What is Asthma Diagnosis and Pharmaceutical Interventions Lifestyle and Dietary Modifications Nutritional Factors Shown to be Beneficial Recommended NaturalMeds Products for Asthma	Printable Version

What is Asthma

Asthma is a chronic pulmonary disease with inflammatory aspects. The chemical mediators histamine and leukotrienes can cause bronchioconstriction where the airways leading to the lungs spasm and become narrower. For people with asthma these airways are very sensitive to allergens, and frequently inflamed. The inflammation can cause increased amounts of mucous, and a tightening of the chest wall. Asthma is commonly linked to allergies, heredity, environment & weight. 1 in every 6 New Zealanders has asthma..
People with asthma have periods without symptoms or minor symptoms. Asthma attacks occur where acute symptoms cause respiratory distress. This can lead to respiratory failure, the inability to breathe. An acute asthma attack can be a medical emergency. If you are suffering from an acute asthma attack, consult your physician or an emergent care clinic immediately.

Asthma can be divided into two main categories: extrinsic, which may also be called atopic, is usually considered an allergic condition. Atopic cases of extrinsic asthma may have some of the same triggers as for hay fever or allergic rhinitis, and food allergies. Intrinsic or idiosyncratic asthma is when no specific allergies are found, and is associated with triggers from the environment such as toxic chemicals, cold air, exercise, infection and stress. In intrinsic asthma there may be hypersensitivity to certain chemicals. In this case it is not regulated through the immune system like an allergy, but more likely through an abnormal autonomic nervous system control.

Symptoms
The symptoms of asthma can range depending of the individual. Some people have mild and brief problems with breathing such as shortness of breath and difficulty breathing on exertion or exposure to air borne chemicals and coughing. Wheezing is a typical symptom associated with asthma where the breath makes a high pitched, creaking or groaning sound during expiration that can be heard with an ear over the chest wall or at the mouth. However, not all people with asthma experience wheezing.

In asthma attacks it may be difficult to breathe or speak without gasping for breath. There may be shallow, rapid breathing with fatigue and confusion due to decreased oxygen consumption. The skin and extremities may turn a bluish colour, known as cyanosis, due to the lack of oxygen. The blood pressure may drop. There may be a decrease in breathing rate because of blocking of the airways by mucous. Some of these situations are life threatening.

The most severe form of asthma is called status asthmaticus. In this condition, the lungs are no longer able to provide the body with adequate oxygen or adequately remove carbon dioxide. Without oxygen, many organs begin to malfunction. The build up of carbon dioxide leads to acidosis, an acidic state of the blood that affects the function of almost every organ. Blood pressure may fall to low levels. The airways are so narrowed that it is difficult to move air in and out of the lungs. Status asthmaticus conditions require immediate medical attention.
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Diagnosis and Pharmaceutical Interventions

The diagnosis of asthma is established after taking a full history and physical examination. Confirmation of the diagnosis is by pulmonary function or spirometry testing. This shows whether the airway obstruction is reversible using a -adrenergic agonist, a medication that pharmacologically opens the lung passages (such as Ventolin). When the spirometry results are normal at presentation, the diagnosis can be made by showing heightened airway responsiveness to histamine, or other compounds, or even hyperventilation of cold air.

Positive wheal-and-flare reactions to skin prick tests can be demonstrated to various allergens, but such findings do not necessarily correlate with the asthma symptoms. Sputum and blood eosinophilia, the white blood cells most associated with allergic reactions, and measurement of serum IgE levels are also helpful but are not specific for asthma. Chest roentgenograms and x-rays showing hyperinflation are also nondiagnostic.
Diagnosis can also be helped by food tolerance testing. Researchers have found that standard blood tests used to evaluate allergies may not uncover food sensitivities associated with asthma, because asthma food sensitivities may be different than true allergies. Testing for food sensitivities can be done by using a food tolerance test that combines IgE, the first antibody produced in an immediate allergic reaction, with IgG, the antibody produced in a delayed hypersensitivity reaction. Delayed hypersensitivity reactions are not commonly tested for by a standard clinician, and reactions cans take up to several hours, days, or even weeks to appear
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Pharmaceutical interventions
There are 2 main types of medications for the treatment of asthma: quick relief medications and those for long term control.

