 |
 |
|
||||||||||||
 |
||||||||||||||
 |
 |
|
 |
|||||||||||
|
||||||||||||||
What you need to know
Don’t let asthma knock the wind out of you. Asthma is a lung disorder characterised by sudden fits of wheezing, coughing, or shortness of breath. According to research or other evidence, the following self-care steps may be helpful:
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or chemist. Continue reading the full asthma article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful. About asthmaAsthma is a lung disorder in which spasms and inflammation of the bronchial passages restrict the flow of air in and out of the lungs. The number of people with asthma and the death rate from this condition have been increasing since the late 1980s. Environmental pollution may be one of the causes of this growing epidemic. Work exposure to flour or cotton dust, animal fur, smoke, and a wide variety of chemicals has been linked to increased risk of asthma.1 Findings from animal and human studies confirm that DTP (diphtheria and tetanus toxoids and pertussis) and tetanus vaccinations can induce allergic responses,2 3 4 5 6 and can increase the risk of allergies, including allergic asthma. An analysis of data from nearly 14,000 babies and children revealed that having a history of asthma is twice as great among those who were vaccinated with DTP or tetanus vaccines than among those who were not.7 Product ratings for asthma
What are the symptoms?An asthma attack usually begins with sudden fits of wheezing, coughing, or shortness of breath. However, it may also begin insidiously with slowly increasing manifestations of respiratory distress. A sensation of tightness in the chest is also common. Dietary changes that may be helpfulA vegan (pure vegetarian) diet given for one year in conjunction with many specific dietary changes (such as avoidance of caffeine, sugar, salt, and chlorinated tap water) and combined with a variety of herbs and supplements led to significant improvement in one group of asthmatics.8 Although 16 out of 24 people who continued the intervention for the full year were much better and one person was actually cured, it remains unclear how much of the action was purely a result of the dietary changes compared with the many other therapies employed. Vitamin C, an anti-oxidant present in fruits and vegetables, is a powerful anti-oxidant and anti-inflammatory. This anti-inflammatory activity may influence the development of asthma symptoms. A large preliminary study has shown that young children with asthma experience significantly less wheezing if they eat a diet high in fruits rich in vitamin C.9 Studies suggest that high salt intake may have an adverse effect on asthma, particularly in men. In a small, preliminary trial, doubling salt intake for one month led to a small increase in airway reactivity (indicating a worsening of asthma) in men with asthma, as well as in non-asthmatics.10 A few double-blind trials have provided limited evidence of clinical improvement following a period of sodium restriction.11 12 13 14 It is difficult to compare the results of these studies because they used different amounts of sodium restriction. However, they consistently suggest that increased dietary sodium may aggravate asthma symptoms, especially in men.15 Although most people with asthma do not suffer from food allergies,16 unrecognised food allergy can be an exacerbating factor.17 A medically supervised “allergy elimination diet,” followed by reintroduction of the eliminated foods, often helps identify problematic foods. A healthcare professional must supervise this allergy test because of the possibility of triggering a severe asthma attack during the reintroduction.18 Some asthmatics react to food additives, such as sulphites, tartrazine (yellow dye #5), and sodium benzoate, as well as natural salicylates (aspirin-like substances found in many foods).19 20 A doctor or an allergist can help determine whether chemical sensitivities are present. Lifestyle changes that may be helpfulBeing overweight increases the risk of asthma.21 Obese people with asthma may improve their lung-function symptoms and overall health status by engaging in a weight-loss programme. A controlled study found that weight loss resulted in significant decreases in episodes of shortness of breath, increases in overall breathing capacity, and decreases in the need for medication to control symptoms.22 Other therapiesMedical management of asthma includes controlling environmental factors that can trigger an attack (animal dander, dust mites, airborne moulds and pollens, and certain foods). Vitamins that may be helpfulLycopene, an anti-oxidant related to beta-carotene and found in tomatoes, helps reduce the symptoms of asthma caused by exercising. In one double-blind trial,23 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. Vitamin