A Practical Strategy for Asthma Control

Common Sense Challenges Accepted Science: Ignaz Semmelweiss

In medical practice in the mid 1800s, cleanliness was next to prudishness. Said a surgeon of a later era, Sir Frederick Treve, “There was no object in being clean. Indeed, cleanliness was out of place. It was considered to be finicking and affected. An executioner might as well manicure his nails before chopping off a head.” Surgeons operated in blood stiffened frock coats–the stiffer the coat, the prouder the surgeon. From amputation to the dissection of cadavers to women in childbirth, the surgeon made his rounds.

Ignaz Semmelweiss was appointed assistant in a hospital for teaching medical students, the First Obstetric Clinic of Vienna, Austria in 1846. In the adjoining Second Clinic, deliveries of babies were made exclusively by midwives. In the midwife-run Second, the mortality (death rate) of mothers and infants was one third that of the mortality rate of the all-male, surgeon-run First Clinic.

Semmelweiss soon theorized that sanitation was the key. The horrible death of a colleague, slightly wounded while dissecting a corpse, drove him to action: “Day and night, the vision of Kolletschka’s malady haunted me. It was not the wound, but the wound rendered unclean by cadaveric material, which had produced the fatal result.”

When he got his students to wash their hands in chloride of lime, the mortality rate for mothers and newborns dropped from 18 down to 1%. With such a success, Semmelweiss might have been the toast of Medicine of the time. To the contrary, he was jeered and hounded out of the profession in the succeeding years. His simple methods of sanitation were adopted very slowly, and in the face of considerable resistance over the next 30 years.

Semmelweiss himself became mentally unbalanced and died in a madhouse in 1865. His death was caused by a small wound, infected by the purpureal fever from which his simple insight and courage had saved so many.

ABSTRACT: Most asthma begins with an inherited tendency: asthma is considered a chronic condition. But in life, there are a great number of factors that are at least subject to our control, factors that influence our overall health and our asthmatic condition.

Modern medicine recognizes only certain external factors such as airborne allergens, irritants (such as cigarrette smoke) and viral infections as being pertinent causes.

Asthmatic health depends on many factors in addition to the original hereditary tendency. By changing or optimizing these factors, many asthmatics can strengthen themselves (and their own internal control mechanisms) and improve their condition significantly.

  • Strengthen the lungs. Improve aerobic capacity. Learn to breathe deeply
  • Stabilize the immune system and the HPA axis. Rest, good nutrition and resolution of stress are important.
  • Strive for best physical conditioning
  • Get good, restful sleep
  • Strive for peak nutrition beyond adequate protein and carbohydrate intake. Avoid overeating even “good” food.
  • Drink plenty of high quality liquids beginning with good water to maintain optimal hydration. Avoid caffeine, sweet drinks, alcohol
  • Assure good digestion, assimilation and elimination
  • Optimize your environment as best you can, not only avoiding dietetic and environmental problems but replacing them with something better
  • Stabilize your emotional life. Stress has specific detrimental consequences in asthma.
  • Develop a postive attitude, work for a greater good and love life.
  • Analyze the basic aspects of your life and plan for as much improvement as you can possibly make. Seek help from books and knowledgable people so you can make the best choices.

This is not a quick fix. The following strategy includes details based on textbook physiology, published studies and personal experience. It looks easy but it takes some self discipline to learn and embrace healthy new habits.

All of us share a very similar, common physiology. And our modern lives are not dissimilar—we like coffee, ice cream, donuts and think whole wheat bread is health food. Many of us can assess our own lives and figure out what we need to do to get really healthy, especially with straightforward help from a book like 8 Weeks to Optimum Health by Andrew Weil.

But we are not exactly alike. And anyone might miss some important details in their personal health analysis. If you are attempting to make serious changes in life, you would be well advised to get help from a professional, perhaps a good naturopath.

 


Practical Basics of a Strategy to Control Asthma

Part 1: The Current view of Asthma

 

What is Asthma?

While modern medicine draws no conclusions as to which specific internal mechanism causes asthma, this disease involves 1) an overreaction or imbalance of the immune system resulting in inflammation; 2) an oversensitive respiratory system; 3) inadequate internal mechanisms to control inflammation; and possibly other defects. The asthmatic begins with an hereditary tendency to asthma and/or allergy. Then many environmental factors can also be involved.

Asthma is considered a disease of chronic inflammation. Mild symptoms can be quickly aggravated bringing on a severe attack or worse symptoms. Yet it is accepted that asthma symptoms are often “spontaneously reversible”—that is, the body has a natural ability to recover after a period of illness, with or without medication. Many asthmatics experience symptom-free periods for months and even years at a time.

This raises some questions: How do some asthmatics recover spontaneously after a period of sickness? Under what circumstances do some asthmatics resist asthma and maintain good health? Can we strengthen our bodies so that we can resist asthma? What factors make us less vulnerable to asthma and allergic reaction?

Conventional Medical Treatment for Asthma

In asthma care today, the prevailing medical strategy emphasizes 1) the avoidance of allergens or triggering factors, 2) drug therapy, and 3) patient education aimed at teaching asthmatics to avoid allergens and take their drugs. Many asthma sites offer extensive information on Avoidance and Drugs (“medications”), which are certainly important. Please see www.aaaai.org or www.NationalJewish.org for full information on standard treatment for asthma.

