Integrative Therapies (Good Scientific Evidence)

Boswellia: 

Boswellia has been proposed as a potential therapy for asthma. Future studies are needed to assess the long-term efficacy and safety of boswellia and to compare the efficacy of boswellia to standard therapies. Boswellia should not be used for the relief of acute asthma exacerbations. Boswellia is generally believed to be safe when used as directed, although safety and toxicity have not been well studied in humans. 

Avoid if allergic to boswellia. Avoid if have history of stomach ulcers or stomach acid reflux disease (GERD). Use cautiously if taking lipid-soluble medications, agents metabolized by the liver's cytochrome P450 enzymes, or sedatives. Use cautiously with impaired liver function or liver damage or lung disorders. Use cautiously in children. Avoid if pregnant due to potential abortifacient effects or if breastfeeding.

Buteyko Breathing Technique : 

The Buteyko breathing technique (BBT) consists of breathing techniques, relaxation exercises, and asthma education. The technique aims to reduce hyperventilation. Studies have shown reduced use of rescue inhalers among patients receiving BBT. Improvements in other measures of asthma severity have not been shown. Additional study is warranted.

BBT is generally considered safe. Avoid with asthma that changes suddenly ("brittle asthma"). BBT may interact with asthma medications and should be used with caution when decreasing asthma medication. Asthma should be treated by a qualified healthcare professional and patients should always carry a rescue inhaler. Avoid if pregnant or breastfeeding.

Choline :

Choline is possibly effective when taken orally for asthma. Choline supplements seem to decrease the severity of symptoms, number of symptomatic days and the need to use bronchodilators in asthma patients. There is some evidence that higher doses of 3 grams daily might be more effective than lower doses of 1.5 grams daily. Choline is generally regarded as safe and appears to be well-tolerated. Avoid if allergic/hypersensitive to choline, lecithin, or phosphatidylcholine. Use cautiously with kidney or liver disorders or trimethylaminuria. Use cautiously with a history of depression. If pregnant or breastfeeding it seems generally safe to consume choline within the recommended adequate intake (AI) parameters; supplementation outside of dietary intake is usually not necessary if a healthy diet is consumed.

Coleus : 

There is a lack of sufficient data to recommend for or against the use of coleus in the treatment of bronchial asthma. Preliminary data appears to be promising. However, larger, randomized, controlled trials are needed to confirm the safety and efficacy of coleus in bronchial asthma. Coleus is generally regarded as safe, as very few reports have documented adverse effects. However, only a few short-term trials have assessed its safety in a small sample size of patients. Avoid if allergic to Coleus forskohlii and related species or with bleeding disorders. Avoid if pregnant or breastfeeding.

Ephedra :

Ephedra contains the chemicals ephedrine and pseudoephedrine, which are bronchodilators (expand the airways to assist in easier breathing). It has been used and studied to treat asthma and chronic obstructive pulmonary disease, such as asthmatic bronchoconstriction, in both children and adults. Other treatments such as beta-agonist inhalers (for example, albuterol) are more commonly recommended due to safety concerns with ephedra or ephedrine. However, the U.S. Food and Drug Administration (FDA) has collected thousands of reports of serious toxicity linked to ephedra (including over 100 deaths). Ephedra products are banned from dietary supplements because of serious health risks, including heart attack, heart damage, breathing difficulties and fluid retention in the lungs. Avoid ephedra if pregnant or breastfeeding.

Psychotherapy :  

Family psychotherapy may slightly improve wheezing and thoracic gas volume for asthma in children, according to several studies.

Psychotherapy is not always sufficient to resolve mental or emotional conditions. Psychiatric medication is sometimes needed. The reluctance to seek and use appropriate medication may contribute to worsening of symptoms or increased risk for poor outcomes. In order to be successful, psychotherapy requires considerable personal motivation and investment in the process. This includes consistent attendance and attention to treatment recommendations provided by the practitioner. Not all therapists are sufficiently qualified to work with all problems. The client or patient should seek referrals from trusted sources and should also inquire of the practitioner's training and background before committing to work with a particular therapist. Some forms of psychotherapy evoke strong emotional feelings and expression. This can be disturbing for people with serious mental illness or some medical conditions. Psychotherapy may help with post-partum depression, but is not a substitute for medication, which may be needed in severe cases.

Pycnogenol : 

Pycnogenol® is the patented trade name for a water extract of the bark of the French maritime pine (Pinus pinaster spp. atlantica), which is grown in coastal south-west France. Pycnogenol may offer clinical benefit to both children and adults with asthma. Additional study is needed before a conclusion can be made. Avoid if allergic/hypersensitive to pycnogenol, its components, or members of the Pinaceae family. Use cautiously with diabetes, hypoglycemia, or bleeding disorders. Use cautiously if taking hypolipidemics, medications that may increase the risk of bleeding, hypertensive medications, or immune stimulating or inhibiting drugs. Avoid if pregnant or breastfeeding.

Yoga : 

Multiple human studies report benefits of yoga (such as breathing exercises), when added to other treatments for mild-to-moderate asthma (such as standard drug therapy, diet, or massage). Better research is needed before a firm conclusion can be drawn.

Yoga is generally considered to be safe in healthy individuals when practiced appropriately. Avoid some inverted poses with disc disease of the spine, fragile or atherosclerotic neck arteries, risk for blood clots, extremely high or low blood pressure, glaucoma, detachment of the retina, ear problems, severe osteoporosis, or cervical spondylitis. Certain yoga breathing techniques should be avoided in people with heart or lung disease. Use cautiously with a history of psychotic disorders. Yoga techniques are believed to be safe during pregnancy and breastfeeding when practiced under the guidance of expert instruction (the popular Lamaze techniques are based on yogic breathing). However, poses that put pressure on the uterus, such as abdominal twists, should be avoided in pregnancy.