B6 deficiency is common in asthmatics.24 This deficiency may relate to the asthma itself or to certain asthma drugs (such as theophylline and aminophylline) that deplete vitamin B6.25 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.26 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.27 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.28 Magnesium levels are frequently low in asthmatics.29 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,30 31 32 33 but not all,34 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.35 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.36 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.37 Pycnogenol is a proprietary mixture of flavonoids extracted from the bark of a French maritime pine tree. In a double-blind trial, supplementing with pycnogenol significantly improved lung function and asthma symptoms and significantly reduced the need for rescue medication in a group of children (ages 6 to 18 years) with asthma.38 In contrast, no significant changes were seen in the placebo group. The amount of pycnogenol used was 1 mg per pound of body weight per day, in two divided doses, for three months. Supplementation with 1 gram of vitamin C per day reduces the tendency of the bronchial passages to go into spasm,39 an action that has been confirmed in double-blind research.40 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.41 42 Two other preliminary trials found that vitamin C supplementation reduced bronchial reactivity to metacholine, a drug that causes bronchial constriction.43 44 However, other studies,45 including two double-blind trials,46 47 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.48 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).49 People with low levels of selenium have a high risk of asthma.50 51 52 53 54 Asthma involves free-radical damage55 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.56 Most doctors recommend 200 mcg per day for adults (and proportionately less for children)—a much higher, though still safe, level. Double-blind research shows that fish oil partially reduces reactions to allergens that can trigger attacks in some asthmatics.57 Another double-blind study showed that fish oil supplements prevented exercise-induced asthma attacks in people with asthma.58 A few other researchers have reported small but significant improvements when asthmatics supplement with fish oil,59 60 but reviews of the research concluded that most fish oil studies showed little or no benefit.61 62 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.63 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.64 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.65 Each capsule of Lyprinol contains 50 mg of omega-3 fatty acids. A study conducted many years ago showed that 80% of children with asthma had hypochlorhydria (low stomach acid). Supplementation with hydrochloric acid (HCl) in combination with avoidance of known food allergens led to clinical improvement in this preliminary trial.66 In more recent times, HCl has usually been supplemented in the form of betaine HCl. The amount needed depends on the severity of hypochlorhydria and on the size of a meal. Because it is a fairly strong acid, betaine HCl should be used only with medical supervision. In some people with asthma, symptoms can be triggered by ingestion of food additives known as sulphites. Pretreatment with a large amount of vitamin B12 (1,500 mcg orally) reduced the asthmatic reaction to sulphites in children with sulphite sensitivity in one preliminary trial.67 The trace mineral molybdenum also helps the body detoxify sulphites.68 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,69 and preliminary short-term trials have used supplemental amounts of 500 mcg per day.70 People who suspect sulphite-sensitive asthma should consult with a physician before taking molybdenum. Quercetin, a flavonoid found in most plants, has an inhibiting action on lipoxygenase, an enzyme that contributes to problems with asthma.71 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. Bromelain reduces the thickness of mucus, which may be beneficial for those with asthma,72 though clinical actions in asthmatics remain unproven. 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 anti-oxidant 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.73 More research is needed to confirm this promising finding. 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.74 75 76 77 Presumably this clinical improvement is the result of restoration of proper control over immune function. Are there any side effects or interactions? Herbs that may be helpfulThere are two categories of herbs generally used for people with asthma. These are herbs that help dilate the airways and herbs that are anti-inflammatory. Herbs in each category are summarized in the table below.
