Wheeze No More

Why I no longer worry about Asthma

I am currently 24 years old, but ever since I was 2 I have had asthma. For me, this meant daily wheezing and shortness of breath and I often needed to take medication daily just so I could breathe. I especially needed it at night, as asthma is often worse at night (for various reasons) and it is very difficult to sleep when you can’t breathe or are wheezing heavily. Ever since I started to implement my proposed plan, which I will explain in this article, I have not needed an inhaler at all. I no longer take inhaled corticosteroids (Advair) or beta-adrenergic agonists (Ventolin). I will explain what I do now, and why it works. But in summary, the strongest most effective thing I do for my asthma and breathing now is supplemental Phosphatidylcholine (which I will also refer to in this article as PC), but there is more to the story than just the supplement.

*Edit: I recently had an extreme allergic reaction to something I ate and went into anaphylactic shock. In the past, this typically resulted in me not being able to breathe with extreme wheezing that even asthma inhalers couldn’t prevent. However, in this recent episode of anaphylaxis, I did not have any breathing issues whatsoever. I am very happy with this result as it shows me that when my breathing was put to the ultimate test (extreme allergic reaction) I am still free of breathing issues*

Part 1: A Proposed Novel Approach for Asthma:

            Asthmatics can have impaired or dysfunctional surfactant activity. To put this simply, the surfactant is needed to keep airways open. Think of surfactant as a substance in the airways that helps prevent the airways from “sticking together” and keeps the airways from being too dry. Impaired surfactant activity can lead to airway closures in asthmatics and COPD sufferers.

            Surfactant in the airways is composed of phospholipids. The primary phospholipid that makes up the surfactant is phosphatidylcholine (PC). If there is not enough phosphatidylcholine in the airways there will be dysfunctional surfactant activity and airways can be closed because of this, clearly leading to impaired ability to breathe. This can cause wheezing and trouble breathing in of itself, or it can exacerbate the asthmatic response to airway inflammation brought on by an allergen or the cold.

            It’s logical to suspect that if an asthmatic has poor surfactant activity by not having enough phosphatidylcholine in the airways then this must be a result of either an impaired production of the phospholipids or an increased (inappropriate) destruction of the phospholipid containing surfactant. I would argue that the likely cause of surfactant dysregulation is at least in part explainable by the overactivity of the enzyme that breakdown phosphatidylcholine. The main enzyme responsible for this is Phospholipase A2 (PLA2).

            It seems that regardless of the reason why there is insufficient surfactant activity the immediate solution will be the same. Replenish the phospholipid levels to restore adequate surfactant activity, by supplementing or consuming more phospholipids. Given the main phospholipid that makes up the airway surfactant is PC, it makes sense to take PC orally. It is conceivable that one would be able to replenish their PC stores by eating many egg yolks daily as they contain a good amount of PC (along with other foods like legumes that contain lecithin). But personally, this never made a difference to my asthma. When I took PC as a supplement, that very day I no longer had asthma symptoms. I believe that my particular case of asthma was exacerbated by an extreme lack of adequate surfactant, meaning my airways would often close for no particular reason. The supplemental PC worked wonders for me, and it will likely have a beneficial effect on others with asthma or other breathing issues such as COPD.

            The issue is, most PC supplements available contain unsaturated phospholipids. This is an issue because the eicosanoids, prostaglandins, leukotrienes and thromboxanes are all created from arachidonic acid, which is an unsaturated fatty acid. As we age, our phospholipids (such as cardiolipin) slowly become more and more unsaturated. The solution here would be to try and take a saturated version of PC. These are much harder to find and are likely more expensive than the normal PC that is derived from soy or sunflower lecithin. Having said all this, the saturation of the PC is more of a long-term issue. Unsaturated or saturated, a PC supplement is likely to improve the surfactant properties in the airways leading to asthma relief.

A source of saturated phosphatidylcholine is the product “MitoLipin” from https://idealabs.ecwid.com/Cosmetic-Ingredients-c20672605 but sometimes the dose in this product is not high enough, and I will also use other sources of PC, I’ve tried different products and they all work well.

