HERBAL ALTERNATIVES TO ASTHMA

Aabout Author:
Dhirendra C. Patel*
Master of Pharmacy, Department of Pharmaceutics and Pharmaceutical Technology,
S.K. Patel College of Pharmaceutical Education and Research, Ganpat University,
Kherva, Mehsana, Gujarat, India.
dhiren.pharmacy@gmail.com

Abstract:
Herbal medicines are very popular in treatment of the asthma in the modern era because of lots of benefits of it like less cost, less side effects, easily available etc. Herbal alternatives to asthma are better way for treatment of asthma. Various herbal medicines recognize that immune system functioning can play a vital role in helping to control the symptoms of asthma and strengthen the body's defenses against environmental allergens. Herbal medicines like ephedra, ginger, chamomile, elderberry, licorice, mullein, stinging nettle etc are very beneficial in asthma. Scientists have found evidence to support herbal's wide range of medicinal actions. These actions include the lowering of cholesterol levels, relief for allergies and asthma etc. Herbs have been used by people for longer than we have been keeping written record. Originally they were found in the wild by the gatherers and used for lots of different things. I light here, the use of herbals in asthma. It aims to tap into the body’s own healing mechanism by transforming the “triggers” of such attacks as part of the remedy. Opinions of different authors are saying that herbal medication is better way for asthma treatment.

REFERENCE ID: PHARMATUTOR-ART-1479

INTRODUCTION
Herbal:
Herbal is naturally occurring substance which is used widely in modern era. Herbalism is a traditional medicina lor folk medicine practice based on the use of plants and plant extracts. Herbalism is also known as botanical medicine, medical herbalism, herbal medicine, herbology, and physiotherapy. The scope of herbal medicine is sometimes extended to include fungal and bee products, as well as minerals, shells and certain animal parts. Pharmacognosy is the study of medicines derived from natural sources. Traditional use of medicines is recognized as a way to learn about potential future medicines. In 2001, researchers identified 122 compounds used in mainstream medicine which were derived from "ethnomedical" plant sources; 80% of these compounds were used in the same or related manner as the traditional ethnomedical use. Many plants synthesize substances that are useful to the maintenance of health in humans and other animals. These include aromaticsubstances, most of which are phenolsor their oxygen substituted dervatives such as tannins. Many are secondary metabolites, of which at least 12,000 have been isolated a number estimated to be less than 10% of the total. In many cases, substances such as alkaloids serve as plant defense mechanisms against predation by microorganisms, insects, and herbivores. Many of the herbsand spicesused by humans to season food yield useful medicinal compounds. Similar to prescription drugs, a number of herbs are thought to be likely to cause adverse effects. Furthermore, "adulteration, inappropriate formulation, or lack of understanding of plant and drug interactions have led to adverse reactions that are sometimes life threatening or lethal.

Asthma:
Asthma is a common disease in children and adults. It is experienced when there is an inflammation of the airways restricting the oxygen that flows in the lungs and which should be expelled afterward. Asthma is closely associated with allergies since attacks, which can be triggered by a number of factors, are most likely caused by allergens. These so-called “triggers” can be encountered anytime and anywhere hence one must always be prepared. There is no positive way of preventing a child from having asthma but there are ways to reduce the risk of developing it. When a child or an adult has an asthma attack, the normal reaction would be to use a nebulizer or take the medicines prescribed by doctor. The primary intention in this scenario is to provide fast relief to the afflicted person.

Alternative asthma treatment:
There is no denying that millions of people are getting affected each year by asthma and the statistics shows that it is the number one leading cause of chronic illness that affects more than 5 million children in the US alone. Researchers are alarmed by the huge increase of people suffering from it. No matter how scary asthma attack may be, you do not need to keep yourself hidden away from your family and friends and things or activities that have been long part of your routine. And besides, this is a treatable illness, so cheer up and be an obedient patient to your doctor. Aside from the prescribed drugs that your doctor asked you to buy from your favorite commercial and big pharmaceutical companies, there are actually a number of ways how to reduce the cost of your expenses. You just have to look around your kitchen and voila! You have now a garden of affordable, safe and free from chemical remedies to help you fight that irritating wheezing and coughing streak. One of the best home remedies for asthma is honey. When a person is having an attack, you just have to put a bottle or jug of honey under the patient’s nose to restore the normalcy of breathing. Honey can also be taken internally, a few spoonful of honey mixed in a glass of water taken at least three times a day is another form of home remedies for asthma. And so are gingers, garlic and turmeric powder. A clove of boiled garlic can be mixed with a glass of milk and should be taken orally twice a day. In short, it is very easy to remedy of asthma by herbals which are around us.

