In our last article, we talked about the mechanisms of how asthma affects the body. When exposed to an allergen (an allergy-causing substance), the body responds by the airways swelling, the muscles that surround them tightening and respiration (especially exhalation) becoming an exertion. Without treatment, the attack will often improve after a while, but sometimes it doesn’t, causing a life-threatening condition known as “status asthmaticus“.

The cornerstones of asthma treatment are the avoidance of “trigger” allergens, as mentioned previously, and the maintenance of open airways. Medications come in one of two forms: drugs that give quick relief from an attack and drugs that control the frequency of asthmatic episodes over time.

Quick relief drugs include “bronchodilators” that open airways, such as Albuterol (Ventolin, Proventil), among others. These drugs should open airways in a very short period of time and give significant relief. These drugs are sometimes useful for people going into a situation where they know they will exposed to a “trigger”, such as before strenuous exercise. Don’t be surprised if you notice a rapid heart rate on these medications; it’s a common side effect.

If you find yourself using quick-relief asthmatic medications more than twice a week, you are a candidate for daily control therapy. These drugs work, when taken daily, to decrease the number of episodes and are usually some form of inhaled steroid. There are long-acting bronchodilators as well, such as ipratropium bromide (Atrovent). Another family of drugs known as Leukotriene modifiers prevents airway swelling before an asthma attack even begins. These are usually in pill form and may make sense for storage purposes. The most popular is Montelukast (Singulair).

Often, medications will be used in combination, and you might find multiple medications in the same inhaler. U.S. commercial product Advair, for example, contains both a steroid and an airway dilator. Remember that inhalers lose potency over time. Expired inhalers, unlike many drugs in pill or capsule form, have less effect than fresh ones.

It’s important to figure out what allergens trigger your asthma attacks and work out a plan to avoid them as much as possible. Furthermore, make sure to stockpile as much of your asthma medication as possible in case of emergency. Physicians are usually sympathetic to requests for extra prescriptions from their asthmatic patients.

In mild to moderate cases, you might consider the use of natural remedies. There are actually quite a few substances that have been reported to be helpful:

Ginger: A study published in the American Journal of Respiratory Cell and Molecular Biology indicates that Ginger is instrumental in inhibiting chemicals that constrict airways. Animal tests find that extracts of Ginger helps ease asthmatic symptoms in rodents. Use as a tea or extract twice a day.

Ginger and Garlic Tea: Put four minced garlic cloves in some ginger tea while it’s hot. Cool it down and drink twice a day. Some have reported a beneficial effect with just the garlic.

Other herbal teas: Ephedra, Coltsfoot, Codonopsis, Butterbur, Nettle, Chamomile, and Rosemary all have been used in the past to improve an asthmatic attack.

Coffee: Black unsweetened coffee is a stimulant that might make your lung function better when you are having an attack. Don’t drink more than 12 ounces at a time, as coffee can dehydrate you. Interestingly, coffee is somewhat similar in chemical structure to the asthma drug Theophylline.

Eucalyptus: Essential oil of eucalyptus, used in a steam or direct inhalation, is well-known to open airways. Rub a few drops of oil between your hands and breathe in deeply. Alternatively, a few drops in some steaming water will be good respiratory therapy.

Honey: Honey was used in the 19th century to treat asthmatic attacks. Breathe deeply from a jar of raw unprocessed honey and look for improvement in a few minutes. To decrease the frequency of attacks, stir one teaspoon of honey in a twelve ounce glass of water and drink it three times daily.

Turmeric: Take one teaspoon of turmeric powder in 6-8 ounces of warm water three times a day.

Licorice and Ginger: Mix licorice and ginger (1/2 teaspoon of each) in a cup of water. Warning: Licorice can raise your blood pressure.

Black Pepper, Onion, and Honey: Drink ¼ cup of onion juice with a tablespoon of honey, after adding 1/8 tablespoon of black pepper.

Mustard Oil Rub: Mix mustard oil with camphor and rub it on your chest and back. There are claims that it gives instant relief in some cases.

Gingko Biloba leaf extract: Thought to decrease hypersensitivity in the lungs; not for people who are taking aspirin or ibuprofen daily, or anticoagulants like Coumadin.

Vitamin D: Some asthmatics have been diagnosed with Vitamin D deficiency.

Lobelia: Native Americans actually smoked this herb as a treatment for asthma. Instead of smoking, try mixing tincture of lobelia with tincture of cayenne in a 3:1 ratio. Put 1 milliliter (about 20 drops) of this mixture in water at the start of an attack and repeat every thirty minutes or so.

Further research is necessary to determine the amount of effect that the above remedies have on severe asthma, so take standard medications if your peak flow reading is 60% or less than normal.

Don’t underestimate the effect of your diet on your condition. Asthmatics should:

• Replace animal proteins with plant proteins.
• Increase intake of Omega-3 fatty acids.
• Eliminate milk and other dairy products.
• Eat organically whenever possible.
• Eliminate trans-fats; use extra-virgin olive oil as your main cooking oil.
• Always stay well-hydrated; more fluids will make your lung secretions less viscous.

Finally, various breathing methods, such as taught in Yoga classes, are thought to help promote well-being and control the panic response seen in asthmatic attacks. Acupuncture is thought by some to have some promise as well in treating the condition.

Joe Alton, MD