Asthma

Amrita Bindu is an Ayurvedic herbal preparation that contains a mixture of 13 salts and spices. It has been shown to have antioxidant activity. In a preliminary study, children with severe asthma received 250 to 500 mg (depending on their age) of Amrita Bindu twice a day after meals.⁸ After three months of treatment, most of the children were able to stop their prescription asthma medications and were no longer having asthma attacks. While these results are impressive, they should be followed up with a double-blind study, to rule out the possibility that the benefit was due to a placebo effect.

Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements.

Some researchers have suggested that asthma attacks triggered by exercise might be caused by free-radical damage caused by the exercise. Beta-carotene is an antioxidant that protects against free-radical damage. Israeli researchers reported that 64 mg per day of natural beta-carotene for one week in a double blind trial protected over half of a group of asthmatics who experienced attacks as a result of exercise.⁹ More research is needed to confirm this promising finding.

One double-blind trial has investigated the effects of the Ayurvedic herb boswellia in people with acute bronchial asthma.¹⁰ Participants took 300 mg of powdered boswellia resin extract or placebo three times daily for six weeks. By the end of the study, the number of asthma attacks was significantly lower in the group taking boswellia. Moreover, objective measurements of breathing capacity were also significantly improved by boswellia.

In a double-blind study, adult asthma patients taking inhaled steroids took either butterbur extract or placebo.¹¹ There was a significantly greater improvement in airflow in the group that took butterbur extract compared with those who took placebo. A study without a control group showed that people with mild asthma, most still taking various anti-asthma medications, had better airflow but actually showed some evidence of having more frequent asthma attacks when they took butterbur.¹² Therefore more rigorous studies are needed to know how effective butterbur is in people with asthma.

Double-blind research shows that fish oil partially reduces reactions to allergens that can trigger attacks in some asthmatics.¹³ Another double-blind study showed that fish oil supplements prevented exercise-induced asthma attacks in people with asthma.¹⁴ A few other researchers have reported small but significant improvements when asthmatics supplement with fish oil,^15,16 but reviews of the research concluded that most fish oil studies showed little or no benefit.^17,18 It is possible that some of these trials failed to show an improvement because they did not last long enough to demonstrate an effect. There is evidence that children who eat oily fish may have a much lower risk of getting asthma.¹⁹ Moreover, in a double-blind trial, children who received 300 mg per day of fish oil (providing 84 mg of EPA and 36 mg of DHA) experienced significant improvement of asthma symptoms.²⁰ It should be noted that these benefits were obtained under circumstances in which exposure to food allergens and environmental allergens was strictly controlled. Though the evidence supporting the use of fish oil remains somewhat conflicting, eating more fish and supplementing with fish oil may still be worth considering, especially among children with asthma.

In a double-blind study of people with asthma, supplementation with a proprietary extract of New Zealand green-lipped mussel (Lyprinol) twice a day for 8 weeks significantly decreased daytime wheezing and improved airflow through the bronchi.²¹ Each capsule of Lyprinol contains 50 mg of omega-3 fatty acids.

Animal studies have found that extracts of holy basil (Ocimim sanctum) inhibit constriction of the bronchial airway passages.²² Two preliminary clinical trials treated asthma patients with 500 mg of holy basil three times daily for one month.^23,24 Breathing function improved and the frequency of attacks was reduced. Placebo-controlled research is needed to validate these results.

A controlled trial on children with bronchial asthma suggested that 25 drops of ivy leaf extract given twice daily was effective in increasing the amount of oxygen in the lungs after only three days of use. However, the frequency of cough and shortness of breath symptoms did not change during the short trial period.²⁵

Lycopene, an antioxidant related to beta-carotene and found in tomatoes, helps reduce the symptoms of asthma caused by exercising. In one double-blind trial,²⁶ over half of people with exercise-induced asthma had significantly fewer asthma symptoms after taking capsules containing 30 mg of lycopene per day for one week compared to when they took a placebo.

