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Asthma

Definition

Asthma is a disorder of the airways characterised by persistent symptoms of difficulty in breathing; chest tightness; wheezing; viscous bronchial secretions; and coughing, due to inflammation of the airways causing limitation to airflow.

What Causes Asthma

Asthma can be due to a number of causes:

  • allergic reactions to foods (see separate sheet on allergies);
  • animal hair;
  • cigarette smoke;
  • cold air;
  • dust;
  • exercise;
  • genetic;
  • grass pollen;
  • infections;
  • medications, such as aspirin;
  • malfunction of the immune system. Dr Leo Galland, in his book Superimmunity for Kids (1989), showed that children with asthma have difficulty converting essential fatty acids into prostaglandins which regulate the function of the immune system;
  • pollutants (ozone, sulfur dioxide, nitrogen dioxide, carbon monoxide, hydrocarbons, nitrogen dioxide, and photochemical substances are air pollutants that can trigger asthma attacks;
  • Stress.

The incidence of asthma has increased massively in the twentieth century. Why this should be so is still open to debate but the following factors have been cited:

  • in the 1950's it was believed that formula milk was a better start for new born babies and so many mothers gave their children formula believing they were doing the best thing. However, children who were fed formula milk did not benefit from the immunities usually passed through the mother's milk;
  • an allergic reaction to house dust mites has been exacerbated by the higher incidence of wall-to-wall carpeting, heating and insulation;
  • low ozone levels of urban environments;
  • some believe that asthma has been made more dangerous by the use of modern drugs, especially steroids.

Treatment

There is no cure for asthma but there are a number of different treatment approaches of which the following are addressed here : 1) medication; 2) alternative medicine; 3) self-care.

1. Medication

  • Anti-inflammatory medications
  • Corticosteroids - are a man-made form of the human hormone cortisol. They work to reduce inflammation and decrease the activity of the immune system, however they are not useful once an asthma attack has already started. They can be inhaled, taken orally or injected. Inhaling the corticosteroid ensures that it reaches the area where it is needed, largely avoiding damage to other parts of the body. Long term oral corticosteroid use may cause side effects such as ulcers, weight gain, cataracts, weakened bones and skin, high blood pressure, elevated blood sugar, easy bruising and decreased growth in children.
  • Cromolyn - is inhaled and acts differently to a corticosteroid in that it works on the chemicals that cause inflammation, preventing their release and so stopping the cause of the asthma attack. Cromolyn cannot treat an asthma attack once it has started. Some side effects of cromolyn can be coughing, wheezing, nausea and headache.
  • Bronchodilators
         They include beta-agonists, theophylline and anticholinergics and come in inhaled, tablet, capsule, liquid or injectable forms. These are generally used during an asthma attack to relieve coughing, wheezing, shortness of breath and difficulty in breathing. They work by opening up the bronchial tubes-the air passages in the lungs-so that more air can flow through. Side effects of bronchodilators can include nervousness, restlessness and insomnia, and rarely, headaches. Elderly patients and children may be more sensitive to the effects of these medications.
  • Anti-leukotrienes
         Many of the cells involved in causing airway inflammation are known to produce potent chemicals within the body called leukotrienes. Leukotrienes cause the contraction of the airways smooth muscle, increasing leakage of fluid from blood vessels in the lung, and further promoting inflammation by attracting other inflammatory cells into the airways. Side effects of anti-leukotrienes can be headaches, infections, nausea, diarrhoea and generalised pain.

    Treatment pattern
         Treatment for people with asthma often follows a similar pattern: for those with mild asthma (infrequent attacks) inhalers are used on an as-needed basis. Those with significant asthma (symptoms occur at least every week) are treated with anti-inflammatory medications, preferably inhaled corticosteroids, and then with bronchodilators. Acute severe asthma may require hospitalisation, oxygen, and intravenous medications. A peak flow meter, a simple device to measure lung volume, can be used at home to check on lung functions on a daily basis.

    Diet Recommendations when taking medication
         It is important to get proper nutrition when taking oral corticosteroids. Oral steroid use can cause loss of calcium and potassium, important minerals for bone strength and good muscle function. An imbalance of these minerals may cause muscle cramping or heart irregularities.
    • to 4-5 servings per day of dairy products will ensure an adequate intake of calcium, however dairy products can trigger attacks in some individuals, if you suspect this is the case, increase your intake of green vegetables.
    • Potassium supplements should only be prescribed by a doctor.
    • Any swelling may indicate the need for a diet low in sodium. This may include limited use of salt or sodium-rich condiments and processed foods.
    • Eat a well-balanced diet including citrus fruits and fruit juices.
    • Corticosteroids can increase appetite.
  • Hyposensitization therapy or allergy shots
         If the asthma has been triggered by an allergic reaction, these shots may be helpful to prevent an attack.
  • Peak Flow Meters
         These are hand-held machines that measure lung capacity and are useful for identifying the need for medication, and in more serious attacks, the need for hospitalisation.

