Asthma is a prevalent chronic respiratory disorder that can cause significant morbidity and mortality. With more individuals than ever before having asthma, around 25 million people in the U.S., it is imperative that multiple treatment options are available for these individuals to manage their asthma properly. It is also critical to reduce the incidence of developing asthma. Integrative medicine offers various approaches to addressing these concerns, and this article will explore those approaches.

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What is Asthma?

Asthma is a respiratory condition indicated by inflammation in the airways that causes issues with breathing. Specific triggers usually initiate an exaggerated immune response in people with asthma. The immune response creates inflammation, mucus production, and constriction of the airways, leading to breathing issues.

Causes And Triggers Of Asthma

Although there is no known cause of asthma, allergic triggers are the most common initiator of asthma. The allergen in the airway creates an immune-mediated hyper response that starts an inflammatory cascade and constricts the smooth muscles in the airways. Some of the most common allergic triggers include dust mites, cockroaches, pollen, molds, pet dander, and rodents. There are also irritants in the environment that aren't considered allergens, such as cigarette smoke, fires, strong fumes, and chemicals that can initiate an asthma episode. Furthermore, imbalances in the microbiome have also been associated with the development of asthma. This imbalance can interrupt the cell-signaling immune response within the lungs, leading to asthma.

Symptoms of Asthma

Here are some common symptoms of asthma:

● Shortness of breath

● Chest tightness

● Pain

● Coughing

● Wheezing

Functional Medicine Labs That Can Individualize Treatment For Asthma Patients

The approach in functional medicine is to assess for possible underlying triggers that can initiate or exacerbate an asthma response. Here are some typical labs that functional medicine practitioners will run for their asthma patients:

Comprehensive Stool Analysis

The Stool test provides a comprehensive analysis of the stool by assessing markers of digestion, absorption, inflammation, and imbalances in the microbiome. This test is an important consideration if there are imbalances in the microbiome that may be involved with asthma, allowing practitioners to address this possible trigger.

IgE Allergy Panel

This panel can assess for different environmental allergens such as mites, molds, weeds, and pet dander that are often triggers for people with asthma. Practitioners can utilize these results to determine specific triggers so their patients can avoid them.

Food Sensitivity Panel

Food sensitivities can create inflammation in the gut, thus affecting the balance of the microbiome, which can lead to a greater risk of asthma. Utilizing this panel to identify these sensitivities can help practitioners remove inflammatory triggers that can exacerbate asthma and decrease the risk of asthma attacks.

Additional Labs to Check 

An additional test to consider is Spirometry. Spirometry is a breathing test that evaluates how much and how well you can breathe air in and out of your lungs. This test is often used to help diagnose asthma.

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Conventional Treatment for Asthma

Currently, there is no cure for asthma. Conventional treatments for asthma typically involve medications that focus on immediate relief and long-term control. Bronchodilators are often used for short-term management. These include short-acting beta-agonists (SABA) and anticholinergics. Drugs such as corticosteroid preparations, long-acting bronchodilators, and leukotriene antagonists are used for long-term control. New medications can also be used prophylactically before allergic exposure and can reduce allergic asthma. Cromolyn is a prescription medication that is a steroid-sparing anti-inflammatory used prophylactically and derived from the khella plant.

Integrative Medicine Approaches for Asthma

The integrative medicine approach for asthma is a multi-pronged approach that focuses on the whole person to evaluate and manage this condition. It includes conventional pharmaceutical medicine, personalized nutrition, evidence-based supplements, and other therapies, such as acupuncture, to address the underlying factors contributing to the disease. Integrative practitioners will typically individualize the approaches toward the patient's specific health needs and consider all the factors that affect their health.