Amrita bindu is an Ayurvedic herbal preparation that contains a mixture of 13 salts and spices. It has been shown to have anti-oxidant 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.78 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. One double-blind trial has investigated the effects of the Ayurvedic herb boswellia in people with acute bronchial asthma.79 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.80 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.81 Therefore more rigorous studies are needed to know how effective butterbur is in people with asthma. A small double-blind trial found that a constituent of coleus, called forskolin, when inhaled, could decrease lung spasms in asthmatics compared to placebo.82 Coleus extracts standardised 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. Animal studies have found that extracts of holy basil (Ocimim sanctum) inhibit constriction of the bronchial airway passages.83 Two preliminary clinical trials treated asthma patients with 500 mg of holy basil three times daily for one month.84 85 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.86 Two preliminary trials have shown picrorhiza to be of benefit in asthma.87 88 However, a follow-up double-blind trial did not confirm these earlier results.89 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. 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.90 In a follow-up double-blind trial, an alcoholic extract of crude tylophora leaves had comparable effects to that of chewing the crude leaf.91 Another double-blind trial found 350 mg of tylophora leaf powder per day increased the lungs’ capacity for oxygen and reduced night-time shortness of breath, but was not as effective as an antiasthmatic drug combination.92 A fourth double-blind trial found no significant changes in lung volume measurements or asthmatic symptoms after treatment with 400 mg per day tylophora.93 Traditionally, herbs that have a soothing action on bronchioles are also used for asthma. These include marshmallow, mullein, hyssop, and liquorice. Elecampane has been used traditionally to treat coughs associated with asthma.94 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.95 A controlled trial used a highly concentrated tincture of ginkgo leaf and found this preparation helped decrease asthma symptoms.96 For asthma, 120 to 240 mg of standardised ginkgo or 3 to 4 ml of regular tincture three times daily can be used. 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.97 98 99 Saiboku-to has been extensively studied in the laboratory and has been shown to have numerous anti-inflammatory actions.100 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, liquorice, perilla, ginger and jujube. 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.101 Traditionally, it was used by Eclectics to treat coughs and spasms in the lungs from all sorts of causes.102 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.103 Onion may act as an anti-inflammatory in people with asthma. Human studies have shown onion can be a strong anti-inflammatory.104 However, some people with asthma may experience an exacerbation of symptoms if they are allergic to onion and are exposed to it.105 Are there any side effects or interactions? Integrated approaches that may be helpfulA set of breathing exercises called Buteyko breathing techniques has been reported to significantly reduce the need for prescription drugs for people with asthma.106 Although the people in this controlled trial experienced an improved quality of life while doing these exercises, objective measures of breathing capacity did not improve, despite the decreased need for drugs. Antibiotic use during the first year or two of life has been associated with an increased risk of asthma in preliminary studies.107 108 Whether this association might result from allergic versus non-allergic effects remains unknown. However, the association does suggest that, until more is known, gratuitous use of antibiotics in early childhood (e.g., to inappropriately treat viral diseases) should be reconsidered. Of course, the appropriate use of antibiotics in the treatment of infections as necessary should not be avoided. Concerns should