Some medicines may exacerbate asthma

  • Aspirin and other pain relievers: aspirin and drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) may be harmful in people with asthma. Ibuprofen, naporxen and ketoprofen are examples of NSAIDs. Usually acetaminophen can be taken, a medicine used for fever and pain. Very rarely, even acetaminophen may make asthma worse.
  • Antihistamines: antihistamines are safe for people with asthma to use, but they can cause side effects. Some antihistamines can't be taken with certain other medicines.
  • Medicines for blood pressure: Beta blockers are drugs used to control blood pressure and heart disease. Sometimes they are given to people who have anxiety or headaches. This group of drugs includes propranol, atenolol and metoprolol. All of the drugs in this group can make asthma worse.

    ACE inhibitors are another type of medicine given to treat blood pressure, heart disease and, sometimes, diabetes. Drugs such as captopril, enalapril and lisinopril are included in this group. These medicines appear to be safe for people with asthma. However, some people cough when taking ACE inhibitors. If the cough is caused by the medication, it will usually go away a week or so after the medication is stopped.
  • Contrast dyes for x-rays: sometimes when having an x-ray, a shot of contrast dye is given to make the x-ray picture show up. Some contrast dyes may make asthma worse.
  • Other medicines: any medicine can cause wheezing or shortness of breath if there is an allergic reaction to it.

Website:
 www.rxlist.com this is a database of prescription pharmaceuticals to help you find out more information about what has been prescribed.


2. Alternative medicine (by alphabetical order)

  • Acupressure
         Acupressure probably predates acupuncture, it's more widely known sister therapy. Part of traditional Chinese medicine, and described as "acupuncture without needles", it is also based on theories of 'life energy' and meridians. Pressure is applied to acupoints to relieve ailments and promote harmony and health. Much used in China, Acupressure is less common in the West. Acupuncturists may use it as part of their treatment and it is claimed to be suitable for self-treating minor ailments. 'Tuina' is the most common type of acupressure. Other forms include 'shen tao' in which very light pressure is applied using only the fingertips, and 'jin shin do' where relatively few acupoints are used and the patient is encouraged to enter a meditative state. The Japanese version of the therapy, called 'anma' developed into what is now called shiatsu.

(For more information see our fact sheet on acupressure)

  • Acupuncture
         Some studies have shown that this can be helpful to some people with asthma in the short term, however no long-term benefits have been documented convincingly. There are suggestions that it may be effective for people whose asthma is triggered by allergy but less effective for those whose asthma is exercise-induced.

    Research:
    - Joos S, Schott C, Zou H, Daniel V, Martin E. Immunomodulatory effects of acupuncture in the treatment of allergic asthma: a randomized controlled study. J Altern Complement Med 2000 Dec;6(6):519-25
    "The results imply that asthma patients benefit from acupuncture treatment given in addition to conventional therapy. Furthermore, acupuncture performed in accordance with the principles of TCM showed significant immune-modulating effects."

    - Linde K, Jobst K, Panton J. Acupuncture for chronic asthma Cochrane Database Syst Rev 2000;(2):CD000008
    " There is not enough evidence to make recommendations about the value of acupuncture in asthma treatment. Further research needs to consider the complexities and different types of acupuncture."

    (For more information see our fact sheet on acupuncture)

     British Acupuncture Council
    63 Jeddo Road
    London
    W12 9HQ
    Tel: 020 8735 0400
    www.acupuncture.org.uk

    British Medical Acupuncture Society
    BMAS Northwich
    BMAS House, 3 Winnington Court
    Northwich, Cheshire CW8 1AQ
    Tel: 01606 786782

http://www.medical-acupuncture.co.uk/Default.aspx?tabid=40

  • Alexander Technique
    The aim of Alexander technique practitioners is to teach their patients how to improve the awareness of their body and its functions, in order to use it better. It is based on the idea that movement should involve a lengthening and widening of the body that relieves any tension. The technique is usually taught on a one-to-one basis, the teacher makes the patient aware of what optimum posture feels like before beginning to make adjustments and re-educating them in the use of their muscles, the goal being to produce maximum efficiency with minimum effort. Practitioners focus on the use of the body in sitting, standing and walking. All sorts of movements and activities will be considered in the course of a programme of treatment. Alexander technique is thought to be helpful to people with epilepsy, as it improves breathing

Research:

-Dennis J. Alexander technique for chronic asthma. Cochrane Database Syst Rev 2000;(2):CD000995
"Robust, well-designed randomised controlled trials are required in order to test claims by practitioners that AT can have a positive effect on the symptoms of chronic asthma and thereby help people with asthma to reduce medication."

