For parents of asthmatic children, the night can be a stressful time. Just the sound of normal snoring can set internal alarm bells ringing. Jumping out of bed, parents may check on their kids countless times through the night, albuterol inhalers at the ready. Needless to say, it’s not a recipe for sound sleep. Although inhaled albuterol and steroids are lifesaving, can control symptoms, and are an important part of an asthma action plan, we need treatment options that heal the lungs over time. In the realm of natural medicine, there are a number of remedies that show promise. In particular, three treatments stand out in the research: glutathione, quercetin, and magnesium. Each of these therapies target the physiologic changes that take place with chronic asthma.
The mechanics of asthma
In North America, childhood asthma is incredibly common, affecting around 9% of children under 18.1 This translates to 1 in 13 children, making asthma the most common chronic disease in childhood. Children with asthma experience a lot of inflammation in the bronchioles, which are the branch-like vessels that make up the lungs. The bronchioles tighten up in response to inflammatory compounds in circulation. As the bronchioles tighten, specialized cells called goblet cells secrete mucus, leading to edema and swelling. This process is driven by a combination of genetics, allergies, and reaction to inhaled irritants. Over time, the inflammation makes the lungs hyper-responsive, which leads to asthma attacks. Early symptoms include shortness of breath, wheezing or whistling when breathing out, restless sleep, and a feeling of tightness in the chest. Successful treatments focus on the underlying inflammatory and immune changes, and this is where natural remedies can play an important role. Although natural therapies will not arrest an acute attack, they can decrease asthma severity over time by calming chronic inflammation in the lungs.2
Glutathione: An antioxidant to fight inflammation
Oxidative stress is one of the main causes of inflammation that leads to asthma. Simply put, oxidative stress occurs when uncharged molecules—called free radicals—react with body tissues and cause damage. Free radicals run around the body hunting for electrons, stealing them from cells, tissues, and even DNA, to complete their outer rings. Our bodies build up free radicals with prolonged allergic response, toxin exposure, sleep disturbance, heightened stress, chronic infections, and eating certain types of foods (like processed meats, oxidized oils, and those items that have a high glycemic load).
The inflammation caused by free radicals is an underlying cause of many diseases, including autoimmunity, diabetes, heart disease, and dementia.3 By examining lung tissue from mice, pathologists have also discovered that free radicals are abundant in asthmatic lungs.4 This is where glutathione and other antioxidants come into play.
Antioxidants are nature’s answer to free radicals. As electron donors, antioxidants give the hungry free radicals the electrons they crave. When glutathione finds a circulating free radical, it readily donates an electron to neutralize the molecule. After giving the electron, glutathione converts to its oxidized form, glutathione disulfide (GSSG),5 and then undergoes an enzymatic reaction to turn back into glutathione, starting the process all over again. Basically, glutathione is a free radical fighting superhero! In a mouse study, researchers found lower glutathione levels in asthmatic lungs compared to healthy tissues, and the results of a recent study on children found that increasing glutathione over time led to fewer asthma attacks and reduced inflammation.6 By treating the underlying inflammation, glutathione works on the main cause of the disease.
Supplementing with glutathione
Glutathione can be boosted naturally with diet by focusing on certain amino acids. Glutamine, cysteine, and glycine are three building blocks for glutathione, and are abundant in protein-rich foods, legumes, and green vegetables. Grass-fed beef, eggs, yogurt, salmon, spirulina, cabbage, asparagus, and broccoli are all great sources. Weaving in other antioxidants is also helpful: vitamin C, for example, which is found in citrus and leafy greens, is an incredibly safe and effective antioxidant for children.8
When it comes to supplementation, more research is needed to determine the best dosing for children. In my practice, 500 mg of reduced glutathione (GSH) for kids aged 5 and older does the trick. Avoid the nebulized forms, as inhaled glutathione can actually trigger asthma attacks in some children. And although glutathione is safe, long-term supplementation can block zinc absorption.7 To correct this, add in a multivitamin with zinc to keep levels in a healthy range. To decide if glutathione is right for your child’s situation, check with your healthcare provider first.
Calming histamine with quercetin
Flavonoids comprise another class of plant antioxidant that reduce oxidative stress and can help improve lung health.9 One flavonoid showing a lot of promise for childhood asthma is the ancient compound quercetin. When plant life first developed over 700 million years ago, flavonoids were some of the first compounds plants formed as a means to combat oxidative stress from their changing environments. These compounds protected plant cells from damage by scavenging and neutralizing any free radicals in the plant tissue.