be discussed with the prescribing physician. Acupuncture might be useful for some asthmatics. Case reports109 110 and preliminary trials111 112 113 have suggested acupuncture may be helpful for people with asthma, either as a treatment for an acute attack or as a longer term therapy for reducing the number or severity of attacks, decreasing the need for medications, and so on. Placebo-controlled trials using sham (“fake”) acupuncture, however, have been quite contradictory, many of them showing a strong placebo effect that is not significantly improved upon by real acupuncture.114 115 116 117 It is possible that needle insertion in non-acupuncture points has a stimulating effect that benefits asthma. The success of acupuncture may also depend on other factors, such as the type of asthma being treated and certain characteristics of the patient. Nonetheless, since some controlled research has demonstrated positive effects of real acupuncture, people with asthma may want to consider a trial of acupuncture treatment to see if it helps their individual cases. Chiropractic physicians have reported that manipulation may be helpful for patients with asthma.118 119 120 In a controlled study, chronic asthmatics received either real or sham chiropractic manipulations for four weeks, after which the treatments were switched for another four weeks. No improvement in measurements of lung function was found at the end of the study. In addition, while both the manipulation and the sham treatment groups reported significant decreases in asthma frequency and severity, there were no differences between the treatments.121 A larger controlled study compared chiropractic manipulation to sham manual treatments in children whose asthma was still a problem despite usual medical management.122 Both groups experienced a significant decrease in symptoms and need for medication, as well as small increases in ability to breathe. These benefits lasted for four months after the treatments were discontinued. Although there was no additional benefit of chiropractic compared to the sham treatments, it is possible that improvements in both groups were real, rather than placebo effects. The sham therapy, which consisted of “soft tissue massage and gentle palpation [touching],” may have had real effects. More research is needed to address this confusing issue. References1. Blanc PD, Eisner MD, Israel L, Yelin EH. The association between occupation and asthma in general medical practice. Chest 1999;115:1259–64. 2. Mark A, Bjorksten B, Granstrom M. Immunoglobulin E responses to diphtheria and tetanus toxoids after booster with aluminium-adsorbed and fluid DT-vaccines. Vaccine 1995;13:669–73. 3. Mark A, Bjorksten B, Granstrom M. Immunoglobulin E and G antibodies two years after a booster dose of an aluminium-adsorbed or a fluid DT vaccine in relation to atopy. Pediatr Allergy Immunol 1997;8:83–7. 4. Odelram H, Granstrom M, Hedenskog S, et al. Immunoglobulin E and G responses to pertussis toxin after booster immunization in relation to atopy, local reactions and aluminium content of the vaccines. Pediatr Allergy Immunol 1994;5:118–23. 5. Aebischer I, Stadler BM. TH1-TH2 cells in allergic responses: at the limits of a concept. Adv Immunol 1996;61:341–403 [review]. 6. Sen DK, Arora S, Gupta S, Sanyal RK. Studies of adrenergic mechanisms in relation to histamine sensitivity in children immunized with Bordetella pertussis vaccine. J Allergy Clin Immunol 1974;54:25–31. 7. Hurwitz EL, Morgenstern H. Effects of diphtheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States. J Manipulative Physiol Ther 2000;23:81–90. 8. Lindahl O, Lindwall L, Spangberg A, et al. Vegan regimen with reduced medication in the treatment of bronchial asthma. J Asthma 1985;22:45–55. 9. Forastiere F, Pistelli R, Sestini P, et al. Consumption of fresh fruit rich in vitamin C and wheezing symptoms in children. SIDRIA Collaborative Group, Italy (Italian Studies on Respiratory Disorders in Children and the Environment). Thorax 2000;55:283–8. 10. Javaid A, Cushley MJ, Bone MF. Effect of dietary salt on bronchial reactivity to histamine in asthma. BMJ 1988;297:454. 