            You may be wondering what one can do to stop the inappropriate and excessive breakdown of the phospholipids such as PC. I propose that this is caused by upregulated phospholipase A2 (PLA2) which breaks down the PC. There seem to be many reasons for why PLA2 can be upregulated. Estrogen seems to increase PLA2, and this is relevant as women do tend to have asthma more than men. Adrenaline and the other catecholamines also seem to increase the activity of PLA2, along with having a colder body. This suggested that hypothyroid, or at the very least people that do not have an optimal metabolic rate, will have higher levels of PLA2. When thyroid function is suboptimal, the adrenals ramp up the production of hormones like adrenaline which break down phospholipids (and thus the surfactant).

            Whatever the reason PLA2 is upregulated, it would be useful to try and slow it down a bit, by attempting to inhabit it via various approaches. There are drugs that inhibit PLA2 but it’s not likely that they will be available to the vast majority of asthmatics, they are certainly not the first line of defence against asthma. There are many natural supplements that seem to inhibit PLA2 to some degree. Gingko Biloba, Pine Bark extract (Pycnogenol), Gotu Kola and Mimosa Pudica seem to all have some PLA2 inhibition qualities. Interestingly enough, all of these are said to be useful in asthma. I wonder why!

Also, given estrogen can increase PLA2 and progesterone can inhibit it (along with vitamin E), it may make sense for an asthmatic woman to supplement some progesterone dissolved in vitamin E, or at the very least try and increase her production of progesterone by increasing thyroid function. The active thyroid hormone (T3) is needed to convert cholesterol into the steroids, such as progesterone. Men and women with asthma should each try and keep estrogen down. Men should want to increase their androgens (male hormones) which can be protective against asthma. Some people may want to supplement pregnenolone which is the first hormone that comes after cholesterol. Pregnenolone can turn into other beneficial hormones (progesterone or androgens for example). I list some sources at the very end of this article.

            PLA2 is not just harmful because it decreases the surfactant in the airways. PLA2, by breaking open the phospholipids, releases arachidonic acid and this results in an increased production of the eicosanoids via there various enzymes that create them. Eicosanoids are highly inflammatory. One of note is the enzyme lipoxygenase, or LOX, which creates leukotrienes. Leukotrienes are well known to be causative in asthmatics. In fact, one of the main asthma medications is Montelukast (brand name Singular) and this medication is a leukotriene modifier or antagonist. It works by blocking the activity of leukotrienes.

Therefore, PLA2 increases asthma in two ways.

1. By interfering with the airway surfactant

2. By indirectly increasing the production of leukotrienes.

            Other than taking a phospholipid (to restore the surfactant capability in the airways) and inhibiting PLA2 (to protect the existing phospholipids that act as surfactants, and to lower leukotrienes) the third step available to asthmatics is to try and inhibit the very enzyme that creates leukotrienes in the first place, LOX. There are many things that can inhibit (to some degree) the LOX enzyme. Some of the most potent are, Boswellia Serrata (Boswelic Acid), Black Seed (Nigella Sativa), Cloves (Eugenol), vitamin E (Mixed Tocopherols) and there are many other herbs/root extracts that can help inhibit LOX such as ginger.

            Therefore, the general proposed protocol for someone with asthma could take would be:

1. Take a form of PC (and try to increase your consumption of phospholipids by consuming egg yolks and liver)

2. Inhibit PLA2 with something like Gingko Biloba or Pycnogenol

3. Inhibit the LOX enzyme with something like Boswellia Serrata or Clove.

(A fourth step could be to block the effects of leukotrienes directly with a drug like Montelukast, but this would require a prescription and it does come with a black box warning.)

