Montelukast Tied to Psychiatric Adverse Events in Kids, Adults


The asthma medication montelukast (Singulair, Merck) is linked to increased reports of depression and nightmares in adults and children, as well as aggression in children, according to a review of voluntary adverse event reports published online September 20 in Pharmacology Research & Perspectives.

“Because of the high incidence of neuropsychiatric symptoms — especially nightmares — after using montelukast in both children and adults, the clinician should discuss the possibility of these adverse events with the patient and parents,” first author Meindina Haarman, MSc, from University Medical Center Groningen, The Netherlands, said in a news release.

Haarman and colleagues say this is the first study to analyze reports of adverse drug reactions related to montelukast in both children and adults.

Montelukast is used in maintenance therapy for adults and children with asthma and allergic rhinitis. Commonly reported adverse reactions include upper airway infection, fever, rash, nausea, vomiting, diarrhea, and elevated liver enzymes.

Sleep disorders and psychiatric symptoms have also been reported. In 2009, the US Food and Drug Administration mandated that the drug label of montelukast and other drugs in this class list neuropsychiatric symptoms such as depression and suicidality as possible adverse reactions.

Montelukast has also been linked to allergic granulomatous angiitis, also called Churg-Strauss syndrome, a rare autoimmune condition that causes inflammation of small and medium-sized blood vessels in people with airway allergies. The condition can affect various organs, especially the lungs and digestive tract, and can be life-threatening in some cases.

To better characterize the safety profile of montelukast in regular clinic use, the researchers conducted a retrospective study of all adverse drug reactions in children and adults reported to the Netherlands Pharmacovigilance Center Lareb and the World Health Organization (WHO) Global database (VigiBase®) up to 2016.

Overall, there were 331 montelukast-related adverse drug reactions in the Dutch database and 17,723 in the WHO database. Slightly less than one third of the reports in each database involved patients younger than 19 years (32.3% and 32.4%, respectively).

In the analysis, the researchers used the reporting odds ratio (ROR), which provides an estimate of whether an adverse event is disproportionately reported for a certain drug compared with all other drugs. Notably, ROR cannot say anything about causality.

Depression was the most frequently reported adverse reaction overall in the global WHO database (ROR, 6.93; 95% confidence interval [CI], 6.5 – 7.4). Among children only, the most commonly reported ADR was aggression (ROR, 29.77; 95% CI, 27.5 – 32.2).

In the Dutch database, headache was the most frequently reported adverse reaction overall in both adults (ROR, 2.26; 95% CI, 1.61 – 3.19), and children (ROR, 3.18; 95% CI, 2.66 – 3.70).

Other commonly reported adverse reactions in both the Dutch and WHO databases included nightmares in both children and adults. In the WHO database, suicidal ideation was also commonly reported.

Eight patients also reported allergic granulomatous angiitis to the Dutch database, whereas the WHO database had 563 reports of the condition. All patients survived.

The authors noted that the relationship between montelukast and allergic granulomatous angiitis is unclear. Some studies have suggested that the two are not connected, whereas others have suggested a causal relationship. More research is needed to clarify this relationship, they write.

“However, it has been reported that the symptoms of allergic granulomatous angiitis disappeared in some patients after withdrawing montelukast. This can be seen regarded as an argument for a causal relationship,” the authors write.

Until more data are available, “patients treated with montelukast should be followed to detect signs and symptoms of allergic granulomatous angiitis,” they advise.

They also note that the relationship between Montelukast and depression remains unclear. Asthma has been linked to increased depression and lower quality of life, so reports of depression may actually reflect symptoms of the underlying disease and not an adverse reaction to the drug.

“Further research is required to reveal the mechanism for the higher incidence of neuropsychiatric symptoms in patients using montelukast in comparison with other medications,” they conclude.

The authors mention several study limitations. Both databases relied on voluntary reporting of symptoms, which could have lead to underreporting. Also, the study cannot prove montelukast causes these adverse reactions.

THC Makes Cannabis Ideal for Treating Asthma, Study Shows


 

For many , the idea of cannabis being used as an asthma treatment can feel a bit backwards. After all, one of the most common ways cannabis is ingested is by smoking, a method that would seem to be detrimental to those with asthma. However, recent studies have found that cannabis in any form (even smoked) can greatly benefit those suffering from the symptoms of asthma.

Can Marijuana Treat Asthma?

First let’s take a closer look at asthma and what it actually means to have it. Asthma is a fairly common lung disease that results in the narrowing of the airway passage. Due to this narrowing, those suffering from asthma frequently experience feeling out of breath, wheezing or uncontrollable coughing.

While treatment can be used to reduce the effects patients with asthma experience, there is currently no cure for the condition. Asthma attacks can come in many forms and can be triggered by a number of factors including allergies or exercise. While asthma doesn’t reduce your life expectancy, being caught in an intense asthma attack without the proper treatment can be fatal.

So how does a substance that can be smoked help treat asthma? The explanation can be found by examining where asthma begins. Asthma is a chronic inflammatory disease, while cannabis is known for its powerful anti-inflammatory effects. This means cannabis works in an opposite effect to other substances like tobacco and can actually help expand the lungs instead of constricting them. 

Editor’s Note: A 2015 animal study in the Journal of Pharmacology and Experimental Therapeutics identified THC specifically as the active compound in cannabis that could benefit people suffering from asthma. They found that THC had anti-inflammatory and bronchodilator effects on airways (very similar to the effect Ventolin has on the lungs during an asthma attack). This is great news! 

So how powerful can a cannabis treatment actually be? For those suffering from an asthma attack the results are practically instantaneous and are similar to the results found with some of the more common name brand inhalers. 

