Notes on the Herbal Treatment of Asthma

Dr. J’s Respiratory Formula
Ayurveda Herbs, “Asthma”
Pankaja Kasthuri
Ming-Chun Wen et al., “Herbal intervention in adults with asthma”
Health World, “Asthma”
Dr. Richard Firshein, “The Basic Asthma Protocol”
David Hoffmann, The New Holistic Herbal
See also “Natural Asthma Relief, ” by C. Leigh Broadhurst
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source: Dr. J’s Respiratory Formula TOP

Anise    Relaxing expectorant, antiseptic and carminative; good for irritant dry coughs and bronchial infections
Astragalus    Effective for chronic lung weakness
Barberry    Reduces bronchial constriction
Black Cohosh    Reduces mucus levels
Blessed Thistle    Alleviates pneumonitis (inflammation of lung tissue)
Buchu    Respiratory disorders
Chickweed    Asthma treatment, colds & coughs
Echinacea    Antibiotic and anti-inflammatory
Elder    Reduces phlegm; anti-inflammatory and expectorant; useful for upper respiratory tract mucus associated with colds & hay fever
Elecampane    Lung tonic and expectorant
Fennel    Clears lungs
Fenugreek    Reduces mucus and fever
Feverfew    Increases fluidity of lung & bronchial mucus
Garlic    Colds, flu and lung conditions
Ginseng    Promotes lung function
Goldenseal    Good for respiratory system
Hyssop    Warming, expectorant, anti-spasmodic
Marshmallow    Demulcent and expectorant; soothes inflamed respiratory mucous membranes
Mullein    Difficult breathing, asthma
Nettles    Asthma, expectorant, good for mucus in lungs
Red Clover    Inflamed lungs, whooping cough
Sang Bai Pi    Cooling expectorant, antitussive
Valerian    Reduces mucus from colds
Wild Lettuce    Sedative useful for coughs


source: Ayurveda Herbs, “Asthma” TOP

A Natural Herbal Dietary Supplement for ASTHMA: Made from the herb Elecampane (Inula spp. root) plus 21 decongestant, expectorant, demulcent, tonic, and rejuvenative ayurveda herbs in a base of honey.

Herbal extracts of: Elecampane root (Inula helenium), Bala (Sida cordifolia), Mullein herb (Verbascum thapsus), Licorice root (Glychyrrhiza glabra), Yerba Santa herb (Eriodictyon glutinosum), Amalaki fruit (Emblica officinalis), Thyme leaf (Thymus vulgaris), Black Pepper (Piper nigrum), Shilajit (natural Asphaltum), Tulasi (Ocimum santicum), Ajwan (Apium graveolens), Haritaki fruit (Chebulic Myrobalan, Terminalia chebula), Pippali seed (Piper longum), Coffee.

Powdered herbs of: Flax seed (Linum usitatissimum), Manna (Vamsha rochana), Ginger root (Zingiber officinale), Clove buds (Caryophyllus aromaticus), Cardamom seed (Elettaria cardamomum), Turmeric root (Curcuma longa), Bhibitaki fruit (Beleric myrobalan), Myrrh (Commiphora molmol), Cubeb berry (Piper cubeba), Asafoetida (Ferula asafoetida).

Smoking herbs such as mullein, yerba santa, thyme, clove, bayberry, ajwan, and sage in a water pipe is a very effective treatment as well.

The following essential oils are also very helpful and can be used in an essential oil diffuser: turmeric, holy basil, calamus, cardamon, thyme, ajwan, ginger root, clove, sage.



