More people are suffering from asthma, but phytomedicines may help them breathe freely.
An estimated twelve to fifteen million people in the United States have asthma, nearly twice the number of people who suffered from it during the early 1980s, according to the Asthma and Allergy Foundation of America. This disorder—in which the airways narrow and become so inflamed and filled with mucus that simple breathing becomes a perilous chore—is sending more people to hospitals for treatment every year, and about 5,000 people die from it annually as well, according to the foundation.
Most people are unaware that asthma is a “new” disease. It was virtually unknown 100 years ago, and is still rare in many developing countries. Although the tendency to develop asthma can have a genetic basis, the rapidly growing number of sufferers indicates that diet and environment play a strong role in promoting this disease.
People with asthma can control the number and severity of their attacks, though. Triggers set the inflammatory process in motion, and if your trigger threshold is very low, then you’ll have frequent, severe asthma attacks. Conversely, if you identify your inflammatory triggers, do your best to avoid them, and make use of those herbs and supplements that further increase your tolerance, you can reduce the frequency and severity of asthma attacks. (Note: If you’re taking oral asthma medications or using an inhaler, don’t discontinue using them abruptly—asthma is far too serious to take the risk. Instead, work with your physician to find natural treatments and determine how you may safely reduce your medication dosage or prescription.)
Along with tuberculosis and emphysema, asthma was once believed to be a respiratory disease. Today, however, it is considered a chronic disorder, a chronic inflammation of the airways similar to arthritis, a chronic inflammation of the joints. What sparks asthma depends on the person, but whatever the case, that person’s lungs are responding differently from a “normal” person’s lungs. Asthma attacks can be triggered by pollen, dust mites, cigarette smoke, cold air, animal dander, and other allergens. When an asthma attack occurs, the smooth muscles of the bronchi begin to spasm, the airway tissues become inflamed and swollen, and the air passages become blocked by mucus. In medical jargon, this is known as bronchoconstriction, and it results in a more-than-normal effort to breathe.
Asthma attacks may be rare or frequent. Symptoms include shortness of breath, coughing, wheezing, and a “tight chest.” Attacks can come on suddenly or build up gradually and last for hours or days. People with severe asthma may have trouble speaking even a few words without stopping to take a breath. When asthma sufferers appear confused and lethargic and their skin turns blue, they aren’t getting enough oxygen and they need to be immediately taken to a hospital emergency room.
Medical research has traced asthma’s causes to cells lining the airways known as mast cells, which are concentrated in the lungs and mucoid tissue. Mast cells store large amounts of histamine and compounds that promote inflammation, such as leukotrienes and prostaglandins. They release these substances and make the smooth muscles contract in the airways, increase mucus secretion, and encourage some types of white blood cells to come to the area. Mast cells’ action is part of the body’s normal response to foreign substances, or allergens. But in asthmatics, this reaction to allergens, as well as to cold air, stress, and anxiety, is overwhelming and brings on an acute reaction.
Asthma and allergies go hand in hand—allergic reactions are the most common triggers of asthma attacks. In addition to the triggers listed above, asthmatics should be wary of air pollution, perfumes, cleaning products, kerosene heaters, mold, mildew, latex, and insect stings. In scientific studies, bakers, manicurists, hairdressers, and painters have been shown to develop occupation-related asthma, as do those who work in petroleum refineries and in the construction, auto body, and food-processing fields. Studies also show that the incidence of asthma, especially in children, is much greater in urban areas than in rural areas. In the country, the air is cleaner, and children play outside more often than children living in cities.
Two types of food allergies also play a role in triggering asthma. The first type is known as “immediate onset,” developing within a few minutes or hours after eating the culprit food. In addition to the asthma attack, the allergen can affect the skin, airways, and gastrointestinal tract; the sufferer may experience bronchospasms, vomiting, and/or hives.
The second category of food allergy is known as “delayed onset” and develops within two to forty-eight hours after eating an allergenic food. Delayed onset allergies cause a variety of responses, from asthma to ulcers. These reactions aren’t always predictable or easily linked to the offending food. Many asthmatics are allergic to such common foods as milk, eggs, soy, baker’s yeast, and wheat, and they may have multiple food allergies. I recommend that asthmatics seek an ELISA blood test for allergies; skin testing is not sufficient for measuring delayed onset allergies. ELISA stands for Enzyme Linked–ImmunoSorbent Assay and is a state-of-the-art type of allergy testing.
Some herbal products have the potential to provide relief from asthma as well as other chronic inflammatory conditions, including arthritis. These herbs contain phytochemicals that inhibit leukotrienes, biochemicals that keep inflammatory conditions running once they’ve started and that play a large role in asthma. (For more information about leukotrienes and chronic inflammation, see “Inside plants” on page 20 of the January/February 1998 issue of Herbs for Health.) Today’s “cutting edge” asthma medications, known as 5-lipoxygenase inhibitors, inhibit leukotrienes and are largely synthetic. Unfortunately, few herbal products have been tested on asthmatic humans.
However, based on research literature and my experience as a nutrition consultant, I think that natural remedies show promise in quelling asthma attacks. Here are my “top picks”:
The ginkgolides, phytochemicals found only in Ginkgo biloba, block the action of platelet-activating factor (PAF), a biochemical that activates immune cells responsible for inflammation and blood clotting; overproduction of PAF can cause the bronchial tubes to constrict.
