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  Asthma  
 
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Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Other conditions that may be present | Recommendations

 

Asthma is a chronic lung disease in which airways may be inflamed and airway linings become swollen. The airways produce a thick mucus. As the airways narrow, breathing becomes more difficult. The muscles around the airways can also tighten and make the airways narrower. These changes in the airway block the flow of air, making it hard to breathe. This narrowing sometimes gets better by itself, but often requires treatment. Asthma is unlikely to be a single disease, so we should abolish the term altogether, states an editorial in The Lancet, 27 Aug 2006. People with asthma can have a range of different triggers, symptoms, and responses to treatment, and the general consensus now emerging is that asthma is unlikely to be a single disease entity.

Asthma causes the airways to become very sensitive and to react to contact with many airborne substances. Although it occurs at all ages, it is most common in children under 10. There is a 2:1 male:female ratio in children, which equalizes by the age of 30.

Mild episodic asthma is due primarily to bronchial smooth muscle contraction whereas moderate to severe sustained asthma is largely due to chronic inflammation of the bronchi with the presence of such white cells as eosinophils, neutrophils and mononuclear cells. These cells contribute products that inflame the airways.

People with asthma have airways that are super-sensitive to 'triggers' that do not bother people without asthma. When an asthmatic is near to or comes in contact with a trigger, an asthma episode may start. The airways may become swollen, produce mucus, and tighten up. Common triggers for asthma episodes include the following:

  • Dander (or flakes) of skin, hair, or feathers of all warm-blooded pets
  • House dust mites
  • Cockroaches
  • Pollens from grass and trees
  • Molds (indoor and outdoor)
  • Cigarette smoke or wood smoke; scented products such as hair spray, cosmetics, and cleaning products; strong odors from fresh paint or cooking; automobile fumes; and air pollution
  • Infections in the upper airway, such as colds (a common trigger for both children and adults)
  • Exercise
  • Expressing strong feelings (crying, laughing)
  • Changes in weather and temperature
Some medicines relax the airways while others reduce or prevent the inflammation, swelling and mucus. Severe asthma can be a traumatic, even life-threatening experience. Natural methods of asthma management should be tried prior to or along with conventional treatments.

Please see the link between Asthma and Particulate Avoidance for the importance of having a clean environment, once asthma becomes a problem. But, exposure to an unclean atmosphere growing up, may reduce the risk of developing asthma.

Although it's not proven, the relatively quick disappearance of H. pylori from our systems is consistent with the idea that widespread antibiotic use is changing human microbiology, which has a consequence, said Dr. Blaser. Other factors in the decline of H. pylori include improvements in childhood living conditions and smaller family size.

"Many studies show that early childhood use of antibiotics is associated with an increased risk of asthma," said Dr. Chen.

In this study, more than one in 10 children under the age of 10 (11 percent) had taken antibiotics in the prior month. Prior studies have shown that by 15, the average child has received three or four courses of antibiotics just for ear infections. "That translates on an annual basis to an extremely high rate of antibiotic use in childhood," she said.

"Sure, your child's ears may seem a little better after antibiotic treatment for an ear infection, but an increased risk for asthma may be one of the costs," said Dr. Blaser, who is the immediate past president of the IDSA.

May 2012. NEW YORK (Reuters Health) - Amish children raised on rural farms in northern Indiana suffer from asthma and allergies less often even than Swiss farm kids, a group known to be relatively free from allergies, according to a new study.
"The rates are very, very low," said Dr. Mark Holbreich, the study's lead author. "So there's something that we feel is even more protective in the Amish" than in European farming communities.

Researchers have long observed the so-called "farm effect" -- the low allergy and asthma rates found among kids raised on farms -- in central Europe, but less is known about the influence of growing up on North American farms. Holbreich, an allergist in Indianapolis, has been treating Amish communities in Indiana for two decades, but he noticed that very few Amish actually had any allergies.

Amish families, who can trace their roots back to Switzerland, typically farm using methods from the 1800s and they don't own cars or televisions. The researchers surveyed 157 Amish families, about 3,000 Swiss farming families, and close to 11,000 Swiss families who did not live on a farm -- all with children between the ages of six and 12.

They found that just five percent of Amish kids had been diagnosed with asthma, compared to 6.8 percent of Swiss farm kids and 11.2 percent of the other Swiss children. Similarly, among 138 Amish kids given a skin-prick test to determine whether they were predisposed to having allergies, only 10 kids -- or seven percent -- had a positive response.

In comparison, 25 percent of the farm-raised Swiss kids and 44 percent of the other Swiss children had a positive test, the researchers report in the Journal of Allergy and Clinical Immunology. The study did not determine why the kids who grew up on farms were less likely to develop asthma and allergies, but other research has pointed to exposure to microbes and contact with cows, in particular, to partially explain the farm effect (see Reuters Health story of May 2, 2012).

Drinking raw cow's milk also seems to be involved, Holbreich said.

The going theory is this early exposure to the diverse potential allergens and pathogens on a farm trains the immune system to recognize them, but not overreact to the harmless ones. As for why the Amish kids have even lower allergy and asthma rates than the other farming kids, "that piece of the puzzle we really haven't explained," Holbreich told Reuters Health. He speculated that it could be at least partly a result of the Amish having larger families or spending even more time outside or in barns than people on more modern working farms.
 