Standard recommendations for avoidance are fine as far as they go. But perfect avoidance is impossible, and life’s necessities and choices often preclude even effective avoidance. A broader notion of avoidance—the strategy of optimization—will be discussed later.

Active measures other than medications are rarely prescribed. Simple measures like diet and exercise are not often taken seriously by patients. There is an unspoken agreement that the doctor cannot push too hard for lifestyle changes. Doctors are not in the business of trying to make people change. Patients are not inclined to change their habits. Doctors must get results, as quickly as possible, and both parties have a resolute faith in the power of drugs.

Medication: The Benefits

Drug therapy is the real mainstay of asthma treatment. When the main symptom of the illness is the inability to breathe, symptomatic relief is a matter of life or death. The development of medications that provide relief with fewer side effects has been the significant pharmaceutical advance of the past forty years.

Since asthma and allergy are diseases of inflammation—often self- perpetuating—antiinflammatory drugs can prevent irreversible or degenerative tissue damage. The benefits of inhaled corticosteroids (e.g. Aerobid, Flovent, etc.) generally outweigh the drawbacks, controlling airway inflammation consistently with minimal side effects. Cromolyn sodium is another drug that appears to have minimal side effects.

In the present situation of limited therapeutic options, asthma drugs have saved many lives, especially those of small children. As children grow, their immune systems mature and often seem to sort out asthma. At best, drug therapy buys time for our internal system to adjust and resolve (“outgrow”) asthma. More typically, chronic drug therapy allows us to live with little concern for “lifestyle factors.” In other words, if we take medication, we don’t have to change any of our habits.

During childhood, the asthma drugs of the 1950s saved my life, allowing me to breathe while I went through my asthma cycle and recovered. Asthma drugs have their place in medicine.

Medication: The Drawbacks

If medications are effective, why then should an asthmatic/allergic try to reduce dependency on them? In fact the reduction of medication is a primary stated goal of conventional asthma therapy, due to concern over side effects.

Drug therapies control symptoms, not the causes of asthma. When symptoms are alleviated, underlying factors of the condition tend to be left unexamined and unchanged.

Most medication has side effects, some known and some not yet known. Prednisone, the most effective asthma medication has dangerous side effects when used more than occasionally. In physiology, repeated stimulation generally results in lowered sensitivity, often intolerance and sometimes suppression of function. This means that after we take a medication for a long time, the body gets used to it and tends to need more to get the desired effect. Beta2 agonist inhalers (such as albuterol) are a classic example of how excessive use actually makes asthma worse.

Drug dependence is not always convenient and can be expensive.

Medication is not always effective.

Asthmatics today look forward to a lifetime of drug dependence unless they are lucky enough to “grow out” of it.

In spite of rising costs and billions of dollars spent on new treatments, the number and severity of asthma cases is increasing. Both incidence of and death from asthma have approximately doubled since 1980. This may indicate that worsening social, dietetic or environmental factors are critical in asthma. It may also show that current medical understanding and standard medical treatment are not adequately meeting the problem.

Part 2: General Considerations

Genetics:

Asthma begins with a genetic or hereditary basis. But it can apparently be induced in some people with no hereditary tendencies. For many people this fosters a sense of doom and dependence; that is, no hope without drugs or other medical intervention. Such a sense may tend to discourage a person from taking more active steps to control his condition.

But genetic tendencies need not guarantee a lifetime of suffering and drug dependence. One of the pioneers of modern nutrition, Dr. Roger Williams, experimented with a species of rat with a genetic malformation of the inner ear. Williams found that this problem, which adversely affects the rats’ balance, could be fully overcome by feeding them high levels of the mineral, manganese. Conversely, this inner ear abnormality could be induced in normal rats by feeding them a diet deficient in manganese. This problem was reversed when a normal diet containg manganese was resumed.

Humans are not the same as rats; and human health problems are rarely resolved by a single simple nutritional expedient. But the scientific principle shown here is quite valid for humans, including those suffering from asthma and allergy: “The fact that hereditary factors are involved in faulty development does not preclude the possibility that such faults can be corrected by appropriate … adjustments.” (Dr. Roger Williams, Nutrition Against Disease , Bantam Books, 1981; p.61)

Variability:

There is a wide variability in triggers- many substances are known to bring on symptoms or attacks in different people. Exposure to pollens, dust mite dander or certain perfumes may make one person sick; another person might react only to certain nuts or formaldehyde. This is well accepted by today’s medical authorities.

Another type of variability—not well accepted in modern medicine is the week to week (sometimes day to day) variability in each individual’s sensitivity to their allergens or triggers. That is, an overweight person or a person suffering from poor sleep tends to be more vulnerable to his particular triggers than when that same person is 30 pounds lighter, well rested, in top physical shape. This seems intuitive: common sense suggests that the better a persons basal health, the less severely affected he’ll be by any outside agent.

Loading:

The concept of immunologic loading is accepted to by some authorities in the field of allergy. The theory is that everyone’s immune system has a certain capacity to protect the body. This capacity can be likened to a barrel, different for every individual, that can hold or withstand a certain amount of negative factors before it “overflows” resulting in serious symptoms or illness. This theory may also hold for asthma.

