Title : Asthma
link : Asthma
Asthma
Asthma is a lung disorder in which
spasms and inflammation of the bronchial passages restrict the flow of air in
and out of the lungs. The number of people with asthma and the death rate from
this condition have been increasing 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.
Findings from animal and human
studies confirm that DTP (diphtheria and tetanus toxoids and pertussis) and
tetanus vaccinations can induce allergic responses, 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.
What are the symptoms of
asthma?
An asthma attack usually begins
with sudden fits of wheezing, coughing, or shortness of breath. However, it may
also begin insidiously with slowly increasing manifestations of respiratory
distress. A sensation of tightness in the chest is also common.
Dietary changes that may be
helpful
A vegan (pure vegetarian) diet
given for one year in conjunction with many specific dietary changes (such as
avoidance of caffeine, sugar, salt, and chlorinated tap water) and combined
with a variety of herbs and supplements led to significant improvement in one
group of asthmatics. Although 16 out of 24 people who continued the
intervention for the full year were much better and one person was actually
cured, it remains unclear how much of the action was purely a result of the dietary
changes compared with the many other therapies employed.
Vitamin C, an antioxidant present
in fruits and vegetables, is a powerful antioxidant and anti-inflammatory. This
anti-inflammatory activity may influence the development 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.
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. Several 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. Although most people with asthma do not suffer from food allergies,
unrecognized food allergy can be an exacerbating factor. A medically supervised
“allergy elimination diet,” followed by reintroduction of the eliminated foods,
often helps identify problematic foods.
A health care professional must
supervise this allergy test because of the possibility of triggering a severe
asthma attack during the reintroduction. Some asthmatics react to food
additives, such as sulphites, tartrazine (yellow dye #5), and sodium benzoate,
as well as natural salicylates (aspirin-like substances found in many foods). A
doctor or an allergist can help determine whether chemical sensitivities are
present.
Lifestyle changes that may be
helpful
Being overweight increases the
risk of asthma. 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. Nutritional supplements that may
be helpful.
Lycopene, an antioxidant related
to beta-carotene and found in tomatoes, helps reduce the symptoms of asthma
caused by exercising. In one double-blind trial, over half of people with
exercise-induced asthma had significantly fewer asthma symptoms after taking
capsules containing 30 mg of lycopene per day for one week compared to when
they took a placebo.
Vitamin B6 deficiency is common
in asthmatics. This deficiency may relate to the asthma itself or to certain
asthma drugs (such as theophylline and aminophylline) that deplete vitamin B6.
In a double-blind trial, 200 mg per day of vitamin B6 for two months reduced the
severity of asthma in children and reduced the amount of asthma medication they
needed. In another trial, asthmatic adults experienced a dramatic decrease in
the frequency and severity of asthma attacks while taking 50 mg of vitamin B6
twice a day.
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. Magnesium
levels are frequently low in asthmatics. 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. Magnesium
supplements might help prevent asthma attacks because magnesium can prevent spasms
of the bronchial passages. In a preliminary trial, 18 adults with asthma took
300 mg of magnesium per day for 30 days and experienced decreased bronchial
reactivity.
However, a double-blind trial
investigated the effects of 400 mg per day for three weeks and found a
significant improvement in symptoms, but not in objective measures of airflow
or airway reactivity. The amount of magnesium used in these trials was 300 to 400
mg per day (children take proportionately less based on their body weight).
Supplementation with 1 gram of
vitamin C per day reduces the tendency of the bronchial passages to go into
spasm, an action that has been confirmed in double-blind research. Beneficial
effects of short-term vitamin C supplementation (i.e., less than three days) have
been observed. In one double-blind trial, 500 mg of vitamin C per day for two
days prevented attacks of exercise-induced asthma. Two other preliminary trials
found that vitamin C supplementation reduced bronchial reactivity to
metacholine, a drug that causes bronchial constriction.
However, other studies, including
two double-blind trials, have failed to corroborate these findings. The only
double-blind trial of a long duration found that vitamin C supplementation (1
gram per day for 14 weeks) reduced the severity and frequency of attacks among
Nigerian adults with asthma. A buffered form of vitamin C (such as sodium
ascorbate or calcium ascorbate) may work better for some asthmatics than
regular vitamin C (ascorbic acid).
