Asthma: A Review of Complementary and Alternative Therapies

Abstract

1. Cecilia Bukutu, PhD* 2. Christopher Le* 3. Sunita Vohra, MD, FRCPC, MSc* 1. *Complementary and Alternative Research and Education (CARE) Program, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. On behalf of the American Academy of Pediatrics Section on Complementary and Integrative Medicine Although effective medications for managing asthma exist within conventional Western medicine (eg, inhaled corticosteroids and bronchodilators), some parents turn to complementary and alternative medical (CAM) therapies to treat their children's asthma. (1) Some reasons cited for using CAM therapies include concern about the long-term effects of steroid use; frustration that asthma does not resolve with conventional therapies; dissatisfaction with physician-patient interactions; belief that CAM is natural and, therefore, safe; and desire to have autonomy in making health choices. (1)(2) This review of published scientific literature assesses the efficacy and safety of some common CAM therapies in preventing and treating pediatric asthma. Natural health products (NHPs), including vitamins, minerals, herbal remedies, and other dietary supplements such as fish oil and probiotics, are used widely to prevent and treat asthma. (3) Like conventional therapies, NHPs used to treat asthma can be categorized as having anti-inflammatory, bronchodilator, and other effects. Few of these NHPs have been evaluated in pediatric trials. ### Vitamin C Vitamin C is an important antioxidant found in abundance in the extracellular fluid lining of the lung. Low intake of vitamin C is associated with pulmonary dysfunction. (4) Several observational studies in children have reported a beneficial relationship between a high fruit intake and improved lung function. (5)(6) However, a 2004 Cochrane systematic review of eight randomized, controlled trials (RCTs) concluded that evidence was insufficient to recommend a specific role for vitamin C in treating asthma. (4) Of the eight included studies, three small studies (fewer than 41 participants each) concluded that vitamin C supplementation was beneficial; five studies, including the largest trial (n=210), showed little or no beneficial effect. Larger, long-term RCTs are needed to clarify the possible role of vitamin C in the treatment of asthma. Most researchers have used daily doses of 500 to 1,000 mg. …