By this model we may be subject to “loading factors” that are neither allergens or triggers- that is they do not instantly cause allergic or asthmatic reactions (as in the current “trigger” model) but they make the body more susceptible to triggers by loading up the body’s residual capacity to deal with allergens and other external agents. Even when we cannot avoid allergens and triggers, a protective immune barrel that is less full makes us less liable to degrees of symptomatic suffering, perhaps first a runny nose, then coughing up mucous, then to wheezing and bronchoconstriction .

Overweight, lack of exercise; dairy products (or certain other foods for different people); excessive consumption of starches and sweets; poor quality sleep are examples of factors that can load up the immune system. Even if they do not make us sick immediately, they can make an important contribution. By the same token, good quality sleep, lower intake of sweets and dairy, and better physical conditioning may help relieve the immune burden.

Optimization:

The details of an individual’s asthma symptoms or progression are difficult to understand while taking medications which both alleviate symptoms and mask the causes. In spite of variations, there are enough similarities in human physiology that general guidelines can be formulated to improve asthmatic health. It is not necessary to stop taking medication in order to begin a program of improvement.

Even if we cannot name the single cause of asthma, we can take steps to improve our health: to stabilize our immune systems, strengthen our respiratory system, improve our physical conditioning, minimize our hypersensitivity, and maximize our own innate capability for health.

Part 3: The Critical Factors

Heredity

Many studies show that a mother with allergic tendencies can reduce the chances of her child becoming allergic by being very careful with the food she eats while pregnant; the food she eats while nursing; and weaning foods for the child. The asthmatic or allergic mother should avoid any suspicious (that is, toxic and commonly allergenic) foods at least during breast- feeding. And she should avoid eating great quantities of any single food—it is best to vary the diet.

This may not be easy. It may take planning, mainly choosing attractive yet affordable food and nutritious substitutes for any foods you are giving up. It is important to find alternative foods that you really enjoy. Try different things and determine to develop a taste for something new, especially fruits and vegetables. In most cases vitamin/mineral supplementation is helpful, especially with calcium and magnesium if you are removing dairy products from your life.

Very young children with potential allergic tendencies, up to the age of two, three, or maybe even five years, should definitely avoid, as much as possible foods that are typically allergenic, until their immune systems mature.

Foods that are most likely to be allergenic or poorly tolerated (see Elimination Diet, below) include milk, eggs, wheat, corn, peanuts, chocolate. Oranges, nuts, chicken, fish, soy (tofu may be less problematic than the beans themselves) and tomatoes are also common offenders. Almost any food that is eaten often can be a problem food. The offenders are usually proteins, rarely fats or carbohydrates.

Diet and Nutrition

The human body has developed over several hundred thousand years eating plants, fruits, roots, meats, seeds and so on. Only in the last 5,000 years did we begin to eat large quantities of grains. Sugar, milk products, and eggs in large quantities are very recent dietary habits. Diets high in soda pop, potato chips, candy bars, fats, sugars, sodium and 3,000 different additive substances could well be called “food faddism.”

Eat slowly, calmly, chew your food well and above all, enjoy it. Do not eat late meals. Avoid eating after 6 p.m. if symptoms are bothering you or you are on the verge of asthma. A congested colon, especially during sleep, is likely to worsen asthma symptoms. Eat lots of fruit and vegetables. These have important nutritive effects that vitamin/mineral supplements cannot supply.

Avoid overeating. Regulate your caloric intake according to what your body is “burning.” The more you eat that you do not need, the more your body must work to store it or eliminate it. The more non nutritious the food you eat, the more your liver and immune system must work to detoxify and remove it from your body.

Numerous studies show a clear correlation between obesity/overweight and asthma.

Eating good food may not be enough. If you are sedentary, if you eat too much, if you eat toxic or many allergenic/intolerant foods along with the good food, or if for some reason your body does not absorb certain nutrients well, you may not get the nutrition needed for good health. Asthmatics with digestive problems should try eating less, eating more carefully and changing their diet. If this does not help, try betaine hydrochloride (in capsule, before a meal), and digestive enzymes (after a meal) or seek professional guidance.

Nutritional intake varies greatly among humans. Many Americans fall short of optimal nutrition amidst an epidemic of obesity and overweight. Sick people—probably including asthmatics—usually have increased or special nutritional needs. Many common drugs cause the body to use up or excrete certain nutrients. Air pollution, the fast pace of life, chronic fear, anxiety and other environmental factors result in higher stress levels- and thus increase the need for rest and for some nutrients.

Recommended Daily Allowances (RDA) are average estimates of adequate nutrition to maintain the health of an average, reasonably healthy human. These levels are considered sufficient to prevent illness caused by a deficiency of each specific nutrient.But the RDA does not suggest what the intake for optimal health might be, nor does it account for special needs of people with chronic illness.

Dietary Oil

Leukotrienes, inflammatory mediators far more powerful than histamines, and inflammatory prostaglandins are considered by medical authorities to be important causes of asthma. These are among several classes of substances called eicosanoids. A number of health problems are thought to come from an overbalance of a class of eicosanoids derived from arachidonic acid, a fatty acid in animal products. Arachidonic acid can also be produced in the body from linoleic acid (omega-6), found in almost all vegetable oils.