It is also relevant to note that there may very well be issues with the production of phosphatidylcholine, and this may possibly be related to someone’s genes. A large proportion of one’s methylation process goes towards the production of PC. In order to make PC from other phospholipids it must be methylated. This requires the addition of a methyl group. People then that have methylation issues could possibly be undermethylated in this certain pathway that leads to PC. I am not exactly sure what to do here, or even if “supporting methylation” in general would help. What I do know, is that by taking PC you take some of the “stress” off the methylation system by giving it what it is trying to make. So taking PC helps people struggling to methylate. In general, things that are recommended to people that have issues methylating are vitamins B6 and B2, TMG (trimethylglycine), creatine and certain forms of folate (vitamin B9) and vitamin B12. Methylation support may help with asthma because of its role in the production of PC, and it also may be relevant in more indirect ways, as methylation is important for histamine levels as well, which can be involved in asthma.

“Decreased methyl group will decrease the synthesis of phosphatidylcholine, a major phospholipid required for very low-density lipoprotein (VLDL) assembly and homeostasis.”

From the paper “Homocysteine and lipids: S-adenosyl methionine as a key intermediate”

“Genetic impairments in folate enzymes increase dependence on dietary choline for phosphatidylcholine production at the expense of betaine synthesis.”

From the paper “Genetic impairments in folate enzymes increase dependence on dietary choline for phosphatidylcholine production at the expense of betaine synthesis”

            In theory, this approach should help anyone that experiences trouble breathing, such as wheezing and laboured breaths. All three areas may need to be addressed. For example, Montelukast did not have much of a positive effect on me, not until I started taking PC. I believe I was clearly a case of someone that was affected by a lack of adequate surfactant activity. While things like black seed oil, Boswellia serrata, and Ginkgo Biloba can all be helpful for asthma, the strongest effect I experienced was definitely the PC. I currently employ all three steps personally as this seems the best way to make sure I don’t experience any asthma issues. If I am covering all these bases I do not require any medication for asthma.

Part 2: Other Relevant Asthma Considerations

A very old asthma treatment was the use of the anticholinergic herb known as jimsonweed or thornapple. In fact, in the old days, people could buy what were called “asthma cigarettes” which contained thornapple/jimsonweed. These work by acting as antagonists to acetylcholine, which is known to be a bronchoconstrictor. In fact, in an episode of the popular show “Outlander,” the main character Clair (a healer) helps a man (Ned Gowan) suffering from allergy-induced asthma by having him smoke some thornapple.

From jimsonweed, they created anticholinergic drugs. The drug atropine was an anticholinergic drug that was sometimes used for asthma, and more recently they have made Atrovent and Spiriva. Atrovent and Spiriva are both anticholinergic inhalers that can be used to help with trouble breathing, such as the prevention of wheezing by opening up the airways. These drugs can and are used for asthma, but technically they are used for COPD. The very fact that acetylcholine can restrict airways and that anticholinergics have been used for many years as asthma/COPD treatment should show you that one area of interest in the asthmatic is figuring out what is happening with the cholinergic system.

This is interesting especially because I propose that taking phosphatidylcholine is useful for asthma. It is of course possible that PC would increase acetylcholine, but clearly, the surfactant-improving effect of PC outweighs the risk of the increase in acetylcholine. Other anticholinergics have been known to be useful in breathing issues, such as Benadryl. The drug ketotifen has been shown to be useful against asthma, this drug is an antihistamine, anticholinergic and serotonin antagonist. All three of these can be involved in its ability to improve breathing.

A major cause of increased acetylcholine is organophosphate pesticides. So, if you have asthma make sure to be careful of being in places where they spray these pesticides and be careful eating foods that may have this pesticide residue on them.

Histamine and other things released from mast cells are likely very involved with asthma, especially since many allergies can invoke an asthmatic episode in people. Unfortunately, antihistamines are usually not, by themselves, enough to prevent or treat an asthmatic episode. They can likely be helpful, like Benadryl, but are not enough on their own. Many people report improved asthma symptoms, or a complete reversal of asthma, by employing many antihistamine approaches. Natural antihistamine approaches usually include stinging nettle leaf tea, quercetin, the amino acid theanine and even kidney extract/desiccated kidney. Other nutrients that can be useful against excessive histamine are vitamin C, vitamin B6, vitamin A and vitamin E. All of these have shown some use in asthma prevention. As mentioned before, methylation is also relevant for histamine, but I need to investigate this relationship more.