 
 

Signs, symptoms & indicators of Asthma:
 
 
Supplements and Medications  Using asthma medication

Symptoms - Respiratory

  Wheezing or wheezing after exercise only
  Chest tightness
  Air hunger
  Easily being short of/always being short of breath or normal breathlessness
  Chronic/recent productive cough
 Not all people with asthma wheeze. For some, chronic coughing, which often occurs during the night or after exercise, may be the only symptom.

  Chest pressure

Counter-indicators:
  Absence of wheezing
 While wheezing is an expected symptom of asthma, it is possible to have asthma without wheezing being present.

Coughing due to asthma may not respond to cough suppressants, but only to medications for asthma. So, correctly diagnosing asthma may require pulmonary function tests. Any cough that does not resolve within a month or so should be evaluated by a doctor familiar with cough-variant asthma.
 
 

Conditions that suggest Asthma:
 
 
Allergy  Environmental Illness / MCS
 Respiratory complaints include adult onset “asthma”, shortness of breath, and fibrotic lung disease.

Lab Values

  Eosinophilia

Metabolic

  Bruxism (Clenching/Grinding Teeth)
 Allergy may play a role in bruxism. It is noticed that bruxism is more frequent in those experiencing periods of allergic rhinitis or asthma.

Nutrients

  Vitamin B6 Requirement
 Children with asthma have been shown to have a metabolic defect in tryptophan metabolism. Tryptophan is converted to serotonin, a known bronchoconstricting agent in asthmatics. Studies have shown that patients benefit from either a tryptophan-restricted diet or B6 supplementation to correct the blocked tryptophan metabolism. Pyridoxine may also be of direct benefit to asthmatic patients, since it is a key cofactor in the synthesis of all the major neurotransmitters.
 
 

Risk factors for Asthma:
 
 
Allergy  Allergy to Cow's Milk
 "Symptoms of milk-protein allergy include cough, choking, gasping, nose colds, asthma, sneezing attacks..." [Annals of Allergy, 1951; 9]

  Allergy / Intolerance to Foods (Hidden)
 Asthma is one of the three manifestations of a pattern of allergy that is called atopy. The associated disorders are eczema and hay fever. Asthma due to allergy can come from both airborne and food sources. Patients with delayed pattern food allergy have the most severe and persistent inflammatory form of chronic asthma.

While airborne problems are more obvious to asthmatic sufferers, food problems may be a well-hidden source of lung disease. Many studies of food allergy involve patients with food-induced asthma. Eczema and asthma are often associated in atopic patients with food allergy.

In a group of 320 children with atopic dermatitis, 55% had asthma. Food challenges triggered respiratory symptoms in 59% (rhinitis, laryngeal edema, wheezing, and dyspnea). Asthma is frequently treated only as an airborne allergy problem or as a problem unrelated to allergic processes and the possible role of food allergy is neglected. It is overlooked because the usual skin tests are often negative and the history is often not helpful as symptoms appear gradually, hours or days after ingestion of the food. Milk, wheat, egg, yeast, preservatives, colorings, coffee and cheese are the main foods implicated.

Food allergens may be found in the bloodstream within circulating immune complexes that trigger the release of immune mediators into the bloodstream. These chemicals cause a variety of symptoms, including constriction of the bronchial smooth muscle in the lungs; this is the first event during an asthmatic attack. Airflow is reduced in the narrowed tubes. Air has a harder time leaving the lungs than entering, with the result of prolonged noisy exhalation. This inflammatory, obstructive phase is the most important mechanism of chronic asthmatic bronchitis.

Childhood

  Vaccinations
 Findings from animal and human studies confirm that DTP (diphtheria and tetanus toxoids and pertussis) and tetanus vaccinations can induce allergic responses [1, 2, 3, 4, 5] and can increase the risk of allergies, including allergic asthma. An analysis of data from nearly 14,000 infants and children revealed that having a history of asthma is twice as great among those who were vaccinated with DTP or tetanus vaccines than among those who were not. [6]

[1] Vaccine 1995;13: pp.669-73
[2] Pediatr Allergy Immunol 1997;8: pp.83-7
[3] Pediatr Allergy Immunol 1994;5: pp.118-23
[4] Adv Immunol 1996;61: pp.341-403 [review]
[5] J Allergy Clin Immunol 1974;54: pp.25-31
[6] J Manipulative Physiol Ther 2000;23: pp.81-90

Environment / Toxicity

  Gulf War Illness

Infections

  Mycoplasma Infection

Metabolic

  Sulfite Sensitivity
 Some asthmatics learn the hard way that drinking alcohol can trigger the wheezing, coughing symptoms of an asthma attack. Chemicals, such as sulfite preservatives in wine, may be the cause of these attacks. Wines are clearly the major offenders among alcoholic drinks, with red wine being the worst. Sulphites appear to affect mainly asthmatics, and children more than adults. Approximately 10% of American adult asthmatics are sensitive to sulphites.

