Asthma and Complementary Health Approaches: What You Need To Know
Asthma is a chronic lung disease that can affect people of all ages. Symptoms may include wheezing, coughing, or chest tightness. More than 25 million people in the United States have asthma.
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.
About Complementary Health Approaches
Complementary health approaches are a group of diverse medical and health care systems, practices, and products whose origins come from outside of mainstream medicine. They include such products and practices as herbal supplements, other dietary supplements, meditation, spinal manipulation, and acupuncture.
Complementary approaches can be classified by their primary therapeutic input (how the therapy is taken in or delivered), which may be:
- Nutritional (e.g., special diets, dietary supplements, herbs, probiotics, microbial-based therapies)
- Psychological (e.g., meditation, hypnosis, music therapies, relaxation therapies)
- Physical (e.g., acupuncture, massage, spinal manipulation)
- Combinations such as psychological and physical (e.g., yoga, tai chi, dance therapies, some forms of art therapy) or psychological and nutritional (e.g., mindful eating)
Nutritional approaches include what the National Center for Complementary and Integrative Health (NCCIH) previously categorized as natural products, whereas psychological and/or physical approaches include what was referred to as mind and body practices.
What the Science Says About Complementary Approaches for Asthma
Psychological and Physical Approaches
Complementary health approaches, including psychological and physical approaches, are not a substitute for medical treatment of asthma. However, researchers are studying some of these approaches to see whether they might be helpful additions to asthma treatment plans.
Anxiety and stress are associated with worsening of asthma symptoms, and poor asthma control is linked to greater symptoms of anxiety and depression. Approaches that help people with asthma manage stress, anxiety, or depression might help them feel better and improve their asthma control.
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.
Herbal Products and Traditional Medicines
- 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.
Omega-3 Fatty Acids
It’s been suggested that supplements of omega-3 fatty acids, such as those found in fish oil, might help prevent or treat asthma because of their anti-inflammatory effect. However, studies of omega-3s have had inconsistent results.
- A 2021 review examined 16 studies (464 participants) of omega-3 fatty acid supplementation in people with asthma. Four of the studies looked at fractional exhaled nitric oxide, a marker of lung inflammation, and found that it was lower in participants who were taking omega-3 supplements than in those taking placebos. Four studies reported that omega-3 fatty acids reduced the decline in lung function after exercise that is seen in people whose asthma symptoms are triggered by physical activity (a condition called exercise-induced bronchoconstriction). However, data on the effects of omega-3s on lung function in general and on asthma symptoms were inconclusive.
- Researchers have looked at whether higher intakes of omega-3s or fatty fish by mothers during pregnancy might reduce the risk of asthma in their children. In a 2020 review of 4 studies (1,743 participants), three of which tested omega-3 supplements and one of which tested fatty fish (salmon), no significant reduction in asthma or wheezing was seen in the children.
- Studies have also tested whether giving infants or children omega-3 supplements could reduce their risk of later developing asthma. A 2015 evaluation of five such studies (with a total of 2,415 infants and children), showed no effect on asthma development.
- Side effects from omega-3 supplements are usually mild and may include an unpleasant taste in the mouth, bad breath, digestive symptoms, headache, and smelly sweat. Omega-3s may interact with anticoagulant medicines such as warfarin (Coumadin).
Visit the NCCIH website for more information on omega-3 fatty acids.
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.
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.
- A 2019 review of 14 studies of vitamin D supplementation for asthma (1,421 participants) found evidence that vitamin D may help reduce the risk of asthma exacerbations (asthma attacks), particularly in people with low vitamin D levels. This effect was seen only in adults, but only two studies in children, with a total of 70 participants, looked at effects on asthma exacerbations. Additional evidence on children comes from a study published in 2020. This study, which included 192 children, all of whom had low vitamin D levels, did not find a protective effect of vitamin D supplementation against severe asthma exacerbations.
- 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
Other Complementary Approaches
- 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.
More To Consider
- Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.
For More Information
The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.