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“Pankaja Kasthuri” is a formulation of Indian and Chinese herbs to build long-term natural immunity to allergens as well as reduce inflammation and constriction, prevent edema, and dilate the airways. Each 30 g is prepared with

Black pepper seed (Piper nigrum), 500 mg
Pippali (Indian long pepper) seed (Piper longum), 500 mg
Ginger root (Zingiber officinale), 500 mg
Cardamom seed (Elettaria cardamomum), 500 mg
Cassia (Chinese Cinnamon) (Cinnamomum cassia), 500 mg
Ashwagandha root (Withania somnifera), 500 mg
Tamarind (Tamarindus indica), 500 mg
Cumin seed (Cuminum cyminum), 500 mg
Bael fruit (Aegle marmelos), 5 g
Malabar (Adhatoda vasica), 5 g
Haritaki fruit (chebulic myrobalan) (Terminalia chebula), 4 g
Vibhitaki fruit (belliric myrobalan) (Terminalia bellerica), 3 g
Bichuti root (Tragia involucrata), 3 g
Manjistha (Indian madder) (Rubia cordifolia), 3 g
Sugar candy, 3 g



source: Ming-Chun Wen et al., “Efficacy and tolerability of antiasthma herbal medicine intervention in adult patients with moderate–severe allergic asthma,” Journal of Allergy and Clinical Immunology 116(3):517–524. TOP

Methods. In a double-blind trial, 91 subjects underwent randomization. Forty-five subjects received oral ASHMI capsules and prednisone placebo tablets (ASHMI group) and 46 subjects received oral prednisone tablets and ASHMI placebo capsules (prednisone group) for 4 weeks. Spirometry measurements; symptom scores; side effects; and serum cortisol, cytokine, and IgE levels were evaluated before and after treatment.

Results. Posttreatment lung function was significantly improved in both groups as shown by increased FEV1 and peak expiratory flow findings (P < .001). The improvement was slightly but significantly greater in the prednisone group (P < .05). Clinical symptom scores, use of β2-bronchodilators, and serum IgE levels were reduced significantly, and to a similar degree in both groups (P < .001). TH2 cytokine levels were significantly reduced in both treated groups (P < .001) and were lower in the prednisone-treated group (P < .05). Serum IFN-γ and cortisol levels were significantly decreased in the prednisone group (P < .001) but significantly increased in the ASHMI group (P < .001). No severe side effects were observed in either group.

Conclusion. Antiasthma herbal medicine intervention appears to be a safe and effective alternative medicine for treating asthma. In contrast with prednisone, ASHMI had no adverse effect on adrenal function and had a beneficial effect on TH1 and TH2 balance.

Asthma is characterized by chronic airway inflammation, which adversely affects normal lung function. Corticosteroids, the most potent nonspecific anti-inflammatory agents, produce substantial improvement in objective lung functions of patients with asthma and are the cornerstone of asthma treatment. However, systemic corticosteroids also induce serious systemic adverse effects when given for prolonged periods. Corticosteroids also produce overall immune suppression, resulting in increased susceptibility to infections. The side effects are significantly reduced with inhaled corticosteroids, but in higher doses, side effects including adrenal suppression and reduction in growth velocity have been reported. There is a need for development of additional effective treatments with fewer side effects. Recently, there has been a surge in interest in traditional Chinese medicine (TCM) in Western countries, possibly because of the low cost and favorable safety profile. Although a role for TCM in Western medicine has not been established, TCM is in the mainstream of modern medical practice in China for treatment of various diseases, including asthma, either as monotherapy or as complementary therapy to standard Western medications. However, well-controlled clinical trials using TCM for asthma treatment are still rare.

