Asthma is a huge problem and affects people across the world. Functional medicine is always oriented towards addressing the root cause of disease and with asthma that root cause is immune dysregulation. We can think of immune regulation in three broad categories. One would be weakened immunity, in this one gets frequent colds and flu. A second would be autoimmunity where the body is attacking itself and the third would be hyperactivity or hyper-reactivity where the immune system is hyper-responsive to antigens in the environment and these could include things like dust, pollen, mould, food antigens like gluten, dairy, chemicals like herbicides and pesticides etc.

Asthma falls into the third category of hyperreactivity and that reactivity in case of asthma is often directed at environmental antigens and toxins including moulds, foods, microbes in the gastrointestinal tract, proteins entered inappropriately into the bloodstream by a leaky gut, chemicals like dyes, preservatives, pesticides and herbicides.

From the perspective of functional medicine, the issue is with the immune system reaction to these substances. Everybody may not have asthma on exposure to low levels of these substances and that is why it is important to consider asthma as a condition that is characterized by immune dysfunction or dysregulation.

The functional medicine approach to asthma is in two steps, the first is to identify and address triggers of immune dysfunction and the second would be to take specific steps to balance and regulate the immune system. Diet is one of the bigger asthma triggers. Food intolerances are very common in people with asthma especially gluten and dairy. So, it is always good to eliminate gluten and dairy from the diet in a person suffering from asthma for at least the first two months. Then there are other triggers in food as mentioned earlier like additives, dyes, sugar, etc. These food chemicals can lead to intestinal permeability also known as leaky gut.

In a leaky gut, the protein that should stay in the gut as part of normal food that we eat escapes in the gut and end up in the bloodstream and then the immune system attacks those food proteins because it considers them to be foreign invaders and that immune attack can lead to asthma, allergies and many other conditions characterized by immune dysregulations. The next important gastrointestinal issues including SIBO (Small Intestinal Bacterial Overgrowth), are chronic gut infections like H pylori, fungal overgrowth, dysbiosis.

We also need to address the nutrient status. Minerals like magnesium and zinc have been shown to prevent asthma. Probiotics are great immune regulating supplements.

Another thing to consider is histamine. It is a mediator of the inflammatory response particularly when it comes to the allergic response in human beings and histamine is also found in the diet. With already high levels of histamine in asthma patients, eating food high in histamine can push its level over the edge and exacerbate symptoms. So, for some people eating a diet low in histamine can be helpful.

The next major category of triggers is environmental, this includes toxins that are found in the home cleaning and personal care, mould, biotoxins due to air pollution. Therefore, taking steps that help in decreasing exposure to such toxins will help in managing asthma. Heavy metals and other toxins should also be addressed.

Another important category is related to the HPA (Hypothalamus Pituitary Adrenal) axis that includes stress and sleep deprivation. The connection between stress and the immune system is known for thousands of years. Stress impacts the immune system in numerous ways and is one of the most significant triggers for autoimmune diseases. There are a lot of studies that show that stress depletes the immune system and makes it susceptible to cold and flu.

Exposure to sunlight has a direct impact on our immune system. Music, playing and spending time out, are proved to have a profoundly positive effect on the immune system. All these things are antidote to stress and HPA axis dysfunction. A study has shown that lack of social support is a greater prediction of early death than smoking 15 cigarettes a day.

Several herbs are helpful for asthma or immune regulation in general. There are several studies to support yoga and pranayama a breathing practice to help asthma. Yoga, meditation, progressive relaxation techniques, and exercise have other benefits like stress management relaxation and improving sleep.

Therefore by attending to your diet, lifestyle management and using alternative therapy one can successfully reverse the chronic recurring asthma problem.