If you or someone you know is suffering from asthma and would like to seek cannabis as a treatment option, be sure to check out your state’s list of qualifying medical conditions for medicinal cannabis to see if you are eligible for such a treatment option.

Other Ways to Treat Asthma Naturally

If you’re looking for more natural forms of asthma treatment, talk to your doctor about the following options:

You Can Control Your Asthma


Using what you know about managing your asthma can give you control over this chronic disease. When you control your asthma, you will breathe easier, be as active as you would like, sleep well, stay out of the hospital, and be free from coughing and wheezing.To learn more about how you can control your asthma, visit CDC’s asthma site.

Young woman with asthma inhaler

Asthma is one of the most common lifelong chronic diseases. One in 13 Americans (more than 24 million) lives with asthma, a disease affecting the lungs and causing repeated episodes of wheezing, breathlessness, chest tightness, and coughing.

Although asthma cannot be cured, you can control your asthma successfully to reduce and to prevent asthma attacks, also called episodes. Successful asthma management includes knowing the warning signs of an attack, avoiding things that may trigger an attack, and following the advice of your healthcare provider.

Group of mature couples playing tennisAsthma deaths have decreased over time.

Asthma deaths have decreased over time and varied by demographic characteristics.The rate of asthma deaths decreased from 15 per million in 2001 to 10 per million) in 2016. Deaths due to asthma are rare and are thought to be largely preventable, particularly among children and young adults.

In most cases, we don’t know what causes asthma, and we don’t know how to cure it. Some things may make it more likely for one person to have asthma than another person. If someone in your family has asthma, you are more likely to have it. Regular physical exams that include checking your lungs and checking for allergies can help your healthcare provider make the right diagnosis. Then you and your healthcare provider can make your own asthma management plan so that you know what to do based on your own symptoms.

Using your asthma medicine as prescribed and avoiding common triggers that bring on asthma symptoms, such as smoke (including second-hand and third-hand tobacco smoke), household pets, dust mites, and pollen will help you control your asthma.

Make sure you are up to date on vaccinations that help protect your health. Respiratory infections like influenza (flu) can be very serious for you, even if your asthma is mild or your symptoms are well-controlled by medication. Flu can trigger asthma attacks and make your asthma symptoms worse, and is more likely to lead to other infections like pneumonia. Getting the recommended vaccines will help you stay healthier.

The important thing to remember is that you can control your asthma.

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URL: http://www.romancewithbooks.com

Asthma linked to infertility but not in women on inhaled steroids


https://speciality.medicaldialogues.in/asthma-linked-to-infertility-but-not-in-women-on-inhaled-steroids/

Study Looks at Link Between Asthma and Type 1 Diabetes


asthma

Finnish researchers acknowledged that the associations between asthma and type 1 diabetes are still unclear so they conducted a study to look more into the link between these two immune-mediated conditions.

In their study abstract they state that they conducted a nationwide case-cohort study with Finnish children and used a novel statistical approach.

The children in the study were born between January 1st 1981 and December 31st 2008. There were 81,473 diagnosed with asthma and 9,541 diagnosed with type 1 diabetes up to age 16 by the end of 2009. This data was located in the Central Drug Register that the Social Insurance Institution of Finland keeps.

Regarding the new statistical approach, researchers used “a multistate modelling approach to estimate transition rates between healthy and disease states since birth. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to represent the change in the transition rate between the disease states.”They adjusted for sex and birth decade.

What are the Ties Between Type 1 and Asthma?

The researchers found that a previous asthma diagnosis raised the risk of developing type 1 diabetes by a whopping 41%.

Conversely, a previous diagnosis of type 1 diabetes lowered the risk of developing asthma by 18%.

Based on these findings the researchers conclude that there is an implication here that the relationship between type 1 diabetes and asthma is “more complex than previously thought, and its direction depends on the sequential appearance of the diseases.”

Do you have asthma and type 1 diabetes and if so, which diagnosis came first?

‘Asthma is a killer – it took away my miracle daughter’


Lisa Dennis is looking at photos of her daughter Olivia – a blonde girl with a radiant smile.

These are special moments, frozen in time. Olivia died four years ago, aged 10, after having an asthma attack.

Ten-year-old girl who died from asthma

Her parents did not even know their gymnastics-loving daughter had the condition.

But Olivia is not the only child to lose their life to asthma.

According to the latest data for England and Wales, 37 children and teenagers died from the disease in 2014.

The figure has risen over the past five years. But many of these deaths are thought to be preventable.

Lisa vividly remembers the night Olivia died. It was a bitterly cold night, and they were at home in Kent.

Struggling to breathe

Lisa, who is married and has a younger son, told BBC News: “We’d tried so long to have children, and when she came along, it was just a miracle for us.

“Olivia was a really special, beautiful girl.

“That night, she was on all fours on the bed – and struggling to breathe.

“She collapsed onto the floor. I tried CPR [cardiopulmonary resuscitation], but unfortunately it didn’t work.

Ten-year-old girl who died from asthmaImage copyrightMR AND MRS DENNIS
Image captionOlivia’s parents want an end to complacency about asthma

“I’ll never forget being at the hospital and the consultant asking us if Olivia was asthmatic.

“I said, ‘No, but she has an inhaler.’ He said to us there and then, ‘Your daughter is asthmatic.'”

Lisa’s ongoing grief is compounded by her frustration about what she says is a lack of awareness of asthma.

She had been given an inhaler for an allergy, but Lisa says the word “asthma” was never mentioned to the family, and the medicine was issued by repeat prescription.