In an attempt to develop novel herbal interventions for asthma, we previously tested Chinese herbal formula MSSM-002 (an extract of 14 herbs based on a TCM prescription used to treat childhood asthma in the Pediatric Department of the China-Japan Friendship Hospital in Beijing) on a well characterized murine model of asthma. We found that MSSM-002 virtually eliminated airway hyperreactivity, markedly reduced the total number of cells and the percentage of eosinophils in bronchoalveolar lavage fluid, and inhibited mucus production in lungs of allergen-challenged mice. Interestingly, in contrast with corticosteroids, which suppress both TH1 and TH2 responses, MSSM-002 specifically suppressed TH2 responses (IL-4, IL-5, IgE production), but not TH1 responses (IFN-γ, IgG2a production). We further found that the immunomodulatory effects of MSSM-002 on TH2 cells are caused, at least in part, by downregulation of GATA-3, a TH2 transcription factor, and unlike corticosteroids, MSSM-002 does not induce apoptosis. These findings suggest that MSSM-002 may be of benefit in the treatment of asthma. On the basis of the actions of individual herbs contained in MSSM-002 in our murine asthma model and on TCM formulation concepts, we developed a simplified antiasthma herbal medicine intervention (ASHMI). ASHMI is an extract of 3 herbs: Ling-Zhi (Ganoderma lucidum), Ku-Shen (Radix Sophora flavescentis), and Gan-Cao (Radix Glycyrrhiza uralensis). We found that ASHMI, like MSSM-002, exhibits the same broad spectrum of therapeutic effects on the major pathogenic mechanisms of asthma #8212; airway hyperreactivity, pulmonary inflammation, and airway remodeling — as well as downregulating TH2 responses and direct modulation of airway smooth muscle contraction. In addition, ASHMI significantly suppressed TH2 cytokine production by human PBMCs from patients with asthma. No cytotoxicity was detected at the highest effective dose tested. On the basis of these findings, we undertook a study of the clinical effects, safety, and immunomodulatory effects of ASHMI treatment in patients with asthma compared with standard therapy with prednisone.

Subjects in the ASHMI group received oral ASHMI capsules (4 capsules, three times a day) and placebo tablets similar in appearance to prednisone. Subjects in the prednisone group received oral prednisone tablets (20 mg once a day in the morning) and ASHMI placebo capsules for 4 weeks. For the duration of the study, leukotriene modifiers, antihistamines, and inhaled and intravenous glucocorticoids were prohibited. β2-agonist inhalation was allowed as needed.

... Each ASHMI capsule contained 0.3 g dried aqueous extract. The total daily dose of 12 capsules (3.6 g) is equivalent to extracts of a mixture of the raw herbs Ling-Zhi 20 g, Ku-Shen 9 g, and Gan-Cao 3 g.

[Ling-Zhi, Ganoderma lucidum (Reishi mushroom)

[Ku-Shen, Radix Sophora flavescentis (root of Sophora flavescens or S. angustifolia (yellow mountain laurel))

[Gan-Cao, Radix Glycyrrhiza uralensis (root of G. uralensis or G. glabra (licorice))]

... All 3 herbs in ASHMI have a long history of human use in China and are considered to be safe when used according to TCM practice either alone or in formulas. Clinical, pharmacological, and toxicity studies supporting the clinical use and safety of these 3 herbs in various human diseases, including asthma and other immune disorders, have been published. For example, Ling-Zhi has been used for allergic conditions such as asthma and allergic rhinitis. Ku-Shen has been used for allergy associated conditions such as eczema, pruritus, and asthma and nonallergic conditions such as hepatitis B, acute dysentery, and jaundice. Gan-Cao has been used for asthmalike ailments such as shortness of breath and productive cough and other conditions such as adrenal insufficiency, peptic ulcers, and epigastric spasm. The mechanisms underlying the remarkable effects of ASHMI on chronic asthma are largely unknown but are likely a result of synergistic or additive effects of the complex nature of its constituents.


source: Health World, “Asthma” TOP

Ephedra sinica (Ma Huang) and some other species of oriental ephedra prove exceptionally useful as bronchodilators. It is the original source of the alkaloid L-ephedrine. The natural form is better tolerated, causing fewer heart symptoms. Ephedrine which stimulates the sympathetic nervous system, relieving the bronchial spasm that underlies the asthmatic state, as well other conditions that have a bronchospasm component, such as emphysema. Allergic reactions respond well to ephedra because of its action on the sympathetic nerves.

