Asthma

Asthma

Martha was one of my favorite people--a tall, pretty, free-spirited woman in her thirties who worked as a technician with me in the Medicinal Plants Research Laboratory of the U.S. Department of Agriculture (USDA). We were both involved with the joint USDA/National Cancer Institute plant-screening program, looking for plants with anti-cancer potential.

Martha loved to hike in the woods, and we occasionally hiked together. I can see her now, working happily in my ginseng patch in big, tall cowboy boots. I would never have imagined that she would become one of the thousands of Americans who die each year of asthma.

Asthma Takes Your Breath Away

Asthma is a chronic respiratory ailment that causes wheezing, coughing, chest congestion, shortness of breath and often tremendous anxiety about being unable to breathe.

More than 4,000 people die each year from complications of serious asthma attacks, a number that's increased over 30 percent since 1980. For reasons that remain unexplained, children are more likely to die in summer, while people over 65 are more likely to die in winter.

Many people consider asthma a childhood illness, and there's certainly no shortage of kids with this disease. In 1995, some 3.7 million children and adolescents had it, up sharply from 2.4 million in 1980. But asthma can develop at any age, and the fact is, most people with asthma are adults. About 14 million Americans now have asthma. The disease costs us more than $6 billion a year in medical care and lost productivity.

Doctors say that they don't know what causes asthma or why the number of people who have it keeps rising. Neither do I. But it seems that the closer we get to chemical pollution and the farther we stray from natural foods, the more asthma we see. I believe that outdoor air pollution and "sick buildings" with indoor pollution are a big part of the growing asthma problem.

The symptoms of asthma are caused by bronchial spasms (bronchospasms), a sudden narrowing of the branching tubes that lead into the lungs. While asthma and hay fever­type allergies are distinct conditions, they overlap, especially among those under age 15. Ninety percent of children with asthma also have allergies, and these allergies can trigger asthma attacks.

The reason that bronchospasms can be triggered by allergies is that histamine, the chemical most responsible for allergy symptoms, seems to play a role in asthma attacks as well. But many other things besides histamine can trigger an attack: strenuous exercise, cigarette smoke, respiratory infections, industrial chemicals, aspirin, pet dander, indoor pollution and the sulfites added to many foods.

Stress also plays a role in asthma. Severe anxiety can trigger attacks, and stress generally aggravates asthma symptoms.

Green Pharmacy for Asthma

Doctors treat asthma with a variety of drugs--among them, theophylline (Aerolate, Theo-Dur)--that open up the bronchial tubes. These drugs, known as bronchodilators, are often taken with an inhaler.

If I had asthma, I'd certainly follow a physician's recommendations. This is a potentially fatal illness. But for my treatment, if my doctor suggested theophylline, I'd prefer to get it from its many natural sources, chief among them the plants containing caffeine.

Coffee, tea, caffeinated cola drinks, cocoa and chocolate. All of these popular beverages, as well as chocolate candy, are derived from plants and count as herbal products. And all contain caffeine as well as other compounds that may help fend off asthma.

Joe Graedon, the pharmacist and syndicated newspaper columnist, once wrote in his column that in a pinch, if caught without their medication, people with asthma could drink a few cups of coffee, which is a potent bronchodilator. Some months later he received a thank-you note from a newlywed woman with asthma who forgot her medication on her Hawaiian honeymoon. At one point she started wheezing, realized she'd forgotten her drugs and became panicky, which made her wheezing worse. Then she remembered the column advocating coffee as a workable substitute. She quickly drank three cups. Her wheezing subsided, saving her honeymoon and possibly her life.

Actually, coffee, tea, caffeinated cola drinks, cocoa and chocolate have more than caffeine. All reportedly contain two other major natural anti-asthmatic compounds, theobromine and theophylline, which, along with caffeine, belong to a family of chemicals called xanthines. These chemicals help stop bronchospasms and open constricted bronchial passages.

Levels of these anti-asthmatic compounds vary, depending on the strength of the brew and other factors. But in general, a cup of coffee has the highest levels (about 100 milligrams of caffeine per cup), while a cup of tea or cocoa or a 12-ounce can of cola has about half that amount. A 11Ž2-ounce chocolate bar has a little less than a can of cola.