Toll-free in the U.S.: 1-888-644-6226
tty (for deaf and hard-of-hearing callers):
Email: email@example.com (link sends email)
Know the Science
NCCIH and the National Institutes of Health (NIH) provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. Know the Science features a variety of materials, including interactive modules, quizzes, and videos, as well as links to informative content from Federal resources designed to help consumers make sense of health information.
A service of the National Library of Medicine, PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed.
National Heart, Lung, and Blood Institute (NHLBI)
The NHLBI Health Information Center provides information to health professionals, patients, and the public about heart, lung, and blood diseases and sleep disorders and accepts orders for publications.
P.O. Box 30105
Bethesda, MD 20824-0105
Toll-free in the U.S.: 1-877-NHLBI4U (1-877-645-2448)
Email: firstname.lastname@example.org (link sends email)
To provide resources that help answer health questions, MedlinePlus (a service of the National Library of Medicine) brings together authoritative information from the National Institutes of Health as well as other Government agencies and health-related organizations.
- Brustad N, Eliasen AU, Stokholm J, et al. High-dose vitamin D supplementation during pregnancy and asthma in offspring at the age of 6 years. JAMA. 2019;321(10):1003-1005.
- Clark CE, Arnold E, Lasserson TJ, et al. Herbal interventions for chronic asthma in adults and children: a systematic review and meta-analysis. Primary Care Respiratory Journal. 2010;19(4):307-314.
- Das RR, Sankar J, Kabra SK. Role of breathing exercises and yoga/pranayama in childhood asthma: a systematic review. Current Pediatric Reviews. 2019;15(3):175-183.
- Forno E, Bacharier LB, Phipatanakul W, et al. Effect of vitamin D3 supplementation on severe asthma exacerbations in children with asthma and low vitamin D levels: the VDKA randomized clinical trial. JAMA. 2020;324(8):752-760.
- Lin J, Zhang Y, He C, et al. Probiotics supplementation in children with asthma: a systematic review and meta-analysis. Journal of Paediatrics and Child Health. 2018;54(9):953-961.
- Litonjua AA, Carey VJ, Laranjo N, et al. Six-year follow-up of a trial of antenatal vitamin D for asthma reduction. New England Journal of Medicine. 2020;382(6):525-533.
- National Heart, Lung, and Blood Institute. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. National Heart, Lung, and Blood Institute website. Accessed at https://www.nhlbi.nih.gov/health-topics/guidelines-for-diagnosis-management-of-asthma on December 12, 2021.
- Santino TA, Chaves GS, Freitas DA, et al. Breathing exercises for adults with asthma. Cochrane Database of Systematic Reviews. 2020;3(3):CD001277. Accessed at cochranelibrary.com on November 12, 2021.
- Shaheen SO, Newson RB, Rayman MP, et al. Randomised, double blind, placebo-controlled trial of selenium supplementation in adult asthma. Thorax. 2007;62(6):483-490.
- U.S. Food and Drug Administration. FDA warns consumers about the potential health risks of over-the-counter asthma products labeled as homeopathic. U.S. Food and Drug Administration website. Accessed at fda.gov/drugs/drug-safety-and-availability/fda-warns-consumers-about-potential-health-risks-over-counter-asthma-products-labeled-homeopathic on January 10, 2022.
- Wang Y-H, Huang S-Y, Kuo H-P, et al. N-3 fatty acid supplementation in asthma management: a systematic review and meta-analysis. Allergy. 2021;76(11):3042-3046.
- Wei X, Jiang P, Liu J, et al. Association between probiotic supplementation and asthma incidence in infants: a meta-analysis of randomized controlled trials. Journal of Asthma. 2020;57(2):167-178.
- Yang Z-Y, Zhong H-B, Mao C, et al. Yoga for asthma. Cochrane Database of Systematic Reviews. 2016;4(4):CD010346. Accessed at cochranelibrary.com on December 23, 2021.
- Yeh GY, Horwitz R. Integrative medicine for respiratory conditions: asthma and chronic obstructive pulmonary disease. Medical Clinics of North America. 2017;101(5):925-941.