Other plants from all around the world have marked antispasmodic and bronchodilating effects. Of most importance within western phytotherapy are

Ephedra sinica
Grindelia camporum [giant gum plant, great valley gumweed -- toxic]
Euphorbia pilulifera [pill-bearing spurge]
Drosera rotundifolia [round-leaved sundew]
Prunus serotina [black cherry, wild cherry]
Ammi visnaga [toothpickweed]

One possible prescription for asthma (dyspnoea mixture):

Grindelia camporum -- 24 parts tincture
Euphorbia pilulifera -- 24 parts tincture
Lobelia inflata -- 12 parts tincture [indian tobacco]
Prunus serotina -- 12 parts tincture
Glycyrrhiza glabra -- 12 parts tincture [liquorice]
Leonurus cardiaca -- 12 parts tincture [motherwort]
Ephedra sinica -- 10 parts tincture
Pimpinella anisum -- 1 part essential oil [anise]

5 mL of mixture taken 3 times a day.

If Euphorbia pilulifera proves difficult to obtain then double the amount of Grindelia to make up for it. This combination supplies the following actions.

Pulmonary [lung]    (Lobelia inflata)
Expectorant [helps expel mucus]    (Grindelia camporum, Euphorbia pilulifera, Lobelia inflata, Glycyrrhiza glabra)
Demulcent [soothes mucous membranes]    (Glycyrrhiza glabra)
Antispasmodic [relieves smooth-muscle spasm]    (Grindelia camporum, Euphorbia pilulifera, Lobelia inflata, Prunus serotina, Glycyrrhiza glabra, Pimpinella anisum, Ephedra sinica)
Antimicrobial    (Pimpinella anisum)
Anti-inflammatory    (Glycyrrhiza glabra, Pimpinella anisum)
Anticatarrhal [reduces mucus production]    (Pimpinella anisum, Ephedra sinica)
Cardiotonic    (Leonurus cardiaca)
Nervine [calming]    (Lobelia inflata, Leonurus cardiaca)

One possible prescription for asthma/eczema (atopic [allergic] asthma) in children:

Dyspnoea mixture -- 2 parts
Galium aparine -- 1 part tincture [clivers, goosegrass]
Trifolium pratense -- 1 part tincture [red clover]
Urtica dioica -- 1 part tincture [stinging nettle, common nettle]

5 mL taken 3 times a day.

This combination supplies the following actions.

Alterative [purifier]    (Galium aparine, Trifolium pratense, Urtica dioica)
Pulmonary    (Lobelia inflata[, Urtica dioica])
Expectorant    (Grindelia camporum, Euphorbia pilulifera, Lobelia inflata, Glycyrrhiza glabra)
Demulcent    (Glycyrrhiza glabra)
Antispasmodic    (Grindelia camporum, Euphorbia pilulifera, Lobelia inflata, Prunus serotina, Glycyrrhiza glabra, Pimpinella anisum, Ephedra sinica[, Trifolium pratense])
Antimicrobial    (Pimpinella anisum)
Anti-inflammatory    (Glycyrrhiza glabra, Pimpinella anisum)
Anticatarrhal    (Pimpinella anisum, Ephedra sinica)
Cardiotonic    (Leonurus cardiaca)
Nervine    (Lobelia inflata, Leonurus cardiaca, Trifolium pratense)

... During an actual crisis, inhaling an antispasmodic oil [particularly anise] is the only practical herbal help, and direct sniffing from the oil bottle, or some drops put on a tissue, will be safer than a steam inhalation, as the heat of the latter will increase any inflammation of the mucous membranes and make the congestion even worse.

Hyssop, Hyssopus officinalis [expectorant, pectoral]
Aniseed, Pimpinella anisum [pectoral]
Lavender, Lavandula officinalis [nervine (calming)]
Pine, Pinus sylvestris (Scotch pine, Norway pine) [expectorant]
Rosemary, Rosemarinus officinalis [nervine]

The Textbook of Natural Medicine, by Drs. Pizzorno and Murray, recommends the following nutritional supplements.

Vitamin B6, 25 mg twice a day
Vitamin B12, 100 mcg a day
Vitamin C, 1-2 g a day
Vitamin E, 400 international units (IU) per day
Selenium, 250 mcg a day


source: Dr. Richard Firshein, “The Basic Asthma Protocol” TOP

Magnesium. Over half a century ago, scientists reported that magnesium sulfate worked as a natural bronchodilator, one that opened constricted bronchial tubes without side effects. ... I recommend daily oral supplementation to all asthmatics. My preference is a combination of magnesium aspartate, orotate, and glycinate, in a dose of 500 milligrams a day. A note of caution: excess oral magnesium can cause diarrhea and lead to hypermagnesemia.