The effectiveness of corticosteroids is due to their ability to disrupt the production of all eicosanoids, inflammatory, antiinflammatory and all others. This gives relief probably because afflicted bodies produce far more inflammatories than antis. Unfortunately, the body cannot maintain overall health very long with restricted lipid/eicosanoid metabolism.

A holistic approach tries to influence the body’s production of eicosanoids by nutritional and other methods. Many factors govern the metabolic progression from polyunsaturated fatty acids to eicosanoids. In the presence of ample nutritive factors such as vitamins B3 and B6 as well as zinc and magnesium and such fatty acids as EPA, DHA, and GLA, antinflammatory mediators are more likely to be produced. Excessive intake of other fats, especially polyunsaturated fats tend to be detrimental to the formation of “friendly” eicosanoids.

An asthmatic should minimize intake of animal fats, deep fried foods and foods containing unnatural oils, such as margarine, crisco (trans fatty acids) and olestra. Of the vegetable oils, olive and canola and soy are among the most healthful. Flaxseed oil, extremely high in alpha linolenic acid (omega-3) is therapeutic (and very expensive) in helping to restore the balance with the linoleic acid so high in typcal US diets. Many fish, including sardines, herring, mackeral, and salmon contain important fatty acids of the alpha linolenic class. These are helpful in controlling inflammation in asthma and allergy.

Supplements (Vitamins and Minerals)

While there is no substitute for fruits,vegetables, and other healthful foods, it is good insurance to take a daily vitamin/mineral supplement. In the case of most nutrients, there is an enormous distance between the official US Recommended Daily Allowance (RDA) and toxic doses. Although nutritional supplementation is mainly for prevention, two respected physicians (Drs. Alan Gaby and Jonathan Wright) have developed a protocol for injectable nutrients to “break” an asthma attack.

There are many studies showing the benefits of certain vitamins and minerals for asthmatics, and good ideas as to why these benefits occur:

The body’s highest concentration of vitamin C is found in the adrenal glands. It is used in the manufacture of adrenal hormones and used along with the hormones as they perform their duties. Vitamin C is the antioxidant nutrient most commonly found in the air passages where it protects mucous membranes from the free radical damage caused in asthma and allergy. Blood concentrations of vitamin C are inversely proportional to levels of histamine. Vitamin C is a critical nutrient for all health and can be reaonably supplemented at a rate of 500-2000 mg daily—much more in some cases—preferably in several doses, preferably in buffered powder form such as calcium ascorbate.

Vitamin A (which is best taken in the form of beta carotene at 10–50,000 I.U.) is vital to tissue repair and cell membrane health. Vit A deficiency can suppress mucus secretion and damage the cilia which move the mucus; reduce defense against infection. Vitamin A is absolutely critical in rebuilding the epithelial layer of the entire digestive tract every 3 or 4 days. Beta carotene works with vitamin E (200-800 I.U.), which together are essential to the normal function of the immune system.

All the above mentioned antioxidants protect lungs and airways by binding and detoxifying reactive forms of oxygen and toxic aerosols. Oxygen radicals are destructive byproducts of the inflammatory process as well as causes of ongoing inflammation.

Vitamins B5 (50–500 mg) and B6 (50–100mg) have been found to be important in many asthma studies. They work closely with the other B vitamins and should be taken with a multple B vitamin. B5 is vital to the functioning of the adrenals and the production of corticosteroids. Vitamin B12 is also an important vitamin in asthma control. B vitamins are cofactors in numerous enzymatic and metabolic action. B vitamins are not well absorbed if stomach acidity is low.

Minerals- Much of the US population is at least marginally deficient in zinc, calcium and magnesium. Magnesium (300-1000 mg) may be the single most important- or commonly needed- mineral for asthmatics. (Oxide is the least well absorbed form of magnesium.) Those who have stopped eating milk products may have trouble finding a convenient source of calcium and may need a supplement (300-1000 mg). Calcium citrate is probably the best choice for the money. Zinc is critical for immune function and involved in many basic enzymatic reactions. Zinc (10-20 mg) and selenium (50 mcg) may be helpful for many asthmatics.

A diet high in sodium (especially salt)- typical in our society- is probably detrimental to asthmatics. A “low sodium” diet still leaves almost everyone with plenty of that nutrient. Potassium deficiency may be more common than is thought, occurring mainly in people who eat processed foods, high salt diets or take diuretics. This is another good reason to eat plenty of fruits and vegetables, but for some, potassium supplementation (up to 500 mg) may be helpful.

A high sugar diet robs the body of some nutrients (such as calcium) and displaces others from the diet by filling the belly before the body is nourished. Eating excessive sweets can produce an exaggerated insulin response, lowering sugar levels. The result, especially in children, can be a sharp rise in blood levels of adrenaline, to maintain blood sugar levels. Other effects of adrenal hormones coursing through our blood are not healthful. High sugar intake sharply depresses the effectivenes of the immune system. Chromium is the integral mineral in GTF (glucose tolerance factor), a substance vital to the regulation of sugar metabolism. A chromium supplement (50-150 mcg) can help mitigate the effects of an overly sweet diet, but avoiding sugars is the best course fo a sick person.