- American Academy of Pediatrics Section on Integrative Medicine. Mind-body therapies in children and youth. Pediatrics. 2016;138(3):e20161896.
- Bafeta A, Koh M, Riveros C, et al. Harms reporting in randomized controlled trials of interventions aimed at modifying microbiota: a systematic review. Annals of Internal Medicine. 2018;169(4):240-247.
- Butel M-J. Probiotics, gut microbiota and health. Medecine et Maladies Infectieuses. 2014;44(1):1-8.
- Chan MWC, Wu XY, Wu JCY, et al. Safety of acupuncture: overview of systematic reviews. Scientific Reports. 2017;7(1):3369.
- Chawes BL, Bønnelykke K, Stokholm J, et al. Effect of vitamin D3 supplementation during pregnancy on risk of persistent wheeze in the offspring: a randomized clinical trial. JAMA. 2016;315(4):353-361.
- Cho SH, Jo A, Casale T, et al. Soy isoflavones reduce asthma exacerbation in asthmatic patients with high PAI-1-producing genotypes. Journal of Allergy and Clinical Immunology. 2019;144(1):109-117.e4.
- Clyne A, Yang AWH, Li M, et al. Traditional medicines for asthma in children and adults: a systematic review of placebo-controlled studies. International Journal of Clinical Practice. 2019 Oct 14;e13433.
- Cohen PA. Probiotic safety—no guarantees. JAMA Internal Medicine. 2018;178(12):1577-1578.
- Côté P, Hartvigsen J, Axén I, et al. The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature. Chiropractic & Manual Therapies. 2021;29(1):8.
- Cramer H, Krucoff C, Dobos G. Adverse events associated with yoga: a systematic review of published case reports and case series. PloS One. 2013;8(10):e75515.
- Cramer H, Ostermann T, Dobos G. Injuries and other adverse events associated with yoga practice: a systematic review of epidemiological studies. Journal of Science and Medicine in Sport. 2018;21(2):147-154.
- Cramer H, Ward L, Saper R, et al. The safety of yoga: a systematic review and meta-analysis of randomized controlled trials. American Journal of Epidemiology. 2015;182(4):281-293.
- Creswell JD. Mindfulness interventions. Annual Review of Psychology. 2017;68:491-516.
- Didari T, Solki S, Mozaffari S, et al. A systematic review of the safety of probiotics. Expert Opinion on Drug Safety. 2014;13(2):227-239.
- Farias M, Maraldi E, Wallenkampf KC, et al. Adverse events in meditation practices and meditation-based therapies: a systematic review. Acta Psychiatrica Scandinavica. 2020;142(5):374-393.
- Feary J, Britton J. Dietary supplements and asthma: another one bites the dust. Thorax. 2007;62(6):466-468.
- Fijan S. Microorganisms with claimed probiotic properties: an overview of recent literature. International Journal of Environmental Research and Public Health. 2014;11(5):4745-4767.
- Jiang C, Jiang L, Qin Q. Conventional treatments plus acupuncture for asthma in adults and adolescent: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine. 2019;2019:9580670.
- Lack S, Brown R, Kinser PA. An integrative review of yoga and mindfulness-based approaches for children and adolescents with asthma. Journal of Pediatric Nursing. 2020;52:76-81.
- Lee SH, Chang GT, Zhang X, et al. Acupoint herbal patching for asthma: a systematic review and meta-analysis of randomized controlled trials. Medicine. 2016;95(2):e2439.
- Lethaby A, Marjoribanks J, Kronenberg F, et al. Phytoestrogens for menopausal vasomotor symptoms. Cochrane Database of Systematic Reviews. 2013;(12):CD001395. Accessed at cochranelibrary.com on January 10, 2022.
- Lipton L. Using yoga to treat disease: an evidence-based review. JAAPA. 2008;21(2):34-36, 38, 41.
- Litonjua AA, Carey VJ, Laranjo N, et al. Effect of prenatal supplementation with vitamin D on asthma or recurrent wheezing in offspring by age 3 years: the VDAART randomized clinical trial. JAMA. 2016;315(4):362-370.