People with low levels of
selenium have a high risk of asthma. Asthma involves free radical damage that
selenium might protect against. In a small double-blind trial, supplementation
with 100 mcg 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. Most doctors recommend 200 mcg per day for
adults (and proportionately less for children)—a much higher, though still
safe, level.
Double-blind research shows that
fish oil partially reduces reactions to allergens that can trigger attacks in
some asthmatics. Although a few researchers report small but significant
improvements when asthmatics supplement with fish oil reviews of the research
show that most fish oil studies with asthmatics come up empty-handed. It is possible
that some of these trials failed because they did not last long enough to demonstrate
an effect. There is evidence that children who eat oily fish may have a much
lower risk of getting asthma. Moreover, in a double-blind trial, children who received
300 mg per day of fish oil (providing 84 mg of EPA and 36 mg of DHA) experienced
significant improvement of asthma symptoms. It should be noted that these benefits
were obtained under circumstances in which exposure to food allergens and environmental
allergens was strictly controlled. Though the evidence supporting the use of
fish oil remains somewhat conflicting, eating more fish and supplementing with
fish oil may still be worth considering, especially among children with asthma.
In a double-blind study of people
with asthma, supplementation with a proprietary extract of New Zealand
green-lipped mussel (Lyprinol®) twice a day for 8 weeks significantly decreased
daytime wheezing and improved airflow through the bronchi. Each capsule of Lyprinol®
contains 50 mg of omega-3 fatty acids.
A study conducted many years ago
showed that 80% of children with asthma had hypochlorhydria (low stomach acid).
Supplementation with hydrochloric acid (HCl) in combination with avoidance of
known food allergens led to clinical improvement in this preliminary trial. In
more recent times, HCl has usually been supplemented in the form of betaine
HCl. The amount needed depends on the severity of hypochlorhydria and on the size
of a meal. Because it is a fairly strong acid, betaine HCl should be used only
with medical supervision.
In some people with asthma,
symptoms can be triggered by ingestion of food additives known as sulphites.
Pre-treatment with a large amount of vitamin B12 (1,500 mcg orally) reduced the
asthmatic reaction to sulphites in children with sulphite sensitivity in one preliminary
trial. The trace mineral molybdenum also helps the body detoxify sulphites.
While some doctors use molybdenum
to treat selected patients with asthma, there islittle published research on
this treatment, and it is not known what an appropriate level of molybdenum
supplementation would be. A typical American diet contains about 200 to 500 mcg
per day, and preliminary short-term trials have used supplemental amounts of
500 mcg per day. People who suspect sulphite-sensitive asthma should consult
with a physician before taking molybdenum.
Quercetin, a flavonoid found in
most plants, has an inhibiting action on lipoxygenase, an enzyme that contributes
to problems with asthma.No clinical trials in humans have confirmed whether
quercetin decreases asthma symptoms. Some doctors are currently experimenting
with 400 to 1,000 mg of quercetin three times per day. Bromelain reduces the
thickness of mucus, which may be beneficial for those with asthma, though
clinical actions in asthmatics remain unproven.
Some researchers have suggested
that asthma attacks triggered by exercise might be caused by free-radical
damage caused by the exercise. Beta-carotene is an antioxidant that protects
against free-radical damage. Israeli researchers reported that 64 mg per day of
natural beta-carotene for one week in a double blind trial protected over half
of a group of asthmatics who experienced attacks as a result of exercise. More
research is needed to confirm this promising finding.
The oral administration of a
thymus extract known as thymomodulin has been shown in preliminary and
double-blind clinical trials to improve the symptoms and course of asthma.
Presumably this clinical improvement is the result of restoration of proper control
over immune function.
Herbs that may be helpful
There are two categories of herbs
generally used for people with asthma. These are herbs that help dilate the
airways and herbs that are anti-inflammatory. Eclectic physicians—doctors in
turn-of-the-century North America who used herbs as their main
medicine—considered lobelia to be one of the most important plant medicines.
Traditionally, it was used by Eclectics to treat coughs and spasms in the lungs
from all sorts of causes. A plant that originates in Africa, khella, is also
considered an anti-spasmodic like lobelia. Though it is not strong enough to
stop acute asthma attacks, khella has been recommended by German physicians
practicing herbal medicine as possibly helpful for chronic asthma symptoms.