Asthma: What you need to know

  • Asthma is a common but unpredictable illness
  • It affects the airways and can lead to shortness of breath, coughing and a tight feeling in the chest
  • One in 11 children is affected
  • Inhalers need to be used regularly and effectively
  • The blue inhalers provide relief during an attack, while the brown ones are for more regular use to prevent flare-ups
  • Steroids via an inhaler reduce the inflammation from asthma
  • The UK has some of the highest asthma death rates in Europe

The feeling is shared by Dr Satish Rao, from Birmingham Children’s Hospital, who runs an NHS service in the West Midlands for difficult asthma cases.

He said: “One of the biggest frustrations for us is the complacency among healthcare professionals about asthma in children and young people.

“We have struggled to convince professionals that asthma is a serious illness, and that patients can die from a severe attack.

“It’s probably because it’s a common illness, and quite often we hear staff saying, ‘Oh, it’s just asthma.'”

Dr Rao believes many deaths could be prevented by better information about when to seek medical help.

And he is aware of 16 cases in his region where schools have to work very closely with families and give them extra support to make sure the children keep their condition under control.

‘Asthma is a killer’

The number of child asthma deaths has risen steadily from 17 in 2010 to 37 in 2014.

Portsmouth GP Dr Andy Whittamore, who is also Asthma UK’s clinical lead, says it can be difficult to get young patients to adhere to taking their medicine.

He said: “With children particularly, there’s lots of fear about the medicine itself – and from their parents too.

“Steroids have got a bad press because of abuse by bodybuilders and doping in the Olympics.

“But the doses we give are in very low levels – and if taken correctly, they only go directly into the lungs.”

These misconceptions can be fuelled by stigma, with asthmatic children in particular not wanting to be seen as weak or inferior.

Asthma UK has even found that teenagers sometimes shied away from using inhalers because they thought their shape resembled that of sex toys.

Bereaved mother Lisa believes much more can be done.

She said: “Everyone needs to look at their children – especially anyone with an inhaler – because asthma is a killer.

“And I think doctors need to recognise that and make families aware because this is serious, desperately serious.”

Lisa wants to see awareness posters in GP surgeries, more regular reviews and plans for young asthma patients, and an improved inhaler design so the actual device contains advice for bystanders helping with an attack.

These are simple measures, which could help save lives.

Most People Diagnosed With Asthma May Not, In Fact, Have The Problem, Says New Study


One third of people with asthma may not actually have the condition either because it has got better, or they were wrongly diagnosed in the first place, a new study suggests. The study found that 33 per cent of adults recently diagnosed with asthma by their physicians did not have active asthma.

Over 90 per cent of these patients were able to stop their asthma medications and remain safely off medication for one year, researchers said. “It’s impossible to say how many of these patients were originally misdiagnosed with asthma, and how many have asthma that is no longer active,” said lead author of the study, Shawn Aaron, professor at the University of Ottawa in Canada.

“What we do know is that they were all able to stop taking medication that they did not need, medication that is expensive and can have side effects,” Aaron said. Eighty per cent of the participants who did not have asthma had been /taking asthma medication, and 35 per cent took it daily.

The study also found that doctors often did not order the tests needed to confirm an asthma diagnosis. Instead they based their diagnosis solely on the patients symptoms and their own observations.

“Doctors would not diagnose diabetes without checking blood sugar levels, or a broken bone without ordering an X-ray,” said Aaron. “But for some reason many doctors are not ordering the spirometry tests that can definitely diagnose asthma,” he said.

The study looked at 613 randomly selected patients from 10 Canadian cities diagnosed with asthma in the last five years. After a series of detailed breathing tests followed by consultation with a lung specialist, asthma was ruled out in a third of these patients.

The team was able to access the medical records of 530 of the patients to see how they were originally diagnosed. They found that in 49 per cent of these cases, physicians had not ordered the airflow tests required by medical guidelines.

When the patients that were found not to have asthma were re-diagnosed, most had minor conditions like allergies or heartburn, and 28 per cent had nothing wrong with them at all.

One third of people with asthma may not actually have the condition either because it has got better, or they were wrongly diagnosed in the first place, a new study suggests. The study found that 33 per cent of adults recently diagnosed with asthma by their physicians did not have active asthma.

Over 90 per cent of these patients were able to stop their asthma medications and remain safely off medication for one year, researchers said. “It’s impossible to say how many of these patients were originally misdiagnosed with asthma, and how many have asthma that is no longer active,” said lead author of the study, Shawn Aaron, professor at the University of Ottawa in Canada.

 “What we do know is that they were all able to stop taking medication that they did not need, medication that is expensive and can have side effects,” Aaron said. Eighty per cent of the participants who did not have asthma had been /taking asthma medication, and 35 per cent took it daily.

The study also found that doctors often did not order the tests needed to confirm an asthma diagnosis. Instead they based their diagnosis solely on the patients symptoms and their own observations.

“Doctors would not diagnose diabetes without checking blood sugar levels, or a broken bone without ordering an X-ray,” said Aaron. “But for some reason many doctors are not ordering the spirometry tests that can definitely diagnose asthma,” he said.

The study looked at 613 randomly selected patients from 10 Canadian cities diagnosed with asthma in the last five years. After a series of detailed breathing tests followed by consultation with a lung specialist, asthma was ruled out in a third of these patients.

The team was able to access the medical records of 530 of the patients to see how they were originally diagnosed. They found that in 49 per cent of these cases, physicians had not ordered the airflow tests required by medical guidelines.

 

When the patients that were found not to have asthma were re-diagnosed, most had minor conditions like allergies or heartburn, and 28 per cent had nothing wrong with them at all.