(For more information see our fact sheet on the Alexander technique)

The Society of Teachers of the Alexander Technique (STAT)     
1st Floor, Linton House, 39-51 Highgate Road, London, NW5 1RT 
020 7482 5435 
enquiries@stat.org.uk

http://www.stat.org.uk/  

http://www.stat.org.uk/

Aromatherapy
This uses essential oils in the massage, which therapists believe can be beneficial. Oils can be inhaled, vaporised, used in hot compresses and even gargled. Choice of oils will depend on the nature of the asthma (if it is an allergic response), and any other factors involved. Those said to be good for asthma are bergamot, camomile, clary, lavender, thyme, neroli and rose oil as they are both anti-spasmodic and anti-depressant. Bergamot and lavender are also believed to clear up chest infections. (For more information see our fact sheet on aromatherapy)

This uses essential oils in the massage, which therapists believe can be beneficial. Oils can be inhaled, vaporised, used in hot compresses and even gargled. Choice of oils will depend on the nature of the asthma (if it is an allergic response), and any other factors involved. Those said to be good for asthma are bergamot, camomile, clary, lavender, thyme, neroli and rose oil as they are both anti-spasmodic and anti-depressant. Bergamot and lavender are also believed to clear up chest infections. (For more information see our fact sheet on aromatherapy)


International Federation of Aromatherapists
20A The Mall
Ealing
London
W5 2PJ
Tel: +44(0)208 567 2243
Fax: +44(0)208 840 9288

http://www.ifaroma.org/us/home/


International Federation of Professional Aromatherapists
ISPA House
82 Ashby Road
Hinckley
Leicestershire
LE10 1SN
Tel: 01455 637 987

www.ifparoma.org

  • Biofeedback
    Based on the principle that the mind is intrinsically linked to the body and that our emotions affect our body, biofeedback teaches patients how to be aware of physiological functions that are normally automatic and unconscious and how to use this internal information to improve their health. Using measuring devices patients learn how to monitor their body responses in order to control them. Biofeedback is a non-invasive and painless process, the information is fed back in the form of a light, sound or needle sign on a screen. Once the patients recognise changes in their physical states, they learn how to alter them with guided imaginary or relaxation techniques. After a few sessions they are able to notice these responses and to control them without devices.

Research:

- Kern-Buell CL, McGrady AV, Conran PB, Nelson LA. Asthma severity, psychophysiological indicators of arousal, and immune function in asthma patients undergoing biofeedback-assisted relaxation. Appl Psychophysiol Biofeedback 2000 Jun;25(2):79-91
"These findings, though limited by size of population, suggest a positive effect of biofeedback-assisted relaxation in young, nonsteroid-dependent asthmatics. The mechanisms underlying linkages between psychological, behavioral, and immune responses in asthma require further study."

- Anokhin MI, Sergeev VN, Domanskii VL. Correction of the breathing in the treatment of bronchial asthma by means of biological feedback. Med Tekh 1996 Jan-Feb;(1):26-9 "Treating BA (bronchial asthma) via BFB (biological feedback) correction diminishes psychosomatic disorders: anxiety, bronchodilator dependence, fear of a recurrent episode, whining, irritability, and insomnia."

(For more information see our fact sheet on biofeedback)


EEG Neurofeedback Services
PO Box 895, St Albans, AL1 9EH

DrKaur@eegneurofeedback.net

Telephone/Fax: 01727 874292

http://www.eegneurofeedback.net/

Association for Applied Psychophysiology and Biofeedback (AAPB)
10200 W. 44th Avenue
Suite 304
Wheat Ridge
CO 80033-2840
USA Tel: (001) 303 422 8436
http:// www.aapb.org/

EEG Spectrum
Neurofeedback Research and Clinical Services
18017 Chatsworth Street, #254
Granada Hills, CA 91344
Phone: (800) 789-3456
Fax: (818) 886-1443
info@eeger.com
http://www.eegspectrum.com/

  • Buteyko therapy - breathing therapy
    This is a breathing therapy that aims to teach shallow breathing. Asthmatics breathe more heavily than the norm. The therapy aims to ensure optimal xygenation of the body and its tissues. Developed 40 years ago by Dr Konstanin Buteyko, a Russian Medical scientist, its use in asthma is to change the breathing pattern to reduce or eliminate spasms and enable the patient to be less dependent on medication. The therapy is based on Dr Konstanin's observation of ill and dying patients. He noticed that they breathed much more quickly than healthy people did.
  • Research:

    - Opat AJ, Cohen MM, Bailey MJ, Abramson MJ. A clinical trial of the Buteyko Breathing Technique in asthma as taught by a video.J Asthma 2000;37(7):557-64
    " We conclude that the Buteyko Breathing Technique BBT may be effective in improving the quality of life and reducing the intake of inhaled reliever medication in patients with asthma. These results warrant further investigation."

    - Kuiper D. Dysfunctional breathing and asthma. Trial shows benefits of Buteyko breathing techniques. BMJ 2001 Sep 15;323(7313):631-2


Buteyko method
The Hale Clinic
7 Park Crescent
London W1N 3HE
Tel: 020 7631 0156

  • Chiropractic
    Very similar to osteopathy, chiropractic believes that the essential factor in healthy tissues is the nerves, and uses mainly manipulation techniques to correct tensions and imbalances in the musculo-skeletal system.