  Problem Caused By Being Overweight
 Being overweight increases the risk of asthma. [Arch Intern Med 1999;159: pp.2582-8] Obese people with asthma may improve their lung-function symptoms and overall health status by engaging in a weight-loss program. A controlled study found that weight loss resulted in significant decreases in episodes of shortness of breath, increases in overall breathing capacity, and decreases in the need for medication to control symptoms. [BMJ 2000;320: pp.827-32]

Nutrients

  Magnesium Requirement
 Magnesium levels are frequently low in asthmatics. [J Lab Clin Med 1940;26: pp.340-4] Current evidence suggests that high dietary magnesium intake may be associated with better lung function and reduced bronchial reactivity. Intravenous injection of magnesium has been reported in most, but not all, double-blind trials to rapidly halt acute asthma attacks. Some doctors believe that the modified "Myers' Cocktail" (which contains magnesium) will be the treatment of choice eventually for acute asthma attacks.

  Antioxidant Need/Oxidative Stress w/ Supplements
 Because of its large surface area, the respiratory tract is a major target for free radical insult, not to mention the fact that air pollution is a major source of ROS. Studies suggest that free radicals may be involved in the development of pulmonary disorders such as asthma [J Am Coll Nutr 1995;14(4): pp.317-324]. Cellular damage caused by free radicals is
thought to be partly responsible for the bronchial inflammation characteristic of this disease. It has been suggested that increasing antioxidant intake may help to reduce oxidant stress and help to prevent or minimize the development of asthmatic symptoms.

  Selenium Requirement
 Dietary consumption of apples and selenium intake (assessed by food frequency questionnaire) were each associated with a reduced risk of asthma in an English study of adults. [Am J Respir Crit Care Med 2001;164(10): pp.1823-1828]

  Antioxidant Need/Oxidative Stress w/o Supplements
 Because of its large surface area, the respiratory tract is a major target for free radical insult, not to mention the fact that air pollution is a major source of ROS. Studies suggest that free radicals may be involved in the development of pulmonary disorders such as asthma [J Am Coll Nutr 1995;14(4): pp.317-324]. Cellular damage caused by free radicals is
thought to be partly responsible for the bronchial inflammation characteristic of this disease. It has been suggested that increasing antioxidant intake may help to reduce oxidant stress and help to prevent or minimize the development of asthmatic symptoms.

Symptoms - Environment

  Air pollution exposure
 The number of people with asthma and the death rate from this condition have been increasing rapidly since the late 1980s. Environmental pollution may be one of the causes of this growing epidemic. Work exposure to flour or cotton dust, animal fur, smoke, and a wide variety of chemicals has been linked to increased risk of asthma. [Blanc PD, Eisner MD, Israel L, Yelin EH. The association between occupation and asthma in general medical practice. Chest 1999;115: pp.1259-64]
 
 

Asthma suggests the following may be present:
 
 
Allergy  Allergy / Intolerance to Foods (Hidden)
 Asthma is one of the three manifestations of a pattern of allergy that is called atopy. The associated disorders are eczema and hay fever. Asthma due to allergy can come from both airborne and food sources. Patients with delayed pattern food allergy have the most severe and persistent inflammatory form of chronic asthma.

While airborne problems are more obvious to asthmatic sufferers, food problems may be a well-hidden source of lung disease. Many studies of food allergy involve patients with food-induced asthma. Eczema and asthma are often associated in atopic patients with food allergy.

In a group of 320 children with atopic dermatitis, 55% had asthma. Food challenges triggered respiratory symptoms in 59% (rhinitis, laryngeal edema, wheezing, and dyspnea). Asthma is frequently treated only as an airborne allergy problem or as a problem unrelated to allergic processes and the possible role of food allergy is neglected. It is overlooked because the usual skin tests are often negative and the history is often not helpful as symptoms appear gradually, hours or days after ingestion of the food. Milk, wheat, egg, yeast, preservatives, colorings, coffee and cheese are the main foods implicated.

Food allergens may be found in the bloodstream within circulating immune complexes that trigger the release of immune mediators into the bloodstream. These chemicals cause a variety of symptoms, including constriction of the bronchial smooth muscle in the lungs; this is the first event during an asthmatic attack. Airflow is reduced in the narrowed tubes. Air has a harder time leaving the lungs than entering, with the result of prolonged noisy exhalation. This inflammatory, obstructive phase is the most important mechanism of chronic asthmatic bronchitis.

  Environmental Illness / MCS
 Respiratory complaints include adult onset “asthma”, shortness of breath, and fibrotic lung disease.

Cell Salts

  Cell Salt, Kali Sulf Need

Immunity

  Immune System Imbalance (TH2 Dominance)

Inflammation

  Chronic Inflammation
 Asthma is simply a chronic inflammatory condition of the airways rather than some other part of the body, such as the joints. People with asthma have inflamed, hyperreactive airways that produce excessive bronchial mucus.

Nutrients

  Antioxidant Need/Oxidative Stress w/ Supplements
 Because of its large surface area, the respiratory tract is a major target for free radical insult, not to mention the fact that air pollution is a major source of ROS. Studies suggest that free radicals may be involved in the development of pulmonary disorders such as asthma [J Am Coll Nutr 1995;14(4): pp.317-324]. Cellular damage caused by free radicals is
thought to be partly responsible for the bronchial inflammation characteristic of this disease. It has been suggested that increasing antioxidant intake may help to reduce oxidant stress and help to prevent or minimize the development of asthmatic symptoms.

