Alternative treatments for asthma and allergies

by Dr. Jacki Hart

For those of you sneezing, coughing, wheezing, barely breathing and snoozing through the summer, we thought that it would be a good time to talk about allergies and asthma. The following story helps illustrate issues around suffering with asthma, some conventional ways to approach treatment and potential ways to integrate alternative therapies.

Sophie is a 49-year-old woman with a history of asthma first recognized and diagnosed when she was pregnant with her daughter 15 years ago. Since that time, Sophies asthma has increasingly grown, requiring greater amounts of medication and frequent emergency room visits, culminating in a hospitalization earlier this year. For Sophie, the hospitalization was a turning point. She was tired of the progressive nature of the disease, scared about the potential long term effects of the multiple medications she was using, and, frankly, sick of being sick. She made up her mind that she was going to make some changes, which is exactly what she did.

When Sophie left the hospital, she was using eight puffs per day of a steroid inhaler intended to decrease inflammation in her airways, and four puffs per day of an inhaler designed to reduce bronchial airway spasm or constriction (called a beta-agonist). The idea of this conventional approach is to reduce swelling and to relax the airways, improving the flow of oxygen and, literally, allowing the person to breathe more easily. There is no question that this is absolutely vital in an acute situation; in fact, in addition to the above, many other medications are often required at the time of a bad asthma attack. Often, these treatments, as well as others, are also used over time to maintain open airways and prevent asthma exacerbation. The questions Sophie was asking, however, ncluded:

• Is there a better way to prevent attacks than the constant use of medications?
• What might be happening to her overall by using these medications for so many years?

Sophie had heard from friends and family about the potential use of acupuncture for asthma and decided to explore this approach. At the first visit with the certified, licensed acupuncturist, she had a remarkable experience. For many years, Sophie had noticed that her asthma attacks seemed related to eating or, possibly, to particular foods. After years of trying to get doctors to acknowledge, let alone explain, this potential connection, Sophie listened as the acupuncturist explained that "there is something not right about your digestive system and I think we should focus on that before working on the respiratory system because the two are closely linked." For the first time, Sophie felt that her treatment was based on her whole system - not just one symptom.

In addition to weekly acupuncture treatments -- which eventually tapered to once every other week, and then every three weeks -- Sophie has also incorporated some other changes. Her eating habits have improved and she has eliminated certain foods altogether. She has been exercising more regularly than prior to the hospitalization, drinking lots of water throughout the day, doing yoga and meditation. She has also received a few myofascial treatments, (a particular massage technique), in order to open up her chest wall. These changes in combination have allowed Sophie to reduce her inhaler use to one puff of the steroid and one puff of the beta-agonist per day for the first time in 15 years. This is also the first spring and summer that she has not made a trip to the emergency room, used her nebulizer (a special home breathing machine to self-administer medication), or taken antibiotics.

Sophies story of the progressive nature of her asthma is not atypical. In fact, asthma affects 5-10% of all adults and leads to irreversible damage of the airways in 80% of asthmatic adults over the age of 65. Asthma is also responsible for many deaths in both children and adults - particularly if there is first or second hand smoke exposure aggravating this condition.

Asthma is occasionally, but not exclusively, related to allergies which is why many people are suffering this time of year. Another response to environmental agents such as pollen (found in trees and grass,) dust (aka house mites), and mold is allergic rhinitis, commonly referred to as "hay fever". Many of the suggested alternative approaches are similar for both asthma and allergic rhinitis and Sophie has successfully incorporated several of them.

One alternative method of treatment for asthma and allergies is bodywork. The idea behind using bodywork such as myofascial release is to expand the chest wall by relaxing muscles and breaking patterns developed from the overwork of the soft tissue in asthmatics. Other types of body work which could have this effect include deep tissue massage or Rolfing, craniosacral treatments and osteopathic manipulations. Yoga and meditation are helpful from several perspectives - relaxation, stretching and expansion of the chest wall muscles, and breathing techniques which encourage the flow of oxygen to the necessary and appropriate locations. There are some who believe that there is an emotional component to both asthma and allergies and that eliminating certain stressors as well as learning to relax can help eliminate this physical response/reaction.

Indeed, inability to get enough air - so called air hunger or dyspnea - is very anxiety provoking; and, in the reverse, anxiety can make you feel extremely short of breath. Also of note, Sophie had been tested for food allergies, and was not found to be allergic to any particular foods. Nonetheless, eliminating dairy (thereby reducing mucous secretion in the nasal passages and airways), eating lots of fresh fruits and vegetables, experimenting with vegetarianism and even a macrobiotic diet, avoiding glutens as well as refined sugars, eliminating monosodium glutamate (MSG) and avoiding preservatives can help even when one is not allergic to particular foods per se.

In addition to the approaches mentioned, some other suggested treatments have included herbal remedies such as stinging nettle for hay fever, goldenseal, Chinese ephedra; certain vitamins and supplements such as Esther C, bioflavonoids, vitamin E, garlic and zinc, and homeopathy. I would urge you to use these modalities only under the guidance of a licensed, certified specialist with the knowledge and supervision of your overall care by your regular primary care physician.

In my opinion, acupuncture seems to be one of the best alternatives for the treatment of allergies and asthma. My opinion is based primarily on many case reports similar to Sophie. There have been some Western studies attempting to assess the benefits of acupuncture for asthma and allergies; however, it has been difficult, thus far, to come up with designs that adequately answer this question from the conventional perspective. Nonetheless, many people like Sophie continue to benefit and thousands of cases are reported in the Chinese literature.

Given these successes, in November of 1997, a panel of 12 experts selected by the National Institute of Health (NIH) came out with a Consensus Statement regarding the uses of acupuncture. These experts reviewed existing literature and determined that asthma is one of the conditions for which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. This statement raises several important points, including that alternative and complementary approaches for treatment of asthma and allergies are not mutually exclusive; they can and often should be used in conjunction with one another. As in Sophies case it may be possible to reduce some of ones medications by using these alternative approaches. Use of these alternative treatments and adjustment of your medications should always be done under the direction of your doctor.

Not everyone is going to have the same experience and success as Sophie. However, there is a good chance that you will derive positive benefits from using these treatments in conjunction with your conventional therapy. You may be able to reduce or eliminate some of your standard medications if you approach this process safely and carefully.