    Research:

    - Bronfort G, Evans RL, Kubic P, Filkin P. Chronic pediatric asthma and chiropractic spinal manipulation: a prospective clinical series and randomized clinical pilot study. J Manipulative Physiol Ther 2001 Jul-Aug;24(6):369-77 "The observed improvements are unlikely as a result of the specific effects of chiropractic SMT spinal manipulative therapy alone, but other aspects of the clinical encounter that should not be dismissed readily. Further research is needed to assess which components of the chiropractic encounter are responsible for important improvements in patient-oriented outcomes so that they may be incorporated into the care of all patients with asthma"

    - Hondras MA, Linde K, Jones AP. Manual therapy for asthma. Cochrane Database Syst Rev 2000;(2):CD001002
    " Currently, there is insufficient evidence to support or refute the use of manual therapy for patients with asthma."

    (For more information see our fact sheet on chiropractic)


British Chiropractic Association
59 Castle Street
Reading
Berkshire
RG1 7SN

Phone: 0118 950 5950
e-mail: enquiries@chiropractic-uk.co.uk
Fax: 0118 958 8946

 General Chiropractic Council
44 Wicklow Street
London WC1X 9HL
Tel: 0 20 7713 5155
Fax: 0 20 7713 5844
http://www.gcc-uk.org/

British Association for Applied Chiropractic
The Old Post Office, Cherry Street, Stratton Audley, Bicester OX6 9BA
Phone: 01869 277111ent
ME9 9QJ
Tel: 01795 520 707

  • Herbal treatment

Herbal treatments for asthma can prevent or help recover from an asthma attack, rather than treating an acute episode. It is strongly recommended that a herbalist or naturopathic practitioner be consulted before using herbs.

The following are thought to be useful for asthma, although this is not a comprehensive list.

    • Astragalus (astragalus membranaceous)
    • Licorice root
    • Minor bupleurum
    • Ammi visnaga
    • Brassica spp
    • Commiphor ayrrha
    • Convallaria majalis (lilly of the valley) datura stramonium
    • Ephedara vulgaris
    • Euphorbia hirta
    • Gingko biloba containing the active ingredient ginkgolide B
    • Grindelia robusta
    • Lobelia inflata
    • Marrubium vulgare
    • Polygala senega (milkwort)
    • Sanguinaria canadensis (bloodroot)
    • Sleneicerius grandiflorus
    • Symplocarpus goetidus (skunk cabbage)
    • Thymus vulgaris (thyme)
    • Verbascum thapsus (mullein)
    • Virurnum opulus (cramp bark)


Research:

- Ni J, Dong J, Wu G . Experimental study on effect of antagonizing platelet-activating factor and histamine of synthetic ginkgolide F in guinea-pigs Zhongguo Zhong Xi Yi Jie He Za Zhi 2000 May;20(5):365-7 "Synthetic Ginkgolide F .........may be a promising drug in treatment of bronchial asthma"

- Pinn G. Herbal therapy in respiratory disease. Aust Fam Physician 2001 Aug;30(8):775-9 "The explosion in incidence of asthma has, as in any chronic condition, provided a new area where alternative treatment is increasingly considered by patients. Treatments have been even less well researched than in other areas of herbal medicine, and the potential for abuse and toxicity remains a concern."

- Hu G, Walls RS, Bass D. The Chinese herbal formulation biminne in management of perennial allergic rhinitis: a randomized, double-blind, placebo-controlled, 12-week clinical trial. Ann Allergy Asthma Immunol 2002 May;88(5):478-87 Our results suggest the Biminne formulation is effective in treatment of perennial AR. Its mode of action is unknown.

National Institute of Medical Herbalists
Clover House
James Court
South Street
Exeter
EX1 1EE
Telephone 01392 426022
E-mail: info@nimh.org.uk
www.nimh.org.uk

  • Homoeopathy
    This works on the principle of treating like with like, however homoeopathic remedies are diluted to such an extent that no side effects are experienced, although sometimes symptoms worsen before they get better. Homoeopaths can tailor remedies to suit the individual especially if there is an identified allergic trigger, however most people have more than one allergic trigger. Homeopathic treatments for asthma are directed at preventing or supporting recovery from an asthma attack, rather than treating an acute episode.

    Research:

    - Doerr L. Using homeopathy for treating childhood asthma: understanding a family's choice. J Pediatr Nurs 2001 Aug;16(4):269-76 "The care of childhood asthma may prove to benefit from clinical trials in homeopathy."

    - Linde K, Jobst KA. Homeopathy for chronic asthma. Cochrane Database Syst Rev 2000;(2):CD000353 "There is not enough evidence to reliably assess the possible role of homeopathy in asthma. As well as randomised trials, there is a need for observational data to document the different methods of homeopathic prescribing and how patients respond."

