How to support respiratory health naturally

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By Carolina Brooks, BA, IFMCP

Nasal and pharyngeal mucosal immune health and structural integrity play a significant role in respiratory health. Our nasal airway affects defense and immune function, respiration, olfactory perception, temperature, and humidity regulation. Sudden temperature changes and barometric pressure can cause nasal membranes to swell and increase congestion. Increased congestion allows for a greater concentration of nutrients to facilitate repair of damaged tissue, but can also lead to increased risk of infection.

A 2018 paper in Allergy & Rhinology discussed autonomic nervous system (ANS) dysfunction in the pathogenesis of both cardiovascular and lower airway pathologies such as asthma, yet there has not been much focus on the role of ANS dysfunction in nose and sinus symptoms and how that impacts congestion. A 1995 review in Biological Signals discusses sympathetic nerve stimulation causing constriction via the alpha-adrenergic mechanism, and considers congestion as a withdrawal of sympathetic activity rather than an overexpressive parasympathetic response, which supports my approach of addressing and modulating the buffering capacity of the patient to ensure their adaptive response is appropriate, as well as improving the terrain to make pathogenic organisms less likely to adhere and colonize.

Inflammatory factors play a role, so practitioners should focus on supporting the patient’s immune response with a baseline antiinflammatory diet rich in phytonutrients, reducing histamine-aggravating foods where possible. A 2010 paper in International Journal of General Medicine discussed the contribution of biologically active agents and cell types, which contribute to nasal congestion symptoms such as venous engorgement, increased nasal secretion, tissue swelling, impaired sensory perception, and impaired air flow, such as mast cell activation and histamine release. These agents also influence production and release of proinflammatory molecules such as leukotrienes, prostaglandins, tumor necrosis factor alpha (TNFα), and interleukin-4 (IL-4), which can support nasopharyngeal health and lower bronchial health.

Easily available herbs that are helpful to take as tincture or as teas to reduce histamine formation and modulate inflammatory response include liquorice (Glycyrrhiza glabra), ginger (Zingiber officinalis), turmeric (Curcuma longa),onion (Allium cepa), and black cumin (Nigella sativa). Antimicrobial herbs include thyme (Thymus officinalis), oregano (Origanum vulgare), cinnamon (Cinnammonum zeylanicum), as well as lavender (Lavandula officinalis), cypress (Cypressus Sempervirens) and eucalyptus oils (eucalyptus globulus), which can be used topically in a carrier oil for inhalations or chest rubs. Alongside saline rinses and nebulization of liposomal glutathione or essential oils to reduce congestion and inflammation.

A 2011 review on herbal antiasthmatics in Oriental Pharmacy and Experimental Medicine  discussed useful bronchodilator, anti-spasmodic, anti-allergic, and mast cell stabilizing herbs, which I would recommend be included in an herbal protocol include gingko (Ginkgo biloba), Coleus (Coleus forskohlii), Tulsi (Ocimum sanctum), plantain (Plantago major), rosemary (Rosmarinus officinalis), bacopa (Bacopa monnieri), bidens (Bidens parviflora), siris (Albizzia lebek), frankincense (Boswellia serrata), and magnolia (Magnolia officinalis).

In endobiogenic medicine the exocrine pancreas is implicated in mucus production, and impaired  detoxification and drainage must be considered, so as well as supporting the respiratory system, I would focus on reducing sugar in the diet and supporting digestion and pancreatic function with bitter herbs such as artichoke (Cynara scolymus), gentian (Gentiana lutea), and agrimony (Agrimonia eupatoria).

