Natural Asthma Relief

Asthma leaves some 15 million Americans gasping for breath. And asthma’s incidence has been steadily rising in the past four decades, more than doubling since 1980. Although the tendency to develop asthma can be genetic, both environmental and dietary factors are major causes for the increase.

For example, the incidence of asthma, especially in children, is much greater in urban areas where polluted air is more prevalent. Even more striking is that asthma is a new disease. Like coronary artery disease, asthma was virtually unknown 100 years ago, and is still rare in many developing countries.1

Asthma is best described as a chronic inflammatory condition rather than a respiratory disease. In fact, asthma’s origins have more in common with arthritis than they do with emphysema or tuberculosis. Asthma is simply a chronic inflammation of the airway rather than the joints. People with asthma have inflamed, hyperreactive airways that produce excessive bronchial mucus. After repeated asthma attacks, the airway lining becomes scarred, and immune cells, which cause or exacerbate inflammation, proliferate there.2 Asthma eventually damages the airway permanently, making it more prone to inflammation and less functional overall.

Chronic inflammatory conditions are characterized by an excess of free radicals, which irritate and inflame tissues and cause excessive immune reactions.3 Immune responses unavoidably produce free radicals because, in limited amounts, they are a valuable part of the defense mechanism. Antioxidants help reduce most inflammatory reactions including asthma, allergies, sports injuries and post-operative inflammation by quenching free radicals. Think of antioxidants as chemical sacrificial lambs—they preferentially react with free radicals so the free radicals don’t react with the body’s tissues instead.

Various environmental triggers—smoke, dust, allergens—set the inflammatory process in motion. People with low thresholds for these triggers can have frequent severe asthma attacks. Therefore, identifying inflammatory triggers and using natural products that raise thresholds reduce the frequency and severity of asthma attacks.

The Allergy Link
Almost everyone with asthma has allergies, although they may not be fully diagnosed. Allergic reactions are the most common triggers for asthma attacks. Asthma and allergy attacks can be triggered by histamine. Histamine is produced when special connective tissue cells called mast cells are activated by circulating immune system cells, which mobilize when infection, toxins or irritants are present.

Examples of asthma-causing allergens or irritants are air pollution, tobacco smoke, pet dander, dust mites, pollen, perfumes, cleaning products, kerosene heaters, mold and mildew. Bakers, manicurists, hairdressers and painters as well as those who work in the construction, auto body, food-processing and petroleum-refinery industries often develop occupational asthma from breathing chemical and food vapors, flour and dust.4

Food allergies can play a major role as well. Asthmatics are often allergic to common foods such as citrus fruits, dairy products, eggs, soy, wheat and yeasts.5 Many asthmatics are sensitive to food additives and preservatives such as benzoates, sulfites, benzaldehyde and artificial colors (especially tartrazine found in FD&C Yellow No. 5), and so should choose natural, unprocessed foods.

There are two types of food allergies, making diagnosis difficult. The traditional type, called immediate onset, is characterized by reactions that develop minutes after ingesting only a tiny amount of the allergenic food. Reactions are predictable and typically involve the airway, gastrointestinal tract and skin. Examples are bronchiospasms, vomiting and/or hives from eating shellfish or nuts. Immediate-onset allergies are usually caused by one to three foods and occur in less than 5 percent of the population, although 10 percent of asthmatics have them.6

Far more common, but harder to diagnose, are delayed-onset food allergies. These develop after two to 48 hours and are dependent on the amount and preparation of food eaten. Delayed-onset food allergies cause various responses from asthma to ulcers, and aren’t always predictable or easily linked to the offending food.5 As few as three or as many as 20 foods may be involved.6 Delayed-onset food allergies can have cross reactions, especially among grains and legumes.7 For example, if someone is allergic to kidney beans, then eating black-eyed peas and pinto beans instead is no solution and may eventually cause a similar allergic response.

Asthma Prevention and Relief
Identifying and avoiding the dietary and environmental factors that trigger asthma are essential parts of a natural treatment plan. Unfortunately, people can’t always avoid everything that might bother them, so it is equally important to implement an aggressive nutritional supplement plan designed to raise trigger thresholds.