(For more information see our fact sheet on homeopathy)


British Homeopathic Association
Hahnemann House
29 Park Street West
Luton
LU1 3BE

Tel: 01582 408675
Fax: 01582 723032
info@britishhomeopathic.org
http:// www.trusthomeopathy.org

The Society of Homeopaths
11 Brookfield, Duncan Close,
Moulton Park
Northampton NN3 6WL

Tel 01604 817890
Fax 01604 648848

info@homeopathy-soh.org
http:// www.homeopathy-soh.org

  • Hydrotherapy
    Hydrotherapy (water therapy) is a treatment that is based on the knowledge that water has an ability to alter the blood flow. Hot water dilates blood vessels increasing blood flow to the skin and muscles. This eases stiffness, improves circulation, reduces blood pressure, and boosts the immune system. Waste products can be more effectively removed from the body and more nutrients and oxygen are sent to the tissues, helping to repair any damage. Cold water stimulates. Surface blood vessels constrict sending the blood towards internal organs thereby improving their functioning, and the biochemical reactions that cause inflammation are inhibited. If both hot and cold water are used in a treatment this is said to reduce circulatory congestion caused by muscle spasm, and to stimulate the hormonal system and relieve inflammation.

    (For further information see our fact sheet on hydrotherapy)

    The British College of Naturopathy and Osteopathy
    Lief House
    3 Sumpter Close
    120-122 Finchley Road
    London NW3 5HR
    Tel: 020 7435 6464
    http://www.bcom.ac.uk/index.php

Applied Kinesiology
Developed by a US chiropractor, Dr George Goodheart in the 1960's, Applied Kinesiology is a diagnostic system that uses muscles to indicate imbalance in the body's systems, and its sensitivity to food and toxic substances in the environment. By testing certain muscles using pressure and various substances (i.e. food and homeopathic dilutions of chemicals etc) a practitioner can identify muscle strength. The strength or weakness of muscles can reveal the strengths and weaknesses of the body's systems, as muscles, organs and glands are believed to be connected via "energy circuits", or pathways.

(For more information see our fact sheet on Kinesiology)

The Association of Systematic Kinesiology, (A.S.K.)
1b Theaklen House
Theaklen Drive
St. Leonards on Sea
East Sussex
TN38 9AZ

admin@systematic-kinesiology.co.uk

0845 020 0383

http://www.systematic-kinesiology.co.uk/

Kinesiology Federation
PO Box 10426
Newark
NG24 9NF

0845 260 1094

admin@kinesiologyfederation.co.uk

http://www.kinesiologyfederation.co.uk/

  • Magnet Therapy
    It is difficult to find some scientific explanation on how magnets work, there is a lack of research and all claims can only be hypothesised. The main therapeutic benefit of magnet therapy seems to be an increase of oxygen in the blood. Under the action of magnets cells are revived and regenerated, the body can better absorb nutrients and heal itself. Magnets increase the blood flow, which has an effect on the lymphatic system as they carry waste away, they help flush lactic acid that builds up and thus help ease pain and inflammation.The action of magnetic fields on asthma works through relaxing spasms of bronchial muscles.

    Magnets can be placed on the lymph nodes or meridians following the theory of acupuncture or on specific areas of the body which need healing.
    Magnets should not be used by pregnant women or individuals who have a pacemaker or other metal implants. Strong magnets should be used with care on small children.

    (For more information see our fact sheet on Magnet therapy)

    The International Magnetic Therapists Association
    121 Counter St, Suite 902
    Kingston, Ontario,
    Canada, K7K 6C7

E-Mail: magnet@king.igs.net

Phone: 613-353-1168

  • Massage
    Massage is a hands-on technique used to stimulate the body through the skin, the body's largest sensory organ. Massage boosts the circulatory and immune systems and is part of many health systems. Different massage techniques are practised and integrated into various complementary therapies. Massage directly affects heart-rate, blood pressure, respiration, digestion and skin tone. The aim of massage for asthmatics is again to relieve physical tensions, which many massage therapists believe will then relieve mental and emotional tensions.

    Western (or Swedish) massage is generally given to a patient lying on a table. Different degrees and rhythms of pressure are used and a variety of techniques have been developed. Remedial massage focuses on conditions such as muscle strain. Manual lymph drainage (a gentle pumping massage) stimulates the lymphatic system to help eliminate metabolic wastes from the body. Eastern massage, such as shiatsu, uses acupressure techniques applying pressure rather than stroking, aiming to balance energy forces in the body.

    Research

    - Field T, Henteleff T, Hernandez-Reif M, Martinez E, Mavunda K, Kuhn C, Schanberg S. Children with asthma have improved pulmonary functions after massage therapy. J Pediatr 1998 May;132(5):854-8
    "It appears that daily massage improves airway caliber and control of asthma."

    - Field T.Massage therapy for infants and children. : J Dev Behav Pediatr 1995 Apr;16(2):105-11
    " Generally, the massage therapy has resulted in lower anxiety and stress hormones and improved clinical course."

