Asthma or Not? Cough in Children With Asthma

A cough is likely due to asthma if it refuses to go away over days, weeks or months, is worse at night or early in the morning, or if it comes and goes without notice.

A cough is even more likely due to asthma if the child also suffers from a chronic rough skin rash called eczema, or if a parent or other close relative has asthma.

Kids and adolescents can develop asthma at any age. So, no matter at what age such a cough began, the recognition that the child might have an underlying asthma condition is essential.

Sadly, many parents are reluctant to accept a diagnosis of asthma, a dilemma which leads to unnecessary pain and suffering, delay in treatment and even loss of life. For parents who can’t come to term with their child having asthma, I have good news: a cough due to asthma quickly gets better with proper medications. Moreover, children can outgrow their asthma.

Why people suffer from asthma

People who suffer from asthma have sensitive, hyper-responsive lungs, in the same way that people who suffer from eczema have sensitive skin.

A sensitive lung can go into spasm or constriction at any time. Spasm narrows small air channels, limiting airflow within the lungs and suddenly making it difficult for people with asthma to breathe. During such an episode of asthma attack, patients can experience shortness of breath, wheezing, coughing, fast breathing, and chest tightness or discomfort.

Wheezing is a high-pitched musical sound taking place in the chest of someone who is experiencing an asthma attack. When loud, people nearby can hear it; but at other times it can only be heard by clinicians who listen to the chest with a stethoscope.

Asthma triggers

Catarrh or runny nose with its concomitant viral infection, cold weather, pets such as cats and dogs, dust, dirt, cockroaches, pollutants, paint fumes, perfumes, mold, grass, pollens and cigarette smoke can trigger already sensitive lungs into an episode of coughing and wheezing. Exercise, as well as emotions, also triggers a cough and shortness of breath in people with sensitive lungs.

Cough as a sign of asthma

Cough, a common problem, is one of the many signs of asthma. Parents and caregivers bring children to clinicians when their cough continues for many days and does not resolve with cough syrup. A cough is bothersome to children; it can prevent them from sleeping at night or during the day, can provoke them to vomit, can make them fearful of eating and even cause them to lose weight. When a cough and fever go together in a child, a more sinister illness such as pneumonia comes to mind.

Severity of asthma

When evaluating a child with asthma, it is important to assess the severity of the symptoms. Some children have the intermittent form of asthma, while others have the persistent form.

People with the irregular form of asthma experience symptoms once in a while. Those who have a persistent form experience degrees of symptoms more often, usually on a weekly basis or a daily basis, and sometimes even several times a day.

Examination of children with asthma

Clinicians look for signs of distress when presented with a child with an acute attack of asthma. The in-and-out pulling of chest muscles in a patient, or ‘retraction’, signals air-hunger and agony.

When there is no obvious wheezing, chest retraction or spontaneous coughing, I tend to ask the child, if they are old enough and comfortable, to cough out loud so that I can hear it

By the sound, one can often tell from where a cough is coming: from the throat, or pharynx, or from deep in the chest. The latter would mean that the lungs are the source of the problem, and therefore indicative of asthma. This distinction is important.

Respiratory rates, temperature, pulse rate and oxygen saturation are some of the vital signs obtained at the time of first examination.

Diagnosis of asthma

Clinicians can diagnose asthma in a patient who has a cough by listening to the chest with a stethoscope. A high-pitched musical sound, known as a wheeze, is suggestive of this condition. When a patient’s symptoms are relieved with the use of a bronchodilator, such as albuterol, the diagnosis is all but certain.

Asthma medications

Drugs for asthma treatment, known as bronchodilators, are targeted to open up the narrowed airways so that air can get into the lungs. Another group of medications called ‘inhaled steroids’ reduces mucus production and inflammation in the small air channels. People with frequent asthma attacks should use both medications. Medical practitioners need to explain details of use.

Asthma control and prevention

Prevention is the key to containing asthma. People who have the condition should avoid known environmental triggers; some of the well-known allergens-dust, cats, dogs, smoke, roaches and so on have already been mentioned. Different asthmatics can have different triggers.

An asthma action plan is a set of steps which, when completed by medical practitioners, guides patients on the use of their medication before and during symptoms, and what to do when symptoms do not improve. There is also a section that tells users how to control things in their environment that make their asthma worse.

Why do people die from asthma?

Two years ago, the Center for Disease Control and Prevention, the CDC, in the USA reported 187 children under the age of 18 had died that year as a result of asthma.