AIM OF PRESENT WORK
The aim of present work is to ensure that herbals are very effective in asthma. Herbs have been used by people for longer than we have been keeping written record. Originally they were found in the wild, by the gatherers and used for lots of different things. I light here, the use of herbals in asthma. It aims to tap into the body’s own healing mechanism by transforming the “triggers” of such attacks as part of the remedy. It is not enough that symptoms are stopped for the meantime since such could happen again. What is being addressed by herbal is not merely the body’s condition but the health of the person as a whole. The long term goal is to identify the root of the asthma attacks. A person’s immune system is its main concern for if such system is strengthened and fortified then the possibility of suffering from another attack will be lowered. The externals as well as the internals are dealt with simultaneously in order that the body reaches a balance and can respond adequately to the situation. Treatment of asthma using herbals should not be localized. In any case, asthma should be treated differently from one afflicted person to another. It should be seen as an individual condition since the factors as to its occurrence vary. There is no single, black and white herbals treatment for asthma. Factors like allergens, frequency of attacks, and other symptoms exhibited that must also be taken into consideration for asthma homeopathy. Studies show that herbals treatment for persons suffering from asthma develops an enhanced immune system as they manage to keep their symptoms under control and their body resistance at a high level. Allergens that used to adversely affect their overall health do not have the same effect on their bodies. Herbals are also not a bar to the taking of traditional asthma medications. An asthma herbals treatment does not interfere with the effects of medicines especially if a person’s attacks require him to take some prescribed drugs. It is a safe &alternative way for people with asthma.

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ABOUT ASTHMA
Asthma is an inflammatory disorder of the airways, which causes attacks of wheezing, shortness of breath, chest tightness, and coughing. Asthma is a common chronicinflammatory disease of the airways characterized by variable and recurring symptoms, airflow obstruction, and bronchospasm.

Causes:
Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swell. This reduces the amount of air that can pass by and can lead to wheezing sounds. Most people with asthma have wheezing attacks separated by symptom free periods. Some patients have long term shortness of breath with episodes of increased shortness of breath. In others, a cough may be the main symptom. Asthma attacks can last minutes to days and can become dangerous if the airflow becomes severely restricted. In sensitive individuals, asthma symptoms can be triggered by breathing in allergy causing substances (called allergens or triggers).

Common asthma triggers include animals (pet hair or dander), dust, changes in weather (most often cold weather), chemicals in the air or in food, exercise, mold, pollen, respiratory infections, such as the common cold, strong emotions (stress), and tobacco smoke.

Symptoms
•   Cough with or without sputum production
•   Pulling in of the skin between the ribs when breathing
•   Shortness of breath that gets worse with exercise or activity
•   Wheezing
•   Comes in episodes
•   May be worse at night or in early morning
•   May go away on its own
•   Gets better when using drugs that open the airways (bronchodilators)
•   Gets worse when breathing in cold air
•   Gets worse with exercise
•   Gets worse with heartburn (reflux)
•   Usually begins suddenly

Emergency symptoms
•   Bluish color to the lips and face
•   Decreased level of alertness such as severe drowsiness or confusion
•   Extreme difficulty breathing
•   Rapid pulse
•   Severe anxiety due to shortness of breath
•   Sweating

Additional symptoms that may be associated with this disease
•   Abnormal breathing pattern breathing out takes more than twice as long as breathing in
•   Breathing temporarily stops
•   Chest pain
•   Nasal flaring
•   Tightness in the chest

Exams and Tests of Asthma:
Allergy testing may be helpful in identifying allergens in people with persistent asthma. Common allergens include pet dander, dust mites, cockroach allergens, molds, and pollens. Common respiratory irritants include tobacco smoke, pollution, and fumes from burning wood or gas. The doctor will use a stethoscope to listen to the lungs. Asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes.

Tests may include
•   Arterial blood gas
•   Blood tests to measure eosinophil count (a type of white blood cell) and IgE (a type of immune system protein called an immunoglobulin)
•   Chest x-ray
•   Lung function tests
•   Peak flow measurements

Treatment:
The goal of treatment is to avoid the substances that trigger your symptoms and to control airway inflammation. You and your doctor should work together as a team to develop and carry out a plan for eliminating asthma triggers and monitoring symptoms. There are two basic kinds of medication for the treatment of asthma:
1. Long-acting medications to prevent attacks
2. Quick-relief medications for use during attacks