     British Massage Therapy Council (BMTC)
    27 Old Gloucester Street
    London
    WC1N 3XX

Tel: 0870 850 4452
Email: gcmt@btconnect.com

http://www.gcmt.org.uk/Home.aspx

Massage Training Institute
PO Box 368, 23 Lindsay Avenue, Hitchin SG5 9DT

http://www.massagetraining.co.uk/

London College of Massage
95 Grays Inn Road, London WC1X 8TX

training@londoncollegeofmassage.co.uk

020 7404 7404
www.massagelondon.com

  • Nutrition
    Specific therapeutic foods for controlling asthma are:
    • From a Chinese medicine perspective, foods that enhance the moisture (or Yin aspect) of the Lung are recommended. These are juicy, pungent foods such as garlic, onions, leeks, turnips, grapes, pineapple, green leafy vegetables, apricots, apricot kernels, almonds, walnuts, carrots,
      pumpkin, sunflower seeds, figs, daikon, lychee, tangerines, loquats, honey, molasses, mustard greens, and sesame seeds.
    • Other good foods to reduce inflammation as well as for dilating the bronchi are collard greens, cauliflower, garlic, onions, turnips, endive, apricots, cherries, elderberries, green vegetables, raw nuts and seeds, sprouted seeds and grains.
    • Increase omega-3 and omega-6 fatty acids: vegetable, nut, seed oils, salmon, herring, mackerel, sardines, walnuts, flax seed oil, evening primrose oil, black currant oil.
    • Foods high in flavonoids and carotenoids such as dark green leafy vegetables and deep yellow and orange vegetables.
    • Juices made from the following fresh vegetables and fruits and taken on an empty stomach each morning, are said to help prevent asthma attacks:
      • celery and papaya
      • celery, endive, and carrot
      • spinach and carrot
      • lime, horseradish, and garlic
      • carrot
    • Eating mainly fresh fruits and vegetables (especially apples and tomatoes) nuts and seeds, oatmeal, brown rice and whole grains is thought to help. The diet should be relatively high in protein, low in carbohydrates, and contain no sugar.
    • Include garlic and onions in the diet. They contain quercetin and mustard oils, which have been shown to inhibit an enzyme that aids the release of inflammatory chemicals.
    • Avoid gas-producing foods, such as beans, brassicas (broccoli, cauliflower and cabbage) and large amounts of bran. Gas can irritate an asthmatic condition by putting pressure on the diaphragm.
    • Avoid ice cream and extremely cold liquids. Cold can shock the bronchial tubes into spasms.
    • Eat lightly - a large meal can cause shortness of breath by making the stomach put pressure on the diaphragm.
    • Use an elimination diet to see if certain foods aggravate the asthmatic condition. Common culprits include alfalfa, corn, peanuts, soy, eggs, beets, carrots, colas, cold beverages, dairy products, fish, red meat (especially pork), processed foods, salt, spinach, chicken and turkey, white flour and white sugar.

      Foods to strictly avoid are the mucus forming ones, such as:
      • cow's milk and other dairy products
      • white bread
      • refined foods and processed foods
      • sugar and sweets
      • tofu
      • meat
      • ice cream
      • shellfish
      • watermelon
      • salty foods
      • cold foods
      • bananas
      • mung beans.

Research:

- Li C, Li L, Luo J, Huang N. [Effect of turmeric volatile oil on the respiratory tract] Zhongguo Zhong Yao Za Zhi 1998 Oct;23(10):624-5, inside " Turmeric volatile oil may be an efficacious drug for the treatment of respiratory diseases."

In autumn 2001, Graham Devereux, a researcher at Aberdeen University discovered that children were less likely to suffer from asthma if their mother ate food rich in vitamin E during the pregnancy whilst researchers at the Nottingham University found that apples and tomatoes increased lung capacity and reduce wheezing (May 2001) .

Anthony Seaton conducted a survey that involved 1444 children in Saudi Arabia. The aim was to assess the dietary and other factors for asthma. He found that children whose diet consisted of "fast food" containing low levels of vegetables, milk, fibre, vitamin E, magnesium, calcium, sodium and potassium were more likely to develop asthma than those whose diet included rice vegetables local meat and fruits.

    • Nutritional supplements
             Nutritional supplements for asthma are directed at preventing or supporting recovery from an asthma attack, rather than treating an acute episode.
      • Essential fatty acids (EFAs) help to regulate the inflammatory response. Good sources are evening primrose oil or EPA (fish oil). (See our fact sheet on evening primrose oil).
      • Magnesium has a bronchodilating effect if taken in the proper dosage. Some doctors give magnesium sulfate by injection to treat acute asthma attacks. (See our fact sheet on magnesium).
      • Pantothenic acid (vitamin B5) supports adrenal function and the nervous system.
      • Vitamin B12 deficiency has been linked to some types of asthmatic conditions. Given in either oral or injectable form, this vitamin can help to prevent an asthma attack.
      • Vitamin C supplementation can reduce some of the airway spasms that characterise the disease.

Research:

- Kaur B, Rowe BH, Ram FS. Vitamin C supplementation for asthma Cochrane Review ) Cochrane Database Syst Rev 2001;4:CD000993 "At present, evidence from randomised-controlled trials is insufficient to recommend a specific role for vitamin C in the treatment of asthma. A methodologically strong and large-scale randomised controlled trial is warranted in order to address the question of the effectiveness of vitamin C in patients with asthma."

- Miller AL. The etiologies, pathophysiology, and alternative/complementary treatment of asthma. Altern Med Rev 2001 Feb;6(1):20-47
"Antioxidant nutrients, especially vitamins C and E, selenium, and zinc appear to be necessary in asthma treatment. Vitamins B6 and B12 also
may be helpful. Omega-3 fatty acids from fish, the flavonoid quercetin, and botanicals Tylophora asthmatica, Boswellia serrata and Petasites hybridus address the inflammatory component. Physical modalities, including yoga, massage, biofeedback, acupuncture, and chiropractic can also be of help."

