Asthma – Tailoring Treatment To Your Symptom Severity

The National Heart, Lung, and Blood Institute created recommendations for the treatments that are best for different levels of asthma severity. These recommendations also address the changes you and your health care professional should be considering.

Keep in mind that your particular treatment plan is designed to fit the symptoms you have before you start treatment. As your symptoms improve, you and your health-care provider will reassess how you feel and make any changes if needed. Please — make changes only with the advice of your doctor.

The National Heart, Lung, and Blood Institute’s recommendations are as follows:

If you have mild asthma symptoms that occur once or twice a week.

You may need to use only a reliever, such as an albuterol inhaler, on the days you are having symptoms. If you know the trigger of your asthma and if the trigger is unavoidable, you may want to use your inhaler before an exposure that you can predict. Or if you have exercise-induced asthma, you should consider taking the prescribed number of puffs before exercising.

If you have mild asthma symptoms that occur daily. 

You may need to use a reliever every day, even on good days. You may also want to use a controller every day because this can make your asthma less active and can limit how often you need to use the reliever.

If you have moderate asthma symptoms. 

You should be using an inhaled corticosteroid controller every day. This inhaled drug is the best available for reducing inflammation and controlling asthma symptoms. You also will use a reliever to help treat symptoms when they appear. Some people need a second controller, such as a long-acting airway opener, which is especially helpful for nighttime symptoms. Examples of long-acting airway opening medicines are salmeterol (Serevent), formoterol (Foradil), and the combination inhaler that pairs salmeterol with a corticosteroid (Advair). Doctors are cautious about the use of these long-acting airway openers because of a public health advisory warning that the US Food and Drug Administration issued. These inhalers may put some people at risk for having more severe or even fatal asthma flares, even though they appear to reduce the frequency of flares for most people who use them. Because problems have been rare and because the medications provide valuable symptom relief for many people, lung specialists continue to recommend these medicines to many patients, although the drugs are used with more caution.

A new type of controller, Omalizumab immunotherapy, blocks a part of your allergy response. This controller might be added if other treatments are not working for allergic asthma. Your health care professional may suggest that you try different combinations of controllers and relievers to find the medicines that work best for you. You can test these combinations by trying one for a month or so and seeing how you feel.

If you have severe asthma symptoms. 

You’ll need an intense drug regimen to improve your breathing enough so asthma doesn’t limit your activities. Be aware that your asthma is severe enough that a flare-up could put you in the hospital or threaten your life. Taking daily corticosteroid pills is the best way to control inflammation. You will probably also need to use a long-acting airway opener that acts in concert with the pills. Omalizumab immunotherapy (see above) is a treatment for allergic asthma that may be helpful. Also, you’ll be advised to use your reliever, as needed, to control symptoms.

In any of the cases, you may also try acupuncture, this alternative medicine therapy has been proven to help reduce asthma and allergy symptoms, visit AB Acupuncture to know more about how acupuncture may help you.

Alleviating Arthritis Pain With Herbs Part II

Modern medicine’s answer to arthritis relief is currently a double-edged sword. There are scores of medications to choose from, several of which have been designed for convenient once-daily dosing. These medications also have the backing of the Food and Drug Administration (FDA) which oversees years of medical research before they can be released to the general public.

The medical risks of taking these medications, unfortunately, can be serious. No prescription-based medication can claim to be free of these risks. Stomach ulcers, kidney damage, and bleeding complications are among the most commonly seen.

When looking into the possibility of taking an herbal remedy for arthritis relief, the big question should be, are these a safer alternative to modern medications? Is the effectiveness comparable?

Before we get into that, we also recommend looking into the benefits of acupuncture treatment for alleviating arthritis pain. You can learn more about this when you contact AB Acupuncture. Regular acupuncture treatment in addition to these herbal remedies could have positive effects in addressing your pain.

Now, let’s look at three different herbal remedies with both safety and effectiveness in mind.

Healers practicing Ayurvedic medicine have long used Boswellia serrata, also called Indian Frankincense, to relieve arthritic symptoms. The gummy resin collected from the Boswellia tree contains Boswellia acids which have proven anti-inflammatory properties. In comparative studies against conventional nonsteroidal anti-inflammatory drugs (NSAIDs), Boswellia was found to be safer with equal effectiveness.

Boswellia acts differently than conventional NSAIDs in that it inhibits the production of leukotrienes which are mediators in the chemical pathway that leads to inflamed joints. This means that it isn’t hard on the stomach like aspirin or NSAIDs.

The recommended dose of Boswellia is 450 milligrams of boswellic acids daily (usually 150 mg three times daily). Note, however, that the extract you buy might give the milligram strength of the whole extract, only a percentage of which will be Boswellia acids. You will need to get out your calculator to figure out how much boswellic acid you’re really getting. Why DO they always do that?!?

Personally, I think Boswellia is an excellent choice for arthritis pain relief.