1.   Long-term control medications are used on a regular basis to prevent attacks, not to treat them. Such medicines include:
*   Inhaled corticosteroids (such as Azmacort, Vanceril, AeroBid, Flovent) prevent inflammation
*   Leukotriene inhibitors (such as Singulair and Accolate)
*   Long-acting bronchodilators (such as Serevent) help open airways
*   Omilizumab (Xolair), which blocks a pathway that the immune system uses to trigger asthma symptoms
*   Cromolyn sodium (Intal) or nedocromil sodium (Tilade)
*   Aminophylline or theophylline (not used as frequently as in the past)
*   Sometimes a single medication that combines steroids and bronchodilators are used (Advair, Symbicort)

2.   Quick relief, or rescue, medications are used to relieve symptoms during an attack. These include:
*   Short-acting bronchodilators (inhalers), such as Proventil, Ventolin, Xopenex, and others
*   Corticosteroids, such as methylprednisolone, may be given directly into a vein (intravenously), during a severe attack, along with other inhaled medications

People with mild asthma (infrequent attacks) may use quick relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms. A severe asthma attack requires a check up by a doctor and, possibly, a hospital stay, oxygen, and medications through a vein (IV).

A peak flow meter is a simple device to measure how quickly you can move air out of your lungs. It can help you see if an attack is coming, sometimes even before any symptoms appear. Peak flow measurements can help show when medication is needed, or other action needs to be taken. Peak flow values of 50-80% of a specific person's best results are a sign of a moderate asthma attack while values below 50% are a sign of a severe attack.

Prevention:
Asthma symptoms can be substantially reduced by avoiding known triggers and substances that irritate the airways. Bedding can be covered with "allergy proof" casings to reduce exposure to dust mites. Removing carpets from bedrooms and vacuuming regularly is also helpful. Detergents and cleaning materials in the home should be unscented. Keeping humidity levels low and fixing leaks can reduce growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms this helps reduce the possibility of cockroaches, which can trigger asthma attacks in some people. If a person is allergic to an animal that cannot be removed from the home, the animal should be kept out of the patient's bedroom. Filtering material can be placed over the heating outlets to trap animal dander. Eliminating tobacco smoke from the home is the single most important thing a family can do to help a child with asthma. Smoking outside the house is not enough. Family members and visitors who smoke outside carry smoke residue inside on their clothes and hair this can trigger asthma symptoms. Persons with asthma should also avoid air pollution, industrial dusts, and other irritating fumes, as much as possible.

Asthma control drugs (Allopathic):
Control drugs for asthma are drugs you take to control your symptoms of asthma. You must take them every day for them to work. You and your doctor can make a plan for the control drugs that work for you. This plan will include when you should take them and how much you should take. You may need to take these drugs for at least a month before you start to feel better. Take them even when you feel okay. Take enough with you when you travel. Plan ahead. Make sure you do not run out.

Inhaled Corticosteroids: Inhaled corticosteroids help keep your airways from swelling up. This helps keep your asthma symptoms away. These inhaled corticosteroids are used with a metered dose inhaler (MDI) and spacer:

Flunisolide (Aerobid)
Budesonide (Pulmicort)
Mometasone (Asmanex)
Triamcinolone (Azmacort)
Fluticasone (Flovent)
Beclomethasone (Qvar)

You should use an inhaled steroid drug every day, even if you do not have symptoms. After you use it, rinse your mouth with water, gargle, and spit out. If your child cannot use an inhaler, your doctor will give you Pulmicort Repulse. This drug is used with a nebulizer. This machine can turn liquid medicine into a spray, so your child can breathe the medicine in.

Long-acting Beta-agonist Inhalers: Long-acting beta-agonist inhaler drugs are another kind of medicine that helps keep your asthma symptoms away. These drugs relax the muscles of your airways.

Salmeterol (Serevent): use 2 times a day.
Formoterol (Foradil): use 1 time a day.

Use a long-acting beta-agonist inhaler drug every day, even if you do not have symptoms. It is common to use both of these drugs and inhaled steroids.

Combination Therapy: Your doctor may ask you to take both a steroid drug and a long-acting beta-agonist drug. It may be easier to use an inhaler that has both drugs in them. Three of these are:

Advair HFA
Advair Diskus
Symbicort

Leukotriene Modifiers: These medicines are used to prevent asthma symptoms. They come in tablet or pill form. Leukotriene modifiers include:

Monoleukast (Singulair)
Zafirlukast (Accolate)
Zileuton (Zyflo)

Cromolyn: Cromolyn is a medicine that may prevent asthma symptoms. It can be used in a nebulizer, so it may be easy for young children to take. It is also available as an aerosol.

