As an MD with Asthma

As an MD with asthma, I have tried various remedies for my chronic and acute asthma episodes.

The best "alternative" combination that works for both acute and chronic asthma for me is:

pycnogenol + quercetin
pycnogenol 100 mg; quercetin 500-1000 mg taken at the end of the evening meal .

They have anti-inflammatory and anti-bronchospasm mediator activities.

For pycnogenol the following randomized trial is pertinent:

Pycnogentol Randomized Trial:
J Asthma. 2004;41(8):825-32

Pycnogenol as an adjunct in the management of childhood asthma.

Lau BH, Riesen SK, Truong KP, Lau EW, Rohdewald P, Barreta RA.

Division of Microbiology and Molecular Genetics, Department of Biochemistry and Microbiology, School of Medicine, Loma Linda University, Loma Linda, California 92350, USA. bLau@som.llu.edu

A randomized, placebo-controlled, double-blind study involving 60 subjects, aged 6-18 years old, was conducted over a period of 3 months to determine the effect of Pycnogenol (a proprietary mixture of water-soluble bioflavonoids extracted from French maritime pine) on mild-to-moderate asthma. After baseline evaluation, subjects were randomized into two groups to receive either Pycnogenol or placebo. Subjects were instructed to record their peak expiratory flow with an Assess Peak Flow Meter each evening. At the same time, symptoms, daily use of rescue inhalers (albuterol), and any changes in oral medications were also recorded. Urine samples were obtained from the subjects at the end of the run-in period, and at 1-, 2-, and 3-month visits. Urinary leukotriene C4/D4/E4 was measured by an enzyme immunoassay. Compared with subjects taking placebo, the group who took Pycnogenol had significantly more improvement in pulmonary functions and asthma symptoms. The Pycnogenol group was able to reduce or discontinue their use of rescue inhalers more often than the placebo group. There was also a significant reduction of urinary leukotrienes in the Pycnogenol group. The results of this study demonstrate the efficacy of Pycnogenol as an adjunct in the management of mild-to-moderate childhood asthma.

As far as I am aware, quercetin has not been evaluated in a randomized controlled trial but if one puts "quercetin" in Pubmed, one comes up with over 5000 references documenting its chemical potential to be anti-inflammatory; and various individuals have proposed doing a randomized control trial for quercetin as an rx of allergic sinusitis (related pathophysiologically to asthma). It is interesting that in a letter to the British Medical Journal in Jan 2006, an Italian scientist argues that quercetin could have some properties that make it a better agent than Tamiflu for the treatment of Bird Flu (that has a "cytokine storm" inflammatory mediators as its mechanism for causing death).

pycnogenol has some anti-thrombotic properties that could theoretically potentiate its side effects. The Natural Medicine Database (subscribed to by the VA Hospital System) notes that there is the theoretical side effect of potentiating autoimmune disease in women by pycnogenol. So, there is the theoretical contraindication of SLE and similar disorders for pycnogenol.

quercetin is a flavinoid from red wine. It should not be combined with Monoamine Oxidase inhibitors because of the risk of increased blood pressure with the combination.

A very adequate supply of both pycnogenol and quercetin can be obtained at a reasonable cost from http://www.iherb.com.

I have absolutely no financial interest in the above. If you do this without consulting your personal physician, you could be assuming a risk in taking these agents. It is also possible you could develop a complication by taking these agents that has never been reported. While taking quercetin and taking Bioperin (the agent in black pepper that blocks glucuronidation and helps absorption of some nutraceuticals, e.g., curcumin) at a dose of 10 mg my blood pressure went from ~130 systolic to 190 systolic. That occurred because Bioperin has monoamine oxidase A and B inhibitory activity and interacted with an agent (quercetin) that is a red wine extract. It is known that MAO inhibitors can elevate blood pressure when taken with red wine but it has not been reported, to my knowledge, that quercetin could be the responsible chemical in red wine for that interaction. The morale to this story is there is no free lunch and you could have an unforeseen interaction / complication by taking pycnogenol and quercetin. It is also theoretically possible and not unlikely that someone, sometime has consumed a large amount of black pepper (Bioperin is ~5-6% of black pepper), drank a quantity of wine, greatly elevated their blood pressure and had a stroke as a result.

