Patients with
asthma and
allergic rhinitis may benefit from hydration and a diet low in
sodium,
omega-6 fatty acids, and transfatty
acids, but high in
omega-3 fatty acids (i.e., fish, almonds, walnuts, pumpkin, and flax seeds), onions, and fruits and vegetables (at least five servings a day). Physicians may need to be more cautious when prescribing
antibiotics to children in their first year of life when they are born to families with a history of atopy. More research is needed to establish whether supplementation with probiotics (lactobacillus and bifidobacterium) during the first year of life or after
antibiotic use decreases the risk of developing
asthma and
allergic rhinitis. Despite a theoretic basis for the use of
vitamin C supplements in asthmatic patients, the evidence is still equivocal, and long-term studies are needed. The evidence is stronger for
exercise-induced asthma, in which the use of
vitamin C supplementation at a dosage of 1 to 2 g per day may be helpful. It is also possible that
fish oil supplements, administered in a dosage of 1 to 1.2 g of EPA and DHA per day, also may be helpful to some patients with
asthma. Long-term studies of
fish oil and
vitamin C are needed for more definite answers. For the patient interested in incorporating nutritional approaches,
vitamin C and
fish oils have a safe profile. However,
aspirin-sensitive individuals should avoid
fish oils, and red blood cell
magnesium levels may help in making the decision whether to use additional
magnesium supplements. Combination herbal formulas should be used in the treatment of
asthma with medical supervision and in collaboration with an experienced herbalist or practitioner of TCM. Safe herbs, such as Boswellia and gingko, may be used singly as adjuncts to a comprehensive plan of care if the patient and practitioner have an interest in trying them while staying alert for drug-herb interactions. No data on the long-term use of these single herbs in
asthma exist. For the motivated patient, mind-body interventions such as yoga,
hypnosis, and
biofeedback-assisted relaxation and
breathing exercises are beneficial for stress reduction in general and may be helpful in further controlling
asthma. Encouraging parents to learn how to
massage their asthmatic children may appeal to some parents and provide benefits for parents and children alike. Acupuncture and chiropractic treatment cannot be recommended at this time, although some patients may derive benefit because of the placebo effect. For patients with
allergic rhinitis, there are no good clinical research data on the use of
quercetin and
vitamin C. Similarly, freeze-dried stinging nettle leaves may be tried, but the applicable research evidence also is poor. Further studies are needed to assess the efficacy of these supplements and herbs.
Homeopathic remedies based on extreme dilutions of the
allergen may be beneficial in
allergic rhinitis but require collaboration with an experienced homeopath. There are no research data on constitutional homeopathic approaches to
asthma and
allergic rhinitis. Patients with
COPD are helped by exercise, pulmonary rehabilitation, and increased caloric
protein and fat intake.
Vitamin C and n-3 supplements are safe and reasonable; however, studies are needed to establish their efficacy in
COPD. On the other hand, there are convincing data in favor of N-acetyl-
cysteine supplementation for the patient with
COPD at doses ranging between 400 and 1200 mg daily. Red blood cell
magnesium levels may guide the use of
magnesium replacement. The use of
L-carnitine and
coenzyme Q10 in patients with
COPD needs further study. The addition of
essential oils to the dietary regimen of patients with
chronic bronchitis is worth exploring. Patients with
upper respiratory tract infections can expect a shorter duration of symptoms by taking high doses of
vitamin C (2 g) with
zinc supplements, preferably the nasal
zinc gel, at the onset of their symptoms. Adding an herb such as echinacea or Andrographis shortens the duration of the
common cold. The one study on Elderberry's use for the flu was encouraging, and the data on the homeopathic remedy Oscillococcinum interesting, but more studies should be performed. Saline washes may be helpful to patients with
allergic rhinitis and chronic
sinusitis. Patients also may try the German combination (available in the United States) of elderberry, vervain, gentian, primrose, and sorrel that has been tested in randomized clinical trials.
Bromelain is safe to try; the trials of
bromelain supplementation were promising but were never repeated. The preceding suggestions need to be grounded in a program based on optimal medical management. Patients need to be well educated in the proper medical management of their disease and skilled at monitoring disease stability and progress. Asthmatic patients need to monitor their
bronchodilator usage and peak flow meter measurements to step up their medical treatment in a timely manner, if needed. Patients welcome physician guidance when exploring the breadth of treatments available today. A true patient-physician partnership is always empowering to patients who are serious about regaining their function and health.