Gill Stannard

Monday, April 28, 2008

asthma

What is asthma?

With over 2 million Australians being diagnosed with asthma, including up to 1:4 children, we are living in one of the most allergy prone countries in the world.

Asthma is an inflammatory condition of the airways in the lungs. It may feel like a persistent, irritated cough, a tightness in the chest or a distinctive wheezing sound when trying to breathe. This may be caused by a change in air temperature, exercise, dust, pollens, cigarette smoke, a respiratory infection or a wide range of allergens. When triggered, this causes swelling, constriction and the production of thick, sticky mucus that makes breathing, especially exhaling air, very difficult. Most asthma attacks are well managed with preventative (eg: steroids) or acute (eg: Ventolin) drugs but sometimes an asthma attack can be fatal. Because of this, all practitioners take a diagnosis of asthma very seriously.

Can you treat asthma without drugs?

Firstly it is important to actually make sure that someone actually has asthma. This may sound strange but asthma is misdiagnosed in both children and adults at an alarming rate. In kids there has been a tendency to classify most prolonged coughs as asthma.
Associate Professor Colin Robertson from the Royal Children's Hospital Melbourne is also a spokesman for the National Asthma Council of Australia. He says he's spent more time undiagnosing asthma than diagnosing it over the past decade. “Throughout the quarter of last century, there was an amazing awareness campaign for improving the diagnosis of asthma, which has been incredibly effective, and perhaps a bit too effective, so that children with a wide range of respiratory symptoms are having the diagnosis of asthma and not all of them have it.” ABC ’7.30 Report’, 8.4.03


In adults as well as children, common conditions such as 'silent reflux’ (gastrointestinal oesophageal reflux or GORD/GERD) which often triggers coughing after food, coffee, exercising or lying down - may be more likely to be a culprit in a person with no past history or allergies. The cough does not significantly improve on asthma medication, nor develop into serious breathing problems.

With a clear diagnosis of asthma, it would be unusual for a naturopath to tell a client to cease their pharmaceutical drugs. Treatment is generally centred around – decreasing triggers, reducing mucus, improving breathing, increasing immunity and trying to decrease the incidence of respiratory infections.

Can foods cause asthma?

Asthma is typically seen initially in children with a family history of atopic allergies eg: eczema, asthma, hayfever, hives. Often they have a history of eczema or other skin rashes before developing respiratory problems. This may go away when they use topical steroid creams but later it is not unusual for some of these children to present with asthma. Some naturopaths believe that the eczema is the body’s way of trying to get the person to avoid an allergen and when this is dampened down or ‘cured’ with drugs it can express itself in a different way such as asthma or persistent rhinitis. While there is much debate as to whether foods like dairy products or wheat “cause” asthma or produce mucus in the respiratory system, in practice an appropriate low allergy diet does tend to provide good results.

In my experience, when all dairy foods (including ‘hidden’ dairy in some processed foods) are removed from the diet long term, it can improve most allergic respiratory conditions. While other triggers still abound – such as pollens and changes in air temperature, food is the one thing we can control most of all.

Other things we can’t always control that have been linked to developing asthma and other allergies include: caesarean birth, antibiotics in the first 6 months of life, being bottle rather than breast fed, air pollution, passive smoking or being overweight.

Nutrients for asthma

A number of studies have shown a connection between low nutrition, especially antioxidants such as Vitamins E, A and C and asthma. These nutrients tend to have anti-inflammatory actions, so too does fish oil. There is some evidence that magnesium may be implicated in asthma.

Try to avoid polyunsaturated vegetable oils, margarine, vegetable shortening, all partially hydrogenated oils that might contain trans-fatty acids and deep-fried foods, due to their ability to provoke inflammation. Use anti-inflammatory herbs like ginger and turmeric.

Typically, a low allergy diet for asthma is a good starting place. This is one without wheat, dairy, soy, corn (including high fructose corn syrup), eggs, nuts and all additives. Include alternative sources of calcium such as seeds (eg tahini), beans, and edible fish bones (eg: in canned salmon and sardines, also high in good oils). Ideally most food is cooked from scratch, as processed food even when it doesn’t contain suspected allergens, is low in nutrition. Increase the amounts of seasonal fruits and vegetables, grains such as quinoa, brown rice, oats and barley and other wholefoods like beans and lentils.

After 3-6 weeks, introduce a new food group, one at a time, each week and see if there is any worsening in the asthma. Record symptoms on a chart, peak flow readings and how often acute medication is needed.

Alternative treatments for asthma

Both Western and Chinese herbal medicines are frequently used for asthma. I use herbs like elecampane, hyssop and sundew to strengthen the lungs, as well as immune stimulants and nervous system tonics as required depending on the individual. Unfortunately in Australia some strong but effective herbs like lobelia and ephedra are no longer available to be prescribed by herbalists.

There are potentially issues with the contamination and adulteration of some Chinese medicines bought overseas or in Australia. These have included heavy metals or the inclusion of non-disclosed pharmaceutical drugs. This is less likely to occur if you are given raw herbs to decoct rather than pre-made tablets or powders.

Manual treatments – including osteopathy, chiropractic and remedial massage can often help if the diaphragm is tight of other musculo-skeletal problems are apparent.

Buteyko technique - has some of the most promising results for asthma management. This is a breathing technique that needs to be taught by a qualified instructor. I would thoroughly recommend every asthmatic to give it a go.

Appropriate exercise: There is a good reason why so many of our gold medal winning swimmers began their life as asthmatics. While exercise can be a trigger for asthma attacks, swimming is largely beneficial, though preferably in an outdoor, non-chlorinated pool. Yoga and chi-gong can also be useful.

Other common asthma triggers

Analgesic drugs, such as aspirin and nsaids, panadol is often a safer choice.

Cleaning products especially aerosol and spray based ones. White vinegar and bicarbonate of soda are effective cleaners and much safer for asthmatics.

Cockroaches mould and dust mites. This offers some solutions.

Cats and dogs are controversial. Though an obvious trigger for some, growing up in a home with pets, such as in this study looking at cats, can also reduce your chances of becoming an asthmatic. And here's a study in support of dogs.

Not taking your asthma seriously. While complementary therapies may reduce your need for medication, doing nothing and not having an action plan is a disaster waiting to happen.

As reminded by a caller on the show - check your heating. Gas heaters, especially those with a pilot light, can provoke asthma in some. Also clean out your ducted heating every year. It costs a little money but is worth it when you see the gunk pulled out of the ducts that you were breathing in.

Update: April 2009. "A low intake of vitamins A and C could raise the risk of asthma, a team which reviewed 40 studies carried out over the past 30 years has said.

A Nottingham University-led team found people with a low intake of vitamin C had a 12% increased risk of asthma, the Thorax journal reported.

For vitamin A the raised risk was less clear cut, the team said, but there was still a significant association." Read more

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