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Asthma in Adults

Description

An in-depth report on how asthma is diagnosed, treated, and managed in adults.

Other Treatments

Some agents are being investigated that have anti-inflammatory effects, which might help reduce dependence on corticosteroids. Certain antibiotics, such as clarithromycin (Biaxin), may improve lung function in asthmatic patients who show evidence of infection with the atypical organisms Mycoplasma or Chlamydiapneumoniae. Dapsone, an agent known as a sulfone is also under investigation.

Alternative Treatments

Alternative therapies are being widely used by children, adolescents, and adults with asthma. In one study, nearly half of asthma or allergy sufferers resorted to alternative treatments. To date, however, evidence does not support any value from most alternative therapies, including high-dose vitamins, urine injections, homeopathic remedies, and most herbal remedies.

Relaxation and Stress-Reduction Techniques. Patients report benefits from many stress reduction techniques, such as acupuncture, hypnosis, breathing relaxation techniques, massage therapy, and meditation practices.

Acupuncture
Acupuncture, hypnosis and biofeedback are all alternative ways to control pain. Acupuncture involves the insertion of tiny sterile needles, slightly thicker than a human hair, at specific points on the body.

The Buteyko Breathing Method. The Buteyko breathing method is an experimental approach designed to increase levels of carbon dioxide in the body. To do this, patients are trained to reduce their volume of breath and to avoid hyperventilation (over-breathing). Some studies are reporting that patients use this method reduce their use of medications and improve their quality of life. The system originated in Australia and is not yet widely available in the U.S.

Probiotics. Probiotics are beneficial bacteria that may help protect against allergies and asthma. Antibiotic over-use and modern hygiene may specifically be reducing these helpful organisms. Probiotics can be obtained in active yogurt cultures and in supplements, which are being studied for protection.

Herbal Remedies. Herbal remedies have been used with apparent success in Eastern nations, but few have been studied rigorously in the United States. Butterbur (also known as Petasites hybridus, butter dock, blatterdock, bog rhubarb, and exwort), a traditional herbal remedy, is used for seasonal allergies and asthma. In a 2002 study, it was as effective and less sedating than a commonly prescribed antihistamine for treating seasonal allergies over a two week period. More research is needed. Even when natural remedies appear to be effective in trials, there are no standards or regulations in the U.S. to guarantee their quality, effectiveness, or safety. Of great concern are their growing use and the possibilities of serious drug interactions. Patients who try alternative treatments must be sure to inform their physician.

Warnings on Alternative and So-Called Natural Remedies

Alternative or natural remedies are not regulated and their quality is not publicly controlled. In addition, any substance that can affect the body's chemistry can, like any drug, produce side effects that may be harmful. Even if studies report positive benefits from herbal remedies, the compounds used in such studies are, in most cases, not what are being marketed to the public. There have been a number of reported cases of serious and even lethal side effects from herbal products. In addition, some so-called natural remedies were found to contain standard prescription medication.

The following are special concerns for people with asthma and allergic rhinitis:

  • Grapeseed extract is sometimes touted as a natural antihistamine. A 2002 study, however, reported no benefits from it.
  • A 2002 study found no benefits with homeopathy immunotherapy for asthmatic patients allergic to dust mites.
  • Some allergic patients have reported worse symptoms after drinking herbal teas, which may contain leaves or pollens that the patient is sensitive to. In fact herbal remedies themselves can trigger an allergic reaction. For example, echinacea is of special concern. This herbal remedy actually boosts the immune system. People with nasal congestion may mistakenly take it because it is often used to treat colds. In the case of allergies, however, echinacea may worsen symptoms or even trigger them in people who haven't experienced them. People with autoimmune diseases or who have plant allergies should particularly avoid it.
  • Aller Relief Chinese herbal cold and allergy contains trace amounts of aristolochic acid, a chemical that is toxic to the kidneys and a carcinogen. Products containing aristolochic acid have been associated with several reports of kidney failure in Europe. Of specific concern are studies suggesting that up to 30% of herbal patent remedies imported from China having been laced with potent pharmaceuticals such as phenacetin and steroids. Most reported problems occurred in herbal remedies imported from Asia, with one study reporting a significant percentage of such remedies containing toxic metals.
  • Aromatherapy is now often used for relaxation. Some exotic plant extracts in these formulas have been associated with a wide range of skin allergies.

The following website is building a database of natural remedy brands that it tests and rates. Not all are available (www.consumerlab.com). The Food and Drug Administration has a program called MEDWATCH for people to report adverse reactions to untested substances, such as herbal remedies and vitamins (800-332-1088).

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