Asthma

People who are having an asthma attack have real trouble taking a breath. Many people with stuffy noses from hay fever or colds say, "I cant breathe," but they retain the option of breathing through the mouth. Asthmatics, however, know what "I cant breathe" really means. Instead of their nasal passages, it is the bronchial tubes in their lungs that become swollen and clogged. Breathing can become frighteningly difficult.

Asthma involves two conditions: (1) contraction of the small muscles surrounding the bronchial tubes and (2) swelling of the lining of those tubes. Until recently, treatment usually addressed the first aspect of asthma; but in the last decade, it has become clear that tissue swelling is more fundamental.

Conventional medical treatment for asthma involves bronchodilators, which relax the bronchial muscles, and anti-inflammatory medication, which helps relieve the swelling of tissue. The most effective treatments for reducing this inflammation are steroids, inhalable forms of which have been developed that do not cause as many side effects as oral drugs, such as prednisone. Nonsteroidal drugs, such as cromolyn (Intal), are also available.

The conventional treatment of asthma is highly effective in most cases.

Principal Proposed Treatments for Asthma:

Perhaps the most promising natural treatment for asthma is the herb tylophora. Another possibility is an herb more famous for rheumatoid arthritis, boswellia. The herb Coleus forskohlii may also be helpful, but it is really more like a drug than an herb. Vitamin C also appears to be somewhat helpful. The Chinese herb ma huang is definitely effective for mild asthma, but it isnt safe.

Warning: None of these treatments have been shown to be effective for severe asthma. Do not stop your standard asthma medication except on the advice of a physician.

Tylophora: A Promising Treatment for Asthma

The herb Tylophora indica(also called Tylophora asthmatica) appears to offer considerable promise as a treatment for asthma. It has a long history of use in the traditional Ayurvedic medicine of India.

In a double-blind placebo-controlled study of 195 individuals with asthma, the participants who were given 40 mg of a tylophora alcohol extract daily for 6 days showed significant improvement as compared to placebo; the difference was even more marked months after use of the herb was stopped.

Similar results were seen in two double-blind placebo-controlled studies involving over 200 individuals with asthma. The authors of one study noted that it was remarkable that only 6 days of treatment could produce such long-standing benefits.

However, the design of these studies was a bit convoluted, and various pieces of information are missing from the reports, causing some difficulty in evaluating the validity of these trials.

Another double-blind study that enrolled 135 individuals and followed a more straightforward design found no benefit from tylophora. The bottom line: Although tylophora is promising, larger and better studies are necessary to discover whether tylophora is truly effective.

We dont know how tylophora might work in asthma, but it may have anti-inflammatory, antiallergic, adrenal gland–stimulating, and antispasmodic actions.

For more information, including dosage and safety issues, see the full tylophora article.

Boswellia: Possibly Helpful

The herb boswellia has shown promise as a treatment for rheumatoid arthritis. It is thought to work by inhibiting inflammation. Since asthma involves inflammation as well and can be treated by some of the same drugs that treat rheumatoid arthritis, boswellia has been tried for this purpose too.

One 6-week double-blind placebo-controlled study of 80 individuals with relatively mild asthma found that treatment with boswellia at a dose of 300 mg 3 times daily reduced the frequency of asthma attacks and improved objective measurements of breathing capacity. However, further research needs to be performed to follow up this pilot study before boswellia can be described as a proven treatment for asthma.

For more information, including dosage and safety issues, see the full boswellia article.

Coleus forskohlii: May Be Effective, but More Like a Drug Than an Herb

Another herb sometimes recommended for asthma also comes from India, Coleus forskohlii. While there is some evidence that it might work, we cannot give it a wholehearted recommendation. As presently sold, the herb is more like a drug than an herb. Natural Coleus forskohlii contains small amounts of a potent substance called forskolin. However, manufacturers deliberately modify the herb to dramatically increase its forskolin content. Forskolin appears to be safe, but more studies need to be undertaken before it can be recommended for self-treatment.

Vitamin C: Appears to Provide Some Benefits

Many studies have been conducted on the effects of vitamin C in treating asthma. When you put all the results together, it appears that the regular use of high-dose vitamin C provides some benefits.

For more information, including dosage and safety issues, see the full vitamin C article.

Ma Huang: Effective, but Not Safe

The Chinese herb ma huang, also called ephedra, is definitely effective for mild asthma, because it contains the drug ephedrine. However, we cannot recommend using it because of safety concerns. This Chinese herb is a member of a primitive family of plants that look like thin, branching, connected straws. A related species, Ephedra nevadensis, grows wild in the American Southwest and is widely called Mormon tea. However, only the Asian species of ephedra contains the active compounds ephedrine and pseudoephedrine.

