Most of us tend to take breathing for granted. But for people with asthma, getting enough air—sometimes even taking the next breath—becomes a central focus of their lives. Asthma, a disease that affects the ability to breathe properly, can take a mild form. Think of a worried little boy taking out an inhaler to help him restore his breathing while his friends continue to kick a soccer ball around the field.
Asthma can also trigger life-threatening emergencies. Picture white-coated attendants running a gurney down a hospital corridor, as the individual taking that ride gasps for his next breath.
Richard Firshein, DO, experienced that last scenario a couple of times shortly after he left medical school. He’d had asthma for most of his life, but those medical emergencies were one of the deciding factors in his taking up asthma as a specialty in his medical practice.
“Motivated is an understatement,” he says of the commitment that led him to learn everything he could about treating asthma. Dr. Firshein is now medical director of the Firshein Center for Comprehensive Medicine in New York City and the author of two books about holistic treatment for asthma, Your Asthma-Free Child and Reversing Asthma.
Dr. Firshein’s program for treating asthma includes mainstream medical approaches along with breathing exercises, mind-body techniques, diet, and nutritional supplements. Before we home in on diet and nutrients helpful for asthma, it would be helpful to look at the disease itself.
Currently, some 20 million Americans have asthma. Nine million of them are children. Unfortunately, the numbers of people who have this disease are rising rapidly.
Medical science isn’t yet sure what causes it. Scientists do know that there seems to be a hereditary component and that it involves exposure early in life to substances that trigger allergic reactions (allergens). The most common allergens apparently involved in asthma are animal dander, cockroach droppings, pollens, and molds. Cigarette smoke and the chemical irritants in air pollution may also play a role.
Most people who get asthma develop the disease in early childhood, but it is possible for it to show up or dramatically worsen later in life. Symptoms include coughing, wheezing, fatigue, shortness of breath, and a feeling of not being able to get enough air. An acute attack, triggered by exposure to an offending substance, can leave an individual gasping for each breath and can even cause death.
What’s actually triggering those symptoms? Two things: The muscles around the airways tighten down, narrowing the many tiny air passages in the lungs. And at the same time, the airways themselves become inflamed and can clog with mucus. When that double whammy gets under way in earnest, the airways can narrow so much that every breath becomes a struggle.
People who have asthma need to focus on diet with the same intensity as people who have heart disease, says Dr. Firshein. In an individual with asthma, he says, “the role of inflammation and the role of certain substances is amplified.” Eating foods that you’re allergic to, for example, can trigger the release of histamines, which cause inflammation and increase mucus production, and both symptoms worsen asthma, explains Dr. Firshein. Even food sensitivities can cause bodily disturbances that can add to the discomfort.
If, for example, you have lactose intolerance (an inability to digest dairy products), and you also have asthma, it’s doubly important for you to stay away from dairy products of any kind. Forget about that occasional indulgence in a scoop of ice cream. The runny nose and extra mucus in your breathing passages are not worth it.
You also need to avoid any foods that trigger heartburn (reflux), says Dr. Firshein. Reflux involves food coming up from the stomach into the esophagus. That regurgitated food comes up mixed with stomach acid, which is actually hydrochloric acid, a substance so potent that it can peel the paint off of cars, he notes. Reflux fumes can be breathed in, he says, causing a chemical burn to the lungs and contributing to cough. So people with asthma need to strictly avoid any foods that they know to be their personal reflux triggers.
On the other side of the coin, eating a pure, healthy diet helps tremendously in keeping asthma under control, says Dr. Firshein. The diet needs to be “lean and mean, and nutrient-rich,” he states.
In practical terms, he says, this translates into eliminating processed foods and trans fats from your diet and minimizing red meat and dairy products. Instead, you need to eat more whole grains, fruits, and vegetables, especially leafy, green vegetables. These, says Dr. Firshein, are “asthma super foods.” It’s also important, he says, to drink lots of pure water.
Even something as simple as deciding to eat more fruit can apparently make a tremendous difference in the level of asthma symptoms. In one study done in the United Kingdom, researchers studied the dietary habits of adults who had been diagnosed with asthma versus a similar group of adults without asthma. They found greater blood levels of certain nutrients in the non-asthma group and also a greater consumption of foods containing antioxidants. Antioxidants, of course, are substances that neutralize free radicals, molecules that damage the body’s tissues.