Since few people are ever analyzed for nutritional deficiencies, a good supplement provides nutritional insurance. Even low levels of these substances can help. A good multivitamin contains vitamins and minerals already mentioned, and usually constitutes a reasonable minimum. The cost of supplementation can range from twenty cents per day upward. Calcium and magnesium are generally not in multivitamin pills since useful amounts of these would make a multivitamin pill too bulky. They are often found mixed in a single tablet. Allergic/asthmatics may need more magnesium than calcium.

Greater amounts of nutritonal supplements are taken to replenish a depleted body; to ward off an attack and during or recovering from illness. For daily maintenence, doses should be tapered back to smaller amounts. Certain nutrients, notably iron, zinc, selenium and vitamins A and D, can be toxic in high doses over time. There are also good reasons for not taking large amounts of quite harmless nutrients. High intakes of supplements reduce the body’s natural capacity to absorb those nutrients supplemented, especially minerals. When the body gets used to a daily intake of a nutrient, it may become accustomed to excreting large quantities of that nutrient. Several days of missing the supplement may leave the body dangerously low in its residual supply of that particular nutrient.

Food Allergy and Intolerance

Food allergies are defined as reactions to food that cause the body to create specific antibodies to the food, usually involving immunoglobulins, especially IgE. Any other reaction is defined as food intolerance. Thus even people who do not show IgE allergic reactions to the doctor’s scratch testing may have other types immune reactions to certain foods.

Most allergens and viruses are proteins. Proteins have a “personality” (unlike the long chains that are fats and carbohydrates) and the body must consider all proteins as potential enemies. Insufficient stomach acid is associated with food allergies, probably because the stomach’s digestive action is crucial for the breakdown of proteins. Healthy adults need to eat about two ounces of protein per day, more or less depending on weight and activity. Incomplete digestion of proteins creates a number of problems for the body, which is designed to absorb broken down proteins as amino acids. Excessive protein and its peptide derivatives may irritate the immune system and keep it in a state of overreactivity.

Cow’s milk is the most common food allergen, far different from mother’s milk and often poorly tolerated by people who are not strictly allergic. This is more likely due to casein (the main protein in cow’s milk) intolerance than to lactose intolerance. Gluten, the main protein in wheat, is similar in structure to casein. Both resemble viruses and may be attacked as such by the immune system in some cases. These two most common food allergens/intolerants are two of the most common proteins eaten in Western diets today. Even if these do not show up as allergens in IgE skin tests, they still may be problematic.

The Elimination Diet

The majority of people with problems of food allergy and intolerance are sensitive to more than one food. The elimination diet is a process of avoiding all possible troublesome foods for two to three weeks in favor of a very simple, hypoallergenic (hopefully) diet. If improvement of the symptoms is evident, then foods are reintroduced, one at a time into the diet. Then if symptoms recur, that food is a problem and should be left out of the diet. (The approach of eliminating each suspect food—say milk or wheat—one at a time from your diet, is unlikely to work.)

Many people, especially children, on elimination diets lose their worst symptoms, from migraines to eczema. It should be considered a diagnostic tool in determining problem foods. As a long term diet, it would be boring or inconvenient to maintain.

Anyone undertaking an elimination diet should get the Complete Guide to Food Allergies and Intolerance by Dr. Jonathan Brostoff.

Another option is having a state-of-the-art blood test for food antibodies by Serammune Physician’s Lab, phone 800-553-5472.

Hydration (Water and Fluids)

Fluids keep mucus membranes moist, wet enough for easier clearing. Drier mucous membranes inhibit mucous drainage and are more vulnerable to infections. Dried airways also tend to constrict and produce asthma symptoms.

Drink plenty of fluid, but avoid caffeine and sweet drinks. Hot drinks are comforting and helpful for symptomatic relief. Caffeine is capable of producing mild bronchdilating effects, but its stimulation can result in a rebound of bronchconstriction and fatigue. Caffeine and alcohol dry out the body by causing increased urine production. One sweet soda pop contains as much sugar as two candy bars. Pure juice is not recommended— it is just too sweet and its “natural” sugars are not much different in effect from the white crystals on your table. Drink juice occasionally as a treat, and only when diluted by an equal part of water. One exception: real grapefruit juice, watered down to half strength, has much less sugar than other juice and considerable potassium and vitamin C. (This is what I drink when I am sick or have a scratchy throat.) When I’m out of water and on the hoof in the summertime, I drink Gatorade— tastes good with much less sugar due to sweetness-enhancing sodium.

How much liquid should you take? At least two, up to four quarts a day, depending on your activity level and heat. What kind? Find the best quality water possible. Get the habit of making herbal teas, especially from locally available herbs, mints, etc. One bag of commercial fruity flavored herbal tea (costing about 10 cents) can make a quart of good tasting drink. Drink frequently, increasing the amount when the weather is hot, when you are active, or when you are sick.