  Antioxidant Need/Oxidative Stress w/o Supplements
 Because of its large surface area, the respiratory tract is a major target for free radical insult, not to mention the fact that air pollution is a major source of ROS. Studies suggest that free radicals may be involved in the development of pulmonary disorders such as asthma [J Am Coll Nutr 1995;14(4): pp.317-324]. Cellular damage caused by free radicals is
thought to be partly responsible for the bronchial inflammation characteristic of this disease. It has been suggested that increasing antioxidant intake may help to reduce oxidant stress and help to prevent or minimize the development of asthmatic symptoms.

  Vitamin B6 Requirement
 Children with asthma have been shown to have a metabolic defect in tryptophan metabolism. Tryptophan is converted to serotonin, a known bronchoconstricting agent in asthmatics. Studies have shown that patients benefit from either a tryptophan-restricted diet or B6 supplementation to correct the blocked tryptophan metabolism. Pyridoxine may also be of direct benefit to asthmatic patients, since it is a key cofactor in the synthesis of all the major neurotransmitters.
 
 

Recommendations for Asthma:
 
 
Amino Acid / ProteinNot recommended:
  Tryptophan / 5 HTP
 Foods high in tryptophan and supplemental tryptophan should be removed from the diet as some children with asthma have a defect in tryptophan metabolism and reduced platelet transport of serotonin - a known broncho-constricting agent in asthmatics. Alternatively vitamin B6 could be used to supplement the diet as this aids in the metabolism of tryptophan.

Animal-based

  Shark Liver Oil
  Microdose DNA
  Cetyl-myristoleate

Botanical

  Ma Huang (Ephedra equisetina)
 Ephedra contains ephedrine and variable quantities of pseudoephedrine. These components are still widely prescribed and effective drugs in the treatment of asthma, particularly in chronic cases.

Ephedrine is an approved over-the-counter (OTC) treatment for bronchial tightness associated with asthma. OTC drugs containing ephedrine can be safely used by adults in the amount of 12.5 to 25mg every four hours. Adults should take a total of no more than 150mg every 24 hours and refer to labels for children’s dosages. Ephedra sinica continues to be a component of traditional herbal preparations for asthma, often in amounts of 1 to 2gm of the herb per day.

  Licorice Root (Glycyrrhiza glabra)
 Glycyrrhizin, found in licorice root, shows steroid-Iike activity and has a long history of use as an anti-inflammatory and anti-allergic agent, actions which have now been documented. Glycyrrhiza is an expectorant, which can be useful for relieving asthma.

  Cayenne Pepper (Capsicum frutescens)
 Capsaicin, cayenne pepper's major active component, induces long-lasting desensitization of airway linings to various mechanical and chemical irritants. This effect is probably due to capsaicin-induced depletion of substance P in the respiratory tract nerves. The respiratory and gastrointestinal tracts contain neurons which have large numbers of substance P receptors. Depletion of substance P may be desirable in asthma.

  Frankincense (Boswellia carteri)
  Boswellia (Boswellia serrata)
  Coleus (Coleus forskohlii)
 A small double-blind trial found that inhaled forskolin could decrease lung spasms in asthmatics. [Clin Pharmacol Ther 1993;43: pp.76-83] It is unclear if oral ingestion of coleus extracts will provide similar benefits.

  Ivy Leaf (Hedera helix)
 A controlled trial in a group of children with bronchial asthma found that 25 drops of ivy leaf extract given twice per day was effective in improving airflow into the lungs after only three days of use. [Münch Med Wschr 1998;140: pp.32-6] However, the incidence of cough and shortness of breath symptoms did not change during the short trial period.

Standardized ivy leaf extract can be taken by itself or in water at 25 drops twice per day as a supportive treatment for children with asthma. [Giornale Italiano de Dermatologia Venereologia 1993;128; pp.619-24] At least double this amount may be necessary to benefit adults with asthma.

  Tylophora (Tylophora indica/asthmatica)
 One clinical trial with asthma sufferers found that tylophora leaf (150mg of the leaf by weight) chewed and swallowed daily in the early morning for six days led to moderate to complete relief of their asthma symptoms. [J Allergy 1969;43:145–50] In a follow-up trial with asthma patients, an alcoholic extract of crude tylophora leaves in 1gm of glucose had comparable effects to that of chewing the crude leaf. [Ann Allergy 1972;30: pp.407-12]

Another trial found similar success in reducing asthma symptoms using a tylophora leaf powder at 350mg per day. [J Indian Med Assoc 1978;71: pp.172-6] However, the tylophora was not as effective as a standard asthma drug combination. One double-blind trial failed to show any effect on asthma for tylophora. [Ind J Med Res 1979;69: pp.981-9]

Tylophora leaf at 200-400mg of the dried leaf per day or 1-2ml of tincture per day can be used to treat asthma.[Clinical Applications of Ayurvedic and Chinese Herbs. Warwick, Queensland, Australia: Phytotherapy Press, 1996: pp.134–6]

  Picrorhiza (Picrorhiza kurroa)
 Two open-label, non-placebo, controlled human studies have shown picrorhiza to be of benefit in asthma. [Indian J Pharmacol 1975;7: pp.95-6, J Postgrad Med 1977;23: pp.118-20] However, a follow-up double-blind study did not confirm these earlier findings. [J Postgrad Med 1983;29: pp.89-95]

Diet

  Vegetarian/Vegan Diet
 A long-term trial of a vegan diet (elimination of all animal products) provided significant improvement in 92% of the 25 patients who completed the study. Drinking water was limited to spring water (chlorinated tap water was prohibited), and coffee, tea, chocolate, sugar and salt were excluded. [Journal of Asthma 1985; 22:44, p.13]

  Histamine-Restricted Diet
  Food Additive Avoidance
 The elimination of food additives is important in the control of asthma. Some asthmatics react to additives such as sulfur dioxide, tartrazine (yellow dye #5), and sodium benzoate, as well as natural salicylates (aspirin-like substances found in many foods). [J Asthma 1985;76: pp.40-5, Pediatrics 1984;73: pp.631-7] Sulfites in particular have been reported to cause asthma attacks in susceptible individuals. A doctor or an allergist can help determine whether chemical sensitivities are present.