In their report, published in 2006, the researchers summed up their findings: “Symptomatic asthma in adults is associated with a low dietary intake of fruit, the antioxidant nutrients vitamin C and manganese, and low plasma vitamin C levels. These findings suggest that diet may be a potentially modifiable risk factor for the development of asthma.”
The findings also hint that people with asthma might want to select fruits that are rich in vitamin C as a snack of choice. These include strawberries, cantaloupe, oranges, and other citrus fruit.
In addition to eating a healthy, nutrient-rich diet, there are a number of individual nutrients that can be helpful for anyone who has asthma. These nutrients generally serve one of four functions, says Dr. Firshein: They help prevent inflammation, encourage bronchodilation, serve as antihistamines, or clean and repair damaged tissues. Some of these individual nutrients actually perform more than one of these functions at the same time.
B vitamins, which work in tandem with each other, help keep up the body’s energy levels, says Dr. Firshein. Vitamin B6 is of particular importance, he says, as several studies have shown that many people with asthma experience dramatic improvement when they get 50 milligrams of vitamin B6 twice a day. Here are his recommended B vitamin amounts specifically for people with moderate to severe asthma: vitamin B1, 100 milligrams; vitamins B2 and B3, 50 milligrams; vitamin B5, 500 milligrams; vitamin B6, 150 milligrams; vitamin B12, 1,000 micrograms.
If you have mild asthma, consider simply taking a B-complex supplement. Follow the directions on the package.
Calcium and magnesium work together at the cellular level and have much to do with smooth muscle functioning, including breathing, says Dr. Firshein.
It’s important to get enough calcium, somewhere in the range of 1,200 milligrams, according to Dr. Firshein. But he does not always recommend calcium supplements, especially for his younger patients who have strong bones and seem to be getting sufficient calcium from dietary sources. Excess calcium can cause kidney stones, so it’s important not to take too much if you choose to use a supplement, he says. Too little or too much calcium can also cause muscle spasms, he cautions.
Bottom line: If you have asthma and you’re also at risk for osteoporosis, you should discuss calcium supplements with your doctor.
Coenzyme Q10 is a nutrient that every cell of the body uses to create energy. Coenzyme Q10 and oxygen are “the primary source of energy for the body and the source of life,” says Dr. Firshein. “When you’re dealing with a problem like asthma, you’re dealing with something that is all about energy.”
People with asthma often have problems with their energy levels and are frequently exhausted, notes Dr. Firshein, adding that in his clinical experience, coenzyme Q10 seems to help that problem. He suggests taking 300 milligrams in supplement form.
At the cellular level, magnesium works in tandem with calcium, says Dr. Firshein. It helps regulate a number of cell functions and also suppresses allergic reactions, he says. “Magnesium is about flexibility,” he explains. “It makes things more fluid and supple.” And that includes lung function. Magnesium can actually help open bronchial tubes, says Dr. Firshein, and in some hospitals is even given intravenously in the form of magnesium sulfate along with drugs to help treat life-threatening asthma attacks.
Magnesium serves as both an anti-inflammatory and a bronchodilator, says Dr. Firshein. This mineral also helps bowel function, and if you take too much, you can get diarrhea. Dr. Firshein suggests starting with a 100-milligram supplement twice a day. If you tolerate that amount without discomfort, you can increase the dose, up to a total of 500 milligrams daily, he says. He suggests taking magnesium in the form of magnesium aspartate, which is better absorbed.
N-acetylcysteine (NAC) is an amino acid that helps the body manufacture glutathione, a really powerful antioxidant, says Dr. Firshein. At the same time, NAC also thins mucus, which helps keep the airways clear, he says. He suggests taking 1,000 to 2,000 milligrams in divided doses, spaced throughout the day.
The omega-3 fatty acids found in fish oil help tame inflammation, says Dr. Firshein. Inflammation, of course, plays a role in asthma, as it is one of the actions that causes airways to narrow down.
Dr. Firshein recommends getting more fatty, deep-water fish like salmon, tuna, and mackerel in your diet. You can also take a fish oil supplement. He recommends taking as much as 6 to 12 grams of fish oil daily.