Two per cent had serious conditions like pulmonary hypertension or heart disease that had been misdiagnosed as asthma, and went on to receive proper treatment. “It was not a surprise to most patients when we told them they did not have asthma,” said Aaron.

“Some knew all along that their puffer was not working, while others were concerned that they might have something more serious. Thankfully, the majority of the conditions were mild and easily treated,” he said. The study confirms and expands on Aaron’s 2008 study which suggested that 30 per cent of asthma patients had been misdiagnosed.

This MAN Healed 5000 People from Cancer: This Is a Recipe That Kills Tumors in 90 Days – See more at: http://www.choiceandtruth.com/2016/08/this-man-healed-5000-people-from-cancer.html#sthash.6q55okXx.dpuf


Hemp or cannabis oil was used by numerous people for centuries, but it was banned in the second half of the 20th century, as a result of the rise of the billion-dollar pharmaceutical industry.

Rick Simpson is a mechanical engineer and a self-taught doctor, who was diagnosed with skin cancer in 2002 and fought this disease using this miraculous oil. Nowadays, he is one of the greatest world activists for legalization of hemp oil. Using this treatment, he has cured over 5,000 people.

He attended a debate organized in Belgrade, the capital of Serbia, on this topic. He states that hemp or cannabis oil can cure a vast variety of serious health issues, like diabetes, arteriosclerosis, multiple sclerosis, epilepsy, asthma, psoriasis, as well as some of the deadliest forms of cancer.

Rick recounted his story to the Serbian magazine Telegraph “I always tell people – Cannabis will cure you, and you will see that at present, it is the best cure there is in the world!”

He began his story: “It was 2002. The doctors had given up on me because I’d had more than one unsuccessful operation on three pigmented lesions on my face’s skin. As soon as these were removed, they would reappear even more infected! Since I had been studying plants as a hobby for years, one day as I was looking at my wounds in the mirror, I remembered a study from the University of Virginia that said that THC, an active component of cannabis could cure cancer. I took some cannabis oil I had prepared beforehand from the cabinet and dripped a few drops directly on the wound.”
No significant results could be noticed at first. He bandaged his wounds again after applying the oil and waited for few days.

Then, he went on: “After four days I removed the bandages and I couldn’t believe my eyes! The wound was no longer there, and my skin was regenerated! I immediately started talking to people about how I had cured skin cancer with cannabis oil… Everyone laughed at me, but then eleven and a half years have passed, and the cancer still hasn’t returned.”

From then on, Simpson decided to help people in need for this cure, and his work resulted in thousands of cases effectively solved. His last case was an 80-year-old man who was dying from lung cancer.

“The man was all swollen from chemotherapy, open wounds on his legs and was barely breathing! After the doctors had given him no more than 48 hours, his son brought him to me. As I had recommended cannabis oil therapy, the young man had also consulted his father’s doctor. The doctor, of course, rejected such treatment, so in the end the young man took the oil from me, soaked a small cracker in it and gave it to his father.”

In less than thirty minutes, the old man finally started breathing normally again and his breathing completely stabilized during the night.

“Although the doctors “explained” that before death, his vital functions would return briefly, his son didn’t want to wait any longer so he checked his father out of the hospital the next morning. He also stopped all of his father’s prescribed therapy. After six weeks of cannabis oil treatment, the old man no longer needed insulin, and after three months he was completely cured from cancer,”says Rick/
Moreover, he stated that cannabis oil therapy is equally effective in all cases, for it knows no age limit. It can even be given to babies.

In order to supply fresh raw ingredients for his hemp oil, Rick soon started growing marijuana, but his field was raided four times in three years by the police. People who publicly claim to cure cancer are threatened 5-40-year imprisonment, according to laws in North America.

So, Jack was imprisoned for four days in Canada in 2005, for cultivating, owning and selling marijuana. However, at one point he was liable for 12 year imprisonment. He was fined 2,000 dollars.
“The worst of all was that the jurors were people whose dearest I had cured with cannabis oil. Even the judge knew it was all a farce! At one point he even told me that I should be rewarded, instead of tried! All knew, and no one could do anything! They didn’t even allow ten patients I have cured to testify! They also didn’t allow the doctors to come out on the bench, nor me to show a pile of medical documents about the effects of my oil. If you don’t know the meaning of a “coward court,” go to Canada and you will see what I mean,” claims Jack.

Rick claims that he has never sold weed, but only hemp oil, and as he was deeply disappointed by the Canadian government and corrupted doctors, he even put the recipe for hemp oil on the web page phoenixtears.ca.

According to him, the preparation of this miraculous oil is extremely easy. Simpson’s treatment starts with several drops of hemp oil three times a day.

“The usual dose I give to cancer patients is 60 grams within 90 days. And, it is never too late for the patient to start cannabis oil therapy. There isn’t such an excuse as, “It is late”… If you ask me, if I approve of smoking marijuana, I will tell you it isn’t as effective as cannabis oil, but it is scientifically proven that people who smoke marijuana live six years longer than those who don’t.”
Moreover, he adds that as opposed to Europe, North America still puts a blind eye when it comes to legalization of cannabis. He believes that every country in the world should allow their citizens to cultivate and use cannabis for medical purposes. He also points out that pharmacies should be opened for those who can’t cultivate it.

“Little is known that cannabis has been used as one of the most healing remedies hundreds of years before Christ. In the ancient Persian religious scripts, which among other things describe the most healing herbs, cannabis takes the first place,” concludes Rick.
His biggest wish and goal is to live in a world without cancer. – See more at: http://www.choiceandtruth.com/2016/08/this-man-healed-5000-people-from-cancer.html#sthash.6q55okXx.dpuf

8 Proven Ways To Relieve Asthma Naturally


Asthma affects about 300 million people worldwide. It is growing by 50 percent every decade and causes upwards of 180,000 deaths per year. The cause is not well-understood but here are 8 proven ways to help relieve symptoms naturally. 

