Asthma and Complementary Health Approaches: What You Need To Know

In asthma, the airways (the tubes that carry air in and out of the lungs) become inflamed and narrowed at times. Asthma symptoms can range from mild to severe and can happen every day or only occasionally. Severe exacerbations of asthma (asthma attacks) can be life-threatening. Asthma accounts for about 1.6 million emergency room visits a year in the United States and more than 3,500 deaths.

Managing asthma effectively includes having regular asthma checkups with your health care provider, properly using asthma medicines, avoiding asthma triggers, and maintaining a healthy lifestyle.

For more information about asthma, visit the National Heart, Lung, and Blood Institute website.

A variety of breathing techniques have been studied as possible complementary approaches for asthma. 

• A 2020 evaluation of 22 studies involving 2,880 adults found that breathing exercises may have positive effects on quality of life and hyperventilation symptoms but probably not on asthma symptoms in adults with asthma.
• A 2019 review looked at 10 studies (466 participants) that evaluated breathing exercises in children with asthma. The breathing exercises were performed alone, as part of yoga, or as part of composite interventions that also included other treatments. The data were insufficient to allow clear conclusions to be reached. 
• No harmful effects have been reported in studies of breathing techniques in people with asthma.

• Not much research has been done on the effects of meditation in people with asthma. However, a 2018 review of 4 studies (201 participants) found some evidence that meditation may help to improve quality of life in asthma patients.
• In general, meditation is usually considered to have few risks. However, because only a few studies of meditation have systematically looked for harmful effects, it isn't possible to make definite statements about its safety.

Visit the NCCIH website for more information on meditation.

• Little research has been done on spinal manipulation for asthma. A 2021 review found only one high-quality study on this topic, which involved children and adolescents with mild-to-moderate asthma; that study did not show that the treatment was beneficial.  
• Transient side effects of spinal manipulation, such as increased pain or discomfort, stiffness, and headache, are common. Serious side effects are rare.

Visit the NCCIH website for more information on spinal manipulation.

• A 2016 evaluation of 15 studies (1,048 total participants, mostly adults) of yoga for asthma found that yoga probably leads to small improvements in quality of life and asthma symptoms. In most of these studies, yoga was added to usual care for asthma.
• A 2020 evaluation of 9 studies (1,230 participants) of yoga for children or adolescents with asthma provided preliminary evidence that yoga may help to reduce stress and anxiety and improve quality of life and lung function. However, it is uncertain which components of yoga or how much yoga is needed to provide benefits.
• Yoga is generally considered a safe form of physical activity for healthy people when performed properly, under the guidance of a qualified instructor. However, as with other forms of physical activity, injuries can occur. The most common injuries are sprains and strains. Serious injuries are rare. People with health conditions, older adults, and those who are pregnant may need to avoid or modify some yoga poses and practices and should discuss their individual needs with their health care providers and the yoga instructor.

Visit the NCCIH website for more information on yoga.

• Many herbal products have been studied for asthma, but there’s only been a small amount of research on each one, and some of it is of limited quality. A 2010 evaluation of 26 studies of various herbal preparations found there wasn’t enough evidence to justify recommending using any of them for asthma.
• A 2019 review of 18 studies (2,080 participants) of East Asian traditional medicines for asthma could not reach conclusions about whether the products were effective because there was only a small amount of evidence on each individual product.
• Herbs can have side effects, some of them serious, and some herbs may interact in undesirable ways with medicines that are used to treat asthma.

Visit the NCCIH website for more information on herbs.

Environmental changes such as improved hygiene may have led to reduced contact with microorganisms early in life, and this decrease may have contributed to an increase in diseases related to allergies, such as asthma. Studies have been done in which probiotics (live microorganisms that are intended to have health benefits) have been given to pregnant women and/or young infants in the hope of preventing the development of allergies. The effects of probiotics in people who already have asthma have also been studied. 

• A 2020 review of 19 studies (5,157 participants) in which probiotics were administered to pregnant women and/or infants to try to prevent asthma did not show a significant effect of the probiotics on the risk of asthma in the children. All probiotics were considered together in the analysis of these studies, so it’s not clear whether some individual strains of probiotics might have had an effect that was not detectable in the data as a whole.
• A 2018 evaluation of pooled data from 11 studies (910 participants) in which probiotics were evaluated in children with asthma found that taking probiotics led to fewer episodes of asthma and to improvements in two measures of immune responses related to allergic disease. However, no significant improvements were seen in measures of asthma control, asthma symptoms, or lung function, and both the number and quality of the studies were low. The reviewers concluded that the evidence does not confirm or rule out beneficial effects of probiotic supplements in children with asthma.
• Probiotics have an extensive history of apparently safe use, particularly in healthy people. However, few studies have looked at the safety of probiotics in detail, so there’s a lack of solid information on the frequency and severity of side effects. The risk of harmful effects from probiotics is greater in people who are seriously ill or have compromised immune systems.

