Case Studies: Asthma

Learn how to help breathing problems


Ginkgo has anti-inflammatory and anti-allergenic properties.

Christopher Hobbs

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Of all the diseases and symptoms I’ve helped people with throughout my years of clinical experience, breathing problems are among the scariest. During the last year of my mother’s life, I watched helplessly as she literally gasped for breath, the result of 50 years’ heavy cigarette smoking. Whether or not we smoke, these days, the health of our lungs is constantly under attack. Pollutants in the air, secondhand smoke and chronic respiratory allergies, perhaps related to environmental and psychological stressors, all equal peril for the body system that provides the breath of life.

More Americans than ever before now suffer from asthma, according to the Centers for Disease Control and Prevention. The increase in asthma cases and deaths affects all ages, spans every racial group and occurs nationwide. Although methods of prevention and treatment are improving every day, asthma remains a chronic disease in which modern drugs are often ineffective.

My heart really went out to one of my recent asthma patients. Marion came in for several months for acupuncture treatments, and we assessed her underlying pattern based on Traditional Chinese Medicine. Marion said that when she first realized she had asthma, she stopped taking breathing for granted. “I was afraid I would stop breathing when I was asleep and kept waking up, sometimes gasping for air, even though I had no symptoms for days before,” she said. “The anxiety that created in me was intense, and I’ve had prescriptions for drugs to control anxiety for several years.”

I also remember Bill, another patient with severe asthma, who had become very sophisticated with the use of inhalers and other drug therapy. He had an amazing memory for all the different asthma drugs, and as is often the case, I learned a lot about the modern treatment of asthma from my patient.

Bill was a stoic type and wouldn’t talk much about his occasional struggles just to get a good breath of air. He grew up in downtown Los Angeles, and although he was never a smoker, he had been tested and found to be allergic for a variety of environmental triggers. “I reacted to everything on the menu,” he told me with a laugh, followed by a cough.

Asthma: A Modern Epidemic

Asthma is an immunological disease that causes difficulty in breathing. The bronchioles in the lungs are narrowed by inflammation and spasms in the lining of the airway wall. A person with asthma may experience wheezing, shortness of breath and poor exercise tolerance. The disease affects more than 20 million Americans, according to the National Institutes of Health. Asthma has become a modern epidemic: Nearly 4,500 deaths were attributed to asthma in 2000, with 2 million emergency room visits and $12 billion costs in the United States annually.

Like heart disease and other chronic illnesses, the underlying disease can progress over the years, with few, if any, acute symptoms, based on chronic inflammation, and often accompanied by scarring and reduced lung capacity. As the disease progresses, acute attacks with reduced ability to breathe are increasingly possible.

Asthma triggers vary with each person, ranging from viral infections to allergies, or reactions to irritating gases and particles in the air. Possible culprits include respiratory infections, colds, cigarette smoke, pollen, mold, animal dander, feather, dust, food, indoor and outdoor air pollutants, including ozone, as well as exercise, excitement or stress. Even exposure to cold air or sudden temperature change can cause an asthmatic episode.

Chronic mild bronchitis, emphysema and other lung conditions are hard to differentiate from asthma, and even heart disease can cause breathing difficulties. Both heart disease and asthma can occur together, complicating the diagnosis.

Common symptoms of asthma include wheezing, chronic coughs [either productive (a lot of mucus comes up) or not], shortness of breath and a tightness in the chest. During an acute attack, breathing may become very difficult.

Modern Medical Treatments

Modern medicine offers a plethora of drug treatments, including anti-inflammatories and bronchodilators like beta-adrenergic agonists, methylxanthines and anticholinergics. Anti- inflammatory agents can halt the inflammation temporarily and reduce symptoms quickly, but they have side effects, especially when used for years. Because both corticosteroids and inhalers stimulate the sympathetic nervous system, and thus the “flight-or-fight” syndrome, they can produce nervousness, anxiety, insomnia or dry mouth. They can aggravate high blood pressure, increase the risk for some types of seizures and contribute to kidney and liver problems.

Common anti-inflammatories include corticosteroids, cromolyn sodium and a new class of anti-inflammatory medications known as leukotriene modifiers, which block the activity of the chemicals involved in airway inflammation.

Both Marion and Bill told me that while inhalers and other drugs they’ve taken over the last few years have helped them get through a tough period where their asthma was more intense, they felt that the drugs reduced their quality of life overall.

Plants that Fight Back

Both Marion and Bill came to see me because they had read about an herb treatment that proved effective in a recent clinical trial. The herb was boswellia (Boswellia spp.), which is better known as frankincense.

For both patients, I blended two herbal extracts to create a simple formula that could help reduce their symptoms without the side effect of nervous-system stimulation. I blended 300 mg of boswellia extract with 200 mg of butterbur (Petasites hybridus) extract and 60 mg of ginkgo (Ginkgo biloba) extract. These herbs have an anti-inflammatory, antioxidant and mast-stabilizing effect (producing an anti-allergic effect).

In one double-blind, placebo-controlled study, conducted by researchers at the Pharmaceutical Institute at the University of Tubingen, Germany, and published in 1998 in the European Journal of Medical Research, 40 volunteers with long-standing asthma were given 300 mg of boswellia three times daily for six weeks. A majority of the patients (70 percent) experienced improvement of symptoms and, in many cases, complete disappearance of shortness of breath and wheezing, as well as a reduction in the number of attacks, accompanied by improvements in some measures of immune function. Only about 27 percent in the placebo group reported improvements.

Traditional Chinese Herb Treatment

I often combine well-studied herbal extracts with dried herbal teas to help restore internal balance based on the precepts of Traditional Chinese Medicine.

Bill was an excess type, with a bright-red tongue and a fast, fairly strong pulse. Marion was a deficient type, with a tongue that was red but had little or no coating and a number of fine cracks back about one-third of the way from the tip, in the area that corresponds to the lung system.

I made a diagnosis of “Liver Fire Invading the Lungs” in Bill’s case because he had a number of other symptoms that seemed to support this idea, such as frequent irritability, temple headaches and pain over the lower right ribcage. His constitutional formula included herbs to cool and regulate liver function, such as dandelion (Taraxacum officinale), artichoke leaf (Cynara scolymus) and milk thistle (Silybum marianum). He took the concentrated extracts in capsule form, three 500-mg capsules twice daily with meals.

Marion showed signs and symptoms of Kidney Yang Deficiency, and “Lungs Failing to Grasp the Qi.” This is a fairly severe deficiency syndrome of the hormones and nervous system. She agreed to take a formula containing reishi (Ganoderma lucidum), ligustrum (Ligustrum spp.), American ginseng (Panax quinquefolius) and psoralea seed, or bu gu zhi (Cullen corylifolium) for up to three months to strengthen the kidney system. Reishi is one of the best herbs I’ve found for chronic asthma based on deficiency, and it has a great safety record. Be sure to take a concentrated extract, about 1 to 3 grams daily. Products with these herbs are widely available, but I strongly recommend working with a traditionally trained herbalist for a diagnosis that can help reduce symptoms as well as relieve the underlying condition that predisposes a person to asthma in the first place.

Both of my patients also agreed to take the boswellia formula, along with their individual constitutional formulas, for about three months.

Signs Point to Improvement

As I write this column, both patients still use the herbs after three to four months and are experiencing enough improvement that they want to continue. They both have reported less acute episodes, improved feelings of well-being, less nervousness and anxiety, better sleep and better mood.

Christopher Hobbs’s case studies are gleaned from his 30 years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is the creator of the correspondence course Foundations of Herbalism;

“Case Studies” is not intended to replace the advice of your health- care provider.