There is nothing more terrifying than not being able to breathe.  But that’s what asthmatics face every day.  Asthma is a chronic disease characterized by inflammation of the airways. Symptoms include wheezing, shortness of breath, chest tightness and cough.  According to the Global Initiative for Asthma it affects an estimated 300 million people worldwide.  And it increases globally by 50 percent every decade.[i]

Asthma is also deadly.  According to the World Health Organization, it is linked to more than 180,000 deaths per year.[ii]

No single cause of asthma has been identified.  Symptoms may be triggered or worsened by viral infections, allergens, tobacco smoke, exercise and stress, among other things.

Obesity is also linked to asthma.  A study from the Harvard School of Public Health found that obesity is both a risk factor for asthma and is associated with increased severity of the symptoms.

And a study in the journal Allergy looked at data from the 2005-2006 National Health and Nutrition Examination Survey (NHANES).  It found that obese people had more than 2.5 times the risk of developing asthma as people with a normal body mass index (BMI).

Researchers from Duke University also reviewed NHANES data from 2001 through 2004.  They found that people with a BMI in the obese range were 12 percent more likely to have more severe asthma. They hypothesized that the inflammation induced by obesity may contribute to worse asthma symptoms.

Several studies link some asthma cases to childhood vaccines and their timing.  In a study of 1,531 children in Manitoba, Canada, researchers found that the risk of developing asthma by the age of seven was cut in half when the first diphtheria, pertussis, tetanus (DPT) immunization was delayed by more than two months.  Delaying all three doses of DPT vaccines cut asthma risk by 60 percent.

Studies show breast feeding reduces the risk of developing asthma.  In a study of 1500 infants and pre-schoolers, children who were exclusively breast-fed had lower asthma rates than those partially breast-fed or given formula milk.

And a meta-analysis of 12 studies published in the Journal of Pediatrics showed that exclusive breast feeding during the first three months after birth reduced asthma risk by 30 percent.  Researchers attributed the effect to the immunomodulatory properties of breast milk.

For those suffering with the disease, there are natural remedies to relieve symptoms.  Here are just eight proven ways to relieve asthma.

1. Breathing Exercises

Many studies show that breathing exercises have a therapeutic role in the treatment of asthma.   In one randomized controlled trial asthma patients taught breathing exercises showed significant improvements in their quality of life, symptoms, and psychological well-being after six months.

In another study, patients were taught breathing exercises known as the Buteyko Breathing Method named after the Russian physician who developed the technique.  Buteyko breathing exercises increased asthma control 40 percent to 79 percent and significantly reduced the use of corticosteroid inhalers compared with a control group.

In addition, yoga breathing exercises are therapeutic for asthma sufferers.  In a study of 60 patients, half were randomized to receive yoga breathing instructions.  After two months the yoga group showed a statistically significant improvement in lung function as well as improved quality of life.

In another study of 17 university students half the subjects were taught a set of yogic breathing exercises, physical postures, and meditation three times per week.  After 16 weeks, data showed that the yoga significantly improved relaxation, led to a more positive attitude, and reduced use of inhalers.  The researchers concluded that yoga techniques seem beneficial as an adjunct to the medical management of asthma.

2. Turmeric

Studies show that one of the active components in the spice turmeric, curcumin, inhibits the allergic response.  Other research suggests that curcumin works by preventing or modulating inflammation and oxidative stress in the airways.[iii]

In one study 77 patients with mild to moderate bronchial asthma were randomly assigned to two groups.  One group received standard asthma treatment while the other group received the standard therapy plus 500 mg per day of curcumin.  After 30 days researchers concluded thatcurcumin significantly helped improve airway obstruction and suggested that curcumin is effective and safe as an add-on therapy for the treatment of bronchial asthma.

3. Magnesium

Researchers from Brown University School of Medicine tested intravenous magnesium on pediatric patients with moderate to severe asthma.  Thirty patients were randomly assigned to receive either 40 mg/kg of magnesium sulfate or a saline solution.  Just twenty minutes later themagnesium group showed remarkable improvement in short-term lung function.

Taking magnesium orally is also effective for asthma control.  In a study published in theJournal of Asthma 55 patients were randomly assigned to take 340 mg (170 mg twice a day) of magnesium or a placebo.  After 6.5 months the magnesium group had better bronchial reactivity, and better subjective measures of asthma control and quality of life.

In another study from Brazil 37 patients all received inhaled fluticasone (brand name Flonase) twice a day and the asthma drug salbutamol as needed.  Half the group also took 300 mg per day of magnesium.  After two months bronchial reactivity improved significantly in the magnesium group only. The magnesium group also had fewer instances of worsening asthma and used less salbutamol compared to the placebo group.

4. Vitamin D

Asthma has been linked to lower levels of vitamin D.  In a study of 483 asthmatics under 15 years of age and 483 matched controls, researchers found that vitamin D deficiency was more prevalent in asthmatics.

A review of vitamin D studies found vitamin D and its deficiency have a number of effects in the body which could affect the development and severity of asthma.  Researchers concluded thatvitamin D may improve lung function and response to steroids, and reduce airway remodeling.

And in a double blind, randomized, comparative study, 140 patients received standard treatment for asthma while half also received 1000 mg per day of vitamin D3.  After six months researchers found that the vitamin D3 significantly improved the quality of life for severe asthmatics.

