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 can't breathe," but they retain the option of breathing through the mouth. Asthmatics, however, know what "I can't 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) inflammation of the lining of those tubes. Traditionally, treatment primarily addressed the first aspect of asthma; in the past two decades, though, it has become clear that tissue swelling is the underlying cause.
The conventional treatment of asthma is highly effective for most people. Treatments include both short- and long-acting bronchodilators, which relax the bronchial muscles, and anti-inflammatory medication, which helps relieve the swelling of tissue. Bronchodilators alone may be sufficient treatment for mild asthma or asthma that occurs only with exercise. Anti-inflammatory steroids in the cortisone family taken by inhalation are the mainstay of treatment for moderate to severe asthma. Although these are much safer than oral steroids, they may still increase risk of osteoporosis and other problems when they are taken in high doses or for a long time. Other drugs used to reduce inflammation include montelukast (Singulair), nedocromil (Tilade) and cromolyn (Intal). (Interestingly, Intal is derived from a Mediterranean herb named khella.) The newest drug treatment for asthma, omalizumab (Xolair), appears to be very safe and effective, but it is currently extremely expensive and, for this reason, it is seldom used.
Principal Proposed Natural Treatments
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.
The herb Tylophora indica (also called Tylophora asthmatica ) appears to offer some promise as a treatment for asthma. It has a long history of use in the traditional Ayurvedic medicine of India. However, all of the studies on this herb were performed in India decades ago and fail to reach modern standards of design and reporting.
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.
For more information, including dosage and safety issues, see the full
Boswellia: Possibly Helpful
The herb boswellia has shown promise as a treatment for
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.
For more information, including dosage and safety issues, see the full
Coleus forskohlii : May Be Effective, But More Like a Drug Than an Herb
Another herb sometimes recommended for asthma also comes from India,
Ma Huang: Effective, But Not Safe
The Chinese herb ma huang, also called
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. Ephedra's 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 recommend against using ma huang for asthma.
Other Proposed Natural Treatments
Other Herbs and Supplements
In a double-blind trial, 32 people with steroid-dependent asthma were given either placebo or
of eucalyptus for 12 weeks.
Another small double-blind, placebo-controlled study evaluated the effects of 4 weeks of treatment with a Japanese herbal mixture traditionally called
Many studies have been conducted on the effects of vitamin C in treating asthma, but the evidence that it works remains inconsistent and highly incomplete.
One study found potential benefit with the spice
Essential fatty acids, such as
A study of 72 children with moderate, persistent asthma found that combined or single supplementation with omega-3 oils, zinc and/or vitamin C improved their symptoms and lung function. Combined supplementation was associated with greatest improvement. The reliability of these results should be questioned, however, since about 20% of children dropped out before the end of the 38-week study.
One study suggests that the natural substance hyaluronic acid might be helpful for asthma when taken by inhalation.
Natural medicine practitioners frequently recommend the flavonoid
Alternative medical literature frequently mentions
Other natural products commonly recommended for asthma include the herbs
Children with asthma may have reduced growth, possibly due to use of inhaled steroids. One study failed to find protective benefits with a
Two exceedingly preliminary studies reported by one research group has led to publicized concerns that use of the insomnia supplement
A team of three researchers analyzed 13 trials on acupuncture in the treatment of asthma.
A more recent review of acupuncture for asthma came to identical conclusions.
Other Alternative Therapies
Some people with asthma may also have
A special breathing technique called Buteyko breathing may reduce medication use and subjective symptoms, though it does not appear to actually improve lung function.
In two controlled studies,
5. Gopalakrishnan C, Shankaranarayanan D, Nazimudeen SK, et al. Effect of tylophorine, a major alkaloid of Tylophora indica , on immunopathological and inflammatory reactions. Indian J Med Res. 1980;71:940-948.
9. Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res. 1998;3:511-514.
19. Scheidegger C, Dahinden C, Wiesmann U. Effects of extracts and of individual components from Petasites on prostaglandin synthesis in cultured skin fibroblasts and on leucotriene synthesis in isolated human peripheral leucocytes. Pharm Acta Helv. 1998;72:376-378.
46. Mihrshahi S, Peat JK, Marks GB, et al. Eighteen-month outcomes of house dust mite avoidance and dietary fatty acid modification in the Childhood Asthma Prevention Study (CAPS). J Allergy Clin Immunol. 2003;111:162-168.
