Asthma

People without asthma breathe easily despite a miasma of pollens, moulds, animal dander and cigarette smoke. For a person with asthma, inhaling certain irritants triggers a cascade of events. The smooth muscle encircling the airways constricts, diminishing their diameters. The mucous membranes swell and produce excessive mucus, further narrowing the air passages.

Unfortunately, asthma has become more common in recent years, particularly among children, which resesarchers now believe is a result of a diet of junk food and of increased pollution in the air.

Doctors prescribe asthma medications according to the disorders severity and how frequently attacks occur. Although many asthma drugs cause side effects, they have also saved lives.

If you have asthma, you should work in close parthership with your doctor to try herbal remedies; never stop taking any asthma medication or change your dosage without your doctor's approval.

Some of the herbs traditionally used for asthma can interact with asthma drugs in negative ways. That said, there are herbs that have been shown through either years of traditional use or medical studies to help people with asthma regain their respiratory health.

DRUG TREATMENT

Beta-Adrenoceptor Stimulants, Bronchodilators
Eformoterol fumarate (Foradil, Oxis), fenoterol hydrobromide (Berotec), salbutamol (Ventolin) salmeterol (Serevent), terbutaline sulphate (Bricanyl, Monovent), tulobuterol hydrochloride (Respacal).

Function: relax the smooth muscle encircling the airways to widen their diameter, also known as bronchodilatation.

Side effects: hand tremor, increased heart rate and blood pressure, dizziness, nervousness.

Inhaled Corticosteroids
Beclometasone (AeroBec, Asmabec, Beclazone, Becotide, Qvar), budesonide (Pulmicort), fluticasone propionate (Flixotide, Seretide).

Function: reduce or prevent inflammation.

Side effects: at higher dosages, hoarseness, cough and oral thrush.

Antimuscarinic Broncodilators

lpratropium bromide (Atrovent, Ipratropium Steri-Neb, Respontin).

Function: opens the airways by blocking nerves that would otherwise constrict the airways.

Side effects: dry mouth, cough.

Adrenergics
Theophylline (Lasma, Nuelin, Slophyllin, Theo-Dur, Uniphyllin Continus).

Function: bronchodilatation.

Side effects: irritability, restlessness, nausea, vomiting, rapid heartbeat, headache, insomnia.

Oral Corticosteroids
Methylprednisolone (Medrone).

Function: reduces or prevents inflammation.

Side effects: increased appetite, fluid retention; with long-term use, muscle weakness, easy bruising, high blood pressure, depressed immune function, osteoporosis, cataracts.

Leukotriene Receptor Antagonists
Zafirlukast (Accolate), montelukast (Singulair).

Function: inhibit the formation or action of inflammatory chemicals called leukotrienes.

Side effects: headache and nausea.

OTHER DRUGS

Sodium cromoglicate (Intal, Cromogen Easi-Breathe, Spincaps).

Function: inhibit the release of inflammation-causing chemicals from cells called mast cells; must be taken every day to be effective.

Side effects: slight throat irritation, dry cough.

HERBAL REMEDIES

Ginkgo (Ginkgo biloba)
This herb has long been used by the Chinese to treat asthma. The leaves contain ginkgolides, which inhibit platelet-activating factor, a chemical involved in asthma and allergies. Small studies on humans show that taking ginkgolides orally reduces narrowing of the airways in response to inhaled allergens and it partially protects against exercise-induced asthma.

Typical dosage: 40 milligrams of standardised extract three times per day, for six to eight weeks.

Caution: rare cases of skin. allergies or gastro­intestinal upset have occurred. Consult your doctor before using ginkgo if you use aspirin daily or take a blood-thinning drug such as warfarin.

Coffee (Coffea arabica) and Tea (Camellia sinensis)
Both of these beverages contain caffeine, a chemical cousin to the asthma drug theophylline. Researchers have found that a caffeine dose of 7 milligrams per 1 kilogram of body weight significantly improves the lung function of people with asthma and prevents exercise-induced asthma attacks.

