Nutritional Interventions for Asthma

The prevalence of asthma has steadily increased in the United States for almost three decades, with no signs of slowing down.

According to the Centers for Disease Control and Prevention, the number of new asthma cases has more than doubled between the years of 1980 and 2004.

Environmental control is an essential part of managing asthma, including identifying and eliminating allergenic foods and desensitizing against inhalant allergens, such as mold, pollen and dust mites. Allergy identification and elimination/desensitization may not immediately reduce asthma attacks, so prescribing specific nutrients may help achieve better asthma control.

Magnesium deficiency has been observed in some individuals with asthma.

Nonetheless, studies show that oral magnesium can provide long-term relief of symptoms and may help prevent exacerbations.

Typical dose range for an adult is between 400-600 mg per day, although some individuals with asthma require higher amounts. (excess magnesium can cause loose stool or diarrhea).

Other studies suggest intravenous magnesium can stop an acute attack. However, this should only be done by a healthcare provider experienced in IV nutritional therapy.

Some older studies suggest 50-200 mg per day of vitamin B6 (pyridoxine) may help prevent asthma attacks in children.

One study found that adults with asthma had lower serum pyridoxal-5-phosphate levels compared with adults who did not have asthma. The use of bronchodilators and steroids also decreased in those taking pyridoxine.

A potential side effect of vitamin B6 is “stocking glove” paresthesia, which is a sensory neuropathy extending from the elbows to the tips of the fingers or the knees to the toes.

This generally occurs in administering vitamin B6 in amounts greater than 500 mg a day for prolonged periods of time, but caution should be taken when using high doses of vitamin B6 in children.

A 2005 study found that taking 1 mg per pound of body weight of Pycnogenol^® increased peak flow and reduced the need for rescue medication. For example, a 200 lb man would take 200 mg of the extract.

Pycnogenol^® is a natural plant extract from the bark of the maritime pine tree, which has antioxidant, anti-inflammatory and anti-histamine properties.

Pycnogenol^® has an excellent safety profile and is safe to use in children.

Fish oil concentrate or cod liver oil can effectively improve pulmonary function in asthmatics. Fish oil is high in omega-3 fatty acids which can reduce inflammation in the lungs. One study found that children with asthma who took fish oil supplements rich in EPA and DHA for 10 months had fewer asthma symptoms compared with asthmatic children who received placebo.

Most nutritionally oriented physicians recommend taking 3-6 g per day of fish oil concentrate.

Vitamin C has many health benefits, including the prevention of asthma.

A 2006 study found adult asthmatics who took 1 g (1000 mg) per day of vitamin C for 16 weeks had stable lung symptoms, even after they discontinued their steroid inhalers.

Evidence suggests sodium ascorbate may be more beneficial for asthma than ascorbic acid.

Higher amounts may be necessary to help control asthma symptoms or prevent recurrence. Excessive amounts of vitamin C can cause abdominal pain or diarrhea in some individuals, which can often be avoided if taken in divided doses. One should not abruptly stop taking high doses of vitamin C as that can rarely lead to bleeding gums or other symptoms of vitamin C deficiency, known as “rebound scurvy”.

People with asthma who take oral or inhaled glucocorticoid steroids may become deficient in DHEA. Although the relationship between DHEA and asthma is not clear, so asthmatics do benefit from supplementing with DHEA if their serum levels are low. Men often need 10-30 mg per day, whereas women benefit from 5-15 mg.

Serum levels should be monitored to ensure the proper dose is being prescribed.

In Conclusion

While these nutritional interventions are being instituted, I recommend continuing patients on their OTC or prescription medications. Tapering of medicines may be appropriate after determining that pulmonary function has improved. I recommend periodic pulmonary function testing and regular peak flow readings as objective measurements to ensure your treatment plan is effective.