What is asthma?

If you suffer from episodes of shortness of breath, wheezing sounds when you breathe, a feeling of tightness in the chest, and chronic coughing of thick clear or white phlegm, you may be one of the 4% of Americans who have asthma. During an attack of asthma, the bronchial tubes constrict or spasm, making it difficult for you to get in enough air. When the spasm of the airway is mild, you may just feel a little tightness or wheezing, a little cough—a tolerable nuisance. But sometimes, attacks can cause severe spasm, and then asthma can be life-threatening if not treated correctly and in time. Any asthmatic who has had this kind of severe attack should be under a physician's watchful care.

AsthmaJust as there are many degrees of asthma severity, there are many causes for asthma. Some people develop asthma with allergy to pollens, pets, dust, foods, or medications. Some people wheeze when they exercise, or only when they have a respiratory infection. Although prescription medication may still be the cornerstone of asthmatic care, can vitamins and minerals help? Yes.

What helps asthma?

• Caffeine in coffee and its cousin, theobromine, found in tea, both act as effective bronchodilators (substances that relax and open up the bronchial tubes). In fact, the prescription bronchodilator theophylline, long used in asthmatic treatment, is really nothing more than an altered form of caffeine (but about twice as potent). Recommendation: Unless you avoid caffeine for other health reasons (heart problems), you can help to relieve mild wheezing and constriction of asthma with the amount of caffeine contained in 3 or 4 6-ounce cups of regular coffee throughout the day. Each cup contains about 150 mg caffeine. Warning: If you currently take a prescription theophylline bronchodilating medicine, you must take great care in using caffeine, since the two are related. Toxic amounts of theophylline can build up when you combine these substances. Toxic symptoms include snaking tremors, nausea, vomiting, irritability, sleeplessness, and hyperactivity.

• Asthmatic wheezing increases when the diet is low in niacin. Especially when the wheezing occurs because of allergy, niacin supplementation helps to relieve symptoms, probably by keeping the mast cells from releasing their histamine (see Section II, Allergies, page 176). Recommendation: Take 100 mg niacin daily.

•  AsthmaVitamin B6 (pyridoxine) levels in asthmatics may be low, especially in people who take theophylline bronchodilator medicines. Supplementation of the vitamin seems to help asthmatic wheezing, sometimes significantly. Recommendation: we would begin at a 50 mg dose once or twice daily. If after 3 to 4 weeks your asthmatic attacks become less severe and occur less often, remain at that dose. If your response has been less dramatic at this level, you can increase the dose to 100 mg twice daily, but do not increase beyond that point, and immediately discontinue use of the supplemental dose of the vitamin if you develop numbness or tingling of your feet and hands. At higher doses, vitamin B6 can occasionally cause nerve irritation that can persist if you continue to supplement the vitamin at the high dose. The 200 mg dose—which some researchers have used even in children—should offer no problem to you, but better to err on the side of safety with this vitamin. Some people have this reaction and some do not, but there's no way ahead of time to predict who will and who won't.

•  Vitamin B12 has proven an excellent relief for asthmatic wheezing in numerous research tests in people of all age categories, including even toddlers. Exactly how the vitamin helps to relax the bronchial tubes is unclear, but it appears quite effective in improving your ability to tolerate exercise and allergens, substances that stimulate allergic symptoms. Recommendation: If your physician will assist you, the best route of administration is to take 1000 micrograms by injection weekly for 4 weeks, then monthly to every 3 to 4 months as needed to maintain control of symptoms. Failing that, look for the drug in sublingual form (dissolves under the tongue) and keep to the same schedule. All ages, in the research testing, took the same dose.

• Vitamin C deficiency may cause an increase in asthmatic symptoms (wheezing and tightness), especially in asthma that occurs with allergy and with exercise, possibly by reducing histamine release or by stimulating the body to produce "good" eicosinoid messengers. (See discussion in Section we on vitamin C, pages 50-54, and eicosinoids, pages 24-27, for more details.) Attacks become less frequent and less severe in people who respond, although we hasten to add that some people do not respond to this therapy. Recommendation: Take 500 mg to 1000 mg prior to exercising, if you wheeze after exercise. Take a daily dose of at least 1000 mg (1 gram) to improve ongoing asthma symptoms.