My guess is that the numbers of children who die of asthma every day within the inner cities of underdeveloped countries such as Onitsha in Nigeria, where pollution is at every street corner and people breathe air mixed with smoke, dirt and dust, are countless.

Simple measures such as avoiding asthma triggers and prompt use of asthma medication would prevent many unnecessary deaths. Failure to recognize the illness is the most heartbreaking and obvious reason for the high numbers. Furthermore, lack of access to much-needed medication as well as a delay in seeking expert medical intervention is often to blame.


Disclaimer: This article is not intended to diagnose or treat any diseases but is merely based on the author’s experience. Readers should consult their physician before implementing any part of the suggestions.

Overcoming GERD Asthma

Those who suffer from GERD – otherwise referred to as acid reflux – will tell you that though the main problems revolve around the digestive system, there are other things within the body that can be affected by excess acid. The connection between the symptoms of GERD and other maladies is hard to find at first, and this means most think they have two, or even three, unrelated problems. There are times though, when treating one can help with treatment of the other. If you are having problems with your respiratory system, you should know about the GERD asthma connection.

If you look around for information on the link between GERD and asthma, you are going to find that some believe GERD causes asthma in some people, and other who are of the opinion that it just makes pre-existing asthma worse.

Whatever the case, the outcome is still the same. Asthma can be very detrimental to your quality of life, and in some cases, it can be a very serious condition. Learning how to get GERD under control can help with the symptoms and severity of asthma in some patients.

Before you can try to reduce problems with GERD and asthma, you have to understand what the connection is. You may already be aware that the acid from the stomach can damage the lining of the esophagus, which causes a lot of the pain associated with acid reflux, but you may not know that this acid can leak into the lungs as well.

This generally occurs when GERD is left untreated. The acid can reflux up the esophagus and be inhaled into the lungs, usually when a patient is lying down, and can do damage to the tissues within the lungs. This is called aspiration.

The acid can damage the tissues of the esophagus, but they do have ways to fight back. The tissues of the lungs, however, are very vulnerable. This means the acid is going to cause serious damage in a short amount of time. This can lead to asthma, or to a worsening of a pre-existing case. There is another theory other than the acid entering the lungs while sleeping that makes some sense.

Some asthma medications may act as a muscle relaxant, loosening the Lower Esophageal Sphincter muscle that separates the stomach and the esophagus, making reflux worse. If you have asthma and take medication, you might want to talk with your doctor about that possibility.

One of the best ways to stop GERD from aggravating asthma is to get the acid reflux under control. This can be done in a variety of ways, the easiest and least expensive option being changing your diet. You can also take over-the-counter acid blocker, or one prescribed by a doctor if they think a stronger version is needed.

Once the acid production is slowed down, the amount being aspirated into the lungs will lessen. You can also watch how much you eat and when you eat it. Eating smaller meals that digest quickly will lessen the amount of acid in the stomach, and try to avoid eating 3 – 4 hours before bedtime.

You should also take a look at your bedroom and sleeping habits. You may cope with your GERD asthma symptoms much more easily if you have found a way to keep down the amount of allergens in the air. Dust mites, and other minute particles floating around in the air can greatly aggravate your already damaged and inflamed tissues. Look for ways to cut down on the amount of allergens in your home, and raise your head and chest while sleeping. This helps to keep acid from refluxing at night.

Estrogen, Asthma and Black Cohosh

Some of this is not exactly news; it’s been known for a long time that there is a direct link between hormone replacement therapy and asthma. This is supported by the number, ages and gender of those most likely to develop it. As children, boys prior to puberty have the highest rates. After puberty, girls and women of child bearing years are more likely. After menopause, the risks level off…unless HRT is used.

Front page health news today introduces us to a French study that suggests it is not all hormones, but primarily estrogen that causes the increased risk. It’s not a little risk, either. Women taking estrogen are fifty-four percent more likely to develop asthma than those who have never used any HRT.

Aside from the risk factor, there is a good reason these studies are being done on post menopausal women. Fluctuations of these hormones has ceased, so the basis for the study is neutral.

What does this have to do with black cohosh? That herb is one of the main supplements suggested to women to ease the problems menopause causes. No one likes hot flashes, mood swings and the other symptoms this process causes. Black cohosh contains a phyto-estrogen, which could be as dangerous as prescription medications in causing asthma.

Black cohosh is not the only one. Soy isoflavones do as well. That’s why there are warnings about not giving them to boys and teens who are still developing, and why pregnant women are told not to use them. The estrogen levels are too high.