5. Diet

Many people find their asthma symptoms disappear on a dairy elimination diet.

A meta-analysis of data from more than 30 studies in the journal Nutrition Reviews found high intake of fruit and vegetables may reduce the risk of asthma and wheezing in adults and children.  Researchers concluded that eating more fruit and vegetables could reduce the risk of asthma in adults and children by 46 percent.

Another study found tomatoes particularly powerful.  Researchers in Australia had asthmatic adults eat a low antioxidant diet for 10 days.  Measures of asthma severity worsened.  Then for seven days the patients were randomized to receive either a placebo, tomato extract (45 mg lycopene/day), or tomato juice (45 mg lycopene/day). Patients receiving tomato extract or tomato juice reduced their signs of asthma.  The researchers suggested that lycopene-rich supplements should be further investigated as an asthma therapy.

And research from Johns Hopkins University found that sulforaphane, or foods rich in sulforaphane like broccoli, may be adjuvant treatments for asthma. Sulforaphane is an antioxidant and anti-inflammatory phytochemical also found in other cruciferous vegetables like Brussels sprouts, cabbage, cauliflower, bok choy, kale, collards, broccoli sprouts, arugula, and watercress.

6. Fish Oil

Many studies show that fish oil relieves chronic inflammation like that found in asthma. In one study of 20 asthmatic patients, researchers compared fish oil to montelukast (brand name Singulair).  Montelukast is a drug used to prevent the wheezing and shortness of breath caused by asthma.

The subjects were randomly assigned to receive either 10 mg of montelukast tablets or 10 fish oil capsules totaling 3.2 g EPA and 2.0 g DHA every day for three weeks.  Thereafter all the subjects received both treatments together for another three weeks. Results showed that montelukast and fish oil were equally effective (and fish oil was slightly better) at reducing airway inflammation.

7. Pine Bark

Pycnogenol® is a standardized extract of French maritime pine bark with anti-inflammatory properties. Italian researchers compared it to the use of corticosteroid inhalers for relieving asthma symptoms.  A total of 76 patients used an inhaler.  Half the group also received 50 mg of Pycnogenol morning and evening.

After six months 55 percent of the Pycnogenol patients were able to reduce their inhaler use compared to only six percent of the control patients. In addition, none of the Pycnogenol patients had a worsening condition but 18.8 percent of the inhaler-only group deteriorated. Researchers concluded that Pycnogenol was effective for better control of allergic asthma and reduced the need for medication.

Also, Pycnogenol is effective to help manage mild-to-moderate childhood asthma.  In a randomized, placebo-controlled, double-blind study, 60 subjects, aged 6-18 years old, were given either Pycnogenol or placebo.  After three months, the Pyconogenol group had significantly more improvement in lung functions and asthma symptoms. They were also able to reduce or stop their use of rescue inhalers more often than the placebo group.

8. Vitamin B6

In a double-blind study of 76 asthmatic children, patients received 200 mg daily of vitamin B6 (pyridoxine).  After five months researchers found vitamin B6 led to significant improvements in asthma symptoms and reduction in dosage of bronchodilators and cortisone.

For more information on the underlying causes, triggers, and reversal of asthma read “Asthma Solved Naturally.”

Thumb-Sucking, Nail-Biting, and Atopic Sensitization, Asthma, and Hay Fever


Abstract

BACKGROUND: The hygiene hypothesis suggests that early-life exposure to microbial organisms reduces the risk of developing allergies. Thumb-sucking and nail-biting are common childhood habits that may increase microbial exposures. We tested the hypothesis that children who suck their thumbs or bite their nails have a lower risk of developing atopy, asthma, and hay fever in a population-based birth cohort followed to adulthood.

METHODS: Parents reported children’s thumb-sucking and nail-biting habits when their children were ages 5, 7, 9, and 11 years. Atopic sensitization was defined as a positive skin-prick test (≥2-mm weal) to ≥1 common allergen at 13 and 32 years. Associations between thumb-sucking and nail-biting in childhood, and atopic sensitization, asthma, and hay fever at these ages were assessed by using logistic regression with adjustments for sex and other potential confounding factors: parental atopy, breastfeeding, pet ownership, household crowding, socioeconomic status, and parental smoking.

RESULTS: Thirty-one percent of children were frequent thumb-suckers or nail-biters at ≥1 of the ages. These children had a lower risk of atopic sensitization at age 13 years (odds ratio 0.67, 95% confidence interval 0.48–0.92, P = .013) and age 32 years (odds ratio 0.61, 95% confidence interval 0.46–0.81, P = .001). These associations persisted when adjusted for multiple confounding factors. Children who had both habits had a lower risk of atopic sensitization than those who had only 1. No associations were found for nail-biting, thumb-sucking, and asthma or hay fever at either age.

CONCLUSIONS: Children who suck their thumbs or bite their nails are less likely to have atopic sensitization in childhood and adulthood.

 

  • Abbreviations:
    CI
    confidence interval
    OR
    odds ratio
    SES
    socioeconomic status
    TH
    T helper

 

What’s Known on This Subject:

The hygiene hypothesis suggests that childhood exposure to microbial organisms reduces the risk of developing allergic diseases. The effects of thumb-sucking and nail-biting habits are likely to increase microbial exposure, but their effects on allergic diseases are unknown.

What This Study Adds:

Children who sucked their thumbs or bit their nails between ages 5 and 11 years were less likely to have atopic sensitization at age 13. This reduced risk persisted until adulthood. There was no association with asthma or hay fever.