In 1987 in France, a double-blind crossover study of eight asthmatics with allergies showed that 40 mg per day of a ginkgo extract standardized for ginkgolides improved the patients’ abilities to tolerate allergens without risk of bronchoconstriction. A series of studies by the same French laboratory in 1991 confirmed that standardized ginkgo clearly improves asthma: At five different centers in France, sixteen asthma patients at each center were given 240 mg of standardized ginkgo extract or a placebo daily for three days. They then stopped taking either treatment for one week, then took the other treatment for three days. Those receiving ginkgo showed a significant improvement in their ability to forcibly exhale.
The various alkaloids found in ephedra (Ephedra sinica, also known as ma huang) are some of the most effective herbal bronchodilators known; the common asthma medication ephedrine comes from this plant. Ma huang has become controversial, though. It was implicated in the death of a student in Florida in 1996 (for more information about this, see “Ephedra: An insider’s perspective” on page 50 of the July/August 1997 issue of Herbs for Health). Ma huang can cause rapid heart rate, muscle tremors, and restlessness. For many people, responsible use of ephedra is safe, but it shouldn’t be used by people with hypertension, diabetes, prostate and thyroid disease, or insomnia, or by pregnant women or those taking antidepressants, including St. John’s wort.
The alkaloids in ma huang work like the common asthma drugs known as “beta-agonists,” which stimulate the sympathetic nervous system and dilate the bronchial tubes, making it easier to breathe. Ephedra alkaloids are contained in bronchodilators sold over the counter.
Practitioners of Traditional Chinese Medicine often combine ma huang with members of the nightshade family such as Jimson weed (Datura metel). These plants contain alkaloids (including atropine, hyoscyamine, and scopolamine) that can effectively open up the bronchial tubes; however, many nightshade plants are quite dangerous and should be used only under professional supervision.
P. barbatus (also known as Coleus barbatus or C. forskohlii) is a treatment from the Ayurvedic medicine of India. It contains a phytochemical called forskolin (sold as colforsin), an effective, safe bronchodilator. It is used in inhalers in Europe, and the standardized herb is available in capsule form in North America.
In a double-blind, placebo-controlled crossover study conducted in Vienna in 1993, inhaled doses and capsules of the medication fenoterol were compared with colforsin capsules and a placebo. For the sixteen asthmatics involved in the study, each medication increased their ability to breathe compared to the placebo and their ability to breathe before treatment, although colforsin wasn’t as effective as the fenoterol. But fenoterol has serious side effects, while colforsin does not. Chronic use of fenoterol and similar drugs in the group known as beta-agonists is believed to increase, rather than decrease, the frequency and severity of asthma attacks. Colforsin is not a beta-agonist, but relaxes bronchial smooth muscle in a related but more specific manner. A recommended dose is one 500-mg capsule four times daily. Research has been done with up to 10 mg of forskolin, but standardized herb capsules generally contain only 1 mg.
In the Middle East, herbal blends have long been a primary treatment for asthma and allergies. I’ve had success helping people with a traditional liquid herbal blend that is now available in North America as RespirActin. It contains rosemary, sage, cloves, cinnamon, chamomile, thyme, spearmint, witch hazel, juniper, black cumin, fenugreek, and other herbs. The spice blend contains many of the same compounds, including antioxidants, antibronchitics, anti-allergenics, and antihistamines, that are found in commercial pharmaceutical remedies.
Black cumin (Nigella sativa) and rosemary, and phytochemicals derived from them, are used clinically for asthma in the Middle East. A 1991 Jordanian animal study showed that rosemary oil significantly and reversibly inhibits contraction of tracheal smooth muscle stimulated by histamine and acetylcholine; histamine is a strong trigger of asthma and allergy attacks, and acetylcholine is a neurotransmitter. The author of this study had previously found this effect from black cumin seed oil. In studies conducted in 1993 and 1995, the researcher found that black cumin oil also strongly inhibits leukotriene formation and prevents the release of histamine from mast cells. The study also supports the use of N. sativa as a treatment for inflammatory diseases in general.
Traditional herbal blends for asthma also are used in China, Japan, and Korea, including saiboku-to, which has been used in clinics for many years, and is considered in those countries to be an effective treatment for asthma and chronic bronchitis. This blend of ten herbs includes ginger, Korean ginseng, Baical skullcap, magnolia (Magnolia hypoleuca, also known as M. obovata), and licorice.
In a 1993 study in Japan, forty asthma patients were treated with saiboku-to for six to twenty-four months. Each of the forty patients greatly reduced the need for steroid medications after taking the formula. A 1995 study also showed that saiboku-to selectively and significantly inhibits leukotriene formation.
While this formula is not commonly available in North America, the most effective herbs in the blend may be the Baical skullcap and the magnolia; recommended doses of each of these herbs are 500 mg to 1,000 mg three times daily.
Identifying the triggers of your asthma attacks and incorporating safe and effective herbal remedies in your healing plan will, in my opinion, ease your suffering. It’s also best to embark on an aggressive, balanced nutritional plan—a vital part of treating asthma. For nutritional guidance, talk with your health-care provider.
C. Leigh Broadhurst holds a doctorate in geochemistry and is a nutrition consultant in Clovery, Maryland.
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