Asthma is exacerbated by certain nutrient deficiencies. These deficiencies stem from a poor, unsupplemented diet coupled with nutrient depletion from the stress associated with asthma and allergy attacks. Furthermore, undiagnosed food allergies, some asthma medications and candidiasis can irritate the gastrointestinal system, which reduces nutrient absorption.

Asthma is amenable to natural treatments. Asthmatics using medication should not discontinue them abruptly; instead they should work closely with a health care provider to design a plan best suited to the severity of their illness, and decrease medication doses under supervised care. Since asthma can be life-threatening, asthmatics should follow these common-sense precautions:

  • Use hypoallergenic supplements.

  • Avoid magnesium or vitamin C in excess of 3 g per day if kidney disease or dysfunction is present.

  • Avoid fish, fish oil or shark-liver oil if fish allergies are suspected.

  • Be cautious when supplementing medicinal herbs if fruits, vegetables, condiments, culinary herbs and spices or flower pollens trigger allergic reactions.

  • Use one product at a time, and take one caspule daily, to slowly build up the dosage.

I recommend the following daily supplements to prevent or treat asthma. The supplements work synergistically, so to make the most of the plan, include them all.

  • Antioxidants—including 400 IU vitamin E and 100 mcg selenium—counter the free radical damage incurred during inflammatory responses.4 Vitamin C is a powerful antihistamine without side effects, and it enhances immune response.8 Take at least 1 g with bioflavonoids three times per day. For exercise-induced asthma, take 2 g 20 to 30 minutes before exercise.9

  • Fish oil is another anti-inflammatory. Take 2 to 4 g.

  • Glutamine powder is indicated for patients with candidiasis and for food allergy recovery. Take 10 to 20 g.10

  • Magnesium levels are chronically low in asthmatics, and the mineral helps relax the bronchial tubes and smooth muscle of the esophagus.11 A therapeutic dose is 400 to 800 mg.

  • Multivitamins/minerals that include 25 to 75 mg B complex, 400 to 800 mcg folic acid, 15 to 20 mg zinc and 400 mcg chromium picolinate can be helpful. Vitamins B6 and B12 are especially important and are most likely to be deficient.4,12

  • N-acetyl cysteine (NAC) is an antioxidant that increases glutathione levels and thins bronchial mucus.13 Take 200 to 500 mg three times per day.

  • Pantothenic acid (vitamin B5), helps form antibodies. Take 250 mg.

  • Quercetin, a bioflavonoid, is antihistaminic and antiallergenic.14 It is known to inhibit mast cells from releasing inflammatory compounds.15 Take 500 mg twice daily.

How Herbs Free Breathing
Herbal products have the potential to provide relief from many chronic inflammatory conditions, but few have been tested on people with asthma. Herbs can relieve inflammation because they contain antioxidant phytochemicals. Some antioxidant phytochemicals, such as the curcuminoids from standardized turmeric extract, prevent the formation of free radicals as well as quench them after they are formed.

Today’s oral asthma medications inhibit lipoxygenase, meaning they interfere with the action of leukotrienes (LTs).16 Leukotrienes are biochemicals that sustain inflammatory conditions once they are triggered, and thus play a role in asthmatic bronchial inflammation. Some LTs are also strong stimulators of bronchial constriction, and mucus production—they are 1,000 times more potent than histamine. This means just a small amount of LTs can narrow the breathing passages and precipitate an asthma attack.2 Many medicinal plants contain phytochemicals that inhibit lipoxygenase without the dangerous side effects of pharmaceutical prescriptions. The commonly used inhalers are beta-adrenergic stimulators that relax bronchial smooth muscle, thereby mechanically opening the airway. Designed for emergency use only, they do nothing to reduce underlying inflammation. Overuse of inhalers—more than two canisters weekly—increases the risk of death from asthma by increasing side effects, which include desensitization to the medication, increased heart rate and blood pressure, headaches and blurred vision. Steroids used for asthma can cause or exacerbate diabetes, glaucoma, obesity, liver damage, abnormal cholesterol levels and heart disease.

The following two herbal treatments for asthma have been shown to significantly inhibit lipoxygenase activity.