  Therapeutic Fasting
 Fasting lowers the allergic reactions causing asthma.

  Increased Fruit/Vegetable Consumption
 Vitamin C, present in fruits, is a powerful antioxidant and anti-inflammatory agent. Its anti-inflammatory activity may decrease the incidence of asthma symptoms. A large preliminary study has shown that young children with asthma experience significantly less wheezing if they eat a diet high in fruits rich in vitamin C.

Dietary consumption of apples and selenium intake (assessed by food frequency questionnaire) were each associated with a reduced risk of asthma in a case-control study (607 cases and 864 controls) of adults aged 16-50 in England. [Am J Respir Crit Care Med 2001;164(10): pp.1823-1828]

Also see the link between Asthma and Soy regarding apples and pears.

If you want to lower your child's risk of having hay fever you should seriously consider giving him/her a Mediterranean diet, say researchers. Scientists found that children who followed a Mediterranean diet had a 30% lower risk of developing hay fever. It seems, say the researchers, that the diet is not only good for adults, but also for kids.

The researchers found that children who eat a normal Mediterranean diet were 30% less likely to develop hay fever, while those who also consumed very large quantities of fruit while on the Mediterranean diet were over 60% less likely to develop hay fever.

Previous studies have indicated that the Mediterranean diet may reduce your chances of developing diabetes type 2, hypertension (high blood pressure), heart disease and several cancers.

In this study the researchers looked at 690 schoolchildren in Crete, Greece - they were aged 1-18 years. Their parents filled in questionnaires about their kids eating habits and allergic conditions. All the children were tested for the ten most common allergy causes. About 30% of children have allergies, of which half should have symptoms. However, in Crete 30% did have allergies but virtually none of them exhibited symptoms, such as asthma, runny nose and itchy eyes. This anomaly is virtually unheard of, said Paul Cullinan, U.K. National Heart and Lung Institute, one of the authors of the study.

Nearly all the children in the study ate fresh tomatoes and several types of fruit at least weekly, while over half of them consumed them daily. Most of the children ate nuts regularly. [Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete Published Online First: 5 April 2007. by BMJ Publishing Group Ltd & British Thoracic Society]

Most teenagers in the United States and Canada don't choose to eat fish and fruit nearly as often as they choose burgers and chips. Now, a study of more than 2,100 teens conducted by the Harvard School of Public Health and Health Canada has found that those who eat the least fruit and fish have the weakest lungs.

"Most of the adolescents in our study had dietary intakes of fruit, vegetables, vitamin E, and omega-3 fatty acids below recommended daily levels," said Jane Burns, a researcher at the Harvard School of Public Health. Fish are high in healthful omega-3 fatty acids.

"Low intakes were associated with lower lung function and increased odds of asthma and chronic bronchitis," said Burns. About 20 percent of people under 18 years old cough, wheeze and suffer from asthma and bronchitis. [Environment News Service, August 1, 2007]

  Milk / Dairy Products
 Please see the link between Asthma and Soy.

  Alcohol Consumption
 Red wine intake was associated with reduced asthma severity in a study of adults in England. [Am J Respir Crit Care Med 2001;164(10): pp.1823-1828]

However, alcoholic drinks may aggravate asthma due to sensitivity to the alcohol itself as well as to the many nonalcoholic components such as sulfites and histamine.[Clin Exp Allergy, 2002;32: pp.186-191]


Not recommended:
  Soy Isoflavones (genistein, daidzein)
 While a higher consumption of whole milk, apples and pears was associated with a reduced risk of asthma and atopy in a study of 1,601 young adults in Australia, a higher intake of soy beverages was associated with an increased risk of asthma and atopy. [Am J Clin Nutr 2003;78(3): pp.414-21]

Drug

  LDN - Low Dose Naltrexone

Environmental

  Particulate Avoidance
 In a September, 2004 study co-funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Environmental Health Sciences (NIEHS), and published in the New England Journal of Medicine it was found that a HEPA air filter, when used in conjunction with dust mite proof mattress and pillow covers, cockroach extermination and a HEPA vacuum, dramatically reduced asthma symptoms.

Though no air cleaning system can remove all allergans from a home, studies have shown they can significantly reduce the levels of airborn allergans and irritants, in some cases, by up to 90%. The HEPA filter has long been used in laboratory experiments, and has been proven to reduce the level of particles in the air. Many air filtration systems rely solely on HEPA technology, or, include a HEPA filter as part of a multi-filtration system.

