Asthma: a Naturopathic approach

By Dr. Seth Yates, ND

(Ed note: For more information about natural treatment options for asthma, please contact Seth via the clinic at 613-839-1198.)

Asthma is a condition affecting the lungs, and is characterized by inflamed and hypersensitive airways. Asthma rates have significantly increased in the past 20 years, however conventional treatments still offer no cure for patients suffering from this condition.  Take a moment to read some current asthma statistics.

Asthma Statistics

• In Ontario, when you’re born you have a 40% chance of developing asthma at some point before the age of 40
• Asthma is very common – about 2.5 million Canadians and 300 million people worldwide have asthma.
• The direct and indirect costs of asthma in Canada are estimated to be $1 billion.
• You can initially be diagnosed with asthma at any age, but it is most common to be first diagnosed when you’re under the age of 10.
• In childhood, more males than females have asthma. In the teen years, this shifts to more females than males with asthma.
• Asthma is the leading cause of hospital admissions among children.
• The prevalence of asthma increased 75% from 1980-1994.
• Asthma rates in children under the age of five have increased more than 160% from 1980-1994.

Current Treatment and Side Effects:

Current medications used in the treatment of asthma include steroids (to decrease inflammation), short acting beta-2 agonists (open airways during asthma attack), long acting beta-2 agonists (used to open airways as a preventative measure against asthma attacks).  Though the proposed mechanism of these drugs sound promising, they come with many side effects.

Steroids:
Steroid use can decrease immune function, decrease bone density and strength as well as decreasing growth hormone, which is an essential hormone for childhood growth and development and adult bone metabolism, increasing the risk of osteoporosis.  Adrenal gland suppression is another common side effect of chronic corticosteroid use, and this is true of the steroids in asthma inhalers as well, which can lead to Cushings syndrome.  Symptoms of this condition include weight gain, a “moon face,” muscle wasting, weakness, and poor wound healing.

Budesonide is considered to be the safest steroid for use in asthma, but its side effects can include:  headache (11.3% of users), sore throat (10.5%), upset stomach (6%), thrush (yeast infection of the mouth 6%), sinus infections (6%), bronchitis (6%), dizziness, runny nose, sneezing, coughing, nausea, gas, vomiting, fatigue, back pain and other pains.

Long-Acting Beta 2 Adrenergic Agonists:
Long-acting beta-2 adrenergic medications are prescribed to help open the airways in attempts to prevent asthma attacks.  However, they have not been proven to be effective and scientific research indicates that they actually increase the risk of serious asthma attacks (250% increase) and asthma related deaths (350% increase).  Despite being banned by the FDA in the U.S. for individual use, these meds are still prescribed in ‘combination inhalers’ such as Symbicort.  It was postulated that the addition of a corticosteroid to the beta 2 adrenergic agonists would decrease reaction, but a large review by Cochrane Database (published Oct, 2008) has demonstrated that this is not the case.

Naturopathic Considerations for the Treatment of Asthma

Like most health related conditions, asthma is a ‘multi-factorial’ condition and requires multi-factorial treatment.  Treatments are aimed at balancing the immune response to decrease allergic reactions, decreasing inflammation through diet and herbs, correcting nutritional deficiencies, identifying and removing any possible triggers, and training the patient with breathing exercises.  Here are some of the treatments that are documented in the current research studies.

Magnesium supplementation:

There is a significant percentage of the population that is deficient in magnesium.  Studies have indicated that children with asthma have significantly lower levels of magnesium (when using a magnesium: calcium ratio).  Nebulized magnesium given through an inhaler has been proven to improve lung function testing in patients with asthma, as well have a significant anti-oxidant effect on the lung tissues by influencing the glutathione redox system.

Magnesium has also been found to help in acute asthma attacks in corresponding to decreasing hospital stay times and admissions. Oral magnesium supplementation helped to reduce bronchial reactivity to methacholine, to diminish their allergen-induced skin responses and to provide better symptom control in pediatric patients with moderate persistent asthma treated with inhaled fluticasone.

Fish Oil (Omega 3):
Omega 3 fatty acids are very commonly found to be deficient in patients with asthma.  EPA and DHA are examples of omega 3 fatty acids found in fish, and it has ben shown that these compounds reduce the synthesis of leukotrienes in the body.  Leukotrienes are produced in excess during an allergic and inflammatory reaction in the body, such as asthma.

It has been studied that people consuming the lowest amounts of EPA and DHA (omega 3’s found in fish) as children were more likely to develop asthma than those consuming adequate levels.  It has also been found that pregnant mothers consuming the lowest amount of EPA and DHA are more likely to have children with allergies than mother that consumed adequate levels of the omega 3’s.  A study linking mothers omega consumption to asthma was not found, but it is important to note that both conditions are hypersensitivity reactions in the bodies mucus membranes so there could be a correlation with this information.

It has also been found that supplementation with EPA and DHA can reduce the symptoms of asthma and decrease the reliance on rescue medication. However, high levels of omega 6 oils (linoleic acid found in most vegetables oils) has been shown to increase symptoms.

I feel it is important to note that for pregnant mothers, I only recommend a high quality (micro-distilled) fish oil supplement as a source of omega 3’s.  Fish should be avoided because of the possible contamination of mercury and other heavy metals.

Herbs and Chinese Medicine:
Herbs and Chinese Medicine have been used for thousands of years in the treatment of disease.  It is my opinion that this accumulated wisdom passed down from doctor to doctor far outweighs the conclusions of a single research study performed over the period of a few weeks.  However, as science gradually tries to catch up to this age old empirical wisdom, it is finding that the effects are verifiable in the laboratory also.  Chinese herbs and acupuncture have proven to be beneficial in treating asthma and allergies.

On of the more researched formulas is called “Food Allergy Herbal Formula 2”. This formula contains many immunomodulating herbs and has repeatedly shown to be effective in reducing the symptoms of asthma and food allergies.  I feel that it is important to note that while this formula is found effective in the treatment of these conditions, chinese formulas are even more effective when they are modified to match the individual needs of the patient.

Anti-Oxidants:
Severe asthma is characterized by persistent airway inflammation and increased formation of reactive oxygen species. Glutathione (GSH) is an important antioxidant in the epithelial lining fluid (ELF), however people with asthma show elevated levels of oxidative stress.  Therefor, one would assume that an increase in the antioxidants could help decrease the symptoms of asthma and decrease the damage from  the reactive oxygen species (ROS).

Breathing Exercises:
Poor breathing patterns are often associated with many respiratory diseases including emphysema, bronchitis and asthma.  Clinically, I have found that very few people know how to breathe properly and some training is often necessary to improve function.

A recent study looked at the effects of yoga in asthmatic children.   The children practiced yoga three times a week for 7 weeks.  After this training the children showed improved cardiopulmunary function, muscular strength, endurance and flexibility.  Another study found that breathing training caused a significant decrease in the anxiety correlated with asthma, as well as an improvement on an Asthma Control Questionnaire.  Other studies have found similar results, as well as many participants were able to significantly reduce there corticosteroid use.