This kind of advice should, pro forma, be checked out with one's personal physician who has probably never heard of either pycnogenol and quercetin. That is not a critique of the physician; it is just a fact that physicians are, in general, very skeptical of "alternative treatments" and do not have the time to keep up with the literature as the above randomized controlled trial.

I do believe we overlook agents such as these because of their "alternative medicine" origin and no drug company (other than the one that patented pycnogenol) can claim a monopoly

One way to assess efficacy is to look at stuffy nose symptomatology, especially if it happens overnight. That is likely due to some of the same kind of inflammatory mediators as mediates asthma. If one gets significant relief of symptoms in 3 days of the stuffy nose symptoms while taking these agents QHS (at bedtime) then one will likely, in my opinion, benefit by taking these agents for asthma. AND, if one benefits by taking them for stuffy nose symptoms then it is likely, in my opinion, that these agents (plus others) could be very efficacious for the acute treament of Bird Flu influenza (see cytokine storm above and December 7, 2002 issue of The Lancet medical journal and comment by Hong Kong physicians about the pathology of H5N1 influenza).

We should be sponsoring randomized controlled trials of pycnogenol and quercetin - again, I have no dog in that hunt but very much would like that hunt to be pursued by multiple groups for multiple reasons above and otherwise with regard to clinical observations about the efficacious effects of these nutraceuticals.

Charles Beauchamp MD, PhD

By setred1970
Posted September 13, 2007 at 11:57 pm
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I just wanted to say thank you for the good information. I took Pycnogenol for several years before I was diagnosed with allergic asthma after hearing that it was one of the strongest anti-oxidants out there. While I did not have the data that you can supply I am anxious to discuss this with my pulmonogist to see what he says. I am already on Xolair and still having frequent symptoms at certain times of the year. I look forward to trying this combination and seeing even better benefits. Thanks again. Sharon.

By stay_well
Posted September 28, 2007 at 8:54 am
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I also have been taking pycnogenol with grape seed extract,red wine extract and billberry extract for the last five years. I don't have any health challenges and because of these nutrients I have excellent cholestrol counts, blood sugar and blood pressure even though I am over 50 and most of my peers are on several phamacueticals. This has also allowed my son who is basically allergic to his world have very few symptoms from his allergies. I love this nutraceutical!

By naturalnurse23
Posted October 6, 2007 at 6:14 pm
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Charles,
Are you familiar with the work and research of Dr. F. Batmanghelidj? He has a very interesting book, "Your Body's Many Cries for Water" that explains the role dehydration plays in asthma and how rehydrating the body with water and salt can improve and sometimes cure asthma. In the book, there are many testimonies of readers who have tried his simple recommendation and experienced amazing results. I have been a Registered Nurse for almost 10 years now and I am studying alternative medicine as a result of the disappointment I have seen and personally experienced with allopathic medicine. So many drugs are actually dangerous to your body and make you dependent onthem. Not to mention the long term damage many individuals experience. I know you are trained as an MD to diagnose and treat with drugs and/or surgery, and I believe they have their place, but with all of the side effects and drugs that are taken off the market every year because of bad reactions and even death should be a red flag to not only health care providers, but the general public seeking health care. The best thing about Dr. B's recommendation is there are no side effects! The rest of your body will benefit as well! You should know as a physician the importance water is for the body to carry out its everyday functions and waste removal. I am asking you as a fellow healthcare provider and conscious thinking being, think outside the box! Although I would use water that has been through the reverse osmosis filtering process or natural spring water because our tap water has been tainted with fluoride and chlorine.