Quick relief medications include the beta adrenergic catecholamine epinephrine and isoprterenol. These are short acting (30-90 minutes) and must be administered via the blood stream or inhaled; most often they are medications used in emergency situations. Other inhaled compounds such as salbutamol (albuterol) can last 4-6 hours. The major side effects from these medications are related to the excitability effect they have: tremors, dizziness and nervousness. They should not be used for people on beta blocker heart medications or oral corticosteroids. If prescribed with certain antidepressants such as MAOI or TCAs, caution should be used.

Other medications include methylxanthines. Of these theophylline (Nuelin) is the most common as it is considered to be one of the least expensive asthma and lung medications. Theophylline is given for maintenance therapy. It acts very quickly and is very close to caffeine in its other physiological effects; palpitations, insomnia, rapid heart rate and breathing. It can also have more significant adverse reactions such as nausea, vomiting and gastric irritation, headaches and even seizures, and is thought to deplete vitamin B6.

Long acting medications are oral and inhaled glucocorticoids, and leukotriene modifiers. These medications are taken on a daily basis regardless of symptoms. Glucocorticoids are not directly targeted at opening up the bronchioles but are anti-inflammatories. Inhaled glucocorticoids have fewer side effects than oral glucocroticoids. The main side effects of glucocorticoids are voices changes and oral Candida infections. Their use may increase body’s need for calcium, chromium, magnesium, potassium, selenium, Vitamin B6 and Vitamin D, and interfere with blood sugar and insulin sensitivity. Montauks (Singular) is a blocker of inflammatory leukotienes. It has less interaction with nutrients but more interactions with other drugs in the liver, as liver function tests are elevated after its use.
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Lifestyle and Dietary Modifications

Reducing the allergic threshold should be the first step for most kinds of asthma. Dietary changes can lead to significant improvement, especially if food sensitivities or allergies are a factor. The most common allergenic foods are eggs, fish, shellfish, nuts, peanuts, milk, chocolate, wheat, citrus fruits and food additives and colourings, as it is estimated that around 5-10% of patients with asthma are sulphite sensitive.

For environmental allergies, keep your living space and bedrooms as clean from pollens as possible. Keep windows and door shut, so wind blown allergens can’t get in and if you’ve been outside alot undress out side of your bedroom, leaving the clothes outside the room until they are cleaned. Wash your hair before going to bed; this will keep pollen from getting on your pillows. When driving avoid opening windows and keep the air conditioner on recirculate.

A vegan diet plus reduction in caffeine, sugar, tap water and salt can lead to significant improvement. One reason for this may be that a vegan diet is lower in the fatty acids found in animal products that can cause inflammation and contribute to the disease process.

Being overweight increases asthma risk. Losing 10% or more of body weight significantly reduces symptoms. Some asthma patients experience symptoms triggered by aspirin. Patients who use OTC pain relievers are recommended to take acetaminophen or herbal medicines. Air pollution can trigger symptoms, and supplementation with antioxidants can help prevent this reaction.
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Natural Factors Shown to be Beneficial

Magnesium
There is statistical evidence for a correlation between the declining magnesium intake and the increased prevalence of asthma. This mineral has a relaxing effecting on the respiratory airways, especially on the large airways, and reduces inflammatory chemicals.
Dose: 200-400 mg a day

Vitamin C
Vitamin C is a major antioxidant for the health of the lungs, and is present in the tissues of the airways. It reduces airways spasms, particularly in exercise-induced asthma.
Dose: 1 gram per day

Butterbur (Petasides hybridus)
This herb has been widely used in Germany for over a quarter of a century. It promotes normal function of the lung tissues by reducing pro-inflammatory leukotrienes
Dose: 25-100 mg twice a day of a standardised extract with the pyrrolizidine alkaloids removed.