Fish oil can also apparently be helpful with a problem that many people with asthma face—asthma symptoms that come on during and after exercise. Known as exercise-induced bronchoconstriction (EIB), the symptoms can be particularly frustrating for young would-be athletes and for otherwise healthy people with asthma who are trying to stay in shape.
Several studies have shown that fish oil can be helpful in dealing with EIB. In one small study, for example, Timothy Mickleborough, PhD, and colleagues at the Human Performance and Exercise Biochemistry Laboratory at Indiana University in Bloomington found that fish oil supplements help people with asthma reduce their use of bronchodilators while exercising.
The Indiana researchers concluded: “Our data suggest that fish oil supplementation may represent a potentially beneficial nonpharmacologic intervention for asthmatic subjects with EIB.”
The bioflavonoid quercetin is a natural antihistamine, says Dr. Firshein. He suggests taking 300 milligrams daily, divided in three doses and spaced throughout the day.
Vitamin A plays a role in preserving the health of epithelial tissue, the delicate mucus-producing membranes that line the passages of the nose and lungs, says Dr. Firshein. People who don’t get enough of this vitamin are more susceptible to upper respiratory infections, which are particularly problematic for people with asthma, he notes. He recommends taking 5,000 IU.
Vitamin C is a great supplement for people with asthma for a number of reasons, says Dr. Firshein. It stimulates the immune system, has a mild antihistamine effect, and it’s an anti-inflammatory, he explains. This vitamin, he says, “can have a very profound effect on reversing asthma and improving the risk factors.”
In his experience, says Dr. Firshein, high doses of vitamin C really do help reduce the number of bouts with colds and flu that people have, as well as also the severity of the symptoms. This is significant for those who have asthma, as the inflammation and excess mucus that accompany colds and flu can greatly worsen their ability to breathe.
Dr. Firshein recommends taking 1,000 milligrams of vitamin C three times a day. High doses of vitamin C can cause diarrhea in some individuals. If this much vitamin C is problematic for you, back off on the amount until you find a dose that eliminates this side effect.
The mineral zinc is important for immune system functioning and can help you fight off infections and deal with allergies, says Dr. Firshein. He suggests taking 25 milligrams.
Your Asthma-Free Child: The Revolutionary 7-Step Breath of Life Program by Richard N. Firshein, DO
Reversing Asthma: Reduce Your Medications with This Revolutionary New Program by Richard N. Firshein, DO
Asthma Survival: The Holistic Medical Treatment Program for Asthma by Robert S. Ivker, DO
If you have asthma, you should be under the care of a physician. Discuss all supplements you wish to take with your doctor.
B-complex |
Follow package directions |
Calcium |
1,200 milligrams |
Coenzyme Q10 |
300 milligrams |
Magnesium aspartate* |
200 to 500 milligrams |
N-acetylcysteine |
1,000 to 2,000 milligrams in divided doses, spaced throughout the day |
Omega-3 fatty acids |
6 to 12 grams of fish oil† |
Quercetin |
100 milligrams three times a day |
Vitamin A |
5,000 IU |
Vitamin B1‡ |
100 milligrams |
Vitamin B2‡ |
50 milligrams |
Vitamin B3‡ |
50 milligrams |
Vitamin B5‡ |
500 milligrams |
Vitamin B6‡ |
150 milligrams |
Vitamin B12‡ |
1,000 micrograms |
Vitamin C§ |
1,000 milligrams three times a day |
Zinc |
25 milligrams |
*Start with 100 milligrams twice daily. If that amount causes diarrhea, back off on the dose. If not, gradually increase the dose, but don’t take more than 500 milligrams daily. Fish oil has a blood-thinning effect. If you’re taking any kind of blood-thinning drug, talk to your doctor before taking fish oil supplements.
†This is a lot of fish oil. If you can’t handle this much, back off on the amount until you find a dose that is comfortable for you.
‡These B vitamins are for people with moderate to severe asthma. Taking them in divided doses throughout the day will enhance absorption. If you have mild asthma, consider simply taking a B-complex supplement.
§This much vitamin C can cause diarrhea as a side effect. If it does, back off on the dose until you find an amount that is comfortable for you.