If you wish to take these supplements anyway, I have two recommendations. One is that you make sure your doctor knows, so you can be monitored. Asthma is a potentially life threatening condition. The doctor can help you with the second recommendation; that you have what you need available should an asthma attack begin. Asthma doesn’t always have warning signs.

Here are a few symptoms to look for; shortness of breath, coughing, wheezing sounds when breathing and blueness on the lips and fingernails. If these symptoms develop, get medical help immediately. Your life could be at risk.


First of all, I want to make it clear that this information is not to diagnose nor to prescribe and it should not take the place of the advice of your doctor. This is intended to complement conventional medicine, not to replace it. Consult with your doctor before starting any kind of nutritional or physical program.

Asthma is considered a spasm or inflammation of the bronchial tubes that lead to
the lungs. This can be due to irritation caused by allergies to food or airborne
pollution, or a sensitivity that is out of what we call the "norm." This sensitivity
could be to all the above or it can be emotional. Some researchers think it could be
an inherited or genetic weakness. I have not seen enough research for this to be
substantiated, so I leave that up to the experts. I do know, however, it can happen
at any age yet it is more common during childhood and some kids just outgrow it.
About 6 to 7% of the population has asthma, and it seems to be more common
among males.

There is a lot of controversy about asthma. The main problem is not taking a breath
in but in releasing the breath out. If we look at this from a psychological standpoint
it has to do with letting go of certain attitudes, or holding on to certain emotions.
We know that certain stress increases an asthmatic's condition or can even bring
about an attack. What this is telling many of us is that asthma can be very much tied
in with our minds and emotions. I know this from some of the latest research I have
read and from having an asthmatic son and stepson. I was able to put many medical
and natural remedies to work with my own family.

There is much to learn about asthma and whether or not nutritional approaches can
really help this condition. In my experience, asthma can be as different as the
patient that has it, and every case needs to be looked at separately. I feel very
strongly about this approach with all symptoms or diseases. We need to treat the
whole person and not lump everyone into the same category of asthmatics, for

We do know that many asthmatics seem to have airborne allergies and / or sensitivity
to foods. Often times the traditional allergy tests like skin or blood tests can
confirm certain serious allergies. However, it's some of the not so commonly
recognized food allergies that may be the problem. By just eliminating commonly
known allergens such as dairy products, wheat, peanuts, excessive sugar, and
According to other nutritional doctors, certain shellfish, shrimp and sulfates, which
seem to irritate the mucous lining, I know most will improve.

Eliminating dairy products would be beneficial if the person gets excessive mucus
when ingesting them. Wheat is a common allergen for most people because the
gluten is very hard to digest. There are very good alternative sources for calcium
such as many green leafy vegetables, cabbage, and cauliflower, as well as sunflower
seeds and almonds. You can purchase soy milk, almond milk or rice milk; these
Alternative products are less mucus forming. Once again, every individual is
different. Care must be used if certain foods are eliminated and then introduced
again because there may be a harsher reaction to them the second time around.

Here in Hawaii, we have another problem – molds, mildew and airborne allergens
such as pollen and certain dusts. Some asthmatics are allergic to ordinary house
dust. If your child has sensitivities to these pollutants there are air purifiers, ionizing
machines, etc. that can be of benefit in the home. When I had my son tested for
allergies there were even couch dust allergies that affected him. You may want to
get dehumidifiers for their bedroom. All of these things can help.

If we look at the work by Dr. Robert Young about having the body be more alkaline,
we can see that many of the problems occur with food choices. The body can do
quite well on a diet low in protein and high in greens, vegetables, and a little
carbohydrate. I find the key is to get some expert advice if you are not a nutritionist,
and none of this information is meant to replace seeing your doctor for asthma.
Hopefully, it will complement and educate you to alternative approaches. Care
should be taken in any change of diet and with the use of medicines or even herbs.

Many allergies to dairy products, bread or yeast, and even to eggs or corn are hard
to test for in the laboratory. Many times the reaction is very subtle and not so
obvious. Changing one's diet will take time before seeing any results. You will not
see dramatic results on a long term condition in a few short months. Once again,
you should think of consulting a nutritional doctor for the best way to approach this

Nutritional Approach

Foods to Eliminate or Cut Down On

Look for specific asthma triggers that produce, for example, excess mucus. If after
eating a pizza, the kid gets a runny nose and starts to cough for the next two days,
this may tell you something. This is an obvious one but many times we don't pay
close attention and there are many more subtle triggers. Foods that create a lot of
gas can cause pressure on the diaphragm and sometimes trigger an asthma attack
as well, so watch for that.