11. Burney PG, Neild JE, Twort CH, et al. Effect of changing dietary sodium on the airway response to histamine. Thorax 1989;44:36–41. 12. Carey OJ, Locke C, Cookson JB. Effect of alterations of dietary sodium on the severity of asthma in men. Thorax 1993;48:714–8. 13. Medici TC, Schmid AZ, Hacki M, Vetter W. Are asthmatics salt-sensitive? A preliminary controlled study. Chest 1993;104:1138–43. 14. Gotshall RW, Mickleborough TD, Cordain L. Dietary salt restriction improves pulmonary function in exercise-induced asthma. Med Sci Sports Exerc 2000;32:1815–9. 15. Fogarty A, Britton J. The role of diet in the aetiology of asthma. Clin Exp Allergy 2000;30:615–27. 16. Chiaramonte LT, Altman D. Food sensitivity in asthma: perception and reality. J Asthma 1991;28:5–9. 17. Rowe AH, Young EJ. Bronchial asthma due to food allergy alone in ninety-five patients. JAMA 1959;169:1158. 18. Sampson HA, Mendelson L, Rosen JP. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med 1992;327:380. 19. Genton C, Frei PC, Pecoud A. Value of oral provocation tests to aspirin and food additives in the routine investigation of asthma and chronic urticaria. J Asthma 1985;76:40–5. 20. Townes SJ, Mellis CM. Role of acetyl salicylic acid and sodium metabisulfite in chronic childhood asthma. Pediatrics 1984;73:631–7. 21. Camargo CA Jr, Weiss ST, Zhang S, et al. Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Arch Intern Med 1999;159:2582–8. 22. Stenius-Aarniala B, Poussa T, Kvarnstrom J, et al. Immediate and long term effects of weight reduction in obese people with asthma: randomised controlled study. BMJ 2000;320:827–32. 23. Neuman I, Nahum H, Ben-Amotz A. Reduction of exercise-induced asthma oxidative stress by lycopene, a natural antioxidant. Allergy 2000;55:1184–9. 24. Collipp PJ, Chen SY, Sharma RK, et al. Tryptophane metabolism in bronchial asthma. Ann Allergy 1975;35:153–8. 25. Weir MR, Keniston RC, Enriquez JI, McNamee GA. Depression of vitamin B6 levels due to theophylline. Ann Allergy 1990;65:59–62. 26. Collipp PJ, Goldzier S III, Weiss N, et al. Pyridoxine treatment of childhood bronchial asthma. Ann Allergy 1975;35:93–7. 27. Reynolds RD, Natta CL. Depressed plasma pyridoxal phosphate concentrations in adult asthmatics. Am J Clin Nutr 1985;41:684–8. 28. Sur S, Camara M, Buchmeier A, et al. Double-blind trial of pyridoxine (vitamin B6) in the treatment of steroid-dependent asthma. Ann Allergy 1993;70:141–52. 29. Haury VG. Blood serum magnesium in bronchial asthma and its treatment by the administration of magnesium sulfate. J Lab Clin Med 1940;26:340–4. 30. Skobeloff EM, Spivey WH, McNamara RM, Greenspon L. Intravenous magnesium sulfate for the treatment of acute asthma in the emergency department. JAMA 1989;262:1210–3. 31. Brunner EH, Delabroise AM, Haddad ZH. Effect of parenteral magnesium on pulmonary function, plasma cAMP, and histamine in bronchial asthma. J Asthma 1985;22:3–11. 32. Rolla G, Bucca C, Caria E, et al. Acute effect of intravenous magnesium sulfate on airway obstruction of asthmatic patients. Ann Allergy 1988;61:388–91. 33. Hill JM, Britton J. Effect of intravenous magnesium sulphate on airway calibre and airway reactivity to histamine in asthmatic subjects. Br J Clin Pharmacol 1996;42:629–31. 34. Bernstein WK, Khastgir T, Khastgir A, et al. Lack of effectiveness of magnesium in chronic stable asthma. A prospective, randomized, double-blind, placebo-controlled, crossover trial in normal subjects and in patients with chronic stable asthma. Arch Intern Med 1995;155:271–6. 35. Rylander R, Dahlberg C, Rubenowitz E. Magnesium supplementation decreases airway responsiveness among hyperreactive subjects. Magnesium-Bulletin 1997;19:4–6. 36. Hill J, Micklewright A, Lewis S, Britton J. Investigation of the effect of short-term change in dietary magnesium intake in asthma. Eur Respir J 1997;10:2225–9. 37. Gontijo-Amaral C, Ribeiro MAGO, Gontijo LSC, et al. Oral magnesium supplementation in asthmatic children: a double-blind randomized placebo-controlled trial. Eur J Clin Nutr 2007;61:54–60. 38. Lau BH, Riesen SK, Truong KP, et al. Pycnogenol as an adjunct in the management of childhood asthma. J Asthma 2004;41:825–32. 39. Zuskin E, Valic F, Bouhuys A. Byssinosis and airway responses due to exposure to textile dust. Lung 1976;154:17–24. 