Of course, caffeine and the other anti-asthmatic xanthines are not entirely risk-free. As any java junkie knows, caffeine can cause insomnia and the jitters. But in their natural state, the anti-asthmatic compounds actually cause fewer side effects than pharmaceutical theophylline.

In one survey, 81 percent of pediatricians said that parents had expressed concerns about the side effects of their children's asthma medication, particularly the restlessness and difficulty concentrating that many children experience. At high doses, pharmaceutical asthma medications may also cause headache, insomnia, irritability, nausea, poor appetite, stomachache and even seizures.

At this point, though, I'd like to make myself crystal clear: If I were plagued by life-threatening asthma, I'd listen to my physician and take pharmaceuticals, and I'd use natural approaches only as supplemental treatments.

Ephedra (Ephedra sinica). Many medical botanists say that ephedra is one of the world's oldest medicines. The Chinese, who call it ma huang, have used this herb for thousands of years to treat asthma and other respiratory ailments.

Scientists isolated its active chemical constituents, ephedrine and pseudoephedrine, in 1887. It wasn't until after World War I, however, that American doctors started prescribing these substances. At that time, doctors became aware of the chemicals' effects as bronchodilators, nasal decongestants and central nervous system stimulants. Pseudoephedrine has since become a common over-the-counter decongestant. The chemical inspired the brand name Sudafed.

Whole ephedra--as well as its chemical components ephedrine and pseudoephedrine--has side effects such as insomnia, anxiety, restlessness and possibly aggravation of high blood pressure. So you have to be careful with this herb. In fact, if you take really high doses, very strange things can happen. The medical literature contains 20 case reports of ephedrine psychosis, and the Food and Drug Administration has taken steps to curb the distribution and sale of ephedrine supplements.

Still, if you are careful, this herb is very useful in managing asthma. You might consider making a tea with the dried herb instead of taking the over-the-counter drugs that contain the active compounds. To make a tea, use a level teaspoon of ephedra or a half-teaspoon to one teaspoon of tincture from a health food store or pharmacy.

Because of ephedra's stimulant effect, some ephedra/ma huang products are sold as "energy formulas." In fact, over the last few years, several people have died as a result of abusing this herb. Because it does have stimulant properties, I would advise against using ephedra to treat asthma in children unless you first discuss it with the child's pediatrician.

stinging nettle (Urtica dioica). Four hundred years ago, the British herbalist Nicholas Culpeper claimed that nettle roots or leaves, used in juice or tea, were "safe and sure medicines to open the pipes and passages of the lungs."

For many years, Australians have viewed nettle as a good treatment for asthma. Aussies drink the juice of the roots and leaves mixed with honey or sugar, and they firmly believe that it relieves bronchial troubles. But Americans didn't catch on until a little more than five years ago, when a scientific study was published showing that nettle is a potent antihistamine. Now nettle is increasingly recommended for hay fever and asthma. Friends with allergies and asthma visit my garden regularly to dig up my nettle patch. (You'll need to wear gloves when harvesting stinging nettle leaves, but the stinging hairs lose their sting when the leaves are cooked.)

Anise (Pimpinella anisum) and fennel (Foeniculum vulgare). The Greeks use teas made from these herbs for asthma and other respiratory ailments. They both contain helpful chemicals--creosol and alpha-pinene--that help loosen bronchial secretions. Fennel seeds (actually fruits) can contain as much as 8,800 parts per million (ppm) of alpha-pinene. Ironically,
despite its traditional use for respiratory problems, anise is no superstar. It has only 360 ppm of alpha-pinene.

Many other plants are good sources and could be expected to provide asthma relief. In descending order, they are parsley seed, coriander, juniper berries, sweet Annie, cardamom, sassafras, horsebalm, ginger, Chinese angelica (also known as dong-quai), dill, tarragon and yarrow. You could mix up a pretty good Asthma Tea with any or several of these, especially if you added a little licorice.

Fennel Also known as finocchio, this herb is in the same plant family as carrots and parsley.

Licorice (Glycyrrhiza glabra). Licorice tea soothes the throat and is often recommended for sore throat, cough and asthma. Licorice and its extracts are safe for normal use in moderate amounts--up to about three cups a day. However, long-term use or ingestion of excessive amounts can produce headache, lethargy, sodium and water retention, excessive loss of potassium and high blood pressure.