Eosinophils are thought to be causative for asthmatic episodes in most people. Interestingly enough, vermifuges used to be used (successfully) for asthma in the past (Ray Peat Ph.D even mentioned this once in a newsletter on asthma). It just so happens that one major reason why someone would have elevated eosinophils would be if they had a parasitic infection. Other infections can also lead to increased production of eosinophils. If an asthmatic has high levels of eosinophils, they should try to find out why this is the case. I have heard multiple reports of people being “cured” of their asthma after going on antibiotics for a number of months to treat other conditions, such as Lyme disease. They tended to use the tetracycline class of antibiotics such as minocycline and doxycycline. If the eosinophils are elevated because of an infection that should be dealt with, or else asthma may persist as an issue. My good friend Andra Sitoianu ND also talks about how iron overload and iron in the lungs can be involved in asthma, I definitely agree as parasites thrive on iron. If you have a parasitic infection in the lung (or elsewhere) causing an increase in eosinophils, this should be addressed. Some natural anti-parasitic interventions can be clove, black walnut hull and wormwood, and decreasing potential iron overload. Vitamin D and vitamin C seem to be able to lower excess eosinophils.

            Things that interact with TLR4 (toll-like receptor 4) such as endotoxin (lipopolysaccharide) can also cause an increase in asthma. Endotoxin is the outer shell of gram-negative bacteria. If someone has bacterial overgrowth, such as in the small intestine, then this can cause overactivation of TLR4 which can lead to an increase in breathing issues. This may be part of the reason why antibiotics seem to sometimes help people with asthma, lowering the bacterial load (where they may have been an overgrowth).  There are things that can “block” TLR4 such as naltrexone, Benadryl, vitamin D, vitamin B2 (riboflavin), pregnenolone and progesterone. There is even some evidence that PC (phosphatidylcholine) is a potent TLR4 antagonist, even more reason for why it is so therapeutic in asthma.

            When someone is hypoglycemic or has low blood sugar/glucose, any stress or allergen can produce a more amplified response. The body needs adequate levels of glucose in the blood at all times, so if something causes the blood sugar to drop too low for too long then even minor things can cause wheezing or a full-blown asthma attack. Darkness, such as at night, can lead to lower blood sugar. This may partly explain why asthma is typically worse, or more likely to occur, at night.

Hypothyroid people and people with impaired liver function often have a hard time keeping their blood sugar within a good range. For example, a healthy liver can store a large amount of glucose in the form of stored glycogen. When the body is running low on blood glucose the liver can release some of the stored glycogen into the bloodstream which will increase the blood glucose back to normal levels. In a liver that has trouble storing enough glycogen, or if it has trouble releasing it then the blood sugar can stay too low for too long leaving the asthmatic vulnerable.

Adequate thyroid function also helps to keep the blood sugar within a good range, not too high and not too low. A supplement that supposedly helps the liver to store more glycogen is the amino acid taurine, and possibly glycine as well. Coffee is known to be helpful for asthmatics, perhaps part of the reason coffee is helpful is that it is shown to be beneficial for the liver in different ways. Lastly, oxaloacetate is supposedly good for normalizing blood glucose, and this is part of the reason it can help with PMS. You can supplement oxaloacetate “benaGene” is the product, or you can increase your production of oxaloacetate by consuming more biotin and manganese.

Glutamate can also restrict airways. Vitamin B6 helps us to convert glutamate into GABA, so it should be helpful here. Magnesium, molybdenum and manganese also help with glutamate issues, so eating foods high in those minerals (mussels, gluten-free oats, maple syrup, pineapple, split peas) is a good idea. Theanine also seems to be able to block glutamate.

