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Asthma and Complementary Health Approaches: What You Need To Know

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What’s the Bottom Line?

If you have asthma, follow your health care provider’s recommendations on how to manage your condition. For your safety:

  • Do not substitute other approaches for treatments recommended or prescribed by your health care provider.
  • Consult your health care provider about adding any complementary health products or practices to your asthma management program. If you take medicine for asthma, talk with your provider before starting to take a dietary supplement. Some dietary supplements and medicines can interact in harmful ways.

What do we know about the usefulness of complementary approaches for asthma?

  • Evidence does not support using complementary health approaches instead of proven medical management for asthma.
  • When used in addition to proven medical management, complementary health approaches that help people with asthma manage stress, anxiety, or depression might help them feel better and improve their asthma control.

What do we know about the safety of complementary approaches for asthma?

  • Most psychological and physical complementary health approaches rarely have serious side effects if performed correctly.
  • Many nutritional approaches, such as dietary supplements, are generally considered safe; however, some dietary supplements may cause side effects or interact in undesirable ways with medicines. People with asthma should discuss the use of dietary supplements with their health care providers.
  • The U.S. Food and Drug Administration (FDA) has warned that over-the-counter homeopathic asthma products have not been evaluated by the FDA for safety or effectiveness.

About Asthma

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.

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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 supplementsmeditationspinal 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., yogatai 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.

Breathing Techniques

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.

Meditation

  • 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.

Spinal Manipulation

  • 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.

Yoga

  • 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.

Nutritional Approaches

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.

Probiotics

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.

Selenium

  • 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. 

Soy Isoflavones

  • 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.

Vitamin C

  • 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.

Vitamin D

  • 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

Homeopathy

  • 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

NCCIH Clearinghouse

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):

1-866-464-3615

Website: https://nccih.nih.gov/

Email: info@nccih.nih.gov (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.

Explaining How Research Works (NIH)

Know the Science: 9 Questions To Help You Make Sense of Health Research

Understanding Clinical Studies (NIH)

PubMed®

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.

Website: https://pubmed.ncbi.nlm.nih.gov/

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)

Website: https://www.nhlbi.nih.gov/

Email: nhlbiinfo@nhlbi.nih.gov (link sends email)

MedlinePlus

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.

Information on asthma

Website: https://www.medlineplus.gov/

Key References

Other References


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Acknowledgments

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.

Last Updated: March 2022