•  Vitamin C plus niacin in combination seem to assist one another in reducing asthmatic wheezing. By using the two together, you can reduce the doses of each vitamin and still get relief of asthmatic symptoms. Recommendation: Take 90 to 110 mg of niacin (as nicotinic acid) along with 250 to 300 mg vitamin C daily.

• Tests on blood samples taken from people during asthmatic attacks often show a deficiency in magnesium. This is an extremely important supplement, because it opens the bronchioles and relaxes the muscles inside the air tubes, which stops an acute asthma attack quickly. As a preventive measure, asthmatics can benefit from large doses taken orally. Because magnesium has a laxative effect, it is best taken throughout the day with meals. Recommendations: Adults can take between 1000 and 1500 mg daily; children and infants can tolerate 100 to 400 mg. It is worthwhile to note that when taken with calcium, vitamin C, and the B vitamins intravenously, serious asthmatic symptoms subside within minutes. Although this is not something you can do at home, you may want to discuss injections with your doctor.

•  Coenzyme Ql0 resembles vitamin E in its healing abilities, though it may be an even more powerful antioxidant. It relieves asthma symptoms because it has the ability to counter histamine. Recommendation: Take 100 mg daily.

• Molybdenum deficiency occurs quite often in people who have an allergic sensitivity to sulfites (found in wine and eggs). It is a mineral necessary to the detoxification of the sulfite, and lacking it, you will be more severely troubled by your sensitivity. If you develop asthmatic wheezing when you consume these foods, you may be able to improve your tolerance for these foods by adding molybdenum into your diet. Recommendation: Begin with 250 micrograms of molybdenum twice weekly, then increase to 500 micrograms twice weekly, and finally, if necessary, you may increase to 750 micrograms twice weekly to achieve the maximum response. Remain at the lowest dose at which you see improvement in your symptoms.

• Asthma Physicians have relied on N-acetylcysteine, a modified amino acid or protein building block, in a form breathed in as a mist to thin the thick, sticky secretions in their asthmatic patients. In this inhaled mist form, the drug works very well. It doesn't always give as good a result taken as a pill or capsule by mouth; however, it works quite well for some people to help thin the thick mucus. Although cysteine probably won't alleviate all your asthmatic symptoms by itself, if it works for you, you should be able to reduce the doses of bronchodilator medications necessary to control your other asthmatic symptoms. Recommendation: Begin by taking a dose of 200 mg twice daily, then increase to 3 times daily after a week. If you have not seen a good response at that level, take 400 mg twice daily. If you have not responded at that level, you can increase to 500 mg twice daily; however, 1 would not recommend your going beyond that point, because the likelihood of your getting a good response by doing so is small.

•  Essential fatty acids, important in the body's regulation of inflammatory prostaglandins, can help reduce the swelling and spastic hyperreactivity of the bronchial tubes in allergic asthma especially. Please refer to the complete discussion of eicosinoids in Section we, pages 24-27, to learn about these powerful natural antiinflammatory agents and how they work. Recommendation: Supplementing your diet with a tablespoon or two of corn oil, canola oil, or cold-pressed virgin olive oil made into a light vinaigrette dressing may prove beneficial. Two additional sources of omega-6 essential fatty acids can be found in evening primrose oil capsules and in a product called EicoPro (available from Eicotec, Inc., 21 Tioga Way, Marblehead, Massachusetts 01945), 2 capsules daily. To get maximum benefit, reduce your intake of refined sugars and starches as well. If you cannot obtain this combination product, you can make a reasonable substitute by combining evening primrose oil capsules (which provide essential linoleic acid or GLA) with fish oil capsules (which provide EPA), plus vitamin E (which protects these essential oils from oxidation and damage). Take 500 mg of evening primrose oil (a source of linoleic acid in capsule form), plus 1000 mg EPA fish oil, plus 100 IU vitamin E 1 to 3 times a day. (Warning to diabetics: EPA fish oil can cause blood sugar fluctuations in some diabetics. Carefully monitor your blood sugar if you use this supplemental oil and discontinue its use if your blood sugar becomes difficult to control.)

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