhatsApp or call 020 3951 3429. A telephone appointment is £59, a video consultation is £150, and an in-person visit at our London clinic is £220. Video appointments work well for asthma reviews, and a prescription can be arranged where clinically appropriate.
When asthma is an emergency
An asthma attack that is not responding to your blue inhaler is an emergency. Warning signs include being too breathless to speak in full sentences, your reliever not lasting four hours, and breathing that is fast and exhausting. Use your reliever as directed in your action plan and call 999 if it is not working or you are struggling to speak.
Questions people ask
Can I get an inhaler prescription online?
Yes, where clinically appropriate. If you have an established asthma diagnosis and stable symptoms, a telephone or video consultation is usually enough for a GP to review your control and issue a prescription. If your symptoms suggest poor control or a new diagnosis, the GP will explain what tests or examination are needed first.
Why do I wake up coughing at night?
Night-time cough is a classic sign of uncontrolled asthma, because airways naturally narrow in the early hours. It can also come from reflux or post-nasal drip. A GP consultation can tell the difference and treat the cause.
Is it safe to take a steroid inhaler every day?
Yes. Inhaled corticosteroids act directly in the airways at low doses and are the foundation of safe asthma control. The risks of untreated inflammation, including severe attacks, are far greater than the small risks of the inhaler, and a GP will always use the lowest effective dose.
Do I need an asthma review if I feel fine?
Yes, once a year. Feeling fine is the goal, and the review keeps it that way: it checks your technique, confirms your dose is still right and updates your action plan.
If you are reaching for the blue inhaler more than twice a week, your asthma needs a proper review. Message us on WhatsApp, call 020 3951 3429, or email team@thewellnesslondon.com. Same-day appointments are often available.