40. Bucca C, Rolla G, Oliva A, Farina J-C. Effect of vitamin C on histamine bronchial responsiveness of patients with allergic rhinitis. Ann Allergy 1990;65:311–4. 41. Schachter EN, Schlesinger A. The attenuation of exercise-induced bronchospasm by ascorbic acid. Ann Allergy 1982;49:146–51. 42. Tecklenburg SL, Mickleborough TD, Fly AD, et al. Ascorbic acid supplementation attenuates exercise-induced bronchoconstriction in patients with asthma. Respir Med 2007;Apr 4:Epub ahead of print. 43. Mohsenin V, Dubois AB, Douglas JS. Effect of ascorbic acid on response to methacholine challenge in asthmatic subjects. Am Rev Respir Dis 1983;127:143–7. 44. Zuskin E, Lewis AJ, Bouhuys A. Inhibition of histamine-induced airway constriction by ascorbic acid. J Allergy Clin Immunol 1973;51:218–26. 45. Ting S, Mansfield LE, Yarbrough J. Effects of ascorbic acid on pulmonary functions in mild asthma. J Asthma 1983;20:39–42. 46. Malo JL, Cartier A, Pineau L, et al. Lack of acute effects of ascorbic acid on spirometry and airway responsiveness to histamine in subjects with asthma. J Allergy Clin Immunol 1986;78:1153–8. 47. Kordansky DW, Rosenthal RR, Norman PS. The effect of vitamin C on antigen-induced bronchospasm. J Allergy Clin Immunol 1979;63:61–4. 48. Anah CO, Jarike LN, Baig HA. High dose ascorbic acid in Nigerian asthmatics. Trop Geogr Med 1980;32:132–7. 49. Ruskin SL. Sodium ascorbate in the treatment of allergic disturbances. The role of adrenal cortical hormone-sodium-vitamin C. Am J Dig Dis 1947;14:302–6. 50. Stone J, Hinks LJ, Beasley R, et al. Reduced selenium status of patients with asthma. Clin Sci 1989;77:495–500. 51. Flatt A, Pearce N, Thomson CD, et al. Reduced selenium in asthmatic subjects in New Zealand. Thorax 1990;45:95–9. 52. Kadrabova J, Mad’aric A, Kovacikova Z, et al. Selenium status is decreased in patients with intrinsic asthma. Biol Trace Elem Res 1996;52:241–8. 53. Misso NL, Powers KA, Gillon RL, et al. Reduced platelet glutathione peroxidase activity and serum selenium concentration in atopic asthmatic patients. Clin Exp Allergy 1996;26:838–47. 54. Shaw R, Woodman K, Crane J, et al. Risk factors for asthma symptoms in Kawerau children. N Z Med J 1994;107:387–91. 55. Owen S, Pearson D, Suarez-Mendez V, et al. Evidence of free-radical activity in asthma. N Engl J Med 1991;325:586–7 [letter]. 56. Hasselmark L, Malmgren R, Zetterstrom O, Unge G. Selenium supplementation in intrinsic asthma. Allergy 1993;48:30–6. 57. Arm JP, Horton CE, Eiser NM, et al. The effects of dietary supplementation with fish oil on asthmatic responses to antigen. J Allergy Clin Immunol 1988;81:183 [abstract #57]. 58. Mickleborough TD, Lindley MR, Ionescu AA, Fly AD. Protective effect of fish oil supplementation on exercise-induced bronchoconstriction in asthma. Chest 2006;129:39–49. 59. Broughton KS, Johnson CS, Pace BK, et al. Reduced asthma symptoms with n-3 fatty acid ingestion are related to 5-series leukotriene production. Am J Clin Nutr 1997;65:1011–7. 60. Dry J, Vincent D. Effect of a fish oil diet on asthma: results of a 1-year double-blind study. Int Arch Allergy Appl Immunol 1991;95:156–7. 61. Thien FC, Woods RK, Waters EH. Oily fish and asthma—a fishy story? Med J Aust 1996;164:135–6 [editorial]. 62. Fogarty A, Britton J. The role of diet in the aetiology of asthma. Clin Exp Allergy 2000;30:615–27. 63. Hodge L, Salome CM, Peat JK, et al. Consumption of oily fish and childhood asthma risk. Med J Austral 1996;164:137–40. 64. Nagakura T, Matsuda S, Shichijyo K, et al. Dietary supplementation with fish oil rich in omega-3 polyunsaturated fatty acids in children with bronchial asthma. Eur Respir J 2000;16:861–5. 65. Emelyanov A, Fedoseev G, Krasnoschekova O, et al. Treatment of asthma with lipid extract of New Zealand green-lipped mussel: a randomised clinical trial. Eur Respir J 2002;20:596–600. 66. Bray GW. The hypochlorhydria of asthma in childhood. Q J Med 1931;24:181–97. 67. Anibarro B, Caballero T, Garcia-Ara C, et al. Asthma with sulfite intolerance in children: A blocking study with cyanocobalamin. J Allergy Clin Immunol 1992;90:103–9. 68. Johnson JL, Wuebbens MM, Mandell R, Shih VE. Molybdenum cofactor deficiency in a patient previously characterized as deficient in sulfite oxidase. Biochem Med Metabol Biol 1988;40:86–93. 