Anti-inflammatories


Omega-3 fatty acids. Another star in the nutritional arsenal, omega-3 fatty acids are found in flaxseed and fish oils. Actually incorporating itself into the fatty membrane that surrounds a cell, fish oil works as a natural anti-inflammatory substance. ... I generally recommend 6 grams (6 capsules) of fish oil a day to patients who regularly eat fish, and up to 12 capsules a day for those who are not fish eaters. For strict vegetarians, enough omega-3 fatty acids can be obtained from 3 tablespoons of flaxseed oil a day. Both magnesium and fish oils help slow the inflammatory response.

Borage oil and evening primrose oil. Both these oils, obtained from plants and seeds, provide vegetable sources of GLA, gamma-linoleic acid. Borage oil has about four times as much GLA as does primrose oil. An important function of GLA is that the body can transform it into omega-3 fatty acids, although we need sufficient enzymes in our body to do so. The enzyme that is used to transform GLA into omega-3 is also necessary to create inflammatory chemicals from other plant oils. Therefore, by supplementing GLA, you can use up the enzyme in creating “good” oils and reduce inflammation. ... I recommend 3 grams of borage or primrose oil a day, in three divided doses.

Feverfew. Feverfew [Tanaceturn parthenium] seems to inhibit inflammatory chemicals known as Prostaglandins as well as histamine. It has also been shown to inhibit bacteria and yeasts. Feverfew contains one ingredient, parthenolide, that inhibits PAF, platelet-activating-factor. Because PAF is part of the inflammatory cascade, it can be a potent trigger of allergies. By dampening levels of PAF, allergies and asthma may be eased. I recommend 750 milligrams a day in two divided doses. I currently use two other PAF fighters, ginkgo and alkylglycerol.

Ginkgo. Ginkgo should be taken as a standardized extract of 24 percent, at 40 milligrams a tablet or capsule. I recommend 3 tablets a day, in three divided doses.

Alkylglycerol. An extract of shark oil, these fats are present in high concentrations in bone marrow, the spleen, and the liver and have been shown to stimulate the immune system and inhibit tumor growth. They dampen the PAF response. I recommend 1 or 2 capsules three times a day.

Bronchodilators


Ma huang. This herb contains ephedrine, a nervous system stimulant. Ma huang can reduce swelling in the mucous lining of nasal passages and sinuses. It is a potent bronchodilator. I like to use it for cough associated with asthma because of the soothing effect of the warm tea as it is swallowed and because the ephedra can go right into the mucous membranes. It should not be used in individuals with high blood pressure or heart disease.

Cayenne. Capsicum, or red pepper, stimulates secretion of saliva and thins mucus plugs. It should be used with caution in individuals with peptic ulcer disease. ... I recommend up to 1,000 milligrams a day in three divided doses and/or liberal use in foods.

Coleus forskholii. This herb has been used for centuries in Indian Ayurvedic medicine. It is a rich source of biologically active compounds. The active ingredient, forskolin, helps increase compounds in the body that relax bronchial muscle. Standardized extracts of the herb are most effective if they contain 18 percent forskolin. I recommend 50 milligrams two or three times a day.

Turmeric and ginger. Turmeric is a perennial herb of the ginger family used in Chinese medicine as an antiinflammatory agent. Ginger is a potent inhibitor of prostaglandins, inflammatory chemicals. I prefer ginger in herbal tinctures and teas. Fresh ginger can be sliced, simmered for about twenty minutes in water, and sweetened with honey or milk.

Licorice. This is an extensively studied herb whose formal name is Glycyrrhiza glabra. It contains antiallergic, antibacterial, and antiinflammatory compounds. Two of its components have cortisol-like effects in the body. One ingredient in licorice can raise blood pressure, but deglycyrrhizinated commercial products eliminate this problem. ... Twenty to 40 drops of a tincture in very hot water can be taken as a tea, three times a day. Licorice in its pure form is the preferred treatment, however.

