Occupational Asthma

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Selenium Supplement [1, 26, 27, 28, 29, 30, 31, 32, 33, 34]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. IMPORTANT: Selenium is toxic in high doses. Massive overdoses can cause kidney failure, breathing difficulty and death. Selenium should only be taken at healthy levels which the body is able to tolerate.

Recommendation: no recommendation (Available evidene does not support claims that selenium helps to prevent or treat asthma)

Grade of Evidence: very low quality of evidence

Pine Bark Extract [1, 23, 24, 25]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: weakly in favor  (Early studies indicate potential for Pine bark extract in the treatment of asthma, but more clinical studies need to be done)

Grade of Evidence: low quality of evidence

Oleander Leaf (Nerium Oleander) [1, 19, 20, 21, 22]:

WARNING: This plant is toxic! Not to be ingested. Causes nausea, appetite loss, vomiting, drowsiness, bloody diarrhoea, seizures, irregular heartbeat, heart failure, respiratory depression and death. The plant and any of its extracts should be strictly avoided, especially by children and pregnant women.

Recommendation: Strongly against (There is insufficient evidence to prove the effectiveness of Oleander in Asthma. Please note, this plant and its extracts are poisonous, even when ingested in dry form. Many people have died of heart or respiratory failure after eating parts of the plant or its extracts.)

Grade of Evidence: low quality of evidence

Mugwort (Artemisa Vulgaris) [1, 16, 17, 18]:

Please note, this management does NOT treat the condition itself. It has been proposed only as a weak supportive symptomatic support, and even then, has been discounted due life-threatening side effects

Recommendation: No recommendation (There is insufficient evidence to support claims that mugwart helps to treat symptoms of asthma. More research is needed.)

Grade of Evidence: very low quality of evidence

Kava (Piper Methysticum) [1, 12, 13, 14, 15]:

WARNING: In rare cases, kava may lead to liver failure and other life threatening problems. The FDA warns that those who have had liver problems, or are on medicacations which may affect the liver, patients should check with their doctors before taking Kava. Other side effects include headache, upset stomach, drowsiness, weight loss, bloody urine, and muscle weakness.

Recommendation: weakly in favor (There is insufficient evidence to support claims that Kava helps to treat symptoms of asthma. More research is needed)

Grade of Evidence: low quality of evidence

Gotu Kola (Centella Asiatica, Hydrocotyle Asiatica)[1, 6, 7, 8, 9, 10, 11]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to support claims that Gotu Kola helps in the treatment of asthma in any way. More research is needed.)

Grade of Evidence: low quality of evidence

Evening Primrose Oil  [1, 3, 4, 5]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation  (There is insufficient evidence to support claims that Primrose Oil helps to treat asthma any way.)

Grade of Evidence: very low quality of evidence

Cats Claw (Uncaria Tomentosa) [1, 2]:

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: no recomendation (insufficient evidence to support claims that Cats Claw can help to treat occupational asthma)

Grade of Evidence: very low quality of evidence

Astragalus (Astragalus Membranaceus):

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to support claims that Astragalus helps to treat asthma)

Grade of Evidence: very low quality of evidence

Neural Therapy:

Please note, this management does NOT treat the condition itself. It is proposed only as supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (Available evidence does not support claims that Moxibustion may help to treat asthma)

Grade of Evidence: very low quality of evidence

Moxibustion:

Recommendation: no recommendation (Available evidence does not support claims that Moxibustion may help to treat asthma)

Grade of Evidence: very low quality of evidence

* www.gradeworkinggroup.org

 the case.

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. http://www.nutrasanus.com/cats-claw.html

3. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/evening-primrose

4. http://nccam.nih.gov/health/eveningprimrose/

5. http://news.bbc.co.uk/2/hi/health/4395826.stm

6. Winston, D., Maimes, S., Adaptogens: Herbs For Strength, Stamina, and Stress Relief, 2007, pp. 226-7

7. "A Double-Blind, Placebo-Controlled Study on the Effects of Gotu Kola (Centella asiatica) on Acoustic Startle Response in Healthy Subjects". Journal of Clinical Psychopharmacology. 20(6):680-684, December 2000. Bradwejn, Jacques MD, FRCPC *; Zhou, Yueping MD, PhD ++; Koszycki, Diana PhD *; Shlik, Jakov MD, PhD

8.  B. M. Hausen (1993) "Centella asiatica (Indian pennywort), an effective therapeutic but a weak sensitizer." Contact Dermatitis 29 (4), 175–179 doi:10.1111/j.1600-0536.1993.tb03532.x

9. Cataldo, A., Gasbarro, V., et al., "Effectiveness of the Combination of Alpha Tocopherol, Rutin, Melilotus, and Centella asiatica in The Treatment of Patients With Chronic Venous Insufficiency", Minerva Cardioangiology, 2001, Apr; 49(2):159-63

10. http://en.wikipedia.org/wiki/Gotu_kola#Medicinal_effects

11. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/gotu-kola

12. http://www.publish.csiro.au/?act=view_file&file_id=SP05005.pdf

13. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/kava

14. http://www.kavazen.com/pages/library.htm#KavaZen and Kava Safety

15. http://nccam.nih.gov/health/kava/index.htm

16. Anliker MD, Borelli S, Wüthrich B. Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome. Contact Dermatitis. 2002;46:72-74.

17. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/mugwort

18. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. Philadelphia, PA: Lippincott Williams & Wilkins; 2004.

19. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/oleander-leaf

20. http://www.nerium.com/index-2.html

21. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/WarningLettersandNoticeofViolationLetterstoPharmaceuticalCompanies/UCM165406.pdf

22. http://www.inchem.org/documents/pims/plant/pim366.htm

23. http://www.clinicaltrials.gov/ct/show/NCT00214032

24. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/pine-bark-extract

25. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-pycnogenol.html

26. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/selenium?sitearea=ETO

27. http://www.cancer.gov/Templates/doc.aspx?viewid=ED8AD8E8-6AE5-458D-8091-393F4CB73F0D

28. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-selenium.html

29. http://www.ncbi.nlm.nih.gov/pubmed/9290116

30. http://www.ncbi.nlm.nih.gov/pubmed/9829869

31. http://www.ncbi.nlm.nih.gov/pubmed/10335455

32. http://www.ncbi.nlm.nih.gov/pubmed/2136228

33. http://www.springerlink.com/content/v0r644v4ju5153k2/

34. http://jnci.oxfordjournals.org/cgi/content/full/101/5/283

Public Discussion