Are there any side effects or interactions?
Refer to the individual supplement for information aboutany side effects or interactions.
Herbs that may be helpful
There 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.
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. 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. 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. 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. 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. 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.
Animal studies have found that extracts of holy basil (Ocimim sanctum) inhibit constriction of the bronchial airway passages. Two preliminary clinical trials treated asthma patients with 500 mg of holy basil three times daily for one month. 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.
Two preliminary trials have shown picrorhiza to be of benefit in asthma. However, a follow-up double-blind trial did not confirm these earlier results. 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. In a follow-up double-blind trial, an alcoholic extract of crude tylophora leaves had comparable effects to that of chewing the crude leaf. 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. A fourth double-blind trial found no significant changes in lung volume measurements or asthmatic symptoms after treatment with 400 mg per day tylophora.
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.
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. A controlled trial used a highly concentrated tincture of ginkgo leaf and found this preparation helped decrease asthma symptoms. For asthma, 120 to 240 mg of standardized 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. Saiboku-to has been extensively studied in the laboratory and has been shown to have numerous anti-inflammatory actions. 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.
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. Traditionally, it was used by Eclectics to treat coughs and spasms in the lungs from all sorts of causes. 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.
Onion may act as an anti-inflammatory in people with asthma. Human studies have shown onion can be a strong anti-inflammatory. However, some people with asthma may experience an exacerbation of symptoms if they are allergic to onion and are exposed to it.
Are there any side effects or interactions?
Refer to the individual herb for information about anyside effects or interactions.
Holistic approaches that may be helpful
A set of breathing exercises called Buteyko breathing techniques has been reported to significantly reduce the need for prescription drugs for people with asthma. 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. 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 reports and preliminary trials 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. 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. 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. A larger controlled study compared chiropractic manipulation to sham manual treatments in children whose asthma was still a problem despite usual medical management. 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.