Coffee has between 135 and 150 milligrams of caffeine per 1/4-litre cup; tea has about 60 milligrams plus beneficial anti­oxidants. That means a 10.1/2-11-stone man would have to drink 3 to 3.1/2 cups of coffee to break an asthma attack.

Because consuming a lot of caffeine isn't good for your health, taking coffee or tea to prevent asthma is hardly practical. Still, if you start wheezing and have no other asthma remedy handy, a cup of coffee might be worth a try.

Garlic (Allium sativum) and Onion (A. ceps)
These allium family members have long been used to treat bronchitis and asthma. Laboratory tests show that onion extracts can block the production of certain chemicals involved in inflammation, thereby inhibiting allergen-induced asthmatic responses. The ingredients responsible for this action include mustard oils and quercetin.

Quercetin, an anti-inflammatory and antioxidant substance, can be found sold as a dietary supplement; follow the packet directions for dosage. You can also include lots of onions and garlic in your diet. They also possess anti-inflammatory, immune-stimulating and antimicrobial properties.

Typical dosage: up to three 500- to 600-milligram capsules per day; look for products that contain at least 5,000 micrograms of allicin in a daily dose. Or simply eat one or more raw garlic cloves per day.

Liquorice (Glycyrrhiza glabra)
This herb acts as an expectorant, demulcent, anti-inflammatory, immune stimulator and antiviral - all properties of potential benefit for people with asthma. Liquorice slows the breakdown of the body's corticosteroids such as cortisol, thus prolonging the anti-inflammatory effects of this hormone.

Typical dosage: up to six 400- to 500-milligram capsules per day; or 20 to 30 drops of tincture up to three times per day. (Note: if you have asthma, you'll want to use whole-root products rather than deglycyrrhizinated, or DGL, liquorice, which does not contain the active ingredient glycyrrhizin.)

Caution: do not take liquorice for more than six weeks unless under the supervision of a health practitioner. People who take corticosteroids should not take liquorice without consulting their doctor. Do not take liquorice at all if you have high blood pressure, diabetes, disease of the thyroid, kidney, liver or heart; if you're using diuretics; or if you are pregnant or breastfeeding.

Ephedra (Ephedra sinica)
This herb has a 5,000-year history of use in Chinese medicine as an asthma treatment. It contains ephedrine, which is similar in structure to your body's own adrenaline. It decreases congestion and opens the airways. Because ephedra stimulates the cardiovascular and nervous systems, it can also produce restlessness, anxiety, tremor, insomnia, headache, and elevated blood pressure and heart rate. Ephedra is best used under the supervision of a trained herbal practitioner.

Typical dosage: 15 to 30 drops of tincture in water up to four times per day; or follow manufacturer's or practitioner's directions.

Caution: do not use if you have high blood pressure, heart disease, glaucoma, anorexia, hyperthroidism or diabetes, or if you take theophylline or MAO-inhibiting antidepressants. If you're taking other asthma drugs, check with your doctor before taking ephedra. Do not combine with caffeine use; do not use while pregnant.

Coleus (Coleus forskohlii)
This plant is used in Ayurvedic remedies in India. It contains forskolin, a substance that relaxes the smooth muscle of airways, opening them for easier breathing. In an Austrian study forskolin inhaled as a dry powder helped open the airways in asthma patients. So far, no studies have investigated the impact on asthma patients of whole coleus or forskolin taken in capsules.

Despite this lack of research, forskolin is used in inhalers in some European countries, and it's available as a standardised extract in capsules in the United States. For dosage, follow manufacturer's or practitioner's instructions.

Reishi (Ganoderma lucidum)
This medicinal mushroom boasts several healthful effects, including an ability to reduce allergies. Reishi inhibits some of the chemical mediators of inflammation, including histamine. In China it is used to treat asthma and other allergic diseases. Reishi can also benefit people with asthma because it acts as an immune tonic. Increased resistance to infections might derail colds and the flu, which often provoke asthma symptoms.