69. Sardesai VM. Molybdenum: an essential trace element. Nutr Clin Pract 1993;8:277–81. 70. Moss M. Effects of molybdenum on pain and general health: a pilot study. J Nutr Environ Med 1995;5:55–61. 71. Welton AF, Tobias LD, Fiedler-Nagy C, et al. Effect of flavonoids on arachidonic acid metabolism. Prog Clin Biol Res 1986;213:231–42. 72. Schafer A, Adelman B. Plasma inhibition of platelet function and of arachidonic acid metabolism. J Clin Invest 1985;75:456–61. 73. Neuman I, Nahum H, Ben-Amotz A. Prevention of exercise-induced asthma by a natural isomer mixture of beta-carotene. Ann Allerg Asthma Immunol 1999;82:549–53. 74. Cazzola P, Mazzanti P, Bossi G. In vivo modulating effect of a calf thymus acid lysate on human T lymphocyte subsets and CD4+/CD8+ ratio in the course of different diseases. Curr Ther Res 1987;42:1011–7. 75. Kouttab NM, Prada M, Cazzola P. Thymomodulin: Biological properties and clinical applications. Med Oncol Tumor Pharmacother 1989;6:5–9 [review]. 76. Genova R, Guerra A. A thymus extract (thymomodulin) in the prevention of childhood asthma. Pediatr Med Chir 1983;5:395–402. 77. Bagnato A, Brovedani P, Comina P, et al. Long-term treatment with thymomodulin reduces airway hyperresponsiveness to methacholine. Ann Allergy 1989;62:425–8. 78. Kumar SS, Shanmugasundaram KR. Amrita Bindu—an antioxidant inducer therapy in asthma children. J Ethnopharmacol 2004;90:105–14. 79. Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res 1998;3:511–4. 80. REF:Lee DK, Haggart K, Robb FM, Lipworth BJ. Butterbur, a herbal remedy, confers complementary anti-inflammatory activity in asthmatic patients receiving inhaled corticosteroids. Clin Exp Allergy 2004; 34:110–4. 81. Danesch UC. Petasites hybridus (butterbur root) extract in the treatment of asthma—an open trial. Altern Med Rev 2004;9:54–62. 82. Bauer K, Dietersdorfer F, Sertl K, et al. Pharmacodynamic effects of inhaled dry powder formulations of fenoterol and colforsin in asthma. Clin Pharmacol Ther 1993;43:76–83. 83. Palit G, Singh SP, Singh N, et al. An experimental evaluation of antiasthmatic plant drugs from the ancient ayurvedic medicine. Asp Aller Appl Immunol 1983;16:36–41. 84. Singh SP, Sinha KN, Singh N, Kohli RP. Inula racemosa (Puskarmal), Terminalia belerica (Vibhitaki) and Ocimum sanctum (Tulsi) – a preliminary clinical trial in asthma patients. Proc Int Sem Clin Pharmacol Devel Count 1986;1:18–21. 85. Dixit KS, Singh SP, Sinha KN, et al. Inula racemosa (puskarmal), Terminalia belerica (Bibhitaka) and Ocimum sanctum (Tulsi) – a preliminary clinical trial in asthma patients. Proc Int Sem Clin Pharmacol Devel Count 1986;2:22–27. 86. Mansfeld HJ, Höhre H, Repges R, Dethlefsen U. Therapy of bronchial asthma with dried ivy leaf extract. Münch Med Wschr 1998;140:32–6. 87. Rajaram D. A preliminary clinical trial of Picrorrhiza kurroa in bronchial asthma. Indian J Pharmacol 1975;7:95–6. 88. Shan BK, Kamat SR, Sheth UK. Preliminary report of use of Picrorrhiza kurroa root in bronchial asthma. J Postgrad Med 1977;23:118–20. 89. Doshi VB, Shetye VM, Mahashur AA, Kamat SR. Picrorrhiza kurroa in bronchial asthma. J Postgrad Med 1983;29:89–95. 90. Shivpuri DN, Menon MPS, Prakash D. A crossover double-blind study on Tylophora indica in the treatment of asthma and allergic rhinitis. J Allergy 1969;43:145–50. 91. Shivpuri DN, Singhal SC, Parkash D. Treatment of asthma with an alcoholic extract of Tylophora indica: a cross-over, double-blind study. Ann Allergy 1972;30:407–12. 92. Thiruvengadam KV, Haranatii K, Sudarsan S, et al. Tylophora indica in bronchial asthma: a controlled comparison with a standard anti-asthmatic drug. J Indian Med Assoc 1978;71:172–6. 93. Gupta S, George P, Gupta V, et al. Tylophora indica in bronchial asthma—a double blind study. Ind J Med Res 1979;69:981–9. 94. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics. New York: John Wiley & Sons, 1996, 222–4. 95. Guinot P, Brambilla C, Dunchier J, et al. Effect of BN 52063, a specific PAF-ascether antagonist, on bronchial provocation test to allergens in asthmatic patients—a preliminary study. Prostaglandins 1987;34:723–31. 