By cbDayton
Posted October 7, 2007 at 3:19 pm
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I think we are in agreement.
5 glasses a day plus of good water helps keep the doctor away.
The pycnogenol and quercetin recommendations were made for the excess of inflammatory factors that occur in asthma.
The medications normally used to dampen down lung inflammation are steroids (oral and in spray/powder form) and Singulair (TM) - montelukast (generic name).

The Pycnogenol is a natural product (from pine bark in a proprietary extract)
The quercetin is from red wine, red onions, buckwheat honey; it is a falvinoid like compount.

Both Pycnogenol and quercetin can theoretically have side effects and there is always the possibility of being the done that experiences a unusual and potentially side effect by combining these medications with other medications. And, I am not recommending stopping any medications recommended by a doctor.

It is interesting that on the Asthma and Allergy blog stream, independent of my message, there is the comment of benefit by OP-3, a mixture of ingredients (proanthrocyanins) that include Pycnogenol.

On the website SERMO where only physicians can congregate to discuss things opening (and with much disagreement sometimes), quercetin is cited by five physicians as being efficacious for tretment of allergic rhinitis / sinusitis. That condition is caused by some of the same inflammation factors that causes asthma.

So, my recommendation has some validity in experience BUT should be checked out with one's doctor to ascertain no vigorous objections to trying it..

One "psychological issue" for doctors with nutraceutical rx (such as Pycnogenol + quercetin) is that it is within the power of the patient to try this independent of the physician so it is, so to speak, another potential nail in the coffin of primary care in the USA. HOWEVER, I believe select nutraceutical rx can be "managed" by primary care doctors meeting with groups of people (say with asthma) in their practice, outlining the pros and cons of using nutraceuticals (includes natural products as Pycnogenol / quercetin plus a number of others) in certain disease states (e.g., Asthma, Coronary Artery Disease, Elevated Cholesterol, Elevated triglycerides, Diabetes Mellitus / pre-diabetes, certain cancers and pre-cancerous conditions, high risk for storke and already maxing out on avaiable medications, increased risk for Alzheimer's Disease, Parkinsonism, Depression......etc), and letting each individual make a decision about whether to try or not. AND, the primary care physician can assess individuals in follow-up to determine who did and who did not try the nutraceuticals and learn a lot from their experience. A physician open to the option of trying some alternative remedies, if she is a good physician otherwise, will gain a lot of new business. So, for primary care recommending potentially efficacious nutraceutical treatment likely results in a significant increase in practice revenue - and that is a major concern for primary care physicians who are seeing their income drop much more than the drop for specialists.

As a primary care general internist, I am concerned for my profession of primary care as I am concerned for my patients. There are very few medical students going into primary care internal medicine and that is the profession that will be most needed when the baby boomer generation hits Medicare in full force.

Good Primary Care General Internist skills + Good alternative / complementary care skills = much more cost-effective care for many more people.

By naturalnurse23
Posted October 12, 2007 at 2:44 pm
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Five glasses a day of water? How many ounces does each glass contain? According to Dr. F Batmanghelidj the recommended maintenance amount of water should be at least half your body's weight in ounces of water with a sprinkle of sea salt to balance electrolytes. That is just to maintain hydration. I challenge you, as an asthma sufferer to try this for one month: an 8 oz glass of pure water with a sprinkle of sea salt upon waking, 30 min before each meal, 2 hours after each meal, and another before 8pm. There are no side effects, only benefits from this naturally occuring substance that is the very building block of the majority of our matter and required to exist and carry out normal body processes. Besides that, it's cheap! The only thing it may require from you, which I know as a very busy physician is very valuable, is time and thought. Consider the possibilities. What if after one month you no longer had to depend on inhalers and steroids or other treatments with annoying side effects?
Physicians are so focused and brainwashed into diagnosing and treating disorders and symptoms that they forget the very basic fundamentals of anatomy and physiology that they were taught. The human body is an amazing intricate machine capable of healing itself-when in balance. Good Luck!