Forced air heating and mouth breathing should be avoided if and when possible. Both dry out the mucus membranes. A steady supply of drinking water is the best control. Humidifiers are not recommended because they can, if not kept very clean, promote the growth of molds and bacteria. Perhaps the dampness they create can fool our body’s natural sense of thirst. Whatever you use, be sure to drink enough.

Sweating and urination must be generally beneficial for the asthmatic, particularly for flushing the system. But there are two problems- First, the body can become dehydrated. Natural human thirst and the availabilty of suitable liquid should prevent this, but life contains many mitigating factors. And it is not simply a choice between healthy, normal hydration and dehydration. Some people live in a state of mild dehydration because they forget to drink fluids; or because they drink beverages that stress or dry out the system. Somewhere before actual dehydration, suboptimal hydration stresses the body—in ordinary activity, during exercise, or even during sleep.

Second, excessive urination eliminates certain soluble nutrients, particularly the B vitamins, vitamin C, potassium, and magnesium. Many asthma drugs cause the body to excrete certain vitamins and minerals through urination. These nutrients are among the most important for the health of the asthmatic.

Sodium is the most oft-mentioned electrolyte but in fact few modern asthmatics are short of sodium. Insufficient potassium may be a common problem since it is so readily excreted, yet it is key in regulating body water. Of the other important electrolytes, calcium and magnesium, it’s the magnesium usually in short supply.

Some authorities believe that high sodium diets make asthma worse. This may be true but a low sodium diet may be as bad. Examine your own food intake. If a lot of it is fast food or canned food, your are probably getting lots of sodium.

Potassium can get low when you are living a diuretic or dehydrated lifestyle, or both together. You can often figure out by looking at your diet what you are getting in sodium and potassium. Otherwise, you can just take 100 mg of potassium 4 times in a day, drink plenty of water. If the potassium makes you feel better, then you may have some deficiency of potassium, a condition that can be remedied by diet alone but may be done with pills.

If you are not happy drinking water (i.e. tap water) that is readily available to you, consider getting a reverse osmosis water purification system.

Learn to understand your hydration status and be sensitive to when you are dry and when you have plenty of water in you. It is possible to drink too much liquid. Drinking more water may cause you to get up and urinate in the night. This may be a small price to pay for the privilege of breathing.

When you have an asthma attack, drinking lots of water will not cure you. If you are poorly hydrated, drinking water will help. Develop the habit of excellent hydration.

Exercise and Physical Conditioning

Physical conditioning is recognized by some conventional asthma authorities as extremely important, but it is hardly emphasized in typical modern treatments. Exercise is not the same thing as physical conditioning. Anyone can exercise; good physical conditioning is achieved by regular exercise. You may start out barely walking up and down the stairs, but you will improve, especially if you improve other aspects of your life at the same time.

Exercise induced asthma, or bronchospasm, is a legitimate concern but probably not a simple cause and effect situation. Obviously, a person in poor physical condition will be more stressed by exercise. Make certain that you or your children maintain an excellent state of hydration during exercise. Insufficient hydration may be a common factor in EIA. Many other factors that could be involved. Do not be afraid of exercise or use EIA as an excuse for poor conditioning.

Regular exercise improves circulation, metabolism, and digestion. Physical action promotes better rest and sleep. Good aerobic physical conditioning is a potent protector against bronchospasm or exercised-induced asthma.

Exercise should be fun! Play is important for kids of all age. Enjoyment of exercise, music, dancing, sports have direct effects of relieving stress.

Walking can be done without special equipment. Half an hour of brisk walking, up and down hills if possible, is helpful—if you are not doing someting more strenuous.

An asthmatic in good physical condition is more likely to have good respiratory function. A well toned body will also adapt better to fluctuations in respiratory efficiency. A person in top shape is more likely to have adrenals operating at peak function than a couch potato. Good physical conditioning is very important to your health.

Breathing

Learn to breathe, deeply and calmly, when you are not sick. One key problem in asthma is the asthmatic’s inability to exhale fully, resulting in buildups of stale air in the bottom part of the lungs and insufficient oxygenation. This can be helped by breathing with forceful and complete exhalations from time to time. Deep breathing from the diaphragm leads to calmness and relaxation. This helps prevent the alarm and fear that can aggravate asthma. One of the best effects of strenuous exercise it that it forces deep breathing.

Nasal breathing is superior to mouth breathing since it cleans the air and does not dry out the airways as much. If your nasal passages are clogged, try the safe and useful practice of nasal irrigation.

Unfortunately a lot of our air is not very clean and some is downright dirty. Healthy lungs perform amazing feats in difficult circumstances: they deliver oxygen to the bloodstream and allow the cilia and mucous to remove the particulate crud. But bad air can harm even the healthiest lungs over time.

If you live in an area of dirty air, consider moving somewhere with cleaner air. Or get a HEPA (high efficiency particulate air) rated air cleaner for your house or at least for your bedroom. Good breathing habits are very important to your health.

Sleep and Rest

Rest is of greatest importance to the asthmatic. According to one authority, some asthmatics never achieve a good level of sleep. The body needs high quality sleep to allow the body’s organs to recuperate and recharge. This means 7-9 hours of restful sleep, sometimes more. During the deepest levels of sleep, immune enhancing compounds are released and many immune functions are greatly improved. Learn to rest and relax, even in waking hours. Optimizing our health may well include giving up stimulants, including chocolate, coffee, tea, and sweetened, caffeinated soda pop. Or at least cutting them back seriously.