The “hygiene hypothesis” was suggested by Strachan1 to explain why children from larger families and those with older siblings are less likely to develop hay fever. Strachan1hypothesized that this could be explained if “allergic diseases were prevented by infection in early childhood transmitted by unhygienic contact with older siblings, or acquired prenatally from a mother infected by contact with her older children.” The hypothesis is supported by evidence showing that children who grow up in large families are at greater risk of coming into contact with more infections, promoting T helper (TH)-1 immune responses, whereas children from smaller families are more likely to have TH-2 type responses and a higher risk of atopy.2 The hygiene hypothesis remains controversial, however, as it is unable to fully explain many associations, including the rise of allergies in “unhygienic” inner-city environments, and why probiotics are ineffective at preventing allergic diseases.3

Thumb-sucking and nail-biting are common oral habits among children, although the reported prevalence varies widely, from <1% to 25%.47 These habits have the potential to increase the exposure to environmental microorganisms, and have been associated with the oral carriage of Enterobacteriaceae, such as Escherichia coli and intestinal parasite infections.812 It seems likely that thumb-sucking and nail-biting would introduce a wide variety of microbes into the body, thus increasing the diversity of the child’s microbiome. If the hygiene hypothesis is correct, it is plausible that this would influence the risk for allergies. There is currently no evidence as to whether thumb-sucking and nail-biting influence immune function or risk for allergy. A recent study found that infants whose mothers “cleaned” their pacifiers by sucking them clean were less likely to develop asthma and eczema.13 They concluded that immune stimulation secondary to the exchange of maternal oral bacteria might protect against atopy. We hypothesized that the introduction of microbes by thumb-sucking and nail-biting would influence children’s immune responses and reduce the risk of developing allergies.

We investigated the effect of thumb-sucking and nail-biting in childhood on the development of atopic sensitization, asthma, and hay fever among participants of the Dunedin Multidisciplinary Health and Development Study, a prospective longitudinal population-based birth cohort study followed to age 38 years.

Methods

The Dunedin Multidisciplinary Health and Development Study is a population-based birth cohort study of 1037 participants (52% male participants) born in Dunedin in 1972–1973. Dunedin is a coastal city of ∼120 000 inhabitants including the surrounding rural areas. The cohort represents the full range of socioeconomic status in the South Island of New Zealand, and the study participants are mostly of New Zealand European ethnicity. Follow-up assessments were completed at ages 3, 5, 7, 9, 11, 13, 15, 18, 21, 26, 32, and 38 years. A full description of the study is reported elsewhere.14 The Otago Ethics Committee approved the study, and written informed consent was obtained at each assessment.

Thumb-Sucking and Nail-Biting

When the study members were age 5, 7, 9, and 11 years, parents were asked about their child’s thumb-sucking and nail-biting status. Parents were asked if the statements “frequently sucks their finger/thumb” and “frequently bites their nails” applied to their child. They could choose from 3 responses: not at all, somewhat, or certainly. Children were considered to be frequent thumb-suckers or nail-biters if their parents reported that the oral habit in question “certainly” applied to them at least once.

Atopic Sensitization

Skin-prick testing was first undertaken at age 13 years on 70% (724 of 1031) of the study members. Allergens tested included house dust mite (Dermatophagoides pteronyssinus; Bencard, Brentford, UK), grass, cat, dog, horse, kapok, wool, Aspergillus fumigatus, Alternaria, Penicillium, and Cladosporium (Hollister-Stier, Spokane, WA). At age 32 years, skin-prick tests were repeated in 93% (946 of 1015) of the participants by using the same allergens, but obtained from a different manufacturer (ALK, supplied by Allergy Canada, Thornhill, Ontario, Canada), with the addition of cockroach. A positive response to a skin-prick test was defined by a wheal diameter at least 2 mm larger than the negative saline control. Atopic sensitization was defined as having ≥1 positive response to an allergen.15

Asthma and Hay Fever

Detailed respiratory assessments have been conducted since age 9 using previously developed questionnaires.16 Participants were considered to have current asthma if they reported a diagnosis of asthma and had compatible symptoms or treatment in the previous 12 months.17 Participants were considered to have current hay fever if this was reported at age 13 or 32 years.

Control Variables

A number of potential confounders known to be associated with atopic sensitization in this cohort were considered, including sex and parental history.18 The parent attending with the child at age 7 years was asked whether either parent had asthma or hay fever. This information was supplemented with information obtained from the study members themselves at age 18 years. If either parent had a history of atopy or asthma, the child was considered to have a parental history of atopy.19 At age 3 years, the child’s mother was asked about the initiation and duration of breastfeeding. In most cases this was verified from prospective visiting nurse records. Children were considered to be breastfed if breastfeeding continued for ≥4 weeks.20 Cat and dog ownership from birth to age 9 years was reported from parental recall at age 9 years. Previous analyses of this cohort found that those exposed to both a cat and a dog during childhood had a lower risk of atopic sensitization; therefore, owning both animals was considered a potential confounder.21 A sensitivity analysis included ownership of each animal separately. Parental smoking history was obtained from a parent when the child was aged 7, 9, and 11 years. At aged 13 years, the study members themselves were also asked about their parents’ smoking status. Participants were regarded as being exposed to parental smoking if either parent smoked at any of these ages.19 An index of household crowding was developed according to the total number of children in the house at the assessment at 3 years, divided by the number of rooms (excluding kitchens and bathrooms; R.J.H., unpublished data). The socioeconomic status (SES) of the families was classified on a 6-point scale based on the income and education levels associated with parental occupations using data from the New Zealand Census. The average of the families’ SES over multiple assessments between birth and age 13 years was used for analysis.22