HISTORY
Asthma was first recognized and named by Hippocratescirca 450 BC. During the 1930s–50s, asthma was considered as being one of the holy seven' psychosomatic illnesses. Its etiologywas considered to be psychological, with treatment often based on psychoanalysis and other 'talking cures'. As these psychoanalysts interpreted the asthmatic wheeze as the suppressed cry of the child for its mother so they considered that the treatment of depression was especially important for individuals with asthma. Many ancient societies have a body of traditional medicinelargely based on herbalism that predates the invention of writing. It is not surprising that, as they became literate those cultures felt the urge to commit that knowledge to writing in the form of herbals.Before the advent of printing, herbals were produced as manuscriptswhich could be kept as scrollsor loose sheets or bound into codices. Early handwritten herbals were often illustrated with paintings and drawings. Like other manuscript books, herbals were "published" through repeated copying by hand either by professional scribes or by the readers themselves. In the process of making a copy, the copyist would often translate, expand, adapt, or reorder the content. Most of the original herbals have been lost; many have survived only as later copies (of copies of copies.) and many others are known only through references from other texts. As printing became available, it was promptly used to publish herbals. In Europe, the first printed herbal with woodcut(xylograph) illustrations, the Puch der Natur of Konrad of Megenberg, appeared in 1475.Metal-engraved plates were first used in about 1580. The woodcuts and metal engravings could now be reproduced indefinitely, and they were traded among printers: there was therefore a large increase in the number of illustrations together with an improvement in quality and detail.

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IMPORTANCE OF HERBAL MEDICINE
It recognize that immune system functioning can play a vital role in helping to control the symptoms of asthma and strengthen the body's defenses against environmental allergens. A asthma herbal treatment does not interfere with the effects of medicines especially if a person’s attacks require him to take some prescribed drugs. It is a safe & alternative way for people with asthma. Few herbal remedies have conclusively demonstrated any positive effect on humans, possibly due to inadequate testing. Many of the studies cited refer to animal model investigations or in-vitro assays and therefore cannot provide more than weak supportive evidence.

Some list of plants used as medicine :
•   Aloe vera has traditionally been used for the healing of burns and wounds. A systematic review (from 1999) states that the efficacy of aloe vera in promoting wound healing is unclear while a later review (from 2007) concludes that the cumulative evidence supports the use of aloe vera for the healing of first to second degree burns.
•   Rauvolfia Serpentina, high risk of toxicity if improperly used extensively in India for sleeplessness, anxiety, and high blood pressure.
•   Ginger (Zingiber officinale), administered in 250mg capsules for four days and effectively decreased nausea and vomiting of pregnancy in a human clinical trial.
•   Grapefruit (Naringenin) components may prevent obesity.
•   Honey may reduce cholesterol. May be useful in wound healing.
•   Lemon grass (Cymbopogon citratus), administered daily as an aqueous extract of the fresh leaf has lowered total cholesterol and fasting plasma glucose levels in rats as well as increasing HDL cholesterol levels. Lemon grass administration had no effect on triglyceride levels.

VARIOUS HERBAL MEDICINES USED IN ASTHMA
•   Chamomile tea is used as an antihistamine.
•   Elderberry relieves nasal congestion.
•   Ephedra opens bronchial passages & relieves congestion.
•   Ginger reduces allergic reaction.
•   Green tea opens bronchial passages.
•   Hyssop tea relieves respiratory congestion.
•   Licorice increases mucus production to counter dry cough.
•   Lobelia Tincture or capsules help reduce inflammatory reaction and soothe bronchial tissue.
•   Mullein Oil relieves cough & helps clear bronchial tubes.
•   Nettle, regular use of tea relieves respiratory problems.

1. EPHEDRA (Ephedra Sinica)
This herb has been used for centuries to ease breathing, induce sweating, treat asthma, colds and flush, hay fever, emphysema and obesity. This is a very controversial herb. Some believe that troubles related to this herb stem from western attempts to isolate and extract specific individual chemical compounds rather than using the whole herb. Some compounds in this plant such as ephedrine can relieve asthma but when used in this isolated form can also elevate blood pressure. When the herb is used whole, however it contains other compounds that slow the heart rate and lower blood pressure. These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on tradition or theory:
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in human’s safety and effectiveness has not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified healthcare provider. Alertness, anaphylaxis (a severe allergic reaction), anti-inflammatory, antiviral, appetite suppressant, arthritis, athletic performance enhancer, bed-wetting, body building, colds, cough, depression, diuretic, dyspnea (shortness of breath), edema, fatigue, fevers, flu, freckle-removing, gonorrhea, gout, hives, joint pain, kidney disease, lack of perspiration, liver spots, metabolic enhancement, myasthenia gravis, narcolepsy, nephritis, stimulant, syphilis, upper respiratory tract infections, uterine stimulant.

