Complementary therapies and asthma

Breathing therapies, often called breath retraining, teach you how to breathe slowly through your nose, using your diaphragm (the muscle under your ribs). They also teach you how to reduce 'over-breathing' habits, like yawning and sighing.

Common breathing techniques for asthma include the Buteyko method and the Papworth method.

There's evidence that these techniques can help with asthma symptoms. But you still need to take your preventer medicine every day as prescribed to lower your risk of asthma symptoms and attacks and use your reliever inhaler when symptoms come on.

Getting started on breathing exercises

Breathing retraining is not a quick fix: it takes some time and commitment to learn the techniques and put them into practice. You can ask your GP or asthma nurse about what breath retraining physiotherapy is available in your area.

Research has shown that following a programme of physiotherapy-based breathing exercises at home can work just as well for some people with asthma as going to see a physiotherapist. The University of Southampton have developed a free programme called Breathing Freely.

We have information to help you control your breathing. We also have videos on breathing control and breathing techniques.

Research we have funded has shown that vitamin D can help people with asthma who have low vitamin D levels control their asthma. It can also help people with steroid-resistant asthma get more benefit from their steroid treatments.

Government advice is that everyone should consider taking a supplement containing 10 micrograms of vitamin D every day during the autumn and winter, because in the UK we don't get enough from the sun at this time of year. Read the NHS advice about vitamin D.

Stress is a common asthma trigger. As well as talking therapies, there are a few different treatments to choose from to help you deal with stress and anxiety.

Yoga

Some studies have suggested that yoga, and especially yoga breathing exercises, might be helpful for asthma symptoms, but more research is needed to confirm this.

At the moment medical organisations like the British Thoracic Society don't think there's enough evidence to recommend it as a routine asthma treatment, but say it could be used as a complementary therapy or as an alternative to other forms of breathing exercises.

However, there's good evidence that yoga can help with stress and improve quality of life. There's a good chance it could help with your asthma by bringing down stress levels.

Massage therapy

Studies show massage therapy can be good for reducing stress. This makes it a possible option if you've noticed stress or anxiety triggering your asthma symptoms.

You can find out more about massage therapy and find a qualified and registered practitioner on the Complementary & Natural Healthcare Council website.

Make sure you tell your practitioner you have asthma. This is especially important if they're using a massage oil with essential oils in it. These contain VOCs (Volatile Organic Compounds) which can trigger asthma symptoms for some people.

If you're sensitive to scents and perfumes ask the practitioner to use an unperfumed massage oil and to avoid using scented oil burners, candles, or incense in the room. It's a good idea to mention this when you arrange your appointment.

Mindfulness

Mindfulness is a set of techniques that help you focus on the present moment. It usually involves meditation and breathing exercises. Mindfulness techniques help you manage your thoughts, feelings, and body sensations, so that you are less likely to become overwhelmed by them.

Studies show that people with long-term conditions, including asthma, benefit from improved wellbeing and reduced stress using mindfulness techniques regularly.

The Mental Health Foundation offers a free online guide on mindfulness. The charity Mind also has information on mindfulness techniques.

Hypnotherapy

Not enough research has been conducted to say for sure whether hypnotherapy helps improve asthma symptoms. But hypnotherapy can be an effective relaxation treatment for anxiety and stress, which are asthma triggers. The NHS has more information about hypnotherapy.

There are quite a lot of complementary therapies that some people believe help with asthma, from herbal medicine to muscle exercises and dietary supplements. But often there is not enough evidence of how well they work for healthcare professionals to recommend them. This does not mean that they don't work, just that we don't know enough yet to consider them reliable for treating asthma.

CBD oils

There's been quite a lot of interest in cannabis products recently, particularly cannabidiol (CBD) oils.

A recent study suggests that cannabidiol might be able to reduce inflammation, but it will be some time before research is clear enough for experts to make any recommendations for people with asthma.

According to the NHS, most cannabis products will contain a certain amount of THC, the chemical that gets you high. The risks of using products containing THC are currently unclear but could include mental disturbances and dependency (when it becomes very difficult to stop taking the medication).

Cannabis-based products sold online may be illegal in the UK and potentially dangerous. Health stores can sell legal products containing CBD, but there's no guarantee they will be of good quality or have any beneficial effect.

Propolis

Propolis, sometimes called bee glue, is a substance made by bees. Recent research suggests that propolis could help people with asthma, and there is some evidence that it can reduce inflammation of the airways.