If you wake up often in the early morning and can’t get back to sleep, try going to bed around 9 or 10 P.M. Calcium and magnesium supplements taken in the evening help me to sleep more soundly. When I get to bed very late, or did not sleep well the night before, melatonin (1 or 2 mg) helps assure a delicious and restful sleep. If you have trouble sleeping, try not eating after 5 or 6 P.M. Or make your last meal a light one. If you must eat late, try fresh fruit. It may help to write down what is on your mind, clear it out onto paper, make a list of things to do before you go to bed.

Sleep is generally better after a good day’s work. Good sleep is really important.

Stress

Stress has direct physiological effects in the body. Occasional and momentary stresses can be good for health but chronic stress is hardly ever healthy. The adrenal glands—called “the body’s shock absorber”—respond to stress by secreting adrenal hormones into the blood. This can give some immediate relief from symptoms since these hormones can control the allergic reaction, but it will not last long. The rebound low after the high of adrenal hormone secretion may lead to worse asthma symptoms. Adrenal hormones coursing though the body suppress the immune system and break down the muscles. Stress also occurs with, or results from, inadequate rest, anxiety and unbalanced or poor nutrition.

The adrenal glands become stressed when constantly called upon to react to stress. Tired adrenals and overstimulated receptors are less likely to function at peak effectivenes. Tired or depleted adrenals give less protection against incremental asthma and allergy symptoms.

Stress can be positive if met with physical activity, very good nutrition and a positive attitude. Physical symptoms of asthma can be influenced directly by changes in emotional and mental states.

Asthma is not “all in your head,” but whatever is in your head can have a huge influence on your health.

Emotional Attitude

A positive emotional attitude is extremely important in maintaining good health. Laughter has measurable healing effects. Visualization (a patient’s mental imaging of healing) has been shown to be effective in many instances of other diseases. The developing study of psychoneuroimmunology is science’s official recognition that the mind has powerful and far reaching effects on the body. And it mostly happens in a comprehensible physiological progression. The placebo effect, well demonstrated over the centuries, is the proof of mind over matter.

Sadly, there is no guarantee that you can heal yourself with will power or by thinking good thoughts. There is substantial evidence that caring, sharing, laughing and loving will help you to be more healthy.

My personal childhood experience in having recovered from many asthma attacks (usually in a two week cycle) gave me the almost certain knowledge that I would recover. That assurance that I would regain my health vanquished my fear during the hard times and gave me a calm certainty that I see now was a great asset.

Avoidance of Triggers and Loading

Avoidance of triggers is an important part of self care for asthmatics that is stressed by modern medical authorities, already well covered in many asthma sites and so not covered here.

The term “asthma trigger” carries the connotation that certain substances cause the asthmatic or allergic reactions. Remember that there are other substances and factors that make the body more susceptible, but may not, of themselves bring on symptoms or cause an attack.

Asthma results from an accumulation of factors: it is not necessarily the result of a single stimulus within the preceeding hours. It happens in the context of the body’s condition: weeks or months of certain diet, exercise and living habits. For example, high sugar intake may lower the “allergic threshold” and can increase the severity of an allergic reaction. Alcohol consumption can have a similar effect. Any factors, such as stress and air pollution, which increase the work the body must do to stay healthy tend to increase reactivity to allergens. [See Chemical Sensitivity and Fragrances]

Laboratory Testing, a potentially useful complement to Optimization

Advances in laboratory diagnostic techniques have outpaced the customary usage of lab tests by conventional doctors. Many of these assays have been available for years but now they are much less expensive. For example, the traditional method for measuring cortisol levels is by three or four blood draws at four hour intervals in a single day. For some people, even the thought of a needle in the arm elevates cortisol. A more accurate and less invasive test done with saliva samples, at home, is unknown to most conventional doctors.

Standard blood and urine tests do not determine antioxidant levels, profile fatty acids and amino acids or measure levels of nutrient and toxic elements. But a number of labs across the country do. My favorite is the Great Smokies Diagnostic Laboratory, phone 800-522-4762.

Such tests can help your understanding of your health status but are not vital to a program of health optimization.

Part 4: Conclusion

Developing New Habits

Change is normal in all life. Consciously directing certain changes in our lives over time isn’t such a difficult concept—especially if there is a tangible reward for it. Better health and more happiness are good rewards for anyone. Yes—it is hard to change lifelong habits. Even if the following program were guaranteed to cure us, many of us would still not be ready to give up our beloved ice cream or coffee or cigarettes. Our society believes in drugs; we tend to believe that some combination of pills should be able to fix anything that ails us; we tend to believe that our health is something separate from the rest of our lives that should be taken care of by experts.

Children and teens have a better chance at changing and developing good habits—with proper guidance. Yes, this strategy requires some self discipline but it is not an all or nothing proposition. Asthma and allergy symptoms are progressive. Perfection is not required for better health.

By examining every aspect of life, looking at options, assessing changes that can be made for the better, anyone can change, beginning today—then start doing it—one change at a time, one day at a time. The key is not just to give up the unhealthful habits but to replace them with more positive habits, the details of which you can develop and grow to love. You are not perfect, so don’t beat yourself up. Do keep striving.