- Litonjua AA, Weiss ST. Is vitamin D deficiency to blame for the asthma epidemic? Journal of Allergy and Clinical Immunology. 2007;120(5):1031-1035.
- Milan SJ, Hart A, Wilkinson M. Vitamin C for asthma and exercise-induced bronchoconstriction. Cochrane Database of Systematic Reviews. 2013;(10):CD010391.
- National Center for Health Statistics. Asthma. Accessed at cdc.gov/nchs/fastats/asthma.htm on December 13, 2021.
- National Heart, Lung and Blood Institute. Asthma. Accessed at nhlbi.nih.gov/health-topics/asthma on December 9, 2021.
- Office of Dietary Supplements. Omega-3 Fatty Acids. Fact Sheet for Consumers. Office of Dietary Supplements website. Accessed at ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer on December 16, 2021.
- Office of Dietary Supplements. Selenium: Fact Sheet for Consumers. Office of Dietary Supplements website. Accessed at on December 20, 2021.
- Office of Dietary Supplements. Vitamin C: Fact Sheet for Consumers. Office of Dietary Supplements website. Accessed at on December 20, 2021.
- Office of Dietary Supplements. Vitamin D: Fact Sheet for Consumers. Office of Dietary Supplements website. Accessed at on December 20, 2021.
- Park J-E, Lee S-S, Lee M-S, et al. Adverse events of moxibustion: a systematic review. Complementary Therapies in Medicine. 2010;18(5):215-223.
- Paudyal P, Jones C, Grindey C, et al. Meditation for asthma: systematic review and meta-analysis. Journal of Asthma. 2018;55(7):771-778.
- Smith LJ, Kalhan R, Wise RA, et al. Effect of a soy isoflavone supplement on lung function and clinical outcomes in patients with poorly controlled asthma: a randomized clinical trial. JAMA. 2015;313(20):2033-2043.
- Stoodley I, Williams L, Thompson C, et al. Evidence for lifestyle interventions in asthma. Breathe. 2019;15(2):e50-e61.
- Swain TA, McGwin G. Yoga-related injuries in the United States from 2001 to 2014. Orthopaedic Journal of Sports Medicine. 2016;4(11):2325967116671703.
- Swait G, Finch R. What are the risks of manual treatment of the spine? A scoping review for clinicians. Chiropractic & Manual Therapies. 2017;25:37.
- Van Dam NT, van Vugt MK, Vago DR, et al. Mind the hype: a critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspectives on Psychological Science. 2018;13(1):36-61.
- Venter C, Agostoni C, Arshad SH, et al. Dietary factors during pregnancy and atopic outcomes in childhood: a systematic review from the European Academy of Allergy and Clinical Immunology. Pediatric Allergy and Immunology. 2020;31(8):889-912.
- von Mutius E, Martinez FD. Inconclusive results of randomized trials of prenatal vitamin D for asthma prevention in offspring. JAMA. 2016;315(4):347-348.
- Wang M, Liu M, Wang C, et al. Association between vitamin D status and asthma control: a meta-analysis of randomized trials. Respiratory Medicine. 2019;150:85-94.
- Xiong J, Liu Z, Chen R, et al. Effectiveness and safety of heat-sensitive moxibustion on bronchial asthma: a meta-analysis of randomized control trials. Journal of Traditional Chinese Medicine. 2014;34(4):392-400.
- Xu S, Wang L, Cooper E, et al. Adverse events of acupuncture: a systematic review of case reports. Evidence-Based Complementary and Alternative Medicine: eCAM. 2013;2013:581203.
- Zhou F, Liang N, Maier M, et al. Sanfu acupoint herbal patching for stable asthma: a systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Medicine. 2017;30:40-53.
NCCIH thanks D. Craig Hopp, Ph.D., Hye-Sook Kim, Ph.D., and David Shurtleff, Ph.D., NCCIH, for their review of the 2022 update of this publication.
This publication is not copyrighted and is in the public domain. Duplication is encouraged.
NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.