Magnesium levels are frequently low in asthmatics.²⁷ Current evidence suggests that high dietary magnesium intake may be associated with better lung function and reduced bronchial reactivity. Intravenous injection of magnesium has been reported in most,^28,29,30,31 but not all,³² double-blind trials to rapidly halt acute asthma attacks. Magnesium supplements might help prevent asthma attacks because magnesium can prevent spasms of the bronchial passages. In a preliminary trial, 18 adults with asthma took 300 mg of magnesium per day for 30 days and experienced decreased bronchial reactivity.³³ However, a double-blind trial investigated the effects of 400 mg per day for three weeks and found a significant improvement in symptoms, but not in objective measures of airflow or airway reactivity.³⁴ The amount of magnesium used in these trials was 300 to 400 mg per day. Children usually take proportionately less based on their body weight, but one study of asthmatic children between the ages of 17 and 19 used 300 mg of magnesium per day.³⁵

Two preliminary trials have shown picrorhiza to be of benefit in asthma.^36,37 However, a follow-up double-blind trial did not confirm these earlier results.³⁸ A range of 400 to 1,500 mg of powdered, encapsulated picrorhiza per day has been used in a variety of trials. It remains unclear how effective picrorhiza is for people with asthma.

In three preliminary trials on people with asthma, a traditional Japanese herbal formula known as saiboku-to has been shown to reduce symptoms and enable some people to reduce their use of steroid medication.^40,41,42 Saiboku-to has been extensively studied in the laboratory and has been shown to have numerous anti-inflammatory actions.⁴³ Some of these studies used 2.5 grams three times per day of saiboku-to. A traditional Chinese or Japanese medicine practitioner should be consulted for more information. Saiboku-to contains bupleurum, hoelen, pinellia, magnolia, Asian ginseng, Asian scullcap, licorice, perilla, ginger and jujube.

People with low levels of selenium have a high risk of asthma.^{44,45,46,47,48} Asthma involves free-radical damage⁴⁹ that selenium might protect against. In a small double-blind trial, supplementation with 100 mcg of sodium selenite (a form of selenium) per day for 14 weeks resulted in clinical improvement in six of eleven patients, compared with only one of ten in the placebo group.⁵⁰ Most doctors recommend 200 mcg per day for adults (and proportionately less for children)—a much higher, though still safe, level.

Different preparations of tylophora, including crude leaf, tincture, and capsule, have been tested in human clinical trials. One double-blind trial had people with bronchial asthma chew and swallow one tylophora leaf (150 mg of the leaf by weight) per day for six days. Participants were also given a comparable placebo to be chewed and swallowed during a different six-day period. When consuming tylophora, over half of the people reported experiencing moderate to complete relief of their asthma symptoms, compared to only about 20% reporting relief when consuming the placebo.⁵¹ In a follow-up double-blind trial, an alcoholic extract of crude tylophora leaves had comparable effects to that of chewing the crude leaf.⁵² Another double-blind trial found 350 mg of tylophora leaf powder per day increased the lungs’ capacity for oxygen and reduced nighttime shortness of breath, but was not as effective as an antiasthmatic drug combination.⁵³ A fourth double-blind trial found no significant changes in lung volume measurements or asthmatic symptoms after treatment with 400 mg per day tylophora.⁵⁴

Vitamin B6 deficiency is common in asthmatics.⁵⁵ This deficiency may relate to the asthma itself or to certain asthma drugs (such as theophylline and aminophylline) that deplete vitamin B6.⁵⁶ In a double-blind trial, 200 mg per day of vitamin B6 for two months reduced the severity of asthma in children and reduced the amount of asthma medication they needed.⁵⁷ In another trial, asthmatic adults experienced a dramatic decrease in the frequency and severity of asthma attacks while taking 50 mg of vitamin B6 twice a day.⁵⁸ Nonetheless, the research remains somewhat inconsistent, and one double-blind trial found that high amounts of B6 supplements did not help asthmatics who required the use of steroid drugs.⁵⁹

