Unless your asthma is well controlled, it may subtly interfere with normal activity and get out of hand quickly. In fact, a person with “mild asthma” can have a fatal attack. Asthma occurs when the main air passages in the lungs, called bronchioles, become inflamed and overly sensitive to “triggers.” During attacks, the lungs produce extra mucus and the bronchiole walls narrow, making breathing difficult. No cure exists yet, but nearly everyone can dramatically reduce—and maybe even eliminate—asthma symptoms. Even if you currently use medications to treat your asthma, you may be able to reduce the dose or frequency by more than 50% if you practice good lifestyle control, says Thomas F. Plaut, MD. Here are some doctor-recommended approaches for asthma treatment.
Look Into Allergies
More than 70% of adults with asthma have allergies that set off or worsen symptoms. “Everyone who takes medications daily for asthma needs to find out if they have allergies,” says Plaut. Think about when your symptoms occur and what you are doing at the time. Any patterns may help indicate if you have an allergy. You might want to keep an asthma journal. A board certified allergist can identify your allergens by taking a careful history and performing skin testing for inhalant allergens, including pollen (tree, grass, weed), mold, dust mites, cockroaches, and pet dander, says David Lang, MD.
Watch The Sulfites
Food allergies are commonly suspected as relevant for asthma, but rarely confirmed, says Lang. Generally allergies influencing your asthma symptoms are those that are inhaled. That said, an estimated 5 to 10% of asthmatics suffer from a sensitivity to sulfites, which are often added to wine, beer, dried fruit, and frozen food. (See 7 signs you have a food sensitivity.)
Avoid Plant Pollen
It’s a main asthma trigger. Plants pollinate at specific times of the year, so once you know those that are your triggers, take steps to avoid them. Stay indoors between 5 AM and 10 AM and on dry, hot, windy days, when pollen counts tend to be highest. During the warm months, keep your windows closed and air-condition your house. Doing these two things can cut down on the indoor pollen count by 90% or more, says Lang. Air conditioning also eliminates the high indoor humidity that promotes mold and dust mites. Ragweed is the most common pollen allergen for Americans. This plant’s season runs from August to November, usually peaking in early to mid-September. Check your local TV or newspaper for daily pollen counts to determine when it’s best to stay inside. MORE: 7 Ways Your Home May Be Making You Sick
Switch On The Bathroom Fan
Mold is a common asthma trigger, and it thrives in bathrooms and other high-moisture areas, so good ventilation is essential. Use the bathroom fan every time you bathe or shower to reduce the moisture that mold needs to thrive. Using a squeegee to wipe water off the bathroom tiles is a terrific strategy for preventing mold—and takes only about 30 seconds, says Plaut.
Wash Your Pets Weekly
Dogs and cats are loaded with dander—a combination of skin cells and allergy-causing proteins that can provoke asthma attacks. Some pet owners with asthma may find they are allergic to dander, and the only solution is remove animals from the home. At the very least, wash your pets weekly—with or without shampoo—to reduce dander. And keep your bedroom pet-free, says Lang.
Open Windows When You Cook
Strong food odors—from a smoking frying pan, for example, or the pungent oils in onions and garlic—can irritate airways and trigger asthma attacks. Open the windows during low-pollen months or use an exhaust fan when you cook to help vent the odors outside. MORE: How To Allergy-Proof Your Home
Frequently Change Furnace Filters
During the cold months, central heating systems circulate dust all over the house. Installing electronic air cleaners in place of the standard furnace filters is one of the best ways to control this spread, Plaut says. These devices, available from heating contractors, act almost like dust magnets.
Reduce Exposure To Dust Mites
Despite the name, these microscopic creatures live on the dead skin cells in your home. When they die, their bodies dry up and are ground into dust. They’re a potent asthma trigger—and because people shed millions of skin cells every day, dust mites are hard to eliminate. They can, however, be reduced. Wash sheets, pillowcases, and bathroom towels at least once a week in water 130°F or hotter to kill adult mites as well as the eggs, says Plaut. “It’s also important to encase pillows, mattresses, and box springs in covers made specifically to act as a barrier against dust mites. These covers are available at allergy supply stores,” he adds. These products are available from companies such as American Allergy Supply, National Allergy Supply, and Allergy Control Products. (Here are more ways to make your home hostile to mites.)
Invest In A Good Air Filter
A good air purifier, ideally with a HEPA filter, can really help clear indoor air of allergens, says Elson Haas, MD.
Keep Your Home Pest-Free
Studies have shown that cockroaches—which thrive in the same areas as humans—can trigger asthma. Like dust mites, their dry, dead bodies and feces turn into dust and can trigger an asthma episode, says Plaut. Cockroaches are difficult to get rid of, even if your house is always squeaky-clean. One of the safest ways to control roaches is to sprinkle boric acid in areas where they congregate—around drainpipes, for example, or along kitchen and bathroom baseboards. “Don’t have an exterminator spray the house if you can help it,” says Plaut. The fumes can irritate the airways for days, making asthma symptoms much worse. Many asthmatics are very sensitive to chemical exposures at home and work, adds Haas.