Typical dosage: up to five 420-milligram capsules per day; or up to three 1,000 milligram tablets per day.

Turmeric (Curcuma longa)
This herb is one of the main spices in curry. It contains curcumin, which has anti-inflammatory, antiviral, antioxidant and anti-tumour activity. Further research is needed to prove that this spicy component helps once it's in the human body, but, in the meantime, it won't hurt to include turmeric on your spice shelf.

Typical dosage: 250 to 300 milligrams in standardised capsules, up to three times per day; up to 1 teaspoon of ground spice in food per day; or 10 to 30 drops of tincture up to three times per day.

Caution: do not use if you have gallstones or any obstruction of the bile ducts.

Rosemary (Rosmarinus of cinails)
This common culinary herb has been used traditionally to ease asthma. One labouratory study conducted in Jordan shows that rosemary's volatile oils can block the airway constriction induced by histamine, the chemical culprit of both asthma and other allergy symptoms.

To a warm bath, add 5 to 10 drops of rosemary essential oil or 1 litre of rosemary tea (steep 4 tablespoons of the needles in I litre of hot water for 10 minutes). You can also use the tea for steam inhalation, or just drink up to 3 cups per day.

Astragalus (Astragalus membranaceus)
This herb can be taken as a tonic - part of your long-term daily regimen - to strengthen the immune system's natural defences.

Typical dosage: eight or nine 400- to 500-milligram capsules daily; or 15 to 30 drops of tincture, twice daily.

Mullein (Verbascum thapsus)
Antispasmodic and anti-inflammatory, mullein also fights some of the respiratory viruses that tend to plague people with asthma.

Typical dosage: up to 6 cups per day of tea (steep 2 teaspoons of dried leaves and flowers in 1/4 litre of hot water for 10 to 15 minutes); or 25 to 40 drops of tincture every three hours.

OTHER WAYS TO EASE ASTHMA

Besides herbs, other therapies may help reduce your asthma symptoms.

• Acupuncture. Researchers have found that acupuncture often leads to significant improvement of asthma and other long-term lung conditions, and often results in a reduced need for medication. Side effects are minimal.
• Yoga. A number of studies have found that yoga training improves overall well-being, promotes greater relaxation, increases exercise tolerance and lessens the need for asthma medications.
• Diet changes. Studies have shown that putting adults on a vegan diet - a diet that eliminates all animal products, including dairy and eggs -significantly improves asthma. Researchers believe this diet may work because it increases antioxidants and other helpful botanical chemicals and reduces pro-inflammatory chemicals that are abundant in animal foods. Even if you're not interested in becoming a strict vegetarian, your asthma may improve when you decrease the amount of meat, eggs and dairy products in your diet and increase the amount of fruits, vegetables, and grains.

HERBAL STEAMS?

Steam inhalation is an age-old remedy for loosening the respiratory mucus associated with colds and coughs. Adding aromatic herbs such as eucalyptus, peppermint, thyme and rosemary as infusions or essential oils boosts the therapeutic effect. Theoretically, it would seem that a herbal steam is a good idea.

Well, maybe. Some essential oils, notably spruce needle and pine needle oil, can worsen bronchial spasms. And, for some people with asthma, just inhaling plain steam can trigger coughing.

Proceed with caution if you want to try steam therapy for your asthma. Try plain steam first. If that doesn't provoke an attack, try simmering 15 grams of herbs in 900 millilitres of water for 10 minutes and breathing the steam. If you tolerate the herbs well, then try substituting 3 drops of essential oil for the herbs.

In all cases, carefully pour water in a heat-resistant bowl and place it on a sturdy table. Put a towel over your head and hold your face at least 30 centimetres away from the steam. If any of these steams sets off a bout of coughing or wheezing, stop.