Another Indian herb used for arthritis relief is turmeric, one of the main ingredients in curry powder. Ayurvedic medicine has multiple uses. As it applies to arthritic relief, turmeric is believed to inhibit prostaglandins, much in the same way as NSAIDs do. Unfortunately, the risk of stomach ulcers exists as well. The recommended dose is 500-1000 milligrams several times per day. My advice: it wouldn’t be my first choice because of the risk of stomach ulcers.

Cayenne pepper is a perfect example of an herbal product that was “rediscovered” by modern medicine and subsequently found itself on pharmacy shelves as a “modern arthritic cure”. Healthcare providers call it “capsaicin” and I’m sure it sold for a premium price when it was first released as a prescription-only product.

Capsaicin comes as a cream and fortunately a prescription is no longer needed to purchase it. The strength of the cream is 0.025% or 0.075%. It is applied 3-4 times daily to the painful joint itself.

How does it work? Well, have you ever eaten an extremely hot pepper and noticed that, after the burning subsided, your tongue was numb? The same process works in joints. For the first few days after you start the cream, the joint is supposed to burn a little and there won’t be any pain relief at all. That’s because the cayenne pepper is releasing and subsequently using up Substance P, a chemical essential to the ability to sense pain by the nerves. Once all the Substance P is depleted, the nerve is “numbed” and remains so as long as you keep applying the cream.

I like capsaicin cream. It has no side effects and can be used in combination with medications taken internally. Patience, though, is the key to its success.

Once you reach a reasonable improvement in arthritic pain, stick with the treatment and begin a gentle but persistent exercise program like water-walking, bicycling, or just plain walking. Your joints will actually feel better and you will be less likely to suffer the long-term complications of arthritis. Keep moving and good luck!

Chinese herbs

ABOUT CHINESE HERBS

Chinese herbal medicine is one of the great herbal systems of the world and has an unbroken tradition going back to the 3rd century BC. Together with acupuncture, massage (Tuina), exercise (Tai Qi, Qi Gong), and dietary therapy it forms part of Traditional Chinese Medicine. All these treatments share the same theory and the same aim, not just to treat symptoms but to deal with underlying imbalances and to strengthen the person’s Qi to prevent a recurrence of the disease.

Chinese herbal medicine is extensively practiced throughout clinics and hospitals in China for the treatment of a very wide range of conditions. Because of its systematic approach and clinical effectiveness it has for centuries had a very big influence on the theory and practice of medicine throughout the Far East.

During its two-thousand-year history, great doctors have contributed to its store of knowledge and wisdom, and in the past few decades, a great deal of research has been done in China into every aspect of its use. The result is a subtle, powerful and flexible system.

CONDITIONS THAT CAN BE TREATED

The range of conditions that can be treated with Chinese herbs is wide, but the following may be singled out:

  • Skin problems, including eczema, psoriasis, acne, urticaria
  • Digestive disorders, including diarrhea, constipation, irritable bowel syndrome
  • Gynecological problems, including menstrual problems and pre-menstrual syndrome
  • Chronic fatigue, including ME or ‘post-viral syndrome’
  • Asthma, coughs, bronchitis
  • Hay fever, sinusitis, rhinitis
  • Urinary problems, including chronic cystitis

HOW CHINESE HERBS ARE PRESCRIBED

Chinese herbal medicine uses several hundred substances, mostly of plant origin (roots, seeds, flowers, twigs, and barks). These are hardly ever prescribed singly. They are combined into a formula that usually contains between 8 and 12 ingredients. The exact combination is adjusted to suit the patient’s individual condition and is likely to be altered as the treatment progresses to take account of changes that have occurred. It is therefore a very flexible system that can be closely tailored to the needs of the individual.

The prescribed mixture of herbs is usually prepared by the patient as a decoction (boiled and then simmered in water) and taken twice a day. Consultations will be on average once a fortnight, and you will be given enough herbs to last till the next appointment. In some cases, the herbs may be given in powder form or as pills (these are not as strong as decoctions but are more suitable in those cases where longer-term treatment is indicated). In addition, external treatments (ointments, washes, soaks) may be prescribed for skin problems.

LENGTH OF TREATMENT

The length of treatment will vary depending on the severity of the condition and how long you have had it. In some cases (especially with younger children) you can expect a good response in 2 to 3 weeks. For severe chronic problems, you may need to take the decoctions for 8 to 12 weeks. In certain cases, treatment may be even shorter or longer than these figures suggest. You may also consider using it in conjunction with other forms of Eastern medicine such as acupuncture.

SAFETY OF HERBS

There have been some recent concerns about the safety of certain Chinese herbal medicines. These have arisen from the inclusion of illegal ingredients by some suppliers, either banned toxic materials or ingredients such as steroids which by law can only be supplied by doctors. A good Chinese herbal medicine supplier observes the highest standards of safety and quality and is supplied exclusively by companies with a proven commitment to those standards. In addition, it can also have blood-testing facilities which will be used when appropriate as a further safety measure. Finally, a good sign is if they fully support worldwide conservation programs, and no endangered species of animal or plant is used.