If you decide to use licorice steadily to manage asthma, opt for deglycyrrhizinated licorice extracts (DGLE), which cause fewer problems. There are many over-the-counter preparations of DGLE, especially overseas. You can find them in America, however. I use licorice (modestly), especially during severe episodes of stress, by using a piece of dried root to stir my herb teas.

Ginkgo (Ginkgo biloba). Asian healers have used extracts of ginkgo leaves for thousands of years to treat asthma, allergies, bronchitis and coughs. Ginkgo has become popular in the West because of its benefits for the elderly: increased blood flow to the brain and treatment of stroke and other infirmities of old age. But in China, it's still widely used for asthma.

Ginkgo works because it interferes with platelet-activating factor, a protein in the blood that plays a role in triggering bronchospasms.

Unfortunately, the active constituents in ginkgo--ginkgolides--are pres-ent in very low concentrations in the tree's leaves. To get one reasonable dose of medicine, a person with asthma would have to eat about 50 fresh leaves. I eat a lot of plants that most people wouldn't touch, but not even I would eat that many ginkgo leaves.

The best way to take this herb is to buy a 50:1 extract (50 pounds of leaves yields 1 pound of extract). Health food stores and some pharmacies carry ginkgo extracts. Follow the package directions. You can try 60 to 240 milligrams of standardized extract a day, but don't go any higher than that. In large amounts, ginkgo may cause diarrhea, irritability and restlessness.

Tomato (Lycopersicon lycopersicum), citrus fruits and other foods containing vitamin C. A review of some 40 good studies revealed that vitamin C--about 1,000 milligrams a day--helps prevent asthma attacks, bronchospasms, wheezing, respiratory infections, nasal congestion, watery eyes and other allergy symptoms. Why? Vitamin C inhibits the release of histamine.

I advise eating more plants that are high in vitamin C--not just citrus fruits and tomatoes but also bell peppers and strawberries. You can also take a supplement. The beauty of eating citrus fruits, however, is that in addition to vitamin C, they also contain flavonoids. These are substances that also block the release of histamine, in turn curbing allergy symptoms and allergy-related asthma.

Assorted herbs. I searched my database for anti-asthmatic compounds and came up with quite a few herbs worth mentioning. I found at least six anti-asthmatic substances in tea, fennel and cayenne. Onion, coriander and bell pepper had five. And a large group contained four: cabbage, cacao, carrot, cranberry, currant, eggplant, grapefruit, orange, oregano, sage and tomato.

Looking for herbs with the largest amounts of anti-asthma compounds, I found that licorice and tea were the big winners. Cacao, cardamom, coffee, cola, onion and purslane looked relatively rich.

You could whip up some interesting anti-asthma dishes with these herbs. How about orange-grapefruit-cranberry fruit salad with fennel? Or eggplant with onion, tomato and sage?

Finally, Japanese wasabi is worth a try. The Japanese enjoy wasabi just as Americans and Europeans enjoy horseradish. It certainly clears the sinuses. There's some research suggesting that a spoonful a day can relieve allergies, especially hay fever. This tells me that it should be good for managing asthma as well.

If I had asthma, I'd try wasabi. You can buy it at any grocery store that carries a specialty line of Oriental products. You can use it just as you would horseradish. Try spreading it on crackers or mixing it in a dip, or have it with sushi, as the Japanese do.

You should be aware, however, that wasabi is extremely hot. If you don't enjoy hot foods, don't even consider using this as an asthma treatment.

Vitamin B₆. Melvyn Werbach, M.D., assistant clinical professor of psychiatry at the University of California, Los Angeles, School of Medicine and author of several books on alternative medicine, cites cases of children with asthma who reduced their dosages of anti-asthma medications--bronchodilators and steroids--by taking a daily dose of 200 milligrams of vitamin B₆ in addition to their medication. Adults have experienced decreased frequency and intensity of asthma attacks by taking 50 milligrams of vitamin B₆ twice daily.

The Daily Value for B₆ is only 2 milligrams, and unusually large doses may damage the nervous system. If I had asthma, I'd probably try B₆, but if you want to take B₆ supplements or give them to your child, discuss it with your doctor.