by Dr. Sarah Myhill
Asthma simply means narrowing of the airways. Narrowing occurs because of muscle spasm of the airways. This can be measured by peak flow (how well you can exhale: measured with a simple device) and if the peak flow varies by more than 15% over 24 hours then the diagnosis is asthma.
Narrowing of the airways is perceived by the body as an obstruction. To get rid of the obstruction the body coughs. So asthma often starts with cough. Because airways are normally a bit narrower at night, there is often coughing at night.
Other symptoms include a sensation of chest tightness, wheeze (classically high pitched with a musical quality), shortness of breath, having to work hard to get a breath and of course cough. An acute attack of asthma needs attacking aggressively (see article on Acute Asthma - how to recognise and treat).
Asthma may occur for several reasons:
With respiratory infection: a common cause - sufferers will say that all colds "go on to their chest".
With irritants: such as cigarette smoke, dusts, wood dusts (carpenters), cotton dusts, and other fine particulates from pollution, flour dust (baker's lung).
As a result of allergy. This can be to:
- Inhalants (pollen, animal dander, house dust mite, moulds as in farmers lung), workers handling laboratory animals (urine).
- Foods: this is a commonly over-looked cause of asthma.
- Chemicals: multiple chemical sensitivity is a common problem and exposure to perfumes, vehicle fumes, gas, solvents etc will causing wheezing in the susceptible.
- Bugs: some people are allergic to bacteria or yeast, possibly in the lung or gut.
If the cause of the asthma does not go away, then there will be secondary inflammation of the lung which may become chronic and go onto chronic obstructive airways disease (COAD).
Thus one can see the rationale behind drug treatment of asthma (indeed all airways disease!): use the blue inhaler to reverse the bronchospasm; and the brown inhaler to damp down the chronic inflammation. The problem with these treatments is that in the short term they work so well that doctors have become lazy about looking for the cause of the asthma. No longer are skin tests for allergens routine, there is no elimination dieting, no enquiry about polluting industry, indeed no search at all for possible causes. Sufferers are condemned to a lifetime of inhalers.
The most overlooked cause of asthma is pollution. See work by Dr Dick Van Steenis at www.countrydoctor.co.uk
Prevention of Asthma
This is about finding the cause. Good detective work is required based on the principle that there must be a cause: things do not happen for no reason.
Nutrition: deficiencies in asthma patients are common, especially zinc, magnesium and essential fatty acids. All asthma sufferers should take nutritional supplements. Magnesium is a particularly important deficiency. This is for several reasons. Magnesium is necessary for muscles to relax and deficiency will cause muscle spasm. It is also required to stabilise allergy cells (mast cells), in magnesium deficiency they discharge histamine readily to cause the symptoms of allergy and asthma. I treat acute asthma attacks with intravenous magnesium and it can also be given via a nebuliser with excellent results. See MAGNESIUM DEFICIENCY. All asthmatics should take NUTRITIONAL SUPPLEMENTS.
Anti-oxidants: many of the symptoms may be caused by free radicals and antioxidants (A,C,E and selenium may be very helpful). See ANTIOXIDANTS. This may explain why B12 injections are often very helpful in treating and preventing asthma. B12 provides instant antioxidant cover.
Respiratory infection: at the first sign of infection, take high dose vitamin C, A, zinc and propolis (see TREATMENT OF VIRAL INFECTIONS). Viruses and bacteria are susceptible to temperature. Running a fever kills bugs. Do not prevent this with paracetomol and aspirin!
Identify irritants: such as cigarette smoke, dusts and other fine particulates from pollution. A friend and colleague Dr Dick Van Steenis has shown there is a huge increase in asthma in people living around polluting industry. This is for several reasons such as:
- Small particulate matter: particles may be so tiny that they are inhaled and not picked up in the nose and bronchi. They travel deep into the lungs where they get stuck. The body tries to get rid of them but it fails. Therefore chronic inflammation in the lungs develops resulting initially in asthma and later in chronic lung disease.
- Irritant gases: ozone, nitrous oxide, sulphur fumes, etc
- Nickel: this metal is a common allergen
- Heavy metals: again these cause chronic lung inflammation
- Pesticides, volatile organic compounds (a huge range), dioxins, etc are directly toxic to the lungs. Bad areas are in the South of Wales, Midlands, Merseyside and Liverpool, Central Scotland and South London. You just have to look around at the toxic waste sites and discharging industrial chimneys, especially at night when the worst discharges occur.
- Pollen: tree pollen causes problems in the Spring from February onwards, grass pollen from the last week in May to the second week of July, after which moulds are a problem through the Autumn. Skin tests can be helpful.
Animal dander: usually obvious with wheezing on exposure. Skin tests can be helpful.
House dust mite: often symptoms worse in the morning. See HOUSE DUST MITE.
- Moulds: can cause farmer's lung. Usually in dusty hay and straw.
- Bacterial heat shock proteins: some people only feel really well on antibiotics. This may be because they are allergic to bacterial products. Recent research suggests antibodies to bacterial heat shock protein can cause asthma.
- Foods: this is a commonly over-looked cause of asthma and is diagnosed by elimination dieting - see STONEAGE DIET.
- Bacteria and yeast in the gut: see GUT DYSBIOSIS.
- Chemicals: MULTIPLE CHEMICAL SENSITIVITY is a common problem and exposure to perfumes, vehicle fumes, gas, solvents etc will causing wheezing in the susceptible.
Patients with asthma often hyperventilate and this in turn worsens the asthma. Breathing exercises can be very helpful and can be learned as part of playing a wind instrument or learning to sing. It is well worth having a physio or osteopath look at the shape of the chest as breathing difficulties may be worsened by poor posture. See HYPERVENTILATION.
I often see patients who get asthma for a variety of reasons and I start them on desensitisation to try to turn off all their allergies. A combined approach of environmental control, nutrition and desensitisation usually gets good results. The trouble is this is initially much harder work than using the blue and the brown inhalers and because people, like their doctors, are lazy they take the easy option. See ENZYME POTENTIATED DESENSITISATION.
When there is excessive catarrh or phlegm, this is a symptom of inflammation. A common cause is allergy, especially to dairy products.
Thick phlegm can be thinned and made easier to cough up by N-Acetyl Cysteine 200mgs tds.
Check DHEA levels which are often low in asthmatics, especially when there has been reliance on oral or inhaled steroids. Also well worth a try is "Power Breathe" which is a device for strenghtening the diaphragm see www.powerbreath.com
Salt pipe - A Polish doctor noticed that miners in salt mines never suffered from asthma, in contrast to those in coal or mineral mines. Several of my patients have benefited from this simple device, available from Healthy House