Extract

  Glyconutrients
 Fourteen individuals with a clinical history of asthma reported improvement after following a program of dietary supplementation that included glyconutritionals, phytonutritionals, and a dioscorea complex. The subjects completed a retrospective questionnaire to assess the effect, if any, dietary supplementation had on their asthma. The subjects experienced a mean 86% reduction in the number of symptoms associated with asthma. They were also able to reduce by a mean of 72% the number of other medications they had been taking. This study demonstrated positive benefits in asthma patients who took these dietary supplements. [JANA Supplement No. 1 August 1997]

  Rye Grass Extract

Habits

  Tobacco Avoidance
 Even second-hand smoke should be avoided. In a study of passive smoke exposure, cotinine levels, when tested in asthmatic children, correlated with their bronchial sensitivity. The higher the level of cotinine in the child's urine, the worse the child's bronchial sensitivity. This held true for adults also. [Clin Chem 1999;45(4): pp.505-509]

Lab Tests/Rule-Outs

  Hydrochloric Acid (Trial)
 An older study showed that 80% of children with asthma had gastric acid secretions below normal levels.

  Test for Food Allergies
 Many studies have indicated that food allergies play an important role in asthma. Negative reactions to food may be immediate or delayed. Immediate onset sensitivities in children are usually due to egg, fish, shellfish, nuts, or peanuts. Foods most commonly associated with delayed onset include milk, chocolate, wheat, citrus, and food colorings. Elimination diets have been successful in treating asthma, especially for infants.

Asthmatics who have difficulty controlling their asthma despite the use of appropriate medications should also undergo food allergy testing. [Curr Allergy Rep 2001 Jan;1(1): pp.54-60]

Mineral

  Magnesium
 Magnesium supplements may reduce the bronchoconstriction in asthma by relaxing the muscle around the bronchial tubes. Intravenous solutions containing magnesium and other nutrients have been used successfully to break acute asthma attacks. Oral use improves breathing in asthmatics and the improvement correlates with serum magnesium levels.

In a preliminary trial, 18 adults with asthma took 300mg of magnesium per day for 30 days and experienced decreased bronchial reactivity. [Magnesium-Bulletin 1997;19: pp.4-6] However, a double-blind trial investigated the effects of 400mg per day for three weeks and found a significant improvement in symptoms, but not in objective measures of airflow or airway reactivity. [Eur Respir J 1997;10: pp.2225-9] The amount of magnesium used in these trials was 300 to 400mg per day (children take proportionately less based on their body weight).

  Salt Intake Reduction
 Studies suggest that high salt intake may have an adverse effect on asthma, particularly in men. In a small, preliminary trial, doubling salt intake for one month led to a small increase in airway reactivity (indicating a worsening of asthma) in men with asthma, as well as in non-asthmatics. [BMJ 1988;297:454] At least four double-blind trials have provided limited evidence of clinical improvement following a period of sodium restriction. It is difficult to compare the results of these studies because they used different amounts of sodium restriction. However, they consistently suggest that increased dietary sodium may aggravate asthma symptoms, especially in men. [Clin Exp Allergy 2000;30: pp.615-27]

A study demonstrated that a low-salt diet improves exercise-induced asthma (EIA) The study has shown for the first time that two weeks of altering dietary intake of salt can improve lung function in people with EIA. [Med Sci Sports Exerc 2000;32: pp.1815-9]

Twenty-four patients with asthma and exercised-induced asthma were divided into two groups: Some followed a low-salt diet of some 1,500 mg. of salt, while others were put on a high-salt diet of nearly 10,000 mg. (the usual amount many Americans consume daily). After two weeks, results showed:

High-salt dieters demonstrated a dramatic decline in lung function after exercise; the standard measure for lung functioning ( forced expiratory volume in one second (FEV1)) taken 20 minutes after high-salt dieters exercised dropped by 27.4%, compared with a 7.9% decline experienced by the low-salt group.

Those on the high-salt diet were also found to have more airway cells (another indicator of asthma) and pro-inflammatory mediators that spur airway constriction. [Medicine & Science in Sports & Exercise June 2005, Volume 37, Issue 6: 904-914 ]

  Molybdenum
 Molybdenum may be useful in the treatment of certain cardiovascular conditions, asthma, allergies and mercury toxicity. Because of its involvement with sulfur, it may be warranted to use in asthma that is associated with sulfite sensitivity.

  Selenium
 People with low levels of selenium have a high risk of asthma. [Clin Sci 1989;77: pp.495-500] Asthma involves free-radical damage [N Engl J Med 1991;325: pp.586-7 (letter)] that selenium might protect against. In a small double-blind trial, supplementation with 100mcg of sodium selenite (a form of selenium) per day for 14 weeks resulted in clinical improvement in six of eleven patients, compared with only one of ten in the placebo group. [Allergy 1993;48: pp.30-6] Most doctors recommend 200mcg per day for adults (and proportionately less for children) - a higher, though still safe, level.

Nutrient

  Lycopene
 Lycopene helps reduce the symptoms of asthma caused by exercising. In one double-blind trial [Allergy December, 2000;55: pp.1184-9], over half of people with exercise-induced asthma had significantly fewer asthma symptoms after taking capsules containing 30mg of lycopene per day for one week compared to when they took a placebo.