96. Li M, Yang B, Yu H, Zhang H. Clinical observation of the therapeutic effect of ginkgo leaf concentrated oral liquor on bronchial asthma. Chinese J Integrative & Western Med 1997;3:264–7. 97. Kimura I. Immunologic aspects of kampo medicine. Ann NY Acad Sci 1993;685:529–42. 98. Egashira Y, Nagano H. A multicenter clinical trial of TJ-96 in patients with steroid-dependent bronchial asthma. Ann NY Acad Sci 1993;685:580–3. 99. Nakajima S, Tohda Y, Ohkawa K, et al. Effects of saiboku-to (TJ-96) on bronchial asthma. Ann NY Acad Sci 1993;685:549–60. 100. Bielroy L, Lupoli K. Herbal interventions in asthma and allergy. J Asthma 1999;36:1–65 [review]. 101. Felter HW, Lloyd JU. King’s American Dispensatory, 18th ed. Sandy, OR: Eclectic Medical Publications, 1898, 1983, 1199–205. 102. Ellingwood F. American Materia Medica, Therapeutics and Pharmacognosy, 11th ed. Sandy, OR: Eclectic Medical Publications, 1919, 1998, 235–42. 103. Weiss RF. Herbal Medicine. Gothenberg, Sweden: Ab Arcanum and Beaconsfield: Beaconsfield Publishers Ltd, 1985:221–2 [trans. Meuss AR]. 104. Dorsch W, Ettl M, Hein G, et al. Anti-asthmatic effects of onions: inhibition of platelet-activating factor-induced bronchial construction by onion oils. Int Arch Allergy Appl Immunol 1987;82:535–6. 105. Valdivieso R, Subiza J, Varela-Losada S, et al. Bronchial asthma, rhinoconjunctivitis, and contact dermatitis caused by onion. J Allergy Clin Immunol 1994;94:928–30. 106. Bowler SD, Green A, Mitchell CA. Buteyko breathing techniques in asthma: a blinded randomised controlled trial. Med J Aust 1998;169:575–8. 107. Wickens K, Pearce N, Crane J, Beasley R. Antibiotic use in early childhood and the development of asthma. Clin Exp Allergy 1999;29:766–71. 108. Farooqi IS, Hopkin JM. Early childhood infection and atopic disorder. Thorax 1998;53:927–32. 109. Youguang J. Clinical applications of point Futu. J Tradit Chin Med 1986;6:6–8. 110. Minji W, Yancen Z. Clinical experience of Dr. Shao Jingming in treatment of diseases by puncturing back-shu points. J Tradit Chin Med 1996;16:23–6. 111. Zang J. Immediate antiasthmatic effect of acupuncture in 192 cases of bronchial asthma. J Tradit Chin Med 1990;10:89–93. 112. Sternfeld M, Fink A, Bentwich Z, Eliraz A. The role of acupuncture in asthma: changes in airways dynamics and LTC4 induced LAI. Am J Chin Med 1989;17:129–34. 113. Zwolfer W, Keznickl-Hillebrand W, Spacek A, et al. Beneficial effect of acupuncture on adult patients with asthma bronchiale. Am J Chin Med 1993;2:113–7. 114. Kleijnen J, ter Riet G, Knipschild P. Acupuncture and asthma: a review of controlled trials. Thorax 1991;46:799–802 [review]. 115. Jobst KA. Acupuncture in asthma and pulmonary disease: an analysis of efficacy and safety. J Altern Complement Med 1996;2:179–206 [review]. 116. Biernacki W, Peake MD. Acupuncture in treatment of stable asthma. Respir Med 1998;92:1143–5. 117. Medici TC. Acupuncture and bronchial asthma. Forsch Komplementarmed 1999;6 Suppl 1:26–8 [in German]. 118. Renaud C, Pinchette D. Chiropractic management of bronchial asthma: a literature review. J Chiropractic 1990;27:25–6 [review]. 119. Dennis D, Golden D. Manipulative therapy, an alternative treatment for asthma: a literature review. Chiropractic: The Journal of Chiropractic Research, Study and Clinical Investigation 1992;8(2)40–1 [review]. 120. Ziegler R, Carpenter D. The chiropractic approach to the treatment of asthma: a literature review. J Chiropractic 1992:29(6):71–3 [review]. 121. Nielsen NH, Bronfort, G. Bendix T. et al. Chronic asthma and chiropractic spinal manipulation: a randomized clinical trial. Clin Exp Allergy 1995, 25(1):80–8. 122. Balon J, Aker PD, Crowther ER, et al. A comparison of active and simulated chiropractic manipulation as adjunctive treatment for childhood asthma. N Engl J Med 1998 339(15):1013–20.  Copyright © 2007 Healthnotes, Inc. All rights reserved. www.healthnotes.com Learn more about Healthnotes, the company. Learn more about the authors of Healthnotes. The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or chemist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires September 2008. 2007-09-01 |
|||||||||||||||||||||||||||
Reliable and relatively
consistent scientific data showing a substantial health benefit.