I wanted to focus this post on Asthma- what the recommendations are in treating it, what alternative treatments there are that claim to help it, and if there is any evidence for any of these alternative treatments.
An audio version of this report with a few extras can be found here, episode #336.
Firstly, some facts about asthma.
Asthma is a condition in which people have sensitive airways which react to certain triggers, resulting in various symptoms which range from mild to severe and life threatening.
The trachea, or windpipe, branches into the left and right primary bronchi, which lead in to the left and right lungs. Branching off from the primary bronchi are the secondary and tertiary bronchi, which are progressively smaller again, before branching into the bronchioles, the smallest airway passages. The bronchioles are where asthma affects people. Bronchioles range in diameter from about half a millimetre to one millimetre. The smallest bronchioles join up with little grape-like sacs called alveoli, each sack about the size of a grain of sugar, where gas exchange takes place between the airways and the circulatory system.
There are 3 main factors that cause the bronchioles to become narrowed-
- The inside lining of the bronchioles becomes red and inflamed;
- Extra mucous may be produced which can reduce the diameter of the airways and
- Muscles that surround the bronchioles start to go into spasm- called ‘bronchospasm’, which can contribute to overall bronchoconstriction. This can then lead to coughing, shortness of breath, wheezing and chest tightness.
One in 10 people in Australia have asthma- that’s over 2 million people. There are links to both genetics and the environment which contribute to the causes of asthma. People can have different triggers for their asthma- that is, for different people, different things will cause an asthma attack.
Some common triggers for asthma include cigarette smoke- around 40 per cent of children under the age of 14 years with asthma live with smokers and are likely to be exposed to second-hand smoke. Other common triggers are colds and flu, dust mites, mould, extremes of emotion, pollen, exercise, and pets.
There is currently no cure for asthma, but with the right medication or medications, it can be well controlled and people can lead normal, active lives. If not managed properly, asthma has the potential not only to impact negatively on a person’s quality of life, it can be life threatening. At the moment, more than one person dies every day in Australia from asthma.
For more information about asthma, take a look at asthmaaustralia.org.au.
Now. For the legitimate treatments for asthma before I get on to the alternative, unproven treatments.
Asthma medications are grouped according to their purpose. For example, there are the Reliever medications, which, as the name suggests, are designed to relieve the asthma attack as it is happening. Probably the most common one that people are aware of would be Ventolin, in a blue puffer.
From feedback during my first aid courses, many people don’t realise that using the puffer on its own, directly into the mouth, only delivers about 1/3 of the medicated dose to the bronchioles, where it is needed. This is why a spacer should always be used in conjunction with the puffer- it ensures that the majority of the dose gets to where it is needed.
Then there are the preventers, that are designed to make the airways less sensitive over time, reducing redness and swelling, and helping to dry up mucous. These medications need to be taken every day and will not work in an emergency situation- that is, an acute asthma attack. Ii is not uncommon to hear of people discarding their preventer medications as a result of them not having suffered an asthma attack for a while, not realising that it is precisely because of their preventer medication that they have been symptom free. There are also medications called symptom controllers, that are taken in conjunction with preventers. There are combination medications, which combine the symptom controllers with preventers. So, it can all get a bit complicated, and it may be a while from initial diagnosis to finding the right medication or combination of medications that work for each individual.
Now to the unproven, alternative treatments for asthma.
These are listed on the Asthma Australia website as unproven remedies. This is great- for a peak body to address the alternative treatments out there and to state which ones do and don’t have legitimacy. The ones that don’t: Acupuncture. Air ionisers. Homeopathy, Vitamin C. Probiotics. Bowen Therapy Chiropractic. Osteopathy. Reflexology. Reiki. Vibrational Therapy. Cupping. Moxibustion. The Paleo diet. All of the above have no evidence to support their use in the management of acute or chronic asthma.
A common myth is that ingesting milk will increase mucous production and should therefore be avoided for people with asthma and other respiratory conditions. This is false, unless the person specifically has a dairy intolerance or allergy which can cause respiratory tract symptoms.
So, are there any alternative therapies for asthma that work?
Firstly- Breathing excercises. In people who suffer from mild asthma, some research suggests that certain breathing exercises may have a beneficial effect on long-term management of asthma, and perhaps in the case of acute asthma episodes. Results vary depending on the type of breathing excercises used and the severity of the person’s asthma. Breathing exercises are not recommended as a substitute for using reliever medication when required. A GP or specialist should be consulted about which specific breathing exercises may help.
The Asthma Foundation states that there is some evidence that various herbs can improve asthma symptoms, but that the benefits of using herbal medicine are “much less than those you can gain from the lowest dose of an inhaled corticosteroid preventer medication- the main problems with herbal medicines are a lack of standardisation of the contents and dose, and the risk of side effects.” Checking with a doctor prior to taking any herbs is very important- some are contraindicated for use during pregnancy, and some may interfere with other medications that the patient is on.
Massage- there is some evidence that it may reduce the need of reliever use in children. Keeping in mind that massage aids in relaxation, and that one trigger for asthma is stress, this is unsurprising. It is however important to ensure that whatever oils the massage therapist is using will not in themselves be a trigger for asthma.
Magnesium supplementation has had some positive effects on asthma symptoms- again, only advisable after consultation with the treating physician.
Folic acid- recent research has shown that taking high dose folic acid supplements throughout the entire duration of pregnancy actually increased the risk of having a child with asthma by about 30%- this did not include low dose folic acid from natural sources such as green leafy vegetables. It is still important for women to take folic acid for the first 16 weeks of pregnancy to reduce the chances of neural tube defects in the developing foetus.
Finally- Asthma is the most common underlying medical condition for those that need to be hospitalised for Influenza. It is important for asthmatics to have an annual flu vaccine in order to help prevent infection, and for the rest of us, to contribute to herd immunity and to help prevent the spread of disease. Talk to your GP about vaccinations or learn more at www.nrvs.info (disclosure- I am an administrator of that group, The Northern Rivers Vaccination Supporters).