Supplementation with 1 gram of vitamin C per day reduces the tendency of the bronchial passages to go into spasm,⁶⁰ an action that has been confirmed in double-blind research.⁶¹ Beneficial effects of short-term vitamin C supplementation (i.e., less than three days) have been observed. In double-blind trials, supplementation with 1,000 to 1,500 mg of vitamin C per day for 2 to 14 days prevented attacks of exercise-induced asthma.^62,63 Two other preliminary trials found that vitamin C supplementation reduced bronchial reactivity to metacholine, a drug that causes bronchial constriction.^64,65 However, other studies,⁶⁶ including two double-blind trials,^67,68 have failed to corroborate these findings. The only double-blind trial of a long duration found that vitamin C supplementation (1 gram per day for 14 weeks) reduced the severity and frequency of attacks among Nigerian adults with asthma.⁶⁹ A buffered form of vitamin C (such as sodium ascorbate or calcium ascorbate) may work better for some asthmatics than regular vitamin C (ascorbic acid).⁷⁰

Bromelain reduces the thickness of mucus, which may be beneficial for those with asthma,⁷⁵ though clinical actions in asthmatics remain unproven.

A small double-blind trial found that a constituent of coleus, called forskolin, when inhaled, could decrease lung spasms in asthmatics compared to placebo.⁷⁶ Coleus extracts standardized to 18% forskolin are available, and 50 to 100 mg can be taken two to three times per day. Fluid extract can be taken in the amount of 2 to 4 ml three times per day. Most trials have used injected forskolin, so it is unclear whether oral ingestion of coleus extracts will provide similar benefits in the amounts recommended above. One study found that 10 mg per day of forskolin taken orally for 2 months was of no benefit for adult asthmatics.⁷⁷

Traditionally, herbs that have a soothing action on bronchioles are also used for asthma. These include marshmallow, mullein, hyssop, and licorice. Elecampane has been used traditionally to treat coughs associated with asthma.⁷⁸

Ginkgo biloba extracts have been considered a potential therapy for asthma. This is because the extracts block the action of platelet-activating factor (PAF), a compound the body produces that in part causes asthma symptoms. A trial using isolated ginkgolides from ginkgo (not the whole extract) found they reduced asthma symptoms.⁷⁹ A controlled trial used a highly concentrated tincture of ginkgo leaf and found this preparation helped decrease asthma symptoms.⁸⁰ For asthma, 120 to 240 mg of standardized ginkgo or 3 to 4 ml of regular tincture three times daily can be used.

Traditionally, herbs that have a soothing action on bronchioles are also used for asthma. These include marshmallow, mullein, hyssop, and licorice. Elecampane has been used traditionally to treat coughs associated with asthma.⁸¹

Eclectic physicians—doctors in turn-of-the-century North America who used herbs as their main medicine—considered lobelia to be one of the most important plant medicines.⁸² Traditionally, it was used by Eclectics to treat coughs and spasms in the lungs from all sorts of causes.⁸³ A plant that originates in Africa, khella, is also considered an anti-spasmodic like lobelia. Though it is not strong enough to stop acute asthma attacks, khella has been recommended by German physicians practicing herbal medicine as possibly helpful for chronic asthma symptoms.⁸⁴

Traditionally, herbs that have a soothing action on bronchioles are also used for asthma. These include marshmallow, mullein, hyssop, and licorice. Elecampane has been used traditionally to treat coughs associated with asthma.⁸⁶

Eclectic physicians—doctors in turn-of-the-century North America who used herbs as their main medicine—considered lobelia to be one of the most important plant medicines.⁸⁷ Traditionally, it was used by Eclectics to treat coughs and spasms in the lungs from all sorts of causes.⁸⁸ A plant that originates in Africa, khella, is also considered an anti-spasmodic like lobelia. Though it is not strong enough to stop acute asthma attacks, khella has been recommended by German physicians practicing herbal medicine as possibly helpful for chronic asthma symptoms.⁸⁹