- Nagakura T, Matsuda S, Shichijyo K, Sugimoto H, Hata K.Dietary upplementation with fish oil rich in omega-3 polyunsaturated fatty acids in children with bronchial asthma. Eur Respir J 2000 Nov;16(5):861-5
" The present results suggest that dietary supplementation with fish oil rich in the omega-3 polyunsaturated fatty acids eicosapentaenoic acid and docosahexaenoic acid is beneficial for children with bronchial asthma in a strictly controlled environment in terms of inhalant allergens and diet."

- Rowe BH, Edmonds ML, Spooner CH, Camargo CA. Evidence-based treatments for acute asthma. Respir Care 2001 Dec;46(12):1380-90; discussion 1390-1
"Evidence from systematic reviews indicates that intravenous magnesium sulfate may provide similar benefits in severe asthma."

British Society for Allergy Environmental & Nutritional Medicine (BSAENM)
PO Box 7
Knighton
Powys LD8 2WF
Telephone: 01547 550380 (+44 1547 550380)

Website: http://www.jnem.demon.co.uk/index.html

Osteopathy
Many people with asthma develop bad posture to compensate for they're breathing difficulties, becoming round shouldered with a distended chest. Manipulation therapies aim to correct the compensations and relax the chest, neck, shoulders and diaphragm.

In contrast to chiropractic, osteopathy believes that the essential factor in healthy tissues is the blood flow. It is based on the principle that structure and function are interdependent, so that if the structure is 'out' the function will suffer. If a body is forced to do a function it is not designed for; the structure will be affected. For asthma sufferers the approach would again be to ease tension so that the chest and diaphragm can move more freely.

 The British Osteopathic Association
3 Park Terrace
Manor Road
Luton
Bedfordshire
LU1 3HN

Tel: 01582 488455
Fax: 01582 481533

enquiries@osteopathy.org

British School of Osteopathy
98-118 Southwark Bridge Road
London SE1 0BQ

020 7089 5360
http://www.bso.ac.uk/index2.htm

General Osteopathic Council
Osteopathy House 176 Tower Bridge Road
London SE1 3LU
Tel: 020 7357 6655
www.osteopathy.org.uk

    • Tragerwork
      According to Milton Trager there is a connection between the physical structure of the body and the unconscious mind, as a result emotional trauma may be locked within the tissues of the body. Connective tissue (the fibrous tissues that surround muscles, nerves, organs, glands) is affected by emotional or physical trauma, it can tighten and become rigid which can block the healthy flow of energy and lead to illness.

      During a session the client is assessed by the therapist and then taught a series of mental and physical gymnastics exercises called "mentastics" which involve shaking or swinging the hands or the feet and dance like movements that enhance relaxation. The principle behind mentastics is that this memory of a pleasurable, positive feeling experience can then replace emotional trauma that may have been stored up previously. The therapist "hooks up": he/she enters a state of meditation that is believed to allow him/her to better sense tension areas in the body. Movements such as cradling, rocking, stretching and pulling are used.

      Tragerwork releases unconscious patterns of holding tension as individuals
      are encouraged to "let go".

      (For more information see our fact sheet on Targerwork)

      Trager UK
      Riverside Cottage
      Candor, Nr ProbusTruro, Cornwall
      TR2 4JG

                           Tel: 01872 520492
                           http//:www.trager.co.uk

Trager Institute
3800 Park East Drive
Suite 100, Room 1
Beachwood
Ohio 44122
USA.
Tel: (001) 216 896-9383
http://www.trager.com

    • Yoga
      An ancient Hindu discipline which encompasses the mind, body and emotions, yoga is a series of movements, postures and breathing techniques which can increase suppleness and aid relaxation. There is much anecdotal evidence that using the breathing exercises - Pranayama - can reduce asthma attacks and encourage greater tolerance to certain triggers.

      Research:

      An Australian research team highlighted the benefits of a form of meditation called Sahaja in January 2002.They found that Sahaja meditation eased the symptoms for a short while. This type of meditation is said to "un-clutter" the mind.

      - Sathyaprabha TN, Murthy H, Murthy BT. Efficacy of naturopathy and yoga in bronchial asthma--a self controlled matched scientific study.Indian J Physiol Pharmacol 2001 Jan;45(1):80-6
      " The patients reported a feeling of well being, freshness and comfortable breathing. Naturopathy and yoga helps in inducing positive health, alleviating the symptoms of disease by acting at physical and mental levels."

      - Birkel DA, Edgren L. Hatha yoga: improved vital capacity of college students. Altern Ther Health Med 2000 Nov;6(6):55-63 "The study showed a statistically significant (P < .001) improvement in vital capacity across all categories over time. CONCLUSIONS: It is not known whether these findings were the result of yoga poses, breathing techniques, relaxation, or other aspects of exercise in the subjects' life. The subjects' adherence to attending class was 99.96%. The large number of 287 subjects is considered to be a valid number for a study of this type. These findings are consistent with other research studies reporting the positive effect of yoga on the vital capacity of the lungs."