Compound Herbal Elixir. This product, produced by Eclectic Institute, is used widely by naturopaths and physicians around the country. It is recommended for cough and asthma and contains a wide range of ingredients, including wildcrafted wild cherry, organic elecampane, red clover blossoms, lobelia, fennel, Lomatium dissecturn, white pine, and essential oil of bitter orange. These ingredients work together to stimulate the immune system, treat the symptoms of asthma, and purify the lymph and bloodstream.

Antihistamines


Vitamin C. This vitamin works as a gentle antihistamine without the side effects of medications. ... I recommend 3 grams (3,000 milligrams) a day, in three divided doses.

Stinging nettles. This herb has been utilized for decades as a medicinal agent and edible plant. However, the stinging hairs of fresh nettle leaves contain histamine as well as chemicals that actually liberate histamine when you eat the plant. We don’t know why, but somehow this histamine seems to help allergic people. ... I use nettles for asthma patients with sinus problems or nasal allergies. Care must be taken to obtain a good brand of nettles that has been properly harvested in the spring, when the potent constituents of the stinging leaves are present. I generally recommend 2 capsules, three times a day.

Quercetin. This is a potent bioflavonoid that has been well documented for its antiallergic and antihistamine properties. I find it very helpful for allergies and recommend 300 milligrams a day in three divided doses.

Histidine. This amino acid is actually a building block for histamine. For reasons not fully understood, supplements of histidine seem to reduce allergic symptoms. I recommend 1,500 milligrams in three divided doses daily.



source: David Hoffmann, The New Holistic Herbal TOP

Asthma can stem from a combination of causes. There is often an allergic component that triggers asthmatic attacks. In some cases the cause is purely genetic whilst in others it may be an acquired reaction due to exposure to an irritant. The state of the nervous tone of the body can also lead to bronchial spasms. In predisposed people, tension, anxiety, hyperactivity or exhaustion can cause so much stress that an asthma attack is triggered off. Similarly, spasms or difficulty in breathing could be caused by osteopathic problems that happen to affect the spot where the thoracic nerve comes out of the spine.

The body is usually able to compensate for and balance a lot of influences, but our life style, diet, posture and attitude to life are all powerful contributing factors and have to be taken into account in a treatment.

Asthma will respond well to herbal treatment, but it is impossible to give a prescription that is appropriate in all cases as the various factors involved must be identified and the remedies chosen accordingly. Herbs that help reduce spasm and ease breathing include Grindelia, Lobelia, Mouse Ear, Pill-Bearing Spurge, Sundew, and Wild Cherry.

If there is production of sputum — which of course must be got rid of — expectorants like Aniseed, Blood Root, Coltsfoot, Comfrey Root, Liquorice, and Senega will help.

Where there is an allergic component, it is good to remember the use of the Chinese herb Ephedra.

If the attacks tax the strength of the heart — which they often do — Motherwort will be invaluable with its gentle strengthening action.

If any hypertension is involved, Hawthorn and Lime Blossom will be useful. Anxiety and tension are best treated with Hops, Skullcap, or Valerian.

Occasionally one finds that asthma will respond well to the use of nervines alone, as fear is one of the most potent triggers for an asthma attack. It can even be fear of the attack itself. As such, anything that will augment the person’s inner strength and self-image is called for. The nervines will help this process, but a psychotherapeutic approach can be invaluable in addition. Relaxation techniques can help ... .

A word about dairy products: in many cases of childhood asthma and eczema, milk has been shown to be a trigger for allergic reactions. Such causes may lie at the heart of many adult problems as well. It is vital that our children are breast-fed for as long as possible. When they are weaned, they should not be put on a diet of cow’s milk with its various additions. Instead, dairy products should be kept from the diet, as well as over-refined foods, especially sugar. Red meat is inadvisable. The milk and cheese from goats cause none of the problems that cow’s milk does and can be used as a substitute.




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