Case Study

A 21-year-old female patient came to see me for her initial consultation, complaining of chronic eczema since childhood, severe, chronic nasal congestion which nasal sprays had not managed to clear, and asthma. She was using two different steroid inhalers daily, and was constantly tired to the point of being unable to exercise, complaining of waking unrefreshed and poor-quality sleep, even though she was sleeping eleven or twelve hours a night. Her diet was primarily vegan high in refined carbohydrates as well as wholegrains, and processed foods and she had allergies to nuts, shellfish, and dust mites. My initial protocol focused on optimizing nutrient assimilation, supporting the immune response and emunctories, and removing inflammatory triggers from the diet. She was willing to take a fish oil supplement, so I included a high-dose omega-3 fatty acid supplement. I also insisted that she invest in air filters for both her bedroom and the areas in her home she spent time in to reduce her histamine burden, and arranged some tests.

When we reviewed her case six weeks later, she had already seen significant improvement with these initial measures, but her eczema and nasal congestion had not fully cleared.  Her stool test indicated an extremely low secretory immunoglobulin A (IgA), which would have an impact on mucosal immune response as well as numerous microbes including Candida albicans, Aspergillus niger, Staphylococcus aureus, a gram-positive pathobiont often found on the skin and upper respiratory tract, and known to cause infections in these areas. As a result of this test, I asked her to undergo a skin swab on the affected areas and undergo a Multiple Antibiotic Resistant Coagulase Negative Staphylococci (MARCoNS) nasal swab test.

The skin and MARCoNS swabs both confirmed a thick biofilm, and presence of gram-positive Staphylococcus and both fungal species. The MARCoNS also confirmed presence of Moraxella catarrhalis, a bacteria commonly found in the nasopharyngeal microbiome which a 2021 study in Journal of the British Society for Allergy and Clinical Immunology  linked with early persistent and transient eczema and which tends to colonize where mucosal immune function is low.

After taking her samples, I preemptively told her to start using a xylitol nasal spray as clinically I’ve had great success with this for clearing stubborn biofilm in the sinuses while we waited for the results, and started her on an aromatic water blend of tea tree (Melaleuca alternifolia), oregano, marigold (Calendula officinalis), rosemary, and thyme topically. She would not take tinctures due to her religion, so we used a simple tea blend of tulsi, plantain, Oregon grape, ginger, gentian, and agrimony. She started to use the aromatic water blend as a nasal spray, and alternated this with xylitol until review. We also used numerous supplements, including probiotics, zinc, and Baikal skullcap (Scutellaria baicalensis) to support mucosal immune function and microbiome regeneration.

As she was on a budget and could not review with me frequently, I put her on this protocol for three months. At her next review, she described her nasal congestion as having improved by at least ninety percent, and with using the aromatic water blend, her eczema had cleared for the first time in her life. She no longer used her inhaler daily and was much more energized, sleeping less and having more time to study and work, and was motivated to continue with the dietary adjustments we had put in place as she felt so much better.

References

Hu, C., Duijts, L., van Meel, E. R., Looman, K., Kiefte-de Jong, J. C., Pardo, L. M., Hijnen, D., Pasmans, S., de Jongste, J. C., Moll, H. A., & Nijsten, T. (2021) Association between nasal and nasopharyngeal bacterial colonization in early life and eczema phenotypes. Clinical and Experimental allergy: Journal of the British Society for Allergy and Clinical Immunology. Retreived from: https://doi.org/10.1111/cea.13869

Lung M. A. (1995) The role of the autonomic nerves in the control of nasal circulation. Biological Signals. Retrieved from:  https://doi.org/10.1159/000109439

Mali, R. G., & Dhake, A. S. (2011) A review on herbal antiasthmatics. Oriental Pharmacy and Experimental Medicine, 11(2), 77–90.retrieved from:  https://doi.org/10.1007/s13596-011-0019-1

Naclerio, R. M., Bachert, C., & Baraniuk, J. N. (2010) Pathophysiology of nasal congestion. International Journal of General Medicine, 3, 47–57. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866558/

Yao, A., Wilson, J. A., & Ball, S. L. (2018) Autonomic nervous system dysfunction and sinonasal symptoms. Allergy & Rhinology (Providence, R.I.), 9, 2152656718764233. Retrieved from: https://doi.org/10.1177/2152656718764233