Dietary And Nutritional Interventions for Asthma

Staying away from a Western diet and incorporating a more Mediterranean-style diet has been shown to improve asthma outcomes. A Western diet typically has more animal products and does not meet the daily recommended fruit or vegetable intake. This high saturated fat and low fiber intake can create airway inflammation and decrease lung function in people with asthma. On the other hand, Mediterranean diets, which focus on meals rich in plants and fruits that are high in antioxidants, fiber, and healthy fats, have been associated with greater lung function and improved asthma symptoms. These diets included greater than five servings of vegetables and two servings of fruits daily. 

Another nutritional intervention to consider is avoiding dairy, as removing dairy was shown to improve asthma symptoms. People with asthma are believed to have higher levels of a specific type of mucin in their airways, and certain proteins in dairy milk can stimulate mucous production in these patients triggering asthma. Overall, the best nutritional intervention to decrease the risk of developing asthma or asthma attacks is a diet high in fruits and vegetables while avoiding dairy consumption.

Nutritional Supplements and Herbal Remedies for Asthma

Here are some clinically relevant supplements that integrative practitioners will typically suggest for Asthma: 

Omega-3 Fatty Acids

Omega-3 fatty acids, fish or plant-derived, have been indicated to be an inflammatory mediator that decreases the production of immune responses involved with allergic inflammation. The recommended dose is 1500-2000 mg of EPA daily, done in divided doses.

Pycnogenol

Pycnogenol is an antioxidant and bioflavinoid that is derived from maritime pine. It has been demonstrated to improve airway inflammation, and asthma symptoms, increase pulmonary function, and decrease rescue inhaler use. The recommended dose is 100-200 mg twice daily.

Boswellia

Boswellia is a resin derived from Boswellia plants. It has anti-inflammatory properties and has been shown to improve asthma symptoms and reduce inhalation use. The suggested dose is 300 mg three times daily for adults.

Cordyceps

Cordyceps is an herb commonly used for its adaptogenic properties. It can strengthen the lungs and immune system. This herb has also been associated with reduced asthma symptoms and inflammatory responses that induce asthma at three months of use.

Probiotics

Probiotics are well-known for gut health. In particular, to help maintain the balance of the microbiome. These supplements have been shown to improve inflammation and reduce sensitization to allergens in asthma.

Magnesium

Magnesium is an essential nutrient. Studies indicate that it can cause smooth muscle relaxation in the airways and improve bronchial hyperactivity, peak flow, and quality of life for asthma patients. The recommended dose is 300-500 mg daily. Mg glycinate is a form of magnesium that may have less laxative effects.

Vitamin D3

This vitamin is associated with immunomodulation and anti-inflammatory properties in asthma. It may reduce the risk of asthma exacerbation at 800-2000 IU daily.

Acupuncture And Traditional Chinese Medicine for Asthma

With the prevalence of people seeking complementary and integrative solutions to their chronic conditions such as asthma, many are turning to Traditional Chinese Medicine (TCM) and Acupuncture. TCM will typically use herbal formulas made up of a combination of traditional Chinese herbs to address specific conditions. For asthma, some of the formulas include Anti-asthma Herbal Medicine Intervention (ASHMI), Modified Mai Men Dong Tang (mMMDT), Ding Chuan Tang (a Chinese herbal decoction), and STA-1 (a mixture of ten Chinese herbs). These formulas have been indicated to reduce asthma symptoms, decrease inflammatory responses, improve lung function, and reduce the use of inhalers. 

Regarding acupuncture for asthma, this therapy exhibited relief of asthma symptoms and improved the quality of life in asthma patients in clinical trials. It is thought that acupuncture can improve the function of the immune system and inhibit allergic reactions. Although, more studies need to be completed for further evaluation of efficacy.

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Summary

With more people developing asthma, it is necessary to understand what triggers asthma and how to manage it properly. Knowing that some of the triggers may stem from environmental allergens and also imbalances in the microbiome, integrative medicine can provide complementary approaches to evaluating and managing asthma. These integrative approaches, such as dietary changes, clinically relevant supplements, acupuncture, and Chinese medicine, have effectively managed this condition, making integrative medicine a viable approach to improving the quality of life for asthma patients.