By cbDayton
Posted October 12, 2007 at 4:48 pm
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I don't think we really disagree
5 glasses x 12 oz/glass = 60 oz
8 glasses x 8 oz/glass = 64 oz
Your points about the salt addition are good ones and worth trying but the quality and electrolyte content of a number of "sea salt" preps are open for debate.
Where do you get your sea salt and what is the brand name?

By ilmbg
Posted October 25, 2007 at 9:39 pm
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naturalnurse23- I have been a nurse for 25 years- and know the absolute need for water! Several of us at work, on the unit that I work drink water- some of the other people are stopping coffee/tea/colas. I never drank coffee/tea, but did drink soda until several years ago. Essentially, water is my only drink- I drink about 6-20 oz bottles of water a day in the summer- sometimes more. Now that it is cooler again, I have dropped to about 4/day. I do not put sea salt IN the water, but use it for foods/cooking. I now have the worst allergy related asthma in my life! My tidal is 48%, my FEV 60% of what should be for my age/weight. I must admit I am quite skeptical of this water/asthma cure- I have been drinking water at this amount for several years now.

By Guineapig
Posted November 15, 2007 at 7:03 pm
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Dr. Beauchamp: You have provided some valuable information and "food for thought" for many asthma sufferers.

"Asthma prevention" is a topic that is inter-related with the work I do every day as an EMF/EMR researcher (electromagnetic field/electromagnetic radiation). While I am "non-accredited," I do have about 18 years' experience as grandparent of two innocent toddlers who were diagnosed with rare immune deficiencies, guinea pig studies conducted in my own home, interacting with scientists from around-the-world and currently working on a book titled "Inflammation and EMF/EMR.

Our grandsons were diagnosed with low IgG subclasses 1 and 3. This signified "AGING!!!"
Both boys had chronic asthma -- often intractable asthma that required serial nebulizer treatments around-the-clock.

I discovered they were each sleeping next to "powerwalls" -- walls opposite the electric meter. The boys (cousins living in different cities) were moved away from the location of the electric meter. They both "got well...!!!" Asthma improved rapidly in both boys, they soon exhibited improved appetites and one boy never saw a doctor again for over two years when he went for his preschool physical.

Re my guinea pig studies: the first symptom observed in my guinea pigs after exposure to "powerwall" (my home) was "little coughs." Coughs were soon diagnosed by three separate veterinarians as "ASTHMA....!!!!"

Persons need to make sure they do not have electric appliances and/or some telephone equipment close to beds. Items as seemingly innocuous as an electric clock, noise machine, cordless phone transformer box and much more can potentially cause every health problem from poor quality sleep to cancer.

Be sure and check my website for additional concerns. I learn about new items every day but my webmaster can't keep up with all the changes. Feel free to phone or email with questions.

WEBSITE: WWW.GUINEAPIGSRUS.ORG

Best wishes and take care - Joanne

Joanne C. Mueller, Guinea Pigs "R" Us, 731 - 123rd Avenue N.W., Minneapolis, MN 55448...phone: 763-755-6114 ..... email: jcmpelican@aol.com

By cbDayton
Posted November 17, 2007 at 8:17 am
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This is SPECULATION on my part to explain what could be causing asthma in individuals exposed to strong electromagnetic waves. It is based on my awareness of a Japanese physiologist's studies on the effects of pulse electromagnetic waves on nerves causing induction of a "cholinergic phenotype" PLUS the model of eosinophils (type of cell that increases in active asthma in some individuals) inducing a "cholinergic phenotype":

Am J Respir Cell Mol Biol. 2006 Jun;34(6):775-86. Epub 2006 Feb 2

Eosinophil-mediated cholinergic nerve remodeling.

Durcan N, Costello RW, McLean WG, Blusztajn J, Madziar B, Fenech AG, Hall IP, Gleich GJ, McGarvey L, Walsh MT.

Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.

