In this month’s National Center for Complementary and Alternative Medicine‘s Clinical Digest, researchers weighed in about the effectiveness of using complementary health practices for the relief of asthma symptoms. Asthma is a chronic lung disease that afflicts more than 300 million people worldwide. More than 250,000 people die prematurely every year from asthma, and nearly all of the deaths are preventable. The costs of asthma in the US alone grew from roughly $53 billion in 2002 to more than $56 billion by 2007 — about 8.4% of Americans have asthma — and these numbers rise steadily every year.
Asthma is all too familiar to many of us, causing terrifying episodes of coughing, wheezing, shortness of breath and chest tightness. It has no cure. It is the third-ranking cause of hospitalization among children under 15. Most asthma sufferers are able to control and manage their symptoms with conventional Western therapies and by knowing and avoiding triggers. It is worth noting, however, that nearly half of all adults who are taught how to avoid triggering an attack do not follow this advice. And 40% of uninsured people with asthma, and 11% of those who are insured, cannot afford their prescriptions.
With the growing number of asthma sufferers and the ever-greater need for broader access to timely and effective medical care for these patients, it makes sense that alternative and complementary approaches are being carefully studied. Acupuncture, breathing exercises and herbal supplements are under rigorous scrutiny to see what genuine relief and benefit they can bring. There is also a strong emphasis on prevention in healthcare today, on patients participating in their own care with lifestyle commitments and changes. If asthma sufferers are themselves turning to alternatives and they do the job, great. In fact, anything that the world of alternatives can bring that works safely and effectively will be more than welcome.
So where are we in this quest? Are alternative therapies safe and effective? In terms of asthma, we are not there yet: at this point, there is simply not enough evidence to support the use of any complementary health practices for the relief of this chronic disease‘s symptoms.
This is disheartening, but remember, we are talking only about asthma symptoms, actual lung function. A 2011 study reviewed the placebo response in chronic asthma patients. They found that patients receiving placebo treatments — placebo inhalers, sham acupuncture — reported significant improvement in their symptoms, including chest tightness and perception of difficulty breathing. This is great, except that lung function did not improve in these patients. So while patients reported that they felt better, they were still at risk for serious, even life-threatening consequences from untreated asthma. In short, patients felt good but were nonetheless in very real physical danger.
Here is how the researchers rated the top complementary/alternative therapies in terms of asthma symptom relief:
- There have now been several studies that have systematically looked at acupuncture — using very fine metal needles to stimulate specific points on the body — for asthma. Some studies have found symptom improvement with this treatment, along with a perception of improved quality of life and a slight reduction in medication use. Most of the research, however, showed essentially no difference between real acupuncture and sham acupuncture on asthma symptoms. At this point, then, acupuncture is not a viable or effective alternative to conventional Western treatment for asthma.
- Asthma patients themselves have shown renewed interest lately in breathing exercises or retraining to reduce the incidence of hyperventilation and to regulate breathing in order to better balance oxygen and carbon dioxide in the blood. There are specific techniques, including the Papworth Method and the Buteyko Breathing Technique, that are popular with patients. A review of seven randomized controlled trials indicated a trend towards improvement in asthma symptoms with these methods, but we don’t have enough to go on yet. So far, then, solid evidence to support these alternative practices is lacking.
Herbs and Other Dietary Supplements
- It is worth noting, first, that several conventional asthma treatments have their basis in herbal preparations: the bronchodilator theophylline is found in tea leaves; ephedrine, another bronchodilator, is a compound in the traditional Chinese herb ma huang. But other herbs and dietary supplements that have been studied so far show no potential benefit for the relief of asthma symptoms. These include boswellia, magnesium supplements, omega-3 fatty acids, vitamin C, butterbur, among others.