Both a plant pigment (found in deeply-coloured fruits and vegetables) and a plant protector, quercetin is found abundantly in nature,10 and has a particular affinity for the lungs, as evidenced by scientific findings of quercetin metabolites bound to exhaled carbon dioxide in the breath, suggesting high levels present in the respiratory system.11 As humans evolved, they also developed a reliance on plant flavonoids like quercetin to heal and protect the lungs and other organs. For asthma in particular, quercetin not only neutralizes free radicals, it also blocks histamine release from the immune system.
The asthma-histamine conundrum
Asthma involves the release of high volumes of histamine, triggered by specialized white blood cells called eosinophils. In a balanced environment, eosinophils serve a vital role in our immune defense system by triggering the mast cells to release histamine so the body can fight off viruses, parasites, and other infections. Histamine, in turn, opens up blood vessels to allow other types of white cells to pass through to join the fight. The problem arises when eosinophils overreact to inhaled allergens and irritants, causing a histamine storm that overwhelms the body, and instead of helping it to fight off infection leads to massive inflammation, one of the main underlying causes of asthma.12
Supplementing with quercetin
Quercetin can restore balance to the immune system by helping to block histamine release and other inflammatory mediators by turning off the switches that allow histamine to leave the cell.13 In essence, quercetin tells the mast cells to relax their assault. Quercetin also inactivates the compound IL-5, the role of which is to call eosinophils into the lungs in large numbers.
It is possible to lower histamine release over time by replenishing quercetin through diet. As quercetin enters the digestive system, enzymes break it down into bioactive forms, which bind to sugars, allowing it to cross into the body. To increase your intake of this flavonoid, aim for foods like red onions, peppers, dark leafy greens, tomatoes, broccoli, grapes, green tea, apples, and nuts.
In terms of supplementation, researchers have found improved airway reactivity, decreased mucus production, and decreased frequency of asthma attacks with at least 500 mg per day.14
Opening the airways with magnesium
Keeping the bronchioles open is the main goal of any asthma treatment and magnesium directly acts on the bronchial smooth muscle to promote relaxation. It also supports open airways by blocking calcium channels that tell the bronchioles to contract and by stimulating nitrous oxide, which has a dilating effect. Further, magnesium disrupts the signaling pathway leading to airway spasm. Children with asthma tend to have lower intracellular levels of magnesium compared to healthy subjects, just like glutathione, which suggests that magnesium deficiency may actually be an underlying cause of bronchial hyper-reactivity.15
In 2006, researchers from the Center for Pediatric Medicine in Brazil completed a double-blind study on oral magnesium supplementation for childhood asthma. At the end of the two-month period, the researchers discovered that the children taking magnesium had fewer acute attacks, decreased inhaler use, were less allergic on skin prick tests, and had decreased bronchiole reactivity on an asthmatic response challenge. For such a simple and safe treatment, these are pretty remarkable results!16
Supplementing with magnesium
Magnesium is readily available and abundant in a variety of fruits, veggies, and whole grains, from leafy greens, to avocados and bananas, to quinoa and brown rice. Lightly steaming and sautéing veggies will break down plant cell walls to help release magnesium and other micro-minerals.
Magnesium supplementation is both safe and effective for children with asthma. There are a few forms available, including magnesium citrate, glycinate, and malate. Of these, I prefer magnesium citrate or glycinate as these forms have an affinity for the lungs without causing the loose stools induced by magnesium malate.
Avoiding allergen exposure
When thinking about the underlying causes of asthma, there is one thing missing from the above discussion: preventing and managing environmental allergies. Although the therapies reviewed here will work on the inflammation and hyper-reactivity, it is vital to address ongoing allergen exposure.
Why do some kids develop allergies and asthma? Asthmatic children often inherit dust mite, dander, and pollen allergies from their parents.17 Beyond genetics, other factors include secondhand smoke exposure, childhood obesity, and living in an area with high air pollution. There is also evidence that highly sterile environments can lead to allergies.18 Research suggests that exposure to common bacteria early in life prevents the development of allergic disease:19 another good reason to let kids get outside and play in the dirt!
(See Dr. Leslie Solomonian’s article Exploring the Mysterious Microbiome!)
If allergies have already developed, taking steps to control exposure is important. Many parents of asthmatic children are already familiar with environmental strategies, which include regular vacuuming, using a HEPA air filter, keeping pets out of the bedroom, and avoiding inhaled irritants like smoke. Depending on your water source, a chlorine filter on showers can help as well, as chlorine vapor is a known lung irritant and can worsen chronic asthma.20 These simple steps go a long way in supporting lung health and preventing attacks. (See Manda’s article on keeping childhood toxins out of the home for some more handy tips!)
While your child still may need to tote around that inhaler, there are ways to improve lung health that include natural medicine supplementation. Creating a holistic plan is a solid approach that can help with healing and lung recovery, causing both you and your child to breathe that sigh of relief.
For references visit ecoparent.ca/extras/SUM19