Uses based on scientific evidence
Weight loss:
Ephedra contains the chemical ephedrine which appears to cause weight loss when used in combination with caffeine based on the available scientific evidence. The results of research on ephedrine alone without caffeine are unclear. The amounts of ephedrine in commercially available products have varied widely. Other weight loss treatments have been more commonly recommended due to significant safety concerns with combination products containing ephedra and caffeine.

Bronchodilator (asthma):
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 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.

Allergic nasal symptoms (used as a nose wash):
Early studies suggest that ephedrine nasal spray, a chemical in ephedra, may help treat symptoms of nasal allergies. Additional research is needed before a firm recommendation can be made.

Dosing:
The below doses are based on scientific research, publications, traditional use or expert opinion. Many herbs and supplements have not been thoroughly tested safety and effectiveness may not be proven. Brands may be made differently with variable ingredients even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years or older): The U.S. Federal Government has banned the sale of ephedra since 2004. Consumers are urged to stop using the herbal weight control supplement immediately as it has been linked to numerous adverse health effects including death. Ephedra may cause serious adverse effects in any dose, particularly when used with other drugs such as caffeine. Because of serious safety concerns, ephedra cannot be recommended in any dose.

Children (younger than 18 years): Ephedrine is not recommended in children due to the risk of toxicity and death.

Safety:
The U.S. Food and Drug Administration do not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products and effects may vary. You should always read product labels. If you have a medical condition or are taking other drugs, herbs or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies:
Persons with a known allergy to ephedra, ephedrine, or pseudoephedrine should avoid ephedra. Signs of allergy may include rash, itching, red & flaking skin.

Side Effects and Warnings:
The U.S. Food and Drug Administration (FDA) have collected thousands of reports of serious adverse effects (including over 100 deaths) from the use of various products containing ephedra or ephedrine. The U.S. Federal Government has banned the sale of ephedra since 2004. Consumers are urged to stop using the herbal weight control supplement immediately as it has been linked to numerous adverse health effects including death.

Some people may experience abdominal discomfort (nausea, vomiting, diarrhea, loss of appetite, constipation), anxiety, dizziness, headache, tremor, insomnia, dry mouth, delirium or fainting. Ephedra may also cause irritability, euphoria, hallucinations, seizures or stroke as well as low potassium levels in the blood, exaggerated reflexes, weakness, muscle aches, muscle damage, depression, mania, agitation, suicidal ideas or Parkinson's disease-like symptoms. Persons with prior strokes or transient ischemic attacks, tremor, or insomnia should avoid ephedra. Individuals with a history of a psychiatric illness, especially if treated with monoamine oxidase inhibitors (MAOIs), must first discuss ephedra with a qualified healthcare provider before taking supplements. Examples of MAOIs include isocarboxazid, phenelzine, and tranylcypromine. Ephedra can cause chest tightness, irregular heart rhythms, damage to the heart muscle, high blood pressure, heart attack, inflammation of the heart, fluid retention in the lungs, breathing difficulties, dilated cardiomyopathy, left ventricular systolic dysfunction, coronary dissection, thrombosis or cardiac arrest. Ephedra should be used with extreme caution in persons with a history of heart disease, heart rate disorders or high blood pressure. Other side effects may include liver damage, kidney stones, difficulty passing urine or pain when urinating, increased urine production or contractions of the uterus. These potential effects may limit the use of ephedra by people with kidney disease or enlarged prostate. Individuals with thyroid gland disorders or glaucoma should use ephedra cautiously. In theory, ephedra may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a qualified healthcare provider and medication adjustments may be necessary.

It has been recommended that ephedra use be stopped at least one week prior to major surgical or diagnostic procedures. Pregnancy and Breastfeeding, Ephedra should not be used during pregnancy due to risks to the mother and fetus. Ephedrine crosses the placenta and has been found to increase fetal heart rate. Ephedra may induce uterine contractions. Ephedra should not be used during breastfeeding, due to risks to the mother and child. Ephedrine crosses into breast milk and has been associated with irritability, crying and insomnia in infants.

Interactions:
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments or traditional use. You should always read product labels. If you have a medical condition or are taking other drugs, herbs or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Many drugs can cause increased stimulation when used with ephedra or ephedrine. Examples include caffeine and theophylline. When combined with ephedra, these drugs may lead to difficulty sleeping, nervousness, or stomach upset. The combination of ephedrine and caffeine may be fatal. Many products contain both ephedrine and caffeine and should be used with caution, if at all. Combined ingestion of caffeine and ephedrine has been observed to increase blood glucose and lactate concentrations. Ephedrine and dopamine concentrations are significantly increased. A case report exists of ephedra use associated with the onset of psychosis and autonomic hyperactivity after administration of risperidone.