It is also important to note that a good diet is important for asthma prevention. Certain nutrients are very important for lung health, two notable ones are Vitamin A (Retinol) and Vitamin D. To obtain good levels of vitamin A please try consuming organ meats such as liver, egg yolks and fatty dairy products such as butter or ghee. Check your vitamin D levels on a blood test, if they are low on the scale then you should potentially supplement to increase the levels. For vitamin D you want 50 ng/ml (American value) or 125 nmol/L (Canadian value). Selenium is also another important nutrient when it comes to asthma.

Also, there are other herbs that are supposed to be good for asthma, one such herb is mullein leaf.

Part 3: Further Applications of the Novel Approach

            Asthma is not the only condition that includes an increase in eicosanoids. Many diseases and disorders seem like they can be improved when there is less production of prostaglandins, leukotrienes and thromboxanes. For example, Multiple Sclerosis (MS) seems to be helped by blocking the effects of leukotrienes, and better yet by inhibiting the LOX enzyme. Boswellic acid (from Boswellia Serrata) was even used once in a study to see if LOX inhibition can help with MS. LOX and COX (cyclooxygenase, the enzyme that produces prostaglandins) inhibitors seem to be useful for many other diseases such as the dementias, like Alzheimer’s Disease. In fact, it is thought that Stephen Hawking was able to live so long with ALS in part because of his regular aspirin use, a COX inhibitor (among other things).

            PLA2 inhibitors are being studied for their possible role in helping prevent and reverse many health issues, especially neurological disorders. Interestingly enough, Gingko Biloba (a PLA2 inhibitor) is not only known to be useful in asthma, but also in preventing cognitive decline. So, in addition to keeping LOX and COX down (and thus keeping leukotrienes and prostaglandins down), it seems that keeping PLA2 down would also be very useful. This should indirectly help lower the eicosanoids even further. Any disorder or disease that is made worse by inflammation should benefit from trying to lower excessive PLA2, LOX and COX. This can include arthritis, PMS, migraine and many more.

Summary:

There are many things that can increase or exacerbate asthma symptoms (histamine, eosinophils, serotonin, acetylcholine, leukotrienes, impaired surfactant and so on). However, if you:

1. Replenish Surfactant (take Phosphatidylcholine and possibly support methylation)

2. Inhbit PLA2 (Lower adrenaline and estrogen - experiment with Pycnogenol or Gingko Biloba)

3. Inhbit LOX and Leukotrienes (Vitamin E, Clove, Boswellia Serrata)

4. Keep Histamine, Acetylcholine and Serotonin down (can possibly use Benadryl in severe cases - it opposed all 3)

5. Check for high eosinophils, if high do something about it. Could be parasitic or iron related.

6. Keep TLR4 from being activated. Keep the gut clean, and prevent SIBO and bacterial overgrowth in general. Take things that can block TLR4 - PC, vitamin D, Vitamin B2 etc.

Then you should be on your way to being asthma free.

A special thank you to all the people that have helped me learn about asthma and how to overcome it: Ray Peat, Georgi Dinkov, Danny Roddy, Jay Feldman, Kyle Mamounis, Pedro Do Amaral, Kitty Martone, Chris Masterjohn, Keith Littlewood and Andra Sitoianu, and many others!

I thank God that I have been so blessed to have been helped by so many people.

*None of this is medical advice. I am not a medical professional, always talk to your doctor*

If you enjoyed this article, please consider checking out the other articles I’ve written. Also, please feel free to subscribe (it is free to do so) and share the articles with others. Thank you!

BTW: I am a frequent guest on the podcast “Stuff Your Doctor Should Know”.

Discount code DEAN works at:

1. Ona’s Naturals (progesterone oil, topical progesterone and pregnenolone creams)

2. LifeBlud (Magnesium products, Taurine, Theanine, B vitamins, Methylene Blue)

3. Health Natura (oral pregnenolone, Methylene Blue)

4. Saturee (skin care products, desiccated liver, aged Cascara Sagrada)