Eliminate or greatly reduce potential allergens such as the dairy products and
replace with almond milk or soy products. Buy unyeasted breads, eliminate wheat,
barley and rye gluten products, and cut out peanuts. Reduce or eliminate sodas and
Sweets, even reduce fruit that is too concentrated with natural sugars such as dried
fruit. Juices should always be watered down for kids, anyway. Reduce salt intake and
cut out artificial sweeteners, and check your labels for additives and other unnatural
colors, etc. More natural foods are better for everyone, not just asthmatics. A low
salt diet may reduce bronchial sensitivity and improve asthma status as well.
Remember, work with the child on all levels because emotional distress is also an
important asthma trigger that is often overlooked.

For Adults

The same recommendations apply as far as eliminating the foods above. Alcohol
varies in its effect on individual asthmatics; it can help some (I think it calms them)
or make it worse. Often it conflicts with digestion. Wine may make the condition
worse because of the many sulfates used in making it.

Caffeine can have a modest, acute anti-asthma relief, probably because of its
chemical similarity to the asthma medicine, Theophylline. However, I wouldn't
recommend using coffee. It should be reduced because of its high acidity. Teas
could be used. I'm not fanatical about anything, but coffee on an empty stomach
does not help the body, and if you are asthmatic you already have an overly
sensitive body.


As I said earlier, eat lots of greens; they are great for the body. The key is to try and
eliminate acid foods like meats, bread, sweets, and dairy products. Broccoli is one of
the best vegetables because it is 65% protein. Eat more avocados; they are not
fattening and they have the good fats (see nutrition article). Now there are green
drinks on the market with many grasses that are very high in chlorophyll. Work with
a specialist to get your body back to an alkaline balance. It is the strongest
protection for the immune system. Eat more onions and garlic with your food.
Reduce meat protein and increase protein such as tofu or fish, tuna and salmon
being among the best because they are high in Omega 3 as well as fish oil, which
Has a powerful anti-inflammatory effect and a benefit found in treating rheumatoid
arthritis. It may be helpful for asthma as well. These stimulate and heal the immune
system. Use sea kelp for minerals and seasoning.

Bee pollen has proved to be helpful if eaten from local sources. If the allergies are
airborne, bee pollen can strengthen the immune system and the body will start to
resist the pollens it's allergic to. Be sure to start with a few granules at a time and
work up to two or three teaspoons daily. It's great in smoothies. Discontinue if
rashes or wheezing occur using those small amounts.


(Caution! All herbs are like medicine and should not be taken for long term use
Unless you are consulting with your doctor.)

The best herbs or natural foods are garlic and onions but gingko biloba known best
for its benefit on the mind or its "anti-senility" effects may help. During an attack, I
used a lobelia, goldenseal and bee propolis tincture that worked great for the kids,
not for long term use, though. Other herbs that are beneficial are mullein oil in tea
or juice, slippery elm tea or tablets, horsetail, juniper berries, licorice root and Pau
d'arco tea.

Ma huang, a Chinese herb (ephedra sinica), can be used as a tea twice daily but it's
not recommended for extended use. This plant is a source of the asthma medicine,
ephedrine, a close cousin of Theophylline, a widely used asthma medicine. Most
Doctors recommend the use of the prescription medicines Theophylline or
ephedrine since the potency of the tea is not consistent and can have serious side
Effects like nervousness and irregular heart beat.

Tylophora asthmatica in tea twice daily can be taken but it is not recommended for
long term use, either. This Indian herb has been used to treat asthma in the
Ayurvedic tradition for thousands of years.

Quercitin, 500 mg 3 times daily, is an important bioflavonoid, and is biochemically
Similar to the anti-asthma drug Intalcromolyn. In some experiments quercitin has
been shown to prevent mast cells from releasing histamines, a chemical that
aggravates allergic reactions.