Oxygen / Oxidative Therapies

  Ozone / Oxidative Therapy

Physical Medicine

  Calming / Stretching Exercises
 Studies conducted at yoga institutions in India have reported impressive success in improving asthma. For example, one study of 255 people with asthma found that yoga resulted in improvement or cure in 74% of asthma patients. Another study of 114 patients treated over one year by yoga found a 76% rate of improvement or cure and that asthma attacks could usually be prevented by yoga methods without resorting to drugs.

Another Indian study of 15 people with asthma claimed a 93% improvement rate over a 9-year period. That study found improvement was linked with improved concentration, and the addition of a meditative procedure made the treatment more effective than simple postures and breathing exercises. Yoga practice also resulted in greater reduction in anxiety scores than drug therapy. Its authors believe that yoga practice helps patients through enabling them to gain access to their own internal experience and increased self-awareness.

A study of 46 adolescents with asthma found that yoga practice resulted in a significant increase in pulmonary function and exercise capacity and led to fewer symptoms and medications. Patients were given daily training in yoga for 90 minutes in the morning and one hour in the evening for 40 days. Practice included yogic cleansing procedures (kriyas), maintenance of yogic body postures (asanas), and yogic breathing practices (pranayama).

  Hydrotherapy

Surgery/Invasive

  Surgery
 A new report published in the prestigious New England Journal of Medicine (NEJM - April 2007) shows that patients treated with bronchial thermoplasty, the first non-drug treatment for asthma, demonstrated an overall improvement in asthma control.

Co-Principal Investigators, Dr. Gerard Cox, respirologist at St. Joseph's Healthcare Hamilton's Firestone Institute for Respiratory Health, and Professor at McMaster University, and Dr. John Miller, Division Head of Thoracic Surgery at St. Joseph's Healthcare Hamilton and McMaster University authored the study. The study revealed improved asthma control at one year following the bronchial thermoplasty procedure.

The publication entitled, "Asthma Control during the Year after Bronchial Thermoplasty", showed that patients treated with bronchial thermoplasty, compared to another group that did not receive the procedure, showed significant positive changes such as: decreases in asthma attacks, increases in days with no asthma symptoms, improvement in quality of life, reduction in using medication, and an improvement in asthma control.

Vitamins

  Bioflavonoids
 Quercetin appears to be important in the prevention of asthma attacks. It has been shown to inhibit histamine release from mast cells and basophils when stimulated by antigens (triggers). In addition, quercetin has both a vitamin C-sparing effect and a direct stabilizing effect on membranes, including mast cells. It is also an antioxidant. Other flavones also inhibit histamine release, but to a lesser degree.

  Vitamin C (Ascorbic Acid)
 Supplementation with 1gm of vitamin C per day reduces the tendency of the bronchial passages to go into spasm [Lung 1976;154: pp.17-24], an action that has been confirmed in double-blind research. [Ann Allergy 1990;65: pp.311-4] This amount of vitamin C, while providing benefit, is not curative. Beneficial effects of short-term vitamin C supplementation (i.e., less than three days) have been observed. In one double-blind trial, 500mg of vitamin C per day for two days prevented attacks of exercise-induced asthma. [Ann Allergy 1982;49: pp.146-51]

Both treated and untreated asthmatic patients have been shown to have significantly lower levels of ascorbic acid in both serum and white blood cells. Ascorbic acid has a wide variety of pharmacological effects that appear important in asthmatic treatment.

  Vitamin B12 (Cobalamine)
 In one clinical trial, weekly 1,000mcg intramuscular injections produced definite improvement in asthmatic children. Of 20 patients, 18 showed less shortness of breath on exertion, as well as improved appetite, sleep, and general condition. When given sublingually prior to a sulfite challenge, vitamin B12 appears to be especially effective in cases of asthma caused by sulfite sensitivity.

  Vitamin E
 Vitamin E has multiple actions that makes it a useful supportive agent in asthma treatment.

  Vitamin B6 (Pyridoxine)
 Vitamin B6 deficiency is common in asthmatics. [Ann Allergy 1975;35: pp.153-8] This deficiency may relate to the asthma itself or to certain asthma drugs (such as theophylline and aminophylline) that deplete vitamin B6. [Ann Allergy 1990;65: pp.59-62] In a double-blind trial, 200mg per day of vitamin B6 for two months reduced the severity of asthma in children and reduced the amount of asthma medication they needed. [Ann Allergy 1975;35: pp.93-7] In another trial, asthmatic adults experienced a dramatic decrease in the frequency and severity of asthma attacks while taking 50mg of vitamin B6 twice per day. [Am J Clin Nutr 1985;41: pp.684-8] Nonetheless, the research remains somewhat inconsistent, and one double-blind trial found that high amounts of B6 supplements did not help asthmatics who required the use of steroid drugs. [Ann Allergy 1993;70: pp.141-52]
 
 


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Strongly counter-indicative
May do some good
Likely to help
Highly recommended
May have adverse consequences







GLOSSARY

Acute:  An illness or symptom of sudden onset, which generally has a short duration.

Allergen:  A substance that is capable of producing an allergic response in the body.

Allergic Rhinitis:  Also known as hay fever, this is an inflammation of the nasal mucous membranes that is caused by specific allergen(s). It is an allergy characterized by sneezing, itchy and watery eyes, a runny or stuffy nose, coughing and a burning/scratchy sensation of the palate and throat.

Allergy:  Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.