Bronchodilators used for asthma or the decongestant pseudoephedrine may have increased bronchodilating effects when used with ephedra. If ephedra is taken with monoamine oxidase inhibitor (MAOI) antidepressants such as isocarboxazid, phenelzine and tranylcypromine, severe side effects may develop including dangerously high blood pressure, muscle damage, fever and irregular heart rate. Other antidepressants and medications for psychiatric disorders (phenothiazines, tricyclics, selective serotonin reuptake inhibitors [SSRIs]) may reduce the effects of ephedra and cause low blood pressure and rapid heartbeat. Because ephedra affects blood pressure and heart rate, it may alter the effectiveness of medications given to control blood pressure or heart rhythm including digoxin, alpha-blockers, beta-blockers, diuretics, calcium-channel blockers or angiotensin converting enzyme (ACE) inhibitors. The side effects of ephedra may be worsened by guanethidine, ergot alkaloids (bromocriptine, dihydroergotamine & ergotamine), oxytocin, diuretics, morphine, and anesthetic drugs (halothane, cyclopropane, propofol). Ephedra may lower blood sugar levels although ephedra-caffeine combinations may increase blood sugar. Caution is advised when using medications that may also alter blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary. Ephedra may reduce the effects of steroids such as dexamethasone. Ephedra may increase serum levels of thyroid hormones and may alter thyroid hormone treatments. Medications that alter the acidity of urine may reduce the effectiveness of ephedra. Effects of cholesterol lowering medications may be altered by ephedra, although this has not been proven. Phenylpropanolamine, previously removed from the U.S. market may lead to additive effects if taken with ephedra. Caution is advised with other agents takes for weight loss. Ephedra may also interact with alcohol, general anesthetics and drugs taken for gout. Ephedra products should be stopped 24 hours prior to surgery.

2. GINGER
Ginger is the most widely used and available herbal remedy on the planet with billions of people using it every day as both food and medicine. A tropical perennial growing to a height of two feet, ginger has lance-shaped leaves and bears stalks of white or yellow flowers. Ginger has long been the subject of fable and literature. For centuries, Europeans obtained ginger form Arab spice traders, who protected their sources by inviting stories of ginger field located in lands stalked by a fierce people called troglodytes. And Shakespeare wrote in Love's Labour Lost, "had I but one penny in the world thou shoul have it to buy ginger-bread." Ginger is used either fresh or dried in nearly two thirds of all traditional Chinese and Japanese herbal formulas. Fresh ginger is used to relieve dryness and heat, while dried ginger is used to relieve dampness and chill. In Traditional Chinese Medicine, ginger is said to "rescue devastated yang", a condition in which invading cold or infection has reached the interior of the body. Ginger warms the energy channels and stops bleeding, especially uterine bleeding. It is a detoxifier, and is always included in formulas with potentially toxic herbs such as aconite, acorus and pinellia.

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Constituents:
1, 8-cineole, 6-gingerol, 6-shogaol, 8-shogaol, acetic acid, alpha-linolenic acid, alpha-phellandrene, alpha-pinene, alpha-terpinene, alpha-terpineol, arginine, ascorbic acid, beta-bisolene, beta-carotene, beta-pinene, beta-sitosterol, boron, caffeic acid, camphor, capsaicin, chlorogenic acid, curcumene, gingerols, sesquiphellandrene, zingiberene, resins, starches, fats, proteins etc.

Parts Used:
Dried, peeled rhizome, chopped. Chopped ginger is used to treat "wetter" conditions, such as treating or preventing infections, while powdered ginger is used to treat "drier" conditions, such as allergy, asthma.

Typical Preparations:
Teas, tinctures, encapsulations in herbal formulas and in cooking. First-time users of ginger tend to use too much. To make ginger tea, simmer 3/4 teaspoon (0.5 to 1.0 grams) of chopped ginger in 1 cup of hot water for five minutes in a closed teapot. To treat asthma, use an alcohol-based tincture rather than a tea.