One double-blind trial has
investigated the effects of the Ayurvedic herb boswellia in people with acute
bronchial asthma.77 Participants
took 300 mg of powdered boswellia resin extract or placebo three times daily
for six weeks. By the end of the study, the number of asthma attacks was
significantly lower in the group taking boswellia.Moreover, objective
measurements of breathing capacity were also significantly improved by
boswellia.
Two preliminary trials have shown
picrorhiza to be of benefit in asthma. However, a follow-up double-blind trial
did not confirm these earlier results. A range of 400 to 1,500 mg of powdered,
encapsulated picrorhiza per day has been used in a variety of trials. It remains
unclear how effective picrorhiza is for people with asthma.
Different preparations of
tylophora, including crude leaf, tincture, and capsule, have been tested in
human clinical trials. One double-blind trial had people with bronchial asthma
chew and swallow one tylophora leaf (150 mg of the leaf by weight) per day for six
days. Participants were also given a comparable placebo to be chewed and swallowed
during a different six-day period. When consuming tylophora, over half of the people
reported experiencing moderate to complete relief of their asthma symptoms, compared
to only about 20% reporting relief when consuming the placebo.
In a follow-up double-blind
trial, an alcoholic extract of crude tylophora leaves had comparable effects to
that of chewing the crude leaf. Another double-blind trial found 350 mg of
tylophora leaf powder per day increased the lungs’ capacity for oxygen and
reduced night time shortness of breath, but was not as effective as an anti-asthmatic
drug combination. A fourth double-blind trial found no significant changes in
lung volume measurements or asthmatic symptoms after treatment with 400 mg per
day tylophora.
A controlled trial on children
with bronchial asthma suggested that 25 drops of ivy leaf extract given twice daily
was effective in increasing the amount of oxygen in the lungs after only three
days of use. However, the frequency of cough and shortness of breath symptoms
did not change during the short trial period.
Ginkgo Biloba extracts (GBE) have
been considered a potential therapy for asthma. This is because the extracts
block the action of platelet-activating factor (PAF); a compound the body
produces that in part causes asthma symptoms. A trial using isolated ginkgolides
from ginkgo (not the whole extract) found they reduced asthma symptoms.A controlled
trial used a highly concentrated tincture of ginkgo leaf and found this preparation
helped decrease asthma symptoms. For asthma, 120 to 240 mg of standardized GBE
or 3 to 4 ml of regular tincture three times daily can be used.
In three preliminary trials on
people with asthma, a traditional Japanese herbal formula known as saiboku-to
has been shown to reduce symptoms and enable some people to reduce their use of
steroid medication. Saiboku-to has been extensively studied in the laboratory
and has been shown to have numerous anti-inflammatory actions. Some of these
studies used 2.5 grams three times per day of saiboku-to. A traditional Chinese
or Japanese medicine practitioner should be consulted for more information.
Saiboku-to contains bupleurum, hoelen, pinellia, magnolia, Asian ginseng, Asian
skullcap, liquorice, perilla, ginger and jujube.
Onion may act as an
anti-inflammatory in people with asthma. Human studies have shown onion can be
a strong anti-inflammatory. However, some people with asthma may experience an
exacerbation of symptoms if they are allergic to onion and are exposed to it.
Traditionally, herbs that have a
soothing action on bronchioles are also used for asthma. These include
marshmallow, mullein, hyssop, and liquorice. Elecampane has been used traditionally
to treat coughs associated with asthma.
Ephedrine, an alkaloid extracted
from Ephedra sinica (also known as ma huang), 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 25
mg every four hours. Adults should take a total of no more than 150 mg every 24
hours. They should refer to labels for children’s dosages. Ephedrine has
largely been replaced by other bronchodilating drugs, such as alupent and
albuterol. Ephedra sinica continues to be a component of traditional herbal preparations
for asthma, often in amounts of 1 to 2 grams of the herb per day.
A small double-blind trial found
that a constituent of coleus, called forskolin, when inhaled, could decrease
lung spasms in asthmatics compared to placebo. Coleus extracts standardized to
18% forskolin are available, and 50 to 100 mg can be taken two to three times
per day. Fluid extract can be taken in the amount of 2 to 4 ml three times per
day. Most trials have used injected forskolin, so it is unclear whether oral
ingestion of coleus extracts will provide similar benefits in the amounts
recommended above.
That is Asthma
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