Eosinophils are observed to localize to cholinergic nerves in a variety of inflammatory conditions such as asthma, rhinitis, eosinophilic gastroenteritis, and inflammatory bowel disease, where they are also responsible for the induction of cell signaling. We hypothesized that a consequence of eosinophil localization to cholinergic nerves would involve a neural remodeling process. Eosinophil co-culture with cholinergic IMR32 cells led to increased expression of the M2 muscarinic receptor, with this induction being mediated via an adhesion-dependent release of eosinophil proteins, including major basic protein and nerve growth factor. Studies on the promoter sequence of the M2 receptor indicated that this induction was initiated at a transcription start site 145 kb upstream of the gene-coding region. This promoter site contains binding sites for a variety of transcription factors including SP1, AP1, and AP2. Eosinophils also induced the expression of several cholinergic genes involved in the synthesis, storage, and metabolism of acetylcholine, including the enzymes choline acetyltransferase, vesicular acetylcholine transferase, and acetylcholinesterase. The observed eosinophil-induced changes in enzyme content were associated with a reduction in intracellular neural acetylcholine but an increase in choline content, suggesting increased acetylcholine turnover and a reduction in acetylcholinesterase activity, in turn suggesting reduced catabolism of acetylcholine. Together these data suggest that eosinophil localization to cholinergic nerves induces neural remodeling, promoting a cholinergic phenotype.

PMID: 16456188

A "cholinergic phenotype" of nerves means that the nerves are more likely to potentiate an asthmatic state. STRONG magnetic field OR eosinophil increase due to allergy ---> cholinergic phenotype of nerves --> increased risk of asthma. (A PROPOSED mechanism)

The is an HYPOTHESIS, NOT a FACT. It is speculation on my part and I could well be wrong in my attempted explanation. I am just trying to rationally explain your observations.

BUT, realize that even if the above is correct, one must ask how often electromagnetic fields cause clinical asthma? My answer: Probably not very often. The electromagnetic radiation we are talking about is much different than the magnetic fields around a magnet that are constant (not pulsating) and weaker in intensity.

Thanks for sharing your observations.

By cbDayton
Posted November 17, 2007 at 8:51 am
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Another possible explanation for your observations is "immunomodulation" related to strong electromagnetic radiation:

The following is an article abstract from Pubmed that links electromagnetic radiation with immune system modulation:

J Basic Clin Physiol Pharmacol. 2006;17(4):269-78

Changes in autoimmune markers of the anti-cardiolipin syndrome on days of extreme geomamagnetic activity.

Stoupel E, Monselise Y, Lahav J.

Division of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Sackler Faculty of Medicine, Tel Aviv University, Israel. stoupel@inter.net.il

The possible relation between various biological or medical phenomena and changes in environmental physical activity, such as Solar, Geomagnetic Activity (GMA); Cosmic Ray; Proton, and other particle flux, have been reported. These phenomena seem to be reflected, among others, in the immune system, resulting in changes in immunoglobulin (Ig) levels or outbursts of epidemics. AIM: to examine a possible association of GMA with another aspect of the immune system--autoimmunity. Fluctuations of levels of anticardiolipin (IgG; IgM, IgA subtypes) and lupus anticoagulant (Kaulin clotting time and Dilute Russell's viper venom time) autoantibodies, serving as anticardiolipin syndrome (ACLS) markers, were monitored during days of severe GMA storms and compared with those of lowest/quiet GMA days. Cosmophysical data were obtained from the NOAA National Space Service Center and the National Geophysical Data Center, USA. RESULTS: A significant rise in the levels of anti beta2Gp1-IgA (p = 0.0001); and KCT (p = 0.019) was observed on days of the GMA storms. CONCLUSION: On days of major GMA storms, significant changes in the autoimmune marker levels of ACLS were observed compared with quiet days. An involvement of those changes in clinical events related to GMA storms is possible.

PMID: 17338282

So, (again I AM SPECULATING) strong electromagnetic fields --> immunomodulation --> increased risk of asthma.

The change in immunoglobulin level you note is a possible indicator of "immunomodulation". Presumably, with redrawal from exposure from the electromagnetic field, the "immunomodulation" noted should return to a normal state.

Also if this generalization holds for asthma, one would predict an increase rate of asthma attacks when there are GMA storms.