Summary:
Scientists have found evidence to support ginger's wide range of medicinal actions. These actions include the lowering of cholesterol levels, relief for allergies and asthma, arthritis, colds, and nausea and protecting the digestive tract and liver against toxins and parasites. Ginger inhibits cholesterol production in the liver which makes up to 85% of the cholesterol in circulation in the blood stream. Ginger also decreases the activity of plate-activating factor (PAF), a clotting agent that creates the clot that can result in heart attack of stroke. Ginger's ability to reduce PAF activity also makes the herb effective against allergies and asthma. PAF, which stimulates the inflammation seen in allergy and the bronchial constriction seen in asthma, becomes more active when fat is consumed. Dried ginger, especially dried ginger tinctures, can offset this effect. In a clinical trial in India, the consumption of 5 grams (5 teaspoons) of dried ginger per day for seven days reversed blood lipid elevation caused by daily consumption of 100 grams (3-12/ ounces) of butter. Ginger relieves the pain of rheumatoid arthritis by stopping the immune system's production of inflammatory leukotrienes. Ginger's effects against infection have also been confirmed by laboratory science. One ginger compounds kills cold viruses at a concentration of less than one part per million, a concentration to that found in raw ginger. Ginger contains a chemical called zingibain that dissolves parasites and their eggs. This anti parasitic effect is put to use preparing sushi. Sushi is traditionally eaten with pickled ginger, and ginger extract have been shown to kill the anisakid worm, a parasite sometimes carried in raw fish, within sixteen hours. In addition, ginger tea effectively treats schistosomiasis, a parasitic disease increasingly prevalent among tourists returning to North America, Australia, and Europe from lesser developed areas of the tropics. Ginger can protect the lining of the stomach from alcohol damage which aggravate existing ulcers and promote the development of new ones. Ginger is especially useful in small doses in pregnancy. Chinese researcher report that simply applying a ginger paste to a specific acupuncture point results in a 77-percent correction of breech births, compared to a 52 percent correction in women in the control group who had their babies turned manually. Ginger is also an age-old remedy for morning sickness. When used in herbal formulas, ginger protects the body from carcinogenic effects of valproic acid (Depakote), a medication commonly prescribed for migraine and seizure disorders.

Precautions:
Although there are warning in both Traditional Chinese Medicine and some medical texts about use of ginger during pregnancy, ginger used in moderation, that is 3/4 teaspoon up to three times a day poses no risk to mother's or baby's health. Studies in the late 1990's found that eating as much as 2 to 3 tablespoons of raw ginger or 5 to 8 tablespoons of dried ginger daily will not stimulate uterine contraction. Excessive use may cause gastro-intestinal upset.

3. CHAMOMILE (Chamomile Chamomilla recutita, Composite Family)
This herb has anti-anxiety, antihistamine, anti-inflammatory, antioxidant and antispasmodic properties. It is valued for its treatment of a wide variety of conditions such as allergies, anxiety, ADD, asthma, colic, conjunctivitis, diaper rash, eczema, irritable bowel syndrome, lupus, peptic ulcers and PMS. The flowers are used in teas and tinctures internally and creams and compresses externally.

Cautions: Avoid this herb if taking blood thinners such as warfarin.

4. ELDERBERRY (Elderberry Sambucus nigra, Honeysuckle Family)
This herb is an immune stimulant, very useful in treating upper respiratory infections, asthma, bronchitis, influenzaand sinusitis. The flowers contain ursolic acid, which has an anti-inflammatory action. An infusion of the flowers is used for feverish and mucous conditions of the lungs or upper respiratory tract, including hay fever. The berries are extremely rich in Vitamin C and can be made into a decoction for use throughout the cold& fluseason.

Cautions: Unprocessed berries can cause diarrhea in large doses. The stems should be avoided due to cyanide content.

5. LICORICE (Licorice Glycyrrhiza, Legume Family)
This herb has been used by TCM practitioners for thousands of years to treat ulcers, colds, skin disorders and as a tonic for the heart and spleen. It is also used to treat asthma, lupus, meneire's disease, vitiligo, lyme disease, cancer, celiac disease, crohn's disease, gastritis and peptic ulcer. The root of this herb contains a saponin glycoside called glycyrrhizic acid which has a similar structure to hormones produced by our adrenal glands giving licorice an anti-inflammatory, anti-allergic and anti-arthritic effect similar to cortisone but without the side effects. Steroid like compounds in this herb can change to estradiol and estrone which are estrogen precursors giving it mild estrogenic properties which can be helpful during menopause. Licorice has been quite successful at treating ulcers. It lowers stomach acid levels and relieves heartburn & indigestion. It acts as a mild laxative and can be used for irritation, inflammation and spasms in the digestive tract. Through its beneficial action on the liver, it increases bile flow and lowers cholesterol levels. It has a similarly soothing and healing action in the respiratory system, reducing irritation and inflammation and has an expectorant effect, useful for irritating coughs, asthma and chest infections. It has an aspirin-like action and is helpful in relieving feversand headaches. Its anti-allergenic effect is very useful for hay fever, allergic rhinitis, conjunctivitis and bronchial asthma. Licorice is available in a standardized form and as deglycyrrhizinated licorice (DGL). Each has specific healing properties. Follow indications on labels for each.