Make Your House A Smoke-Free Zone
Cigarette smoke is extremely irritating. It not only triggers asthma attacks but also can increase the risk of asthma in children. If you smoke, take advantage of nicotine patches, prescription medications, or smoking-cessation programs. Let others know that smoking in the house is verboten.
Load Your Diet With Flavonoids
Fight the inflammation that accompanies asthma by eating foods loaded with flavonoids—tiny crystals found in onions, apples, blueberries, and grapes that give them their blue, yellow, or reddish hues. Flavonoids not only strengthen the capillary walls, but they are also antioxidants, and so they help protect the membranes in the airways from being damaged by pollution. Eat a couple of servings of flavonoid-rich foods every day.
Take Fish Oil
Preliminary research shows that diets containing the fatty acids gamma linolenic acid (GLA) and eicosapentaenoic acid (EPA)—found in such fatty fish as salmon, sardines, tuna, and mackerel—may improve the quality of life in people with asthma and decrease their reliance on rescue medication. Plus, studies show that fish oil partially reduces reactions to allergens that can trigger attacks in some asthmatics. Other studies suggest fish oil supplements may prevent exercise-induced asthma attacks. “The best natural sources of omega-3s are fish, particularly salmon or other cold-water fish,” says Plaut. Fish oil capsules are a good alternative, but they can cause “fish burps.”“This can usually be avoided if the capsules are taken frozen right before a meal,” he adds. MORE: 6 Things Omega-3s Can Do For Your Health—And 3 Things They Can’t
Take Magnesium
Magnesium levels are frequently low in asthmatics. Research shows that taking a supplement may improve lung function and reduce reaction of the bronchial passages. Extra magnesium may help to decrease muscle tension and airway spasms, explains Kendall Gerdes, MD. But high doses of magnesium (350 milligrams or more) can cause cramps, gas, or diarrhea for some people, so take what your gut will allow. Gerdes suggests starting with 100 milligrams twice a day and increasing it gradually until you experience some of these side effects. Then cut back the dosage a level at a time until problems subside, and then hold that dose. Make sure you’re taking a form of magnesium that can be easily absorbed by the body, says Gerdes. Magnesium citrate, magnesium chloride, and magnesium glycinate are all good options. Note: If you have heart or kidney problems, be sure to talk to your doctor before taking supplemental magnesium.
Supplement With Quercetin
This flavonoid is extracted from certain fruits and vegetables, such as apples, onions, and the white rinds of citrus, and helps reduce the histamine reactions that can lead to asthma. Quercetin can also be taken as a supplement, says Haas, who recommends 250 to 300 milligrams twice or three times a day along with 500 to 1,000 milligrams of vitamin C. At higher intakes, vitamin C has a mild antihistamine, antiallergy effect. Because asthma is a serious, individualized condition, it’s a good idea to talk with your doctor before making any changes to your treatment plan, he adds.
Stay Active
An active lifestyle can help control asthma much better than a sedentary one. Physical activity helps improve lung capacity and may enable people to use lower doses of medications or to use them less often. All asthma patients should discuss a fitness program with their physicians. It is important to first warm up by either stretching, jogging, or sprinting for 20 to 30 minutes before exercising.
Avoid Exercising In Cold Air
Cold air may irritate the airways and trigger an asthma episode. It is important, however, to exercise throughout the year. If you enjoy skiing or skating, make sure you wear a mask to create a reservoir of warm air, advises Plaut. If you notice that you’re having more asthma episodes during the cold months, consider shifting to warm-weather activities. Swimming is especially good because the moist air soothes the airways and reduces the risk of attacks. (Here are 19 pool exercises to try.)
Change Your Breathing Style
Most people breathe using only their chest muscles. This makes it difficult to empty air from the lungs completely. For those with asthma, it’s important to use the diaphragm as well. This large muscle between the chest and abdomen adds power to your breathing and helps remove “used” air from the lungs, which can reduce feelings of breathlessness, explains Plaut. It takes practice to develop the habit of diaphragmatic breathing (also called abdominal, or belly, breathing). Several times a day, lie on your back with one hand on your belly and the other on your chest. As you breathe in, the hand on your belly should rise slightly, while the hand on your chest should barely move.
Take Up A Wind Instrument
Playing a reed instrument, like the oboe, saxophone, or trumpet, requires diaphragmatic breathing, Plaut says. Even if you aren’t especially musical, playing the instrument is great practice for your breathing muscles.
Practice Stress Control
Yoga, self-hypnosis, deep breathing, and other techniques for reducing stress are good techniques for dealing with asthma because they help the airways open more fully, says Plaut. (Do you have one of these silent signals of stress?)
Wash Your Hands Often
Asthma episodes surge in the autumn and winter, when colds are more common. Even a mild case of the sniffles can make asthma harder to control. A viral infection is a common trigger of an asthma attack. Cold viruses can survive for hours on doorknobs, handrails, and even money. Washing your hands often—at least every few hours—will flush away the viruses before they have a chance to take hold. Some people have infectious asthma, meaning they wheeze only when they have a cold or flu, says Haas.
