All About Asthma: Managing Your Asthma: Complementary and alternative therapies

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All About Asthma: Managing Your Asthma: Complementary and alternative therapies
January 23, 2007
AOL Body
content provided by the Faculty of the Harvard Medical School



People use complementary and alternative therapies for asthma for many reasons. For one thing, medical treatment for asthma can be frustrating. Inhaled medications can be tricky to use properly, and daily medications can feel burdensome and can occasionally cause unpleasant side effects. Many people also worry about potential harmful side effects from long-term use of medications, especially steroids, despite their safety at conventional doses. Some people feel uncomfortable about putting any "foreign chemicals" into their bodies and would prefer to take no medicines at all, even aspirin. Moreover, faithful adherence to treatment programs does not guarantee freedom from asthma symptoms or from frightening asthma flare-ups. Some people turn to complementary therapies to get better control of their asthma.

Many complementary therapies remain unproven in either efficacy or safety. Others are just plain useless, the product of hucksterism, false hope, and greed. In addition, "natural" does not necessarily mean "harmless." Some natural therapies have proved to be dangerous. What follows is a brief review of some of the more popular complementary therapies for asthma and what researchers have learned about them from scientific study.

Acupuncture. According to Chinese medical theory, energy, or qi, flows through the body along pathways called meridians. Along the meridians are "points," where acupuncture needles can be inserted to restore the balance of energy flow thought to be disrupted by disease. The National Institutes of Health convened a panel in 1997 to look at existing research on acupuncture. The panel concluded that acupuncture has been shown to be effective for postoperative dental pain, the nausea of pregnancy, and nausea following surgery or chemotherapy. The panelists listed asthma in a group of conditions for which acupuncture was of uncertain benefit. They felt that it might be a potentially useful adjunctive treatment, but that more high-quality studies were needed.

Acupuncture

It remains unclear whether acupuncture helps people with asthma.

Biofeedback. Using visual or auditory feedback of biological information, some people have learned to control, at least partially, the functioning of involuntary muscles. For example, using biofeedback techniques, people have learned to deliberately slow their heart rate; this is considered an example of "mind-body" interaction and specifically the "relaxation response." One published experiment found that people who used biofeedback could learn to improve their lung function and decrease their need for anti-asthmatic medications compared with people in a control group receiving their usual asthma care. These results are exciting but preliminary, reflecting only one study of a small number of participants who were observed for a short period of time.

Chiropractic care. The idea that chiropractic treatment can make your asthma better derives from the view that nerve irritation caused by misalignment of the vertebrae adversely affects the chest wall and airways, and that correcting the misalignments can reverse these effects. However, in one carefully done study published in the New England Journal of Medicine, the addition of chiropractic spinal manipulations to usual medical care for a period of four months had no effect on the control of childhood asthma. The children who got real chiropractic treatment did not do significantly better than those who got simulated treatment. Similarly, in an earlier study of chiropractic treatment for adults with asthma, there was no significant improvement in the group that received real chiropractic treatment compared with the group that received simulated treatment.

Diet. Several theories maintain that changes in the Western diet since the mid-1980s may have contributed to making asthma more common in this country. However, large studies have found that for the most part there is no link between your diet and your asthma. Only sulfites -- preservatives commonly found in processed potatoes, shrimp, and dried fruit, as well as in wine and beer -- are known tocause asthma attacks, and they cause such attacks only in certain sulfite-sensitive people.

Seafood

Sulfites found in shrimp and other foods may trigger an asthma attack.

Certainly if you believe that something you are eating is making your asthma worse, by all means eliminate it from your diet. However, in general, we do not have enough information to recommend any special asthma-reducing diet applicable to people with asthma or allergies. You need not restrict your diet, nor supplement it in any way.

Herbs. Various kinds of herbs have been used around the world for thousands of years to treat asthma. Some modern drugs are related to these herbal sources. Ephedrine is derived from ma huang, an ancient Chinese herbal remedy for asthma. Theophylline is closely related to caffeine and was first isolated from tea leaves. Some people with asthma today use licorice root, slippery elm bark, and ginkgo biloba. However, convincing evidence is lacking that herbal remedies are effective for asthma, or even that they are safe.

Homeopathy. Another widely used complementary therapy, homeopathy is based on the principle that "like cures like" -- in other words, that small doses of certain drugs can alleviate the very symptoms that they themselves cause when given in large doses. Studies of homeopathic treatments for asthma have produced mixed results: Some showed modest improvements among patients treated with homeopathy; others found no difference between homeopathy and placebo treatment. However, it is difficult to draw clear conclusions from these studies because of their short duration, small number of participants, and use of different homeopathic remedies. In general, studying homeopathic remedies poses a special challenge because in regular practice the treatments are individualized. However, to date, using scientific methods, it has not been possible to show a clear-cut beneficial effect on asthma from any homeopathic treatments.