In the Middle East, herbs have always been a primary treatment for asthma and allergies. A traditional extract blend taken with honey includes black cumin (Nigella sativa), chamomile (Matricaria recutita), cinnamon (Cinnamomum cassia), cloves (Syzygium aromaticum), rosemary (Rosmarinus officinalis), sage (Salvia officinalis), spearmint (Mentha spicata), thyme (Thymus vulgaris) and other herbs. Black cumin seed, rosemary and thyme are known to inhibit the contraction of tracheal smooth muscle that is stimulated by histamine and acetylcholine.17 Chamomile, cinnamon, cloves, rosemary, spearmint and thyme contain many antioxidants. Black cumin seed oil, and the black cumin phytochemicals nigellone and thymoquinone, strongly inhibit lipoxygenase18 and prevent the release of histamine from mast cells.19 The herbs in this blend also contain the lipoxygenase inhibitors caffeic acid, catechin, chlorogenic acid, hydroxycinnamic acids, kaemp-ferol, procyanidin-D2, quercetin and cinnamic acid,14 all of potential benefit to asthmatics.

In Asian countries a blend known as Saiboku-To is used clinically for asthma treatment. It contains 10 herbs including ginger (Zingiber officinale), Korean ginseng (Panax ginseng), magnolia (Magnolia obovata), Baikal scullcap (Scutellaria baicalensis) and licorice (Glycyrrhiza glabra). In Japan, 40 asthma patients were treated with Saiboku-To for six to 24 months, and all were able to greatly reduce their steroidal asthma medications.20 Saiboku-To has also been shown to inhibit lipoxygenase.21 However, the clinical dosage used in Japan is up to 7.5 g of herb powder daily. The most effective herbs in the blend are likely to be Baikal scullcap and magnolia, so I recommend trying 500 to 1,000 mg of each three times per day.

Asthma is yet another chronic disease related to western diets and lifestyles. while people may have a genetic tendency to develop asthma, this tendency was not expressed until after the Industrial Revolution. In other words, it seems we’ve brought asthma upon ourselves, and we can’t rely on drugs to undo the damage. A clean environment, an unprocessed whole-foods diet, nutritional supplementation and herbal medicine are logical ways to reverse the increasing incidence of asthma.

C. Leigh Broadhurst, Ph.D., is a visiting scientist for a government nutrition research laboratory and heads 22nd Century Nutrition, a nutrition/scientific consulting firm.

References

1. Yemaneberhan H, et al. Prevalence of wheeze and asthma in relation to atopy in urban and rural Ethiopia. Lancet 1997;350:85-90.

2. Thien FCK, walters EH. Eicosanoids and asthma: an update. Prostaglandins Leukot Essent Fatty Acids 1995;52: 271-88.

3. Shevdova AA, et al. Increased lipid peroxidation and decreased antioxidants in lungs of guinea pigs following an allergic pulmonary response. Toxicol Applied Pharmacol 1995;132:72-81.

4. Hamilton K, Roberson K. Asthma: clinical pearls in nutrition and complementary therapies. Sacramento (CA): ITS Services; 1997.

5. Kumar RJ. Food hypersensitivity and allergic disease. Am J Clin Nutr 1997:66;526S-9S.

6. Plaut M. Newdirections in food allergy research. J Allergy Clin Immun 1997;94:928-30.

7. Lalles JP, Peltre G. Biochemical features of grain legume allergens in humans and animals. Nutr Rev 1996;54:101-7.

8. Hatch GE. Vitamin C in asthma. In Packer L, Fuchs J. Editors. Vitamin C in health and disease. NewYork: Marcel Dekker; 1997. p. 279-94.

9. Cohen HA, et al. Blocking effect of vitamin C in exercise- induced asthma. Arch Pediatr Adolesc Med 1997;151: 367-70.

10. Shabert J, Erlich N. The ultimate nutrient glutamine. Garden City Park (NY):Avery; 1994.

11. Durlach J. Magnesium depletion, magnesium deficiency, and asthma. Magnesium Res 1995;8: 403-5.

12. Wright JV. Treatment of childhood asthma with parenteral vitamin B12, gastric reacidification and attention to food allergy, magnesium and pyridoxine: three case reports with a background integrated hypothesis. J Nutr Med 1990:1;277-82.

