Asthma

Asthma – Symptoms, Causes & Treatment

Asthma is chronic inflammation of the airways associated with excess swelling, mucous and bronchospasm, resulting in reversible obstruction of airflow. It may be classified as atopic or intrinsic, depending on whether symptoms are triggered by allergens.

Atopic asthma is triggered by exposure to airborne allergens (e.g. pollens, animal dander, dust mite, mould, fragrance) or food (e.g. cow’s milk, wheat, eggs, soy, tree nuts, peanuts, fish, shellfish, MSG, tartrazine and sulphites) allergens, leading to Th2 dominance. It is often associated with hayfever and/or eczema. Th2 are a type of immune regulatory cell that become upregulated when they are overstimulated by allergens.

Intrinsic asthma is usually exercise induced but may also be triggered by cold, dry air, chemical irritants, stress or respiratory tract infections. The bronchospasm is thought to be triggered by loss of moisture from the respiratory tract and increased airway cooling due to an increase in ventilation. In this type of asthma, however, increased IgE and Th2 activation still appears to feature.

Asthma generally develops in children between the ages of 2 and 7, and mostly resolves by puberty. In the last 30 years, the incidence has increased 75% in adults and 160% in children which may be related to factors such as air pollution, the hygiene hypothesis, gut dysbiosis, lack of breastfeeding and poor diet.

Causes

Asthma is thought to be caused by a combination of genetic and environmental factors. Strong research is emerging with relation to bacterial overgrowth of the microbiome and environmental allergens. 

Removing immune triggering foods, dealing with bacterial overgrowth of the gut, intestinal permeability, SIBO, parasites, H Pylori and other bacteria and pathogens have shown to improve asthma dramatically.

Asthma triggers

• Hypersensitivity to aero-allergens (animal dander, pollen, dust)
• Sensitivity to foods or food additives (dairy, wheat, eggs, shellfish, nuts, salicylates, MSG, sulphites, food colouring, histamines etc)
• Sensitivity to medications (especially aspirin, NSAIDs, beta-blockers)
• Respiratory infections
• Gastro-oesophageal reflux: coexists in 80% of people, shows how much gut plays a role in asthma
• Air pollutants
• Exercise, especially in the cold
• Weather changes: extremes of dryness or humidity; temperature changes
• Emotional behaviours that alter breathing (e.g. laughing, crying, shouting)

Risk factors of Asthma

• A compromised Gut microbiome / presence of gut infections and bacteria’s
• Predisposition to high-circulating IgE
• Family history of allergies
• Poor maternal diet
• Lack of breastfeeding
• Early introduction of formula or other antigenic foods
• Childhood exposure to air pollution, tobacco smoke, or mouldy environments
• Paracetamol and antibiotic use in infancy
• Intestinal dysbiosis/permeability
• Hypochlorydia and gastro-oesophageal reflux
• Poor diet and nutritional deficiency: children who eat fast food have a much higher incidence of asthma; specific nutrients include vitamins C, D, E, magnesium, potassium, essential fatty acids
• T4 syndrome (restriction at T4): found in many asthmatics

Signs and Symptoms of Asthma

• Wheezing
• Coughing, especially recurrent, unproductive, nocturnal cough
• Chest tightness
• Shortness of breath

Differential diagnosis

• Mechanical obstruction of air passages
• Hyperventilation
• COPD
• GERD
• Eosinophilic lung diseases
• Cardiac asthma as the result of cardiac tumours or left ventricle or mitral valve disease
• Carcinoid tumours, especially wheezing accompanied by flushing, facial rash or diarrhea
• Congestive heart failure
• Tuberculosis

TREATMENT STRATEGY FOR ASTHMA

• Investigate and resolve gut dysbiosis, gut infections, intestinal permeability, SIBO
• Identify and avoid or manage environmental and food triggers
• Investigate inflammation causes and address inflammation cascade triggers
• Reduce bronchospasm and airway reactivity
• Regulate immune response
• Promote digestive function, optimise gut microflora and repair gut
• Support nervous system and balance HPA (hypothalamus, pituitary, adrenal) axis

Diet plan guidelines for Asthma

• Identify and eliminate any food triggers:
• Elimination diet or blood testing to identify reactivity foods
• Avoidance of antigenic foods such a gluten and casein if often beneficial
• Avoid of food additives that commonly trigger asthma: MSG, sulphites, food colouring

• Emphasise vitamin C and quercetin-rich foods due to anti-inflammatory and anti-histamine action e.g. berries, cherries, citrus, apples, onions, parsley, black and green tea, kale, broccoli

Supplements that support Asthma

• Vitamin C – anti-inflammatory, anti-histamine, immune support, reduces bronchospasm. If asthma is exercise-induced, taking 2000mg vitamin C one hour before exercise may be useful
• Quercetin –  anti-inflammatory, anti-histamine
• Bromelain – between meals: anti-inflammatory
• Magnesium –  reduce bronchospasm
• Vitamin A –  immune support, mucous membrane tonic

FUNCTIONAL MEDICINE TREATMENT OF ASTHMA

The above support considerations will provide assistance for someone suffering Asthma.  A functional medicine approach to this disease investigates the underlying cause of contributing factors to the disease such as food allergies, environmental exposures including mould, gut microbiome imbalance and bacterial overgrowth.  

At our Perth clinic of Advanced Functional Medicine we have substantial experience treating many Asthma sufferers from children to adults.  Thorough investigation is required to identify triggers and immune system reactivity. 

If you or your child are suffering from Asthma we would love to hear from you, what has worked well for you?  Please write a comment below.

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