In Australia, asthma is thought to affect around 10% of both children and adults. It is a chronic inflammatory disorder of the airways, characterised by wheezing, shortness of breath, chronic cough and airway obstruction. The severity of its presentation can vary greatly, from low grade easily controlled forms, to high grade chronic presentations that can result in significant and permanent airway remodeling. Medical treatment is primarily focused on the application of one or a combination of five classes of drugs: B2 agonists, anticholinergics, theophyllines, cromones and corticosteroids. Although these medical agents are crucial in managing severe and possibly life-threatening instances of asthma attack, they do not address the underlying causes of asthma for true therapeutic resolution.
Asthma can be triggered by a number of environmental and physiological factors
Like most disease and condition states, the development of asthma cannot be narrowed down to a particular trigger for all individuals. There tend to be a number of factors that will contribute to a biological terrain in which asthma may present, and these factors and their combinations will differ for everybody. There are, however, some key considerations to investigate when looking for the key to understanding and eradicating the individual asthma presentation.
Exposure to environmental triggers
More often than not, a person presenting with early onset extrinsic (atopic) asthma will have some form of sensitivity to an environmental trigger such as dust mite, cockroaches, animal dander, cigarette smoke or other airborne pollution, or pollen. Sometimes the trigger may be diet based, such as eggs, dairy, nuts, chocolate or chemical additives (especially dyes). In those with late onset intrinsic asthma the trigger may be cold air, exercise or airborne pollution. Unfortunately simply eradicating this trigger will not usually resolve the condition, as there tend to be predisposing physiological mechanisms that have allowed the sensitivity to occur in the first place. Investigating and removing environmental triggers is still an important step, but digging deeper and understanding the predisposing factors is the most important step in treatment.
Underlying factors for sensitisation
As is almost always the case in a naturopathic approach, it’s important to consider the gut. Hypochlorhydria (low stomach acid) may inhibit the adequate breakdown of food constituents (especially proteins). This can then set up an inflammatory reaction in the gut, and ultimately a widening of the usually tight junctions between stomach wall cells that normally regulate the substances entering circulation. As these larger proteins entering the bloodstream are sampled by immune cells (and especially if this happens consistently over a period of time) the foods or environmental sources from which they came are then considered invaders and their presence will set up an inflammatory immune reaction. A comprehensive digestive stool analysis (CDSA) may be helpful in determining digestive status.
Dysbiosis, or an imbalance of healthy and harmful gut microbiota, can also set up a tendency to inflammation and immune hyper responsiveness. Probiotics in the gut act as immune cell conditioners, offering themselves as sampling agents upon which the immune surveillance ‘soldiers’ practice invader recognition and response. When these probiotics are not present in adequate numbers, the immune system will tend towards a more extreme response to relatively harmless substances.
An overgrowth of the common yeast Candida albicans in the gut may produce an acid protease that can act as an allergen and prime immune sensitivity.
Mental and emotional stress can also be a predisposing factor, by reducing the ability of the adrenal glands to produce adequate cortisol and adrenalin. Both of these hormones can be protective against bronchial constriction.
A deficiency of both oestrogen and progesterone may predispose females to asthma, as both of these hormones can act as smooth muscle relaxants.
A consistent dietary approach to reducing asthma incidence
Despite the varied triggers and sensitising factors listed above, the dietary approach to treating asthma is usually fairly consistent. It involves:
- Reducing consumption of red meat
- Reducing consumption of industrial seed oils
- Reducing consumption of sugar
- Eliminating consumption of artificial additives
- Increasing consumption of cold water fatty fish
- Increasing consumption of vegetables and fruits, ensuring a broad spectrum of colour
It can be helpful to undertake an elimination diet to determine specific foods that may trigger an asthma attack (this should be done under the care of a health practitioner). IgG and IgE food panels, as well as ALCAT food and chemical intolerance tests, may also be helpful in identifying specific triggers.
Nutritional supplementation
A primary focus of nutritional supplementation for asthma should involve broad spectrum anti oxidant therapy. Agents such as vitamin C, E and D, selenium, and CoQ10 are all beneficial. Magnesium acts as a smooth muscle relaxant. Fish oil is effective at dampening the inflammatory response. Probiotics (especially Lactobacillus rhamnosus) are effective at modulating the tendency to inflammation.
Herbal allies in asthma treatment
There are a range of herbs that can be useful in treating the symptoms of asthma, however as always they are of little use in resolving the condition if the underlying causes are not identified and treated. Some of the key herbs used are:
- Ivy leaf: helps to relax the airways and expel mucous
- Coleus: can decrease broncho-constriction
- Tylophora: anti-histamine, reduces inflammation in the airways
- Lobelia: stimulates production of adrenalin and noradrenalin
- Boswellia: reduces systemic inflammation
As always any of the treatment approaches mentioned here should be applied under the care of a qualified health practitioner.
I hope this gives you a starting point to consider the various possible underlying causes of an asthma presentation, and hopefully encourage you to pursue further investigations to determine your own triggers and predisposing factors.
In wellness,
James