13. Gordon GR, et al. A trial of antioxidants n-acetylcysteine and procysteine in acute respiratory distress syndrome. Chest 1997:112;164-72.

14. Duke JA, et al. http://www.ars-grin.gov/duke/. U.S. Dept. of Agriculture Phytochemical and Ethnobotanical Data Base 1999, washington, D.C.

15. Pearce FL, et al. Mucosal mast cells III: effect of quercetin and other flavonoids on antigen-induced histamine secretion from rat intestinal mast cells. J Allergy Clin Immunol 1984;73:819-23.

16. Smith LJ. Leukotrienes in asthma: the potential therapeutic role of antileukotriene agents. Arch Intern Med 1996;156:2181-9.

17. Aqel MB. Relaxant effect of the volatile oil of Rosmarinus officinalis on tracheal smooth muscle. J Ethnopharm 1991;33:57-62.

18. Houghton PJ, et al. Fixed oil of Nigella sativa and derived thymoquinone inhibit eicosanoid generation in leukocytes and membrane lipid peroxidation. Planta Med 1995;61:33-6.

19. Chakravarty N. Inhibition of histamine release from mast cells by nigellone. Ann Allergy 1993;70:237-42.

20. Lewith GT, watkins AD. Unconventional therapies in asthma: an overview. Allergy 1996;51:761-9.

21. Kobayashi I, et al. Saiboku-To, an herbal extract mixture, selectively inhibits 5-lipoxygenase activity in leukotriene synthesis in rat basophilic leukemia-1 cells. J Ethnopharm 1995;48:33-41.



Sidebars:

Botanical Remedies

Complementary therapies such as herbal medicine, acupuncture and yoga can reduce asthma severity, often allowing patients to reduce dosages or eliminate the need for pharmaceuticals. Asthma sufferers, however, should not stop taking their medications or substitute herbs for them. Rather, they should make changes to their treatment regimen under the supervision of a qualified medical practitioner.

That said, these herbs have either years of traditional use or clinical trials showing they can help people regain respiratory health.

Ginkgo (Ginkgo biloba) has long been used by the Chinese to treat asthma. The leaves contain ginkgolides, which inhibit platelet activating factor, a chemical that mediates asthma and allergies. Small, placebo-controlled trials show that oral, but not inhaled, ginkgolides (in a formulation called BN52063) significantly reduce bronchoconstriction in response to inhaled allergens1 and partially protect against exercise-induced bronchoconstriction.2

Coffee and tea both contain caffeine, which is chemically related to the asthma drug theophylline. A placebo-controlled trial of 13 asthmatics found that 7 mg caffeine per kg of body weight significantly improved baseline lung function and prevented exercise-induced bronchospasm.3 Coffee has 135 to 150 mg of caffeine per eight-ounce cup; tea has about 60 mg.

Onion (Allium cepa) has long been used to treat bronchitis and asthma. Lab tests showthat onion extracts can block the enzymes that produce chemicals of inflammation such as thromboxane A2, and inhibit allergen-induced asthmatic responses.4 The active ingredients in onion include isothiocyanates, thiosulfinates and the bioflavonoid quercetin.

Licorice (Glycyrrhiza glabra) is an antiviral, expectorant, demulcent, anti-inflammatory and immune stimulant—all properties of potential benefit for asthma sufferers. Licorice slows the breakdown of corticosteroids, thus prolonging the anti-inflammatory effects of hormones such as cortisol.5 Clients should not add licorice to glucocorticoid treatment unless they are under the supervision of a physician who can adjust their drug dosage. When taken continuously for several weeks, licorice can cause sodium and water retention as well as potassium loss, resulting in elevated blood pressure. Therefore, it is not recommended for people with hypertension. There are other contraindications necessitating that its use be monitored.

Ephedra (Ephedra sinica), or Ma huang, has a 5,000-year history of use in Chinese medicine as an asthma treatment.6 One of its active constituents is ephedrine, which is similar in structure to the epinephrine (adrenaline) produced in the body. Actions include bronchodilation and decongestion. Too much ephedra will cause undesirable stimulatory effects such as restlessness, anxiety, tremors, insomnia, headaches and elevated blood pressure and heart rate. Modern beta-adrenergic bronchodilators act in a more specific way, reducing many of these side effects and offering patients a safe and effective treatment.