Visit the NCCIH website for more information on probiotics.

• Some evidence suggests that there may be an association between asthma and low dietary intakes of selenium. However, a high-quality 2007 British trial (in which 197 adults with asthma received either a selenium supplement or a placebo for 6 months) showed no benefit for asthma symptoms or lung function from taking the supplement. People in the United Kingdom tend to have lower dietary selenium intakes than those in many other countries, including the United States, so it’s particularly interesting that selenium wasn’t beneficial there.
• Selenium can be harmful if taken in excessive amounts, causing symptoms such as nausea, skin rashes, discolored teeth, loss of hair or nails, and nervous system problems. Extremely high intakes of selenium can cause severe problems, including heart attacks and kidney failure.

Visit the Office of Dietary Supplements website for more information on selenium. 

• Because preliminary research had suggested a possible link between dietary intake of the soy isoflavone genistein and asthma severity, several U.S. treatment centers looked at whether a soy isoflavone supplement could improve asthma control. The study, which included 386 adults and adolescents with poorly controlled asthma, showed that the supplement did not improve lung function or clinical outcomes when data from all the participants were considered together. However, further analysis of the data showed that the use of soy isoflavones was associated with a significant reduction in the number of severe asthma exacerbations (asthma attacks) in participants who had specific genotypes associated with high production of plasminogen activator inhibitor 1 (PAI-1), which is associated with asthma severity. 
• Soy isoflavones appear to be safe for short-term use.

Visit the NCCIH website for more information on soy.

• A 2013 evaluation of 11 studies involving 419 people concluded that there haven’t been enough high-quality studies to show conclusively whether vitamin C is helpful for asthma.
• Taking too much vitamin C can cause diarrhea, nausea, and stomach cramps. People with the iron storage disease hemochromatosis should avoid high doses of vitamin C. People who are being treated for cancer or taking cholesterol-lowering medication should talk with their health care providers before taking vitamin C supplements. 

Visit the Office of Dietary Supplements website for more information on vitamin C.

• Because low blood levels of vitamin D have been linked to an increased risk of severe asthma exacerbations (asthma attacks), studies have examined whether taking vitamin D supplements could reduce exacerbations. Results of individual studies have been inconsistent. A comprehensive review of the evidence was published in 2023. It included 20 studies: 15 in children (1,155 total participants) and 5 in adults (1,070 participants). The overall results indicated that vitamin D supplementation did not reduce the proportion of people who had one or more asthma attacks. However, only a small number of the study participants had severe asthma or low blood vitamin D levels. 
• Some research has suggested that women with lower intakes of vitamin D may be more likely to give birth to children who develop asthma. Two large studies have been done to find out whether giving high-dose vitamin D supplements to pregnant women can reduce the risk of asthma in their children. 
  • One of the studies, conducted in Denmark, involved more than 600 women; the other, in the United States, involved more than 800. In both studies, pregnant women were randomly assigned to receive either high doses of vitamin D or the usual doses included in prenatal vitamin supplements. 
  • When the children were assessed at the age of 3, the findings were inconclusive. In both studies, fewer of the children whose mothers had received high-dose vitamin D had been diagnosed with asthma or recurrent wheezing, but the difference between the two groups did not reach statistical significance. 
  • The children in both studies were assessed again at the age of 6. At that time, there was no difference in the occurrence of asthma between children whose mothers had received high-dose vitamin D and those whose mothers had received lower doses.
• Vitamin D can be harmful if taken in excessive amounts, causing symptoms such as nausea, vomiting, muscle weakness, confusion, pain, loss of appetite, and dehydration.

Visit the Office of Dietary Supplements website for more information on vitamin D.

• The U.S. Food and Drug Administration (FDA) has warned consumers not to rely on over-the-counter asthma products labeled as homeopathic. These products haven’t been evaluated by the FDA for safety and effectiveness. 
• Asthma products labeled as homeopathic are widely distributed through retail stores and the internet. They can be identified by looking for the word “homeopathic” or “homœopathic” on the product label and looking for whether the active ingredients are listed in terms of dilution (for example, LM1, 6X, or 30C).

Visit the NCCIH website for more information on homeopathy.