Optimization

Go for broke! Do as much as you can to get healthy. Sick people may have to make dramatic changes in their life to really get well. You will almost surely not get well making small changes or one change at a time. It is much easier to maintain good health than it is to regain health from a sick, or heavily drug dependent existence. Then again, the simple elimination of milk and wheat products has brought substantial positive changes to some people. Once you are healthy, it is much easier to feel effects of different foods and situations and more readily identify specific problems. Each section above is very important, no one section is less important than any other.

Our patterns of living today are known to contribute to much illness. Experiment with the patterns of your life—‚your diet, your exercise habits, with fasting, your sleeping times, even with living in other locations. Don’t be afraid to get radical—give up sugar and sweet stuff for two weeks. Get off all your favorite drugs—including chocolate, soda pop, coffee and TV—for a few weeks. Watch yourself carefully to see if it helps.

When we make healthy changes, there are often unexpected benefits. Sickness may be a message from nature (or God) telling us to either shape up or move on to the next world. Memories of our sickness can stimulate us to stay well, take good care of ourselves, and really love ourselves.

Learn from your illness: it can teach you to be a better human.

Take up a project, help others, work for justice. Focus on a cause beyond your own comfort or enrichment.

Lacking exhaustive tests and analyses, optimization is a relatively cheap option for asthma prevention. Even if we do not know the exact mechanism by which asthma and allergy occur, we can do much to control the effects.

Don’t just avoid triggers and negative factors; embrace and love the alternatives! Find the cleanest air you can and breathe it deeply. Do not merely avoid caffeine and sweet drinks: drink something really good, that you really love.

Be alert. Grab the good stuff. Share it. Laugh. Love life!


How I (try to) prevent an asthma attack

We humans share 99.8% of the human genome with each other. And we all live according to the basics of human biochemistry and physiology. That said, we are all different so what works for me may not work for you.

It has taken me many years to learn the specifics of my own asthmatic/ allergic condition- the allergens, the triggers, the “loading factors” as well as the protective factors that keep me healthy. At age 53, I still lack a complete understanding of my condition, but I know enough that I live a rich and vigorous life without drugs, heroic measures or great expense. In the long run, I do the best I can according to the Practical Program above.

But what about an emergency, a sore throat, an attack coming on? My asthma threat always starts as a tickle in a certain area of my throat. If I can’t stop this tickle from progressing, I am liable to get an asthma attack. This happens usually against a background of any two or more of the following conditions:

  • Overweight;
  • Poor sleeping;
  • Poor physical conditioning;
  • Dried out;
  • Overeating;
  • Stress

First, I’ll take a couple of tablespoons of Dale Alexander’s orange flavored, Emulsified Norwegian Cod Liver Oil. Any codliver oil would be fine, but this orange flavored stuff really goes down easy, ideal for kids of any age. This is loaded with vitamins A & D and, as they pass down the throat, I like to think they may have some localized effects at any site of rawness.

Then I’ll make a quart either watered down grapefruit juice, drunk a little at a time or maybe just plain water (or maybe herbal tea) laced with crystalline vitamin C. Nothing sweet. Grapefruit juice has the advantage of containing a considerable amount of potassium, which may be helpful here.

With my drink partly finished and on a table beside me, I’ll bundle up– better to be a bit too warm than cold– and try to sleep. Each time I awaken, I’ll drink a bit more liquid. I expect to sweat some and urinate from time to time.

I’ll continue a restful strategy and eat little or nothing. A pot of soup, maybe some steamed greens. No sweets, no starch. At this point, I might do well to take zinc gluconate (antiviral) and maybe echinacea.

In the best case, the scratchy throat will go away and I’ll get back to living. If not, the scratchy throat continues its evolution. I’ll continue with my strategy and still hope to avoid running through my asthma. No sweets, plenty of good liquid, my regular multivitamin and magnesium supplement, plenty of sleep, stay warm.

If I don’t get better, the cascade begins and I cannot stop the following process. First a sore throat, a cough, a throat clearing really. Then it goes to my nasal passages and I’ll have 24 hour runny nose. I use no antihistamine or decongestant here, and just suffer a bit. Next day it goes to my lungs. As long as I am careful and in generally good shape, the asthma does not get such a powerful grip on me.

At this point, I’ll cough some but IF I take good care of myself, I will be able to operate almost normally at 80-90% of my usual speed for the next 10-12 days.

However, I am still susceptible to getting worse during this time if I overeat, stay up late or do something dumb. I eat very light, get to bed by 10 or 11 pm, take my vitamins (vitamin C and a normal daily mega-vitamin) and avoid stress. I’m happy to get out and work in the sun if there is any. At least walk a bit and stay active. I’m not afraid to sweat or urinate. And after 12 days, I’m back to normal.

This is no magic remedy. I could probably do better and hope to learn more, in time. Mainly I try to stay so healthy that I never get to the first stage of the Dreaded Scratchy Throat.

John Hepler, March 2001

*Please note: this article is an old archive from our website, please refer to our newest blog posts to find more accurate and up-to-date information on these topics.

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