When used appropriately and under medical supervision, ephedra can safely provide some asthma sufferers relief. Ephedra is not recommended for people with high blood pressure, heart disease, glaucoma, anorexia, hyperthyroidism, diabetes, or for pregnant or lactating women. People on theophylline or monoamine oxidase inhibitors should not take this herb.

Turmeric (Curcuma longa) contains curcumin, which has anti-inflammatory, antiviral, antioxidant and anti-tumor activity. In vitro studies show that curcumin blocks the allergen-triggered release of inflammatory chemicals in white blood cells taken from asthma patients.7 Although clinical trials have yet to prove so, in vitro studies suggest that curcumin could help control allergic diseases such as asthma.

Other supportive herbs asthmatics may want to discuss with an herbalist or health care provider are astragalus (Astragalus membranaceus), an immune tonic; echinacea (Echinacea purpurea, E. pallida), an immune stimulant; elecampane (Inula helenium) an antiseptic and expectorant; marshmallow (Althaea officinalis), a demulcent and immune stimulant; mullein (Verbascum thapsus), an antispasmodic and anti-inflammatory; nettles (Urtica dioica), an antihistamine; and rosemary (Rosmarinus officinalis), whose volatile oils have been shown to relax tracheal smooth muscle,8 which theoretically may block bronchoconstriction.

Linda B. White, M.D., is a freelance writer, editor and the coauthor of Kids, Herbs & Health (Interweave Press, 1999).

References

1. Ginot P. Effect of BN52063, a specific PAF-acether antagonist, on bronchial provocation test to allergens in asthmatic patients. Prostaglandins 1987;34:723-31.

2. wilkens JH, et al. Effects of a PAF-antagonist (BN52063) on bronchoconstriction and platelet activation during exercise-induced asthma. Brit J Pharmacol 1990;29:85-91.

3. Kivity S, et al. The effect of caffeine on exercise-induced bronchoconstriction. Chest 1990;97:1083-5.

4. Dorsch W, Wagner h. Newantiasthmatic drugs from traditional medicine? Int Arch Allergy Appl Immunol 1991;94(1-4):262-5.

5. Homma M, et al. A novel 11-beta-hydroxysteroid dehydrogenase inhibitor contained in Saiboku-To, an herbal remedy for steroid-dependent bronchial asthma. J Pharmacy and Pharmacol 1994;46:305-9.

6. Goodman LS, Gilman A. The pharmacological basis of therapeutics. 5th ed. NewYork: Macmillan; 1975:500-7.

7. Kobyashi T, et al. Curcumin inhibition of dermatophagoides farinea-induced interleukin-5 and granulocyte macrophage-colony stimulating factor production by lymphocytes from bronchial asthmatics. Biochemical Pharmacol 1997;45:819-21.

8. Agel MB. Relaxant effect of the volatile oil of Rosmarinus officinalis on tracheal smooth muscle. J Ethnopharmacol 1991:33;57-62.

Are Obese Children At Risk?

Asthma, the leading cause of chronic illness and school absenteeism in children, has now been linked to obesity. Department of Pediatrics researchers from the State University of New York at Buffalo studied 171 urban children ages 4 to 16, the majority of whom were Hispanic. Some 31 percent of asthmatic children were very obese compared with 12 percent of nonasthmatic children.1 Even when they were not very obese, asthmatic children in general had more body fat than nonasthmatics. (Very obese is at or greater than the 95th percentile of the body-mass index.)

Although asthma may reduce a child’s exercise capacity, exercise avoidance couldn’t explain the higher incidence of obesity in the asthmatic children, especially since many of the children effectively controlled their asthma. It is more likely that the overall dietary habits and chronic inactivity that cause obesity also increase the risk for asthma. Researchers theorize obesity itself may, in fact, increase the airway reactivity.

—CLB

References

1. Gennuso J, et al. The relationship between asthma and obesity in urban minority children and adolescents. Archives of Pediatric and Adolescent Medicine 1998;152:1197-1200.




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