By Guineapig
Posted November 18, 2007 at 2:03 pm
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Dr. Beauchamp: Thank you for the studies re electromagnetic radiation and your comments!

I am having some problems with this site in that I know you included two separate posts but now that I have a few minutes to respond (briefly -- much more to say), I am linked to only one of the studies and can't get back to the other one. I will try and do that later this week but with holiday and pie-baking, I may be delayed. You definitely have provided valuable studies re EMF/EMR tho!!!

As to exacerbation of asthma and/or promotion of new cases of asthma due to heavy geomagnetic activity, it is entirely possible that this does occur. I would assume this would require a study of gigantic proportions assuming such an epidemiological study could actually be carried out.

The information in the study re GMA storms can be applied to studies of persons who are sleeping in beds with electric appliances on nightstands and headboards.

Society's problem is that scientists are not being paid to come up with "concousive evidence" re harm from low level, chronic, prolonged EMF/EMR (electromagnetic field/electromagnetic radiation) exposures AND, if certain studies do make the connection, publicity is very limited. Government and industry as well as the cancer societies do not want this information out there.

Dr. Henry Lai, University of Washington, exposed rats to a hairdryer. The press releases at time of the study depicted DNA moving........

Your post has now resulted in an extremely important, "serendipitous event!!!"

I just checked for a link the the Lai/Singh hairdryer study and found a report by USA Today that I didn't know existed.

http://www.usatoday.com/tech/news/2004-02-19-dna-damage_x.htm

I am astonished to read that the above article does, in fact, mention reasons to avoid electric blankets and even electric clocks!!!

The facts re my grandsons and husband, as well as my guinea pig studies, "strongly support" that chronic, prolonged exposure to electric meters and electric appliances IS very hazardous.

Assoc. Prof. Olle Johansson, Karolinska Institute in Sweden (co-author of my book "Inflammation and EMF/EMR) is willing to fly to the United States for the purpose of helping to "spread-the-word" about the critical need to move electric items and telephone equipment away from persons' beds. I sent an appeal to Dr. Mehmet Oz for help in getting on the Oprah Show. Previously, I have written to the Oprah Show several times but continue to be ignored. Same re the Montel Williams Show........ I am desperately trying to obtain funding for Assoc. Prof. Johansson so he can replicate findings re my grandsons rare immune deficiencies (involving asthma, chronic sinus infections, ear infections, gastrointestinal problems and pre-Leukemic blood changes); findings re guinea pigs (involving asthma, severe subacute epicarditis, osteomyelitis, reactive renal amyloidosis and pre-Leukemic blood changes); and also findings re my husband whose Executive Function tests improved after moving his electric clock radio off his nightstand, starting him on nightly melatonin and stopping his statin (Lipitor).

My husband's asthma as well as our two grandsons' asthma and even the guinea pigs' asathma all disappeared after reducing nightly EMF/EMR exposures due to electric meters and/or electric appliances.

Complete blood counts (CBC's with diffs) on my guinea pigs revealed severe neutropenia, lymphocytosis and hypersegmented neutrophils (slowed DNA synthesis). These are pre-Leukemic blood changes and are "markers for irradiation."

The studies you have provided are valuable references that help support findings re above.

As far as comparisons to geomagnetic storms, it is my opinion that sleeping close to electric and telephone equipment every night is equivalent to having a GMA storm in one's bed every night that eventually "wreaks total havoc" on its victims!!!!

Again, thanks much for your valuable contributions, have a nice Thanksgiving, and take care!!! Joanne

Joanne C. Mueller, Guinea Pigs "R" Us, 731 - 123rd Avenue N.W., Minneapolis, Minnesota 55448.....phone: 763-755-6114.....email: jcmpelican@aol.com ( 11-18-07 )

By Guineapig
Posted November 18, 2007 at 2:14 pm
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To All: I attempted to correct several typographical errors in last post. I noticed an item marked "Edit" BUT nothing allowed me to do so...... Joanne

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