Antioxidant:  A chemical compound that slows or prevents oxygen from reacting with other compounds. Some antioxidants have been shown to have cancer-protecting potential because they neutralize free radicals. Examples include vitamins C and E, alpha lipoic acid, beta carotene, the minerals selenium, zinc, and germanium, superoxide dismutase (SOD), coenzyme Q10, catalase, and some amino acids, like cystiene. Other nutrient sources include grape seed extract, curcumin, gingko, green tea, olive leaf, policosanol and pycnogenol.

Asthma:  A lung disorder marked by attacks of breathing difficulty, wheezing, coughing, and thick mucus coming from the lungs. The episodes may be triggered by breathing foreign substances (allergens) or pollutants, infection, vigorous exercise, or emotional stress.

Atopic:  Genetically predisposed toward developing immediate hypersensitivity reactions to common environmental allergens.

Bronchitis:  Inflammation of the mucous membrane of the bronchial tubes, frequently accompanied by cough, hypersecretion of mucus, and expectoration of sputum. Acute bronchitis is usually caused by an infectious agent and of short duration. Chronic bronchitis, generally the result of smoking, may also be known as Chronic Obstructive Pulmonary Disease (COPD) or Emphysema.

Bruxism:  Prolonged, unintentional grinding and clenching of the teeth, usually occurring during sleep. 'Bruxers' are often unaware that they have developed this habit. Symptoms include abraded/chipped teeth (in extreme cases, waking up with tooth chips in the mouth); facial pain; oversensitive teeth; tense facial and jaw muscles; headaches; dislocation of the jaw; damage to the tooth enamel, exposing the inside of the tooth; a popping or clicking in the temporomandibular joint (TMJ); tongue indentations; damage to the inside of the cheek.

Chronic:  Usually Chronic illness: Illness extending over a long period of time.

Cofactor:  A substance that acts with another substance to bring about certain effects, often a coenzyme.

Dermatitis:  A general term used to refer to eruptions or rashes on the skin.

Dyspnea:  Difficult breathing.

Eczema:  Swelling of the outer skin of unknown cause. In the early stage it may be itchy, red, have small blisters, and be swollen, and weeping. Later it becomes crusted, scaly, and thickened.

Edema:  Abnormal accumulation of fluids within tissues resulting in swelling.

Eosinophil:  The eosinophils, ordinarily about 2% of the granulocyte count (60 to 75% of the white blood cells), increase in number in the presence of allergic disorders and parasitic infestations.

Epidemic:  Describes a disease occurring in extensive outbreaks, or with an unusually high incidence at certain times and places.

Free Radical:  A free radical is an atom or group of atoms that has at least one unpaired electron. Because another element can easily pick up this free electron and cause a chemical reaction, these free radicals can effect dramatic and destructive changes in the body. Free radicals are activated in heated and rancid oils and by radiation in the atmosphere, among other things.

Helicobacter Pylori:  H. pylori is a bacterium that is found in the stomach which, along with acid secretion, damages stomach and duodenal tissue, causing inflammation and peptic ulcers. Although most people will never have symptoms or problems related to the infection, they may include: dull, 'gnawing' pain which may occur 2-3 hours after a meal, come and go for several days or weeks, occur in the middle of the night when the stomach is empty and be relieved by eating; loss of weight; loss of appetite; bloating; burping; nausea; vomiting.

Immune System:  A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation.

Magnesium:  An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.

Metabolism:  The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

Neurotransmitters:  Chemicals in the brain that aid in the transmission of nerve impulses. Various Neurotransmitters are responsible for different functions including controlling mood and muscle movement and inhibiting or causing the sensation of pain.

Pulmonary:  Pertaining to the lungs.

Pyridoxine:  (Vitamin B-6): A B-complex vitamin that plays a role as a coenzyme in the breakdown and utilization of carbohydrates, fats and proteins. It facilitates the release of glycogen for energy from the liver and muscles. It also participates in the utilization of energy in the brain and nervous tissue and is essential for the regulation of the central nervous system.

Rhinitis:  Inflammation of the nasal mucous membrane.

ROS:  Reactive Oxygen Species. Molecules including free radicals and other oxygen species.

Selenium:  An essential element involved primarily in enzymes that are antioxidants. Three selenium- containing enzymes are antioxidant peroxidases and a fourth selenium-containing enzyme is involved in thyroid hormone production. The prostate contains a selenium-containing protein and semen contains relatively large amounts of selenium. Clinical studies show that selenium is important in lowering the risk of several types of cancers. In combination with Vitamin E, selenium aids the production of antibodies and helps maintain a healthy heart. It also aids in the function of the pancreas, provides elasticity to tissues and helps cells defend themselves against damage from oxidation.

Serotonin:  A phenolic amine neurotransmitter (C10H12N2O) that is a powerful vasoconstrictor and is found especially in the brain, blood serum and gastric membranes of mammals. Considered essential for relaxation, sleep, and concentration.

Tryptophan:  Essential amino acid. Natural relaxant and sleep aid due to its precursor role in serotonin (a neurotransmitter) synthesis. Along with tyrosine, it is used in the treatment of addictions.

Vitamin B6:  Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.

Yeast:  A single-cell organism that may cause infection in the mouth, vagina, gastrointestinal tract, and any or all bodily parts. Common yeast infections include candidiasis and thrush.