Traditionally, herbs that have a soothing action on bronchioles are also used for asthma. These include marshmallow, mullein, hyssop, and licorice. Elecampane has been used traditionally to treat coughs associated with asthma.⁹⁰

In some people with asthma, symptoms can be triggered by ingestion of food additives known as sulfites. Pretreatment with a large amount of vitamin B12 (1,500 mcg orally) reduced the asthmatic reaction to sulfites in children with sulfite sensitivity in one preliminary trial.⁹¹ The trace mineral molybdenum also helps the body detoxify sulfites.⁹² While some doctors use molybdenum to treat selected patients with asthma, there is little published research on this treatment, and it is not known what an appropriate level of molybdenum supplementation would be. A typical American diet contains about 200 to 500 mcg per day,⁹³ and preliminary short-term trials have used supplemental amounts of 500 mcg per day.⁹⁴ People who suspect sulfite-sensitive asthma should consult with a physician before taking molybdenum.

Traditionally, herbs that have a soothing action on bronchioles are also used for asthma. These include marshmallow, mullein, hyssop, and licorice. Elecampane has been used traditionally to treat coughs associated with asthma.⁹⁵

Onion may act as an anti-inflammatory in people with asthma. Human studies have shown onion can be a strong anti-inflammatory.⁹⁶ However, some people with asthma may experience an exacerbation of symptoms if they are allergic to onion and are exposed to it.⁹⁷

Quercetin, a flavonoid found in most plants, has an inhibiting action on lipoxygenase, an enzyme that contributes to problems with asthma.⁹⁸ No clinical trials in humans have confirmed whether quercetin decreases asthma symptoms. Some doctors are currently experimenting with 400 to 1,000 mg of quercetin three times per day.

The oral administration of a thymus extract known as thymomodulin has been shown in preliminary and double-blind clinical trials to improve the symptoms and course of asthma.^{99,100,101,102} Presumably this clinical improvement is the result of restoration of proper control over immune function.

In some people with asthma, symptoms can be triggered by ingestion of food additives known as sulfites. Pretreatment with a large amount of vitamin B12 (1,500 mcg orally) reduced the asthmatic reaction to sulfites in children with sulfite sensitivity in one preliminary trial.¹⁰³ The trace mineral molybdenum also helps the body detoxify sulfites.¹⁰⁴ While some doctors use molybdenum to treat selected patients with asthma, there is little published research on this treatment, and it is not known what an appropriate level of molybdenum supplementation would be. A typical American diet contains about 200 to 500 mcg per day,¹⁰⁵ and preliminary short-term trials have used supplemental amounts of 500 mcg per day.¹⁰⁶ People who suspect sulfite-sensitive asthma should consult with a physician before taking molybdenum.

There is some evidence that combinations of antioxidants such as vitamin E, vitamin C, and selenium may help improve symptoms of asthma throught to be caused by air pollution.¹⁰⁷ In one double-blind study, 46 Dutch bicyclists were randomly assigned to receive a placebo or 100 mg of vitamin E and 500 mg of vitamin C daily for 15 weeks.¹⁰⁸ Lung function was measured before and after each training session on 380 different occasions, and ambient ozone concentrations were measured during each training session. After analysis, researchers concluded that bicyclists with the vitamins C and E blunted the adverse effects of ozone on measures of lung function. In another double-blind study, 17 adults (18 to 39 years old) were randomly assigned to receive either 400 IU per day of vitamin E and 500 mg per day of vitamin C or a placebo for five weeks.¹⁰⁹ Tests showing improved measures of lung function led researchers to conclude that supplementation with vitamins C and E inhibited the decline in pulmonary function induced in asthmatics by exposure to air pollutants. Also using a double-blind design, another study of 158 children with asthma living in Mexico City were randomly assigned to receive, a daily supplement containing 50 mg of vitamin E and 250 mg of vitamin C or a placebo.¹¹⁰ Tests results suggested that supplementing with vitamins C and E may reduce the adverse effect of ozone exposure on lung function of children with moderate to severe asthma.