However, propolis can also cause serious allergic reactions including shortness of breath, which could make your asthma worse. At the moment, clinical guidelines do not mention propolis as a possible treatment for asthma. If you're thinking about taking propolis you should always discuss it with your GP or asthma nurse first.

Chinese herbal medicine

Some studies have suggested that certain traditional Chinese herbal blends such as Pingchuan Yiqi and ASHMI (anti-asthma herbal medicine intervention) might help to improve asthma symptoms when used as a complementary therapy.

However, according to the British Thoracic Society, it is difficult to tell which ingredients in these blends work and how they work, so more studies are needed.

The NHS warns that not all herbal medicines are regulated, especially if they are manufactured outside the UK. Also, some herbal treatments might interact with medicine you're already taking and cause allergic reactions or other problems. If you are considering a herbal treatment, make sure you talk to your GP or asthma nurse first.

When buying herbal medicines, look out for a traditional herbal registration (THR) marking on the product packaging. If you buy herbal medicines online or by mail order, there is a risk that the medicine could be fake, low-quality, or contaminated. You can read the NHS guidance on herbal medicines.

Anyone can report suspected side effects of herbal medicines via the Yellow Card scheme.

Vitamin C

Currently, there isn't enough evidence to recommend using vitamin C supplements to treat asthma.

According to government advice, you should be able to get all the vitamin C you need through a balanced diet. You should not take more than 1,000mg of vitamin C a day as this could be harmful.

Magnesium supplements

One study found that magnesium supplements helped people control asthma symptoms. However, a review of research found that there isn't currently enough evidence to support using magnesium supplements to treat asthma symptoms.

According to government advice, you should be able to get all the magnesium you need through a balanced diet. You should not take more than 400mg of magnesium a day as this could be harmful.

For some complementary therapies, scientists haven't found any reliable evidence of improvement for asthma symptoms.

Acupuncture

Acupuncture involves putting very fine needles into specific points on the body. There is not currently good evidence that acupuncture is a useful treatment for asthma.

Homeopathy

Homeopathy claims to trigger a self-healing response in the body by using very small doses of substances that cause symptoms. There is not currently good evidence that homeopathy helps people with asthma.

Salt pipes and salt caves

Salt therapies, sometimes called halotherapy, involve breathing in tiny salt particles, either through salt pipes or in salt health resorts. Salt therapies sometimes take place in natural underground caves that contain salt. This type of therapy is called speleotherapy.

There are very few good quality studies into salt therapy. A recent review of the research found only one reliable scientific trial. Inhaling salt can also irritate your airways, which can cause coughing and trigger asthma attacks. Currently, most experts do not recommend salt therapy for people with asthma.

There's also no evidence that salt lamps help with asthma symptoms.

Steam inhalation

Inhaling steam is a common home remedy for easing blockages in the nose and airways. However, there hasn't been any research investigating the effect of steam on asthma specifically.

Studies have not shown that steam helps improve symptoms in other respiratory conditions like respiratory tract infections and bronchiolitis.

For some people, steam can trigger asthma symptoms.

Steam inhalation can cause scalding, both from the hot water and from the steam itself.

Some therapies should be avoided by people with asthma as they might make symptoms worse. Some may even cause a potentially life-threatening asthma attack.

Royal jelly

Royal jelly is made by bees. There's evidence that taking royal jelly has caused very serious reactions in some people with asthma who have allergies.

These have included asthma attacks, breathing difficulties, anaphylactic shock (a life-threatening allergic reaction) and even death.

Butterbur and St John's Wort

Some herbs have been shown to have serious side effects for people with asthma:

• Butterbur is an unlicensed herbal remedy. The Medicines and Healthcare products Regulatory Agency (MHRA) advises people not to take any herbal products containing butterbur to treat conditions like asthma, hay fever, and cough. Butterbur can cause serious side effects, including liver toxicity and organ failure.

  If you've been taking herbal products containing butterbur, stop using them and seek urgent advice from your GP or pharmacist. Find out more about safe and effective treatments to help you deal with hay fever symptoms.

• St John's Wort, must not be used by anyone taking theophylline (a long-acting reliever treatment prescribed for some people with asthma) as it can reduce the effectiveness of the medicine and cause asthma symptoms to get worse.

Essential oils

There's no evidence that essential oils can help asthma. In fact, essential oils can make asthma worse for some people, because they contain volatile organic compounds (VOCs) which can trigger asthma attacks.

Some people find essential oils help them to relax. Studies have shown that this is probably because they expect the oils to work, so start feeling relaxed even though the oils themselves have had no direct physical effect.