Ma huang was traditionally used by Chinese herbalists in the early stages of respiratory infections and for the short-term treatment of certain kinds of asthma, eczema, hay fever, narcolepsy, and edema.

Japanese chemists isolated ephedrine from ma huang at the turn of the twentieth century, and it soon became a primary treatment for asthma in the United States and abroad. Ephedras other major ingredient, pseudoephedrine, became the decongestant Sudafed.

Although ephedrine can still be found in a few over-the-counter asthma drugs, physicians seldom prescribe it today. The problem is that ephedrine mimics the effects of adrenaline and causes symptoms such as rapid heartbeat, high blood pressure, agitation, insomnia, nausea, and loss of appetite. The newer asthma drugs are much safer and easier to tolerate. This is a situation in which synthetic drugs are less dangerous than a natural one. We do not recommend using ma huang for asthma.

Other Proposed Treatments for Asthma:

Vitamin B12

Supplementation with vitamin B12 is said to be effective for asthma. However, the scientific evidence in its favor consists almost entirely of open studies that did not attempt to eliminate the placebo effect.

Quercetin

The flavonoid quercetin is often recommended as a treatment for asthma on the basis of test tube studies that show it can inhibit the release of inflammatory substances from special cells called mast cells. Because the asthma drugs Intal and Tilade are believed to work in the same way, many natural medicine authorities have often recommended quercetin as an equivalent treatment. However, even though significant direct evidence exists that Tilade and Intal actually work, no such evidence yet exists for quercetin. Interestingly, Intal is derived from a Mediterranean herb named khella.

Vitamin B6

Vitamin B6 is often mentioned as a treatment for asthma, but the evidence that it works is weak and contradictory. A double-blind study of 76 asthmatic children found significant benefit from vitamin B6 after the second month of usage. Children in the treated group were able to reduce their doses of bronchodilators and steroids. However, a recent double-blind study of 31 adults who also used either inhaled or oral steroids did not show any benefit.

For more information, including dosage and safety issues, see the full vitamin B6 article.

Butterbur

Preliminary evidence suggests that the herb butterbur may be helpful for asthma.

Elimination Diet

Some people with asthma may also have food allergies. If this is the case, eliminating the offending food from the diet might reduce asthma symptoms. The only reliable way to discover if you are allergic to a certain food is through eliminating potentially allergenic foods from the diet then systematically reintroducing them to see if a reaction occurs. For more information on elimination diets see the article on food allergies.

Antioxidants

Antioxidants, such as vitamin E, beta-carotene, and selenium, are frequently recommended for asthma on the grounds that they may protect inflamed lung tissue. However, there is little direct scientific evidence that they work at this time.

Essential Fatty Acids

Essential fatty acids, such as GLA and those found in fish oil and flaxseed oil, are suspected to inhibit inflammatory responses such as those that occur in asthma. However, most of the studies that tried fish oil as a treatment for asthma found no benefit. One study found that fish oil can actually worsen aspirin-related asthma.

Magnesium

Magnesium is frequently mentioned as a treatment for asthma, but no good studies have shown that oral magnesium is helpful. Some evidence exists that intravenous and inhaled magnesium may offer some short-term benefit, but the relevance of these findings to taking magnesium supplements by mouth is unclear.

Other Herbs and Supplements

A small double-blind, placebo-controlled study suggests that OPCs from pinebark might be helpful for asthma.

Other commonly recommended asthma treatments include the herbs aloe, chamomile, damiana, elecampane, garlic, grindelia, licorice, marshmallow, mullein, onion, reishi, and yerba santa, as well as the supplement betaine hydrochloride. Lobelia inflata is a traditional herbal treatment for asthma; but according to traditional directions, it should be taken to the point of vomiting, a process we can hardly recommend.

Acupuncture

Although there have been numerous reports on acupuncture treatment for asthma, the results have been contradictory.

A team of three researchers analyzed 13 trials on acupuncture in the treatment of asthma. These studies were scored on the basis of design quality, with a maximum possible score of 100 points. Criteria for assigning points included size of the study population, randomization procedure, description of treatment, measurement of effects, follow-up, and the like. Eight studies earned more than 50 points, and the highest score was 72 points. However, the overall quality of studies was judged mediocre, and in any case the results were contradictory. The conclusion was that "claims that acupuncture is effective in the treatment of asthma are not based on the results of well-performed clinical trials."

A more recent review of acupuncture for asthma came to identical conclusions.