Cautions: Do not exceed 3 grams daily for more than 6 weeks especially if suffering from heart disease or high blood pressure. Should be avoided by those with estrogen sensitive disorders.

6. MULLEIN (Mullein Verbascum densiflorum, Spinach Family)
Mullein is an old time remedy for bronchitis and dry, unproductive coughs. The leaves and flowers are used to reduce mucous and expel phlegm. Mullein is valued for its ability to loosen mucus and move it out of the body making it a valuable ally for lung problems. Mullein has also been used to treat lymphatic congestion and as an anti-spasmodic and astringent herb. A popular remedy for treating respiratory ailments such as asthma, coughsand bronchitis. This herb is also used to clear congestion, throats, and control diarrhea. It can be used topically to soothe hemorrhoids and treat cuts scrapes. The infused oilis used to treat earaches. The oil is warmed and placed in the ear on a piece of cotton. Leaves are used medicinally in oils, teas and compresses.

Cautions:Seeds are toxic and should be avoided.

7. STINGING NETTLE (Urtica dioica, Nettle Family)
Stinging Nettle is often used to reduce inflammation in allergic responses, arthritis and lupus. Being very high in iron, chlorophyll and vitamin C. It is also a good tonic for treating anemia, especially if used as an infusion over many weeks. Nettle is very nourishing to the whole system, specifically the adrenals and kidneys. It's also a helpful uterine tonic. The high chlorophyll and mineral content are good for the hormonal system. The roots are used for treating hay fever. In low doses, the root extract stimulates the production of T cells, which help control the immune cells causing the allergic reaction. An infusionof the leaf is said to be a nourishing tonic during pregnancy and lactation. Stinging Nettle grows abundantly in the spring and can be harvested and dried by hanging in a dark, dry place.

Cautions: Use caution when harvesting Stinging Nettle, as the tiny hairs on the stem and leaves can cause a "stinging" sensation that lasts for hours. Dried leaf is available loose and in teas. Tincturesand freeze-dried capsules are also available.

8. ALOE VERA
In the course of studies conducted by the experts, it has been found out that modern medications are likely to promote the development of side effects. With this, the result of a study has showed that Aloe Vera is a sure way to address the condition. Hence, Aloe Vera is regarded as an asthma attack naturist treatment that promotes no side effect on the sufferer. The wonders of Aloe Vera as an asthma attack naturist treatment have been discovered as early as 1951 and were mainly used as a relief in the middle portion of the 1980s. Aloe Vera bears natural steroid compounds that lessen the soreness of the lungs and get rids of the allergens that drive an asthma attack. However, this asthma attack naturist treatment must not be applied during the onslaught of the attack but rather as a preventive measure. Thereare other natural ways to prevent an attack and among of which are the change in your diet and lifestyle as well as getting educated in line with the breathing techniques.

TRADITIONAL CHINESE HERBS FOR ASTHMA
Asthma affects millions of adults and children in the United States. Its increasing prevalence, the absence of curative treatments, and concerns about side effects from long-term use of asthma drugs have prompted interest in complementary and alternative therapies such as traditional Chinese medicine (TCM) herbs. In a recent article, NCCAM-supported scientists from the Mount Sinai School of Medicine reviewed research evidence on TCM herbs for asthma, focusing on studies reported since 2005. Preliminary clinical trials of formulas containing Radix glycyrrhizae in combination with various other TCM herbs have had positive results. One study compared an herbal formula called ASHMI (antiasthma herbal medicine intervention) with the drug prednisone in adults; three others looked at herbal formulas as complementary therapies in children. All of the trials reported improvement in lung function with the herbal formulas and found them to be safe and well tolerated. Most of the trials showed significant improvements in asthma symptom scores, although one did not. A 3-year follow up of 14 patients with asthma taking an extract of Sophora flavescens Ait (a component of ASHMI) reported positive clinical results and no side effects. Laboratory findings on TCM herbal remedies suggest several possible mechanisms of action against asthma, including an anti-inflammatory effect, inhibition of smooth-muscle contraction in the airway, and modulation of immune system responses. The authors noted that clinical trials are under way for ASHMI. They also summarize research on a TCM formula being developed to combat peanut allergy

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