      - Vedanthan PK, Kesavalu LN, Murthy KC, Duvall K, Hall MJ, Baker S, Nagarathna S. Clinical study of yoga techniques in university students with asthma: a controlled study. Allergy Asthma Proc 1998 Jan-Feb;19(1):3-9
      " Yoga techniques seem beneficial as an adjunct to the medical anagement
      of asthma."

      The British Wheel of Yoga
      25 Jermyn Street
      Sleaford
      Lincs
      NG34 7RU
      Tel: 01529 306 851
      www.bwy.org.uk
      Institute for Complementary and Natural Medicine
      ICNM, Can Mezzanine, 32 - 36 Loman Street, London, SE1 0EH

                           Tel:  0207 922 7980

                          Fax:  0207 922 7981

                          Email:  info@icnm.org.uk

                          Website:  www.icnm.org.uk

Complementary and Natural Healthcare Council
Albert Buildings
49 Queen Victoria Street
London
EC4N 4SA Tel: 020 7653 1971
info@cnhc.org.uk

Website: http://www.cnhc.org.uk/index.cfm?page_id=580

3. Self Care

As stated on page one of this fact sheet, asthma can be caused by many different factors. The most important thing an asthma sufferer can do is try to identify what triggers their asthma attacks. Once triggers are identified a number of measures can be taken to limit the effect of these triggers on the individual, for example:

  • Avoid gas cookers: Researchers at Aberdeen University and Napier University in Edinburgh have found that particles released by gas cookers can cause asthma attacks in people suffering from asthma, bronchitis, or heart or lung disease.
  • Avoid carpets and curtains where pollen, pet dander, mould and dustmites can accumulate. Use throw-rugs and blinds instead.
  • Avoid drying sheets and blankets outdoors where they can be contaminated by pollen.
  • Avoid feather pillows.
  • Avoid keeping pets if there is a family history of asthma. 50% of chldren with asthma have symptoms triggered by allergy to cats and dogs. If pets are unavoidable, keep them out of the bedrooms and lounge.
  • Avoid pollen as much as possible. Keep car windows shut. On hot dry days avoid spending too much time outside. Avoid long grass.
  • Be aware of foods that provoke allergic reactions.
  • Cover mattresses and pillows with plastic covers.
  • Damp dust all surfaces regularly.
  • Drink lots of fluids.
  • Ensure a readily available supply of asthma medicine.
  • Hot wash bedding (60 degrees C).
  • Keep bedrooms especially 'pure'.
  • Keep rooms well aired (dust mites like humid conditions).
  • Mop with bleach diluted in water - helps to keep mould from growing.
  • Open windows during and after cooking, when washing or using the bathroom.
  • Remove damp and mould in house quickly and avoid condensation.
  • Replace carpets with lino, tiles, wood flooring etc.
  • Stay sitting up during an asthma attack, avoid lying down.
  • Use a humidifier and keep the filter clean. Use distilled water in humidifiers.
  • Wear a scarf around the nose and mouth when outside in the cold. This warms up the air before it is breathed in.
  • When doing exercise, like swimming, stop if wheezing starts.
  • When vacuuming wear a filter mask to avoid the dust the vacuuming produces. Get a high efficiency vacuum and vacuum often.
  • After an attack try to drink lots of fluids (once you feel able to do so), to thin secretions so that they are easily coughed out.

Asthma in the future

Southampton University, UK, is currently doing research on an asthma 'vaccine' which they believe may be able to 'switch off' allergic reactions in newborn babies which lead to asthma. The vaccine was developed after research indicated that improvements in Western hygiene had destroyed bacteria that helped to regulate the immune systems of newborn babies. Quoted in Metro (3.5.2000) Dr Martyn Partridge, the National Asthma Campaign chief Medical advisor, said: "of all the hypotheses advanced to explain the increase in asthma, the 'hygiene hypothesis' is currently the most plausible."

Resources

GP Surgeries

Many surgeries now run asthma clinics run by specially trained practice nurses.

National Asthma Campaign
18 Mansell Street, London, E1 8AA
Tel: 020 7786 4900
http://www.asthma.org.uk

Asthma and Allergy Information and Research (AAIR)
Department of Respiratory Medicine
Glenfield Hospital
Groby Road
Leicester
LE3 9QP
Tel: 0116 270 7557

American Lung Association
55 W. Wacker Drive, Suite 1150, Chicago, IL 60601
T: 1-800-LUNGUSA | F: 202-452-1805
http://www.lungusa.org

American Academy of Allergy, Asthma, and Immunology
555 East Wells Street
Suite 1100
Milwaukee, WI 53202-3823
Phone: (414) 272-6071
http://www.aaaai.org

National Heart, Lung, and Blood Institute Information Centre
P.O. Box 30105
Bethesda, MD 20854-0105
http://www.nhlbi.nih.gov/health/public/lung/index.htm#asthma

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