Think Twice About Aspirin
Close to 5% of those with asthma are sensitive to aspirin, ibuprofen, and related pain relievers, known as nonsteroidal anti-inflammatory drugs (NSAIDs). For those who are sensitive, an asthma attack or other respiratory problems can begin within 3 hours of taking the drugs. If you have asthma and chronic sinusitis with nasal polyps, your chances of developing a sensitivity to aspirin (known as “aspirin exacerbated respiratory disease”) is about one in three, says Lang. If you need long-term pain relief—from arthritis, for example—your doctor may advise you to switch to acetaminophen or other analgesics that are less likely to trigger asthma attacks. Because acetaminophen may also “cross-react” in those sensitive to aspirin, you should take regular rather than extra-strength acetaminophen, and always avoid not only aspirin but also medications otherwise known as NSAIDs, including ibuprofen, naproxen, and others, Lang says. If you have aspirin sensitivity, the reaction to it and these other drugs can be serious or even life-threatening.
Don’t Put Up With Heartburn
The upward surge of stomach acids that cause the telltale pain of heartburn can also trigger asthma attacks. One of the best ways to prevent heartburn is to eat four or more small meals daily, instead of two or three large meals, says Plaut. Also, don’t eat 2 hours before bedtime. To help prevent stomach acid from going “upstream,” create an incline by raising the head of your bed 4 to 6 inches by putting blocks under the top legs. You can also treat heartburn with over-the-counter antacids or acid-suppressing drugs, such as cimetidine (Tagamet) and ranitidine (Zantac), or proton pump inhibitors (Prilosec). (Try these 9 foods that soothe heartburn.)
Flush Your Sinuses
Millions of Americans get sinus infections every year, and the inflammation and mucus drainage can make asthma worse. Sinusitis often requires treatment with antibiotics, but you may be able to prevent infections by flushing your sinuses at home, says Plaut. Mix 1/2 teaspoon of salt in 1 cup of warm water. Put the solution into a plastic squeeze bottle (available at drugstores), a neti pot, or a measuring cup. Use the solution to rinse out one nostril, then repeat with the other nostril. People susceptible to sinus infections should repeat the treatment at least once daily. If you get infections less often, flush the sinuses only at the first sign of a cold or when your seasonal allergies are worse than usual.
Act Quickly If Asthma Strikes
Don’t ignore early signs of asthma attacks, even if the symptoms—wheezing, coughing, or faster breathing—seem mild at first. Use your rescue medication promptly. It will help reverse airway narrowing before the attack gets more serious, says Plaut.
Keep Track Of Inhaler “Puffs”
Many inhalers have a built-in dose counter. If you use medication to control asthma, the worst thing is to discover that your inhaler is empty right when you need it. To prevent this, put a piece of masking tape on the inhaler and make a mark on the tape every time you use it. If you take a medicine on a regular basis—for example, two puffs a day—you can calculate the date you will run out simply by dividing the total number of doses in the inhaler by the number of puffs you take in a day.
Or Use The Doser
Available at allergy supply stores and catalogs, the Doser attaches to metered inhalers and automatically keeps track of how many doses you have left.
Use A Peak-Flow Meter
A peak-flow meter is a device that measures the speed at which air leaves the lungs. It’s available in drugstores and is an invaluable way to detect the airway narrowing that occurs prior to asthma attacks. A reading between 80 to 100% indicates that your breathing is healthy, says Plaut. Lower scores may indicate that you need higher doses of medication or your asthma isn’t adequately controlled. Keep a daily diary that lists the following: peak-flow levels, frequency and severity of symptoms, number of medicine usages, and exposure to possible triggers. By consulting the diary regularly, you’ll be able to detect factors that cause your asthma to get worse—and those that cause it to improve, Plaut says.
Add Fish To Your Diet
If you or anyone in your family has asthma, put fish on the menu at least twice a week. Fatty fish such as tuna, salmon, and mackerel contain beneficial fats called omega-3 fatty acids. Asthma is an inflammatory disease, and the omega-3s help to damp down many of the body’s processes that create inflammation. Try these 5 simple one-dish recipes.
When To Call A Doctor
Asthma symptoms are often subtle at first, but they can get much worse in a hurry. Report any changes in your usual breathing patterns to your doctor. You also should see a doctor if your wheeze, cough, or shortness of breath worsens after you take your rescue medication. It means the asthma isn’t well controlled, and you have a higher risk for a flare-up, which may be serious.
Panel Of Advisors
Kendall Gerdes, MD, is director of Environmental Medicine Associates in Denver. Elson Haas, MD, is director of the Preventive Medical Center of Marin, an integrated health-care facility in San Rafael, California, and author of seven books on health and nutrition, including The False Fat Diet, Staying Healthy with Nutrition, and The New Detox Diet. David Lang, MD, is head of allergy and immunology in the Respiratory Institute at Cleveland Clinic in Ohio. Thomas F. Plaut, MD, is author of Dr. Tom Plaut’s Asthma Guide for People of All Ages and One-Minute Asthma: What You Need to Know.