54. Hughes R, Goldkorn A, Masoli M, et al. Use of isotonic nebulised magnesium sulphate as an adjuvant to salbutamol in treatment of severe asthma in adults: randomised placebo-controlled trial. Lancet. 2003;361:2114-2117.
55. Mickleborough TD, Murray RL, Ionescu AA, et al. Fish oil supplementation reduces severity of exercise-induced bronchoconstriction in elite athletes. Am J Respir Crit Care Med. 2003 Aug 6. [Epub ahead of print].
58. Campos FL, Da Silva-Junior FP, De Bruin VM, et al. Melatonin improves sleep in asthma: a randomized, double-blind, placebo-controlled study. Am J Respir Crit Care Med. 2004 Aug 11. [Epub ahead of print]
59. Sienra-Monge JJ, Ramirez-Aguilar M, Moreno-Macias H, et al. Antioxidant supplementation and nasal inflammatory responses among young asthmatics exposed to high levels of ozone. Clin Exp Immunol. 2004;138:317-22.
61. Schou AJ, Heuck C, Wolthers OD. Does vitamin D administered to children with asthma treated with inhaled glucocorticoids affect short-term growth or bone turnover? Pediatr Pulmonol. 2003;36:399-404.
66. Gonzalez-Sanchez R, Trujillo X, Trujillo-Hernandez B, et al. Forskolin versus sodium cromoglycate for prevention of asthma attacks: a single-blinded clinical trial. J Int Med Res. 2006;34:200-207.
68. Falk B, Gorev R, Zigel L, et al. Effect of lycopene supplementation on lung function after exercise in young athletes who complain of exercise-induced bronchoconstriction symptoms. Ann Allergy Asthma Immunol. 2005;94:480-485.
69. Murali PM, Rajasekaran S, Krishnarajasekar OR, et al. Plant-Based Formulation for Bronchial Asthma: A Controlled Clinical Trial to Compare Its Efficacy with Oral Salbutamol and Theophylline. Respiration. 2005 Nov 22. [Epub ahead of print]
70. Gontijo-Amaral C, Ribeiro MA, Gontijo LS, et al. Oral magnesium supplementation in asthmatic children: a double-blind randomized placebo-controlled trial. Eur J Clin Nutr. 2006 Jun 21. [Epub ahead of print]
73. Petrigni G, Allegra L. Aerosolised hyaluronic acid prevents exercise-induced bronchoconstriction, suggesting novel hypotheses on the correction of matrix defects in asthma. Pulm Pharmacol Ther. 2006 Jan 3. [Epub ahead of print]
76. Bernstein WK, Khastgir T, Khastgir A, et al. Lack of effectiveness of magnesium in chronic stable asthma. A prospective, randomized, double-blind, placebo-controlled, crossover trial in normal subjects and in patients with chronic stable asthma. Arch Intern Med. 1995;155:271-276 .
78. Niu CK, Chen WY, Huang JL, et al. Efficacy of sublingual immunotherapy with high-dose mite extracts in asthma: a multi-center, double-blind, randomized, and placebo-controlled study in Taiwan. Respir Med. 2006;100:1374-1383.
82. Tecklenburg SL, Mickleborough TD, Fly AD, et al. Ascorbic acid supplementation attenuates exercise-induced bronchoconstriction in patients with asthma. Respir Med. 2007 Apr 4. [Epub ahead of print]
87. Giovannini M, Agostoni C, Riva E, et al. A randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containing Lactobacillus casei in pre-school children with allergic asthma and/or rhinitis. Pediatr Res. 2007 Jun 25. [Epub ahead of print]
90. Olsen SF, Osterdal ML, Salvig JD, et al. Fish oil intake compared with olive oil intake in late pregnancy and asthma in the offspring: 16 y of registry-based follow-up from a randomized controlled trial. Am J Clin Nutr. 2008;88:167-175.
92. Biltagi MA, Baset AA, Bassiouny M, Kasrawi MA, Attia M. Omega-3 fatty acids, vitamin C and Zn supplementation in asthmatic children: a randomized self-controlled study. Acta Paediatr. 2009;98:737-42.
Last reviewed February 2010 by EBSCO CAM Medical Review Board
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.