Holistic care for asthma
Whole-person integrative treatment
Whether you're a provider working with patients who don't respond well to inhalers or someone living with flare-ups despite "doing everything right," there's more to the story on this chronic inflammatory disorder. Conventional meds help, but for many, they don’t go far enough, especially in complex or steroid-resistant cases.
Integrative care may offer something new: a broader lens that encompasses nutrition, botanicals, breathwork, and nervous system support. This piece explores what the latest science says—and how we can rethink asthma care, together.
Asthma affects the conduction zones of the respiratory system, specifically, the bronchi and bronchioles, which are responsible for airflow between the trachea and the deep alveoli in our lungs (Welsh & Prentice, 2023). In asthma, these airways undergo three significant pathophysiologic changes:
Smooth muscle constriction (bronchospasm),
Mucosal inflammation, and
Hypersecretion of mucus
(Sockrider & Fussner, 2020)
These changes narrow the airway lumen, increasing resistance and impairing airflow, especially during exhalation. Over time, repeated inflammation can lead to structural remodeling of the airway wall (Sharma et al., 2024), and this chronic remodeling reduces the elasticity and responsiveness of the airways, making symptoms more persistent and less reversible with treatment.
There are two types of asthma
Recent research has shifted away from treating asthma as a single disease and now focuses on different types based on what is happening in the immune system. Liu et al. (2024) describe two main categories:
Type 2 (T2) asthma: the more common form and often involves allergies or high levels of eosinophils (a type of white blood cell). This type tends to respond well to standard treatments, such as inhaled steroids or newer biologic drugs that target specific immune pathways.
Non-T2 asthma: less understood and often appears in individuals exposed to pollution or those with metabolic issues, and involves various immune cells (Sharma et al., 2024). This form does not respond well to typical medications, which is why researchers and clinicians are starting to explore more personalized and integrative options.
The role of complementary and alternative medicine (CAM) in asthma is increasingly documented in peer-reviewed studies.
Botanicals like frankincense Boswellia serrata show anti-inflammatory properties in early research; others, like flavonoids found in foods and herbs, such as quercetin, may help calm the immune response and reduce airway sensitivity (Ward & Baptist, 2016).
While the science behind these compounds appears promising, many of the studies conducted so far have been small or designed differently, which makes it challenging to draw solid conclusions. Across the board, researchers agree that we need better trials to determine how well these therapies work, how much to use, and for whom they are best suited.
If you're already using herbs or supplements for asthma, ask: Are these evidence-based? Am I using a therapeutic dose? And has this been coordinated with my existing care team?
Mind-body approaches like breathwork and stress reduction are becoming more accepted in asthma care, especially for people whose symptoms are worsened by anxiety or chronic stress.
Techniques such as Buteyko breathing or yogic practices like pranayama have been shown to reduce the frequency of people reaching for the rescue inhaler and improve their awareness of symptoms (Kohn & Paudyal, 2016). While these tools may not significantly impact lung function tests, they can still be incredibly helpful in improving quality of life and reducing stress levels.
Acupuncture and bodywork are also being explored, though the evidence is mixed. Some studies have shown slight improvements in symptoms and medication use with acupuncture; however, results vary significantly depending on the treatment delivery method and study design (Ward & Baptist et al., 2016).
For patients: Could your asthma flares be stress-related? For providers: Are you integrating nervous system regulation techniques into your asthma management protocols?
Communication as part of treatment
Finally, one crucial issue with CAM is that many patients do not discuss it with their doctor. Kohn & Paudyal et al. (2017) note that this lack of communication can lead to missed opportunities to coordinate care or, worse, cause potential interactions with medications.
In Conclusion
Upon reviewing the research as a whole, two significant trends stand out: first, asthma is not a one-size-fits-all condition. It is now being understood through more specific immune-based subtypes. Second, there is growing support for integrative approaches that extend beyond symptom management.
While medications are still essential, especially during acute episodes, they do not always provide a comprehensive solution. Factors such as ongoing inflammation, lifestyle choices, or stress that can affect a person’s day-to-day well-being should also be considered.
This is where nutrition, herbs, breathwork, and stress reduction practices can offer meaningful support, even if the research is still catching up in some areas. When done thoughtfully and grounded in evidence, integrative care gives us more options, especially for those with hard-to-treat symptoms or who want to play a more active role in their health. It is not about replacing conventional treatment but rather expanding what is possible in asthma care with a more comprehensive, long-term approach.
Integrative asthma care isn't about replacing medication. It's about asking better questions, broadening your toolkit, and finding what works for you.
References
Kohn, C. M., & Paudyal, P. (2017). A systematic review and meta-analysis of complementary and alternative medicine in asthma. European respiratory review : an official journal of the European Respiratory Society, 26(143), 160092. https://doi.org/10.1183/16000617.0092-2016
Liu, T., Woodruff, P. G., & Zhou, X. (2024). Advances in non-type 2 severe asthma: from molecular insights to novel treatment strategies. The European respiratory journal, 64(2), 2300826. https://doi.org/10.1183/13993003.00826-2023
Sharma, S., Gerber, A. N., Kraft, M., & Wenzel, S. E. (2024). Asthma Pathogenesis: Phenotypes, Therapies, and Gaps: Summary of the Aspen Lung Conference 2023. American journal of respiratory cell and molecular biology, 71(2), 154–168. https://doi.org/10.1165/rcmb.2024-0082WS
Ward, C. E., & Baptist, A. P. (2016). Characteristics of Complementary and Alternative Medicine (CAM) use among older adults with asthma. The Journal of asthma : official journal of the Association for the Care of Asthma, 53(5), 546–552. https://doi.org/10.3109/02770903.2015.1116090
Welsh, C. & Prentice-Carver, C. (2023). Holes Essentials of Human Anatomy &
Physiology (15th ed). McGraw Hill 9781307879735