Vitamin B6
A deficiency of Vitamin B6 (pyridoxine) is common in asthmatics. This may be in part related to some of the medications, such as theophylline.
Dose: 100-200 mg a day

Fish oil
Fish oils are high in the omega 3 fatty acids eicoapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Omega 3 fatty acids are essential for cell membranes and brain tissue - they improve the fluidity of the cell membrane to allow for better cell to cell communication. Fish oils are natural anti-inflammatories, and can decrease the levels of leukotriene B4 which is a main cause of brochioconstiction.
Dose: 3-6 grams a day

Hydrochloric acid
Many people with asthma have been shown to have hypochlorydria, or low stomach acid. When food is not broken down it contributes to leaky gut syndrome and increases the likelihood of allergy or food intolerance. Supplementation with betaine HCl (a compound that contains hydrochloric acid) improves digestion.
Dose: The amount of betaine HCl used varies with the size of the meal and with the amount of protein ingested. Typical amounts recommended by doctor’s range from 600 to 2,400 mg per meal.

Molybdenum
Molybdenum is involved in sulphite detoxification pathways and most asthmatic suffers have sulphite allergies.
Dose: 50 mcg per day

Tylophora asthmatica
Tylophora is an Ayurvedic herb used in the treatment of respiratory conditions including asthma and hay fever. It provides long lasting bronchiodilating effects, and may have antihistamine properties.
Dose: 200 mg twice a day

Quercetin
Quercitin is a bioflavonoid found in fruits and vegetables. It is a useful anti-inflammatory due to its capacity as an antioxidant. It also helps with the stabilisation of mast cells, when histamine is released in the inflammatory process.
Dose: 200-500 mg two to three times a day
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Recommended NaturalMeds Products for Asthma

Ultimate Omega
Eicosapentaenoic acid (EPA) and docasahexaenoic acid (DHA), the two main components of Omega-3 from fish oil, are essential nutrients for growth and development throughout the human life cycle. Ultimate Omega contains 700 mg of EPA and 500 mg of DHA.
Dose: 2 capsules Pack size: 60 capsules

Vitamin C Ascorbic acid crystals
Vitamin C is an astounding nutrient. Supplementation not only helps with immune function but as an antioxidant protects against free radical damage. It is thought to reduce muscle spasms associated with asthma
Dose: ½ teaspoon two to threes times a day Pack size: 8 ounces (226.796 g)

Magnesium Malate 1250mg
Magnesium is an essential mineral, playing a key role in over 300 enzymatic reactions in metabolism. It relaxes muscle tissues, including helping to relax the passages of the lung to reduce spasm. Magnesium Malate has the highest absorption rate of any form of magnesium.
Dose: 1-2 capsules a day with food Pack size: 90 tablets

Vitamin B6 50 mg
Vitamin B-6 is required for the metabolism of lipids, carbohydrates, and proteins. Many medications to treat asthma deplete Vitamin B 6 from the body.
Dose: 1 tablet two to four times a day Pack size: 100 tablets

Betaine HCl 625 mg
Betaine hydrochloride is a supplemental source of hydrochloric acid, which can be utilised by the stomach to produce pepsin. Many people with asthma are thought to have poor digestive function, and by improving it many symptoms can be reduced. The combination of betaine hydrochloride and pepsin provide an excellent stomach tonic.
Dose: 1-4 capsules with meals Pack size: 90 tablets

Activated Quercetin
Quercetin has the capability to inhibit the release of histamine from mast cells, common in allergic reactions, including those that may trigger asthmatic problems. This form of Quercetin is combined with vitamin C to enhance the immune system, and bromelain to increase absorption.
Dose: 3 capsules twice a day Pack size: 50 capsules

Chem-Defense
Chem-Defense is a combination of the mineral molybdenum, glutathione, a key element in the liver’s pathways, and riboflavin. Together these act to increase detoxification for chemically sensitive individuals or those with allergies. These tablets are orange flavoured sublinguals of more efficient absorption
Dose: 1 capsule one to three times a day Pack size: 45 tablets
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