Vitamins (Recommended doses are for adults or large teenagers)

Very helpful, for most of us as well are most anti-oxidant vitamins. Vitamin A,
10,000 -20,000 IU daily; 10,000 -20,000 IU's daily of natural beta carotene.
Vitamin C, 1500-3000 mg daily. Always take Vitamin C with bioflavinoids, one of
the lungs most important anti-oxidant defenses. High doses can be given to
asthmatics before an acute exposure to irritants or allergens. Vitamin B complex,
500-1000 mg daily with extra Vitamin B-6, 50-200 mg daily; Niacin (vitamin B-3)
or niacinamide; Bromelain (Wobenzime from Maryln Nutriceudicals), 1000-3000 mg
daily. Bromelain is a pineapple enzyme. I'm a great believer in this nutrient for many
things. It is a natural anti-inflammatory nutrient, reducing inflammation not only in
the joints but it also works on the lungs. Also, pycnogenol or grape seed extract is
both anti-inflammatory and an anti-oxidant. Magnesium, 300-600 mg (magnesium
Helps an acute asthma attack when given intravenously.) Most nutrition oriented
Physicians believe oral magnesium can help chronic asthma as well. Vitamin D, 500
IU daily. N-Acetyl Cysteine, 500-1000 mg. This nutrient is converted in the body to
glutathione. It has definite mucous thinning and anti-oxidant effects.

Vitamin B-12, orally 1,000 mcg twice a day or for some acute conditions, an
injection of Vitamin B-12, 1000 mcg weekly may be helpful (see your physician)

Amino acids l-cysteine, 500 mg twice a day on an empty stomach taken with the B.
vitamins and Vitamin C. Along with that, also take l-methionine, 500 mg twice a


Consult an allergist and get a food test (cytotoxic) and a skin test (intracutaneous
titration). Some doctors even do the sublingual provocation and pulse tests to
determine your food allergies or other airborne allergies. Always keep in mind that
the interpretation of these tests is highly subjective often depending on the doctor
that you are working with. Find one that also works with nutrition.

Often times it's more accurate to eliminate suspected foods and to keep a food
diary to identify trigger foods. Watch your child's food or your own carefully.
Consider eliminating the other potentially common allergen foods but only in a
well-supervised approach, and be prepared to treat an acute asthma reaction when
reintroducing suspected foods.

A good example of an elimination diet could be eating many of the greens in salads,
brown rice, sweet potatoes, squash, or for us in Hawaii, poi, which is made from
taro, a great food and hypo-allergenic to most people. Then, of course, many
steamed vegetables can be eaten such as beets and their greens, asparagus, chard,
squash, carrots, artichokes, string beans and spinach. Very small amounts of
cooked fruits such as peaches, apricots, papaya, plums and prunes. No citrus fruits.
Cooking fruits alters the protein in them making them less likely to be allergens.
Then after a cleansing diet, re-introduce some of these foods, one at a time on an
empty stomach, to see the results.

Take an insurance formula multi-vitamin / mineral. The best ones are liquid and they
should be specific for age and weight. Listed above are doses meant for an adult or
a large teenager.

Consider also a six-week trial of 1000 mcg vitamin B-12 injections for the children.

There is a good source for many of these nutrients called "Urban Air Defense" from
Source Naturals, a great company.

I hope this information has been helpful to you but it is not meant to replace your
doctor. Always be sure to check with your physician before undergoing any severe
change in your diet or in your children's diet.


Richard Podell, MD, Andrew Weil, MD, John McDougall, MD, James F. Balch, MD,
and Phyllis Balch, CNC

Asthma: Buteyko’s Theory

Buteyko’s Theory basically says that due to deep respiration an excessive amount of CO2 is removed from the body, resulting in a change in chemical balance which is only partially neutralized by compensatory mechanisms.

Over a period of time the loss of CO2 becomes increasingly disruptive to the functioning of the body. All physical and chemical processes are affected.

The loss of CO2, because of release from the lungs at a rate faster than its creation in the tissues leads to an increase in pH. Generally a state of oxygen deficiency also occurs due to reduction of the Bohr effect.[Less oxygen is taken from the RBC ferry.]

This oxygen shortage will cause an increase in the amount of incompletely oxidized ‘products of metabolism’ which act chemically to lower the pH. [Metabolic acidosis] This effect will not quite cancel out the increased pH from the CO2 loss, and the efficiency of all normal systems will be reduced.

One category of ‘disease’ caused by this problem may be classified as ‘defense mechanisms’, where the action is to reduce further CO2 loss [Asthma, emphysema, etc].

The other category are the ‘diseases’ which occur as a result of the changed pH and compensatory mechanisms. These include disruption of formation of fats, carbohydrates, and proteins; Disruption of the energy production efficiency [decreased ATP formation]; and a disruption in the efficiency of the processes of formation of CO2.

According to Buteyko, normalization of the breathing will not only avoid the existence of diseases of defense , but will also result in removal of the diseases occurring due to the change of function of the body caused by the excess removal of CO2. Treating the symptoms of these diseases without addressing the cause will result in eventual worsening of the problem.