Statistical Analysis

Associations between thumb-sucking or nail-biting during childhood and atopic sensitization, asthma, and hay fever at age 13 years were assessed by using binary logistic regression. Atopic sensitization, asthma, or hay fever at age 13 years were the dependent variables, and the presence of either oral habit (thumb-sucking or nail-biting) status was the main predictor. Initial logistic regression analyses assessed whether the effects of oral habits differed between sexes by testing for sex-by-oral habit interactions. These were not significant and therefore both sexes were analyzed together, with an adjustment for sex. Further analyses also adjusted for parental atopy, breastfeeding, cat and dog ownership, parental smoking, household crowding, and socioeconomic status. To assess whether the oral habits had different effects on sensitization to different allergens, additional analyses were performed for the 3 most common sensitizing allergens in this cohort: house dust mite, grass, and cat.15

To assess whether any association between thumb-sucking or nail-biting and atopic sensitization, asthma, or hay fever persisted into adulthood, these analyses were repeated for age 32 years. Analyses were performed by using Stata 13 (Stata Corp, College Station, TX). P < .05 was considered statistically significant. Analyses used all available data.

Results

Of 1013 children providing data, 317 (31%) had ≥1 oral habit: there was no significant sex difference in prevalence of these habits (Table 1).

TABLE 1

Prevalence of Thumb-Sucking and Nail-Biting in Childhood, and Atopic Sensitization and Asthma at Ages 13 and 32 Years

Of the 724 children who had skin-prick tests at age 13 years, 328 (45%) showed atopic sensitization. The prevalence of sensitization was lower among children who had an oral habit (38%) compared with those who did not (49%) (P = .009). The lower risk of atopic sensitization was similar for thumb-sucking and nail-biting. Children with only 1 habit were less likely to be atopic (40%) than children with no habit at all (49%), but those with both habits had the lowest prevalence of sensitization (31%) (Fig 1). The trend in atopic sensitization across those with neither, 1, or both of these oral habits was statistically significant: P = .005.

FIGURE 1

Prevalence of atopic sensitization and asthma in children aged 13 years with a history of thumb-sucking or nail-biting. Error bars show the 95% confidence intervals. The statistical significance of differences between oral habit categories from χ2 tests are P = .05 for atopy, P = .76 for asthma, and P = .27 for hay fever.

The associations between oral habits and atopic sensitization remained significant in logistic regression analyses adjusting for sex, and after further adjustment for parental atopy, breastfeeding, cat and dog ownership, parental smoking, household crowding, and SES. Repeating the analyses examining cat and dog ownership separately did not materially affect the findings (data not shown). Further analyses of individual oral habits on their own showed a significant association between thumb-sucking and atopy at age 13 years. Nail-biting also was associated with lower risk of atopic sensitization at age 13 years when adjusted for sex, but this was of borderline statistical significance when multiply adjusted (Table 2). Overall, children manifesting 1 or both of these oral habits had ∼30% to 40% reduction in the risk of atopic sensitization across all analyses, whether statistically significant or of borderline significance.

TABLE 2

Childhood Oral Habits and Atopic Sensitization

Thumb-sucking and nail-biting also were associated with a lower prevalence of atopic sensitization in both sex-adjusted and multiply-adjusted analyses at age 32 years (Table 2). The pattern of findings was similar for both thumb-sucking and nail-biting when considered individually, but these associations were of borderline statistical significance in the multiply-adjusted analyses.

None of the associations between oral habits and atopic sensitization to specific allergens (house dust mite, cat, and grass) were statistically significant in sex-adjusted analyses at age 13, but all of these associations were significant at age 32 years. In the multiply-adjusted analyses, there were no significant associations at age 13, whereas at age 32 the reduced odds of house dust mite sensitization remained significant but the associations with grass and cat sensitization were of borderline statistical significance (Table 3).

TABLE 3

Childhood Oral Habits and Sensitization to Specific Allergens

Sensitivity analyses using a 3-mm cutpoint to define a positive skin-prick test showed a similar pattern of findings with a significant reduction in sensitization at both ages 13 and 32 (sex-adjusted odds ratios [ORs]: 0.63 [P = .007] and 0.56 [P < .001], respectively). Children who had sucked their thumbs or bit their nails in childhood had a lower total number positive skin-prick tests at age 13 than those who had not (Wilcoxon rank sum test: P = .0297) and the sum of weal sizes across all 11 skin-prick tests was also less among those who had an oral habit in childhood (P = .043). Similarly, by age 32 those who had sucked their thumbs or bit their nails had fewer positive skin-prick tests (P < .001) and the sum of all 12 weal sizes was lower than among those who had not (P < .001).

At age 13 years, 95 (12.9%) of 735 children were asthmatic and 219 (29.8%) of 735 children reported current hay fever (Table 1). There was no evidence that oral habits in childhood were associated with asthma (13.3% vs 12.8% for those with and without oral habits respectively: P = .8) or hay fever (29.6% vs 29.9%: P = .9) at age 13 years. Nor was there a significant association with specific habits (Fig 1). There were no statistically significant associations between thumb-sucking and nail-biting and asthma or hay fever at ages 13 or 32 years in either sex-adjusted or multiply-adjusted analyses (Tables 4 and 5).

TABLE 4

Childhood Oral Habits and Asthma

TABLE 5

Childhood Oral Habits and Hay Fever

Discussion

The findings from this study support our hypothesis that children who frequently suck their thumbs or bite their nails have a lower risk of developing atopic sensitization. Children who were reported to have either of these habits were less likely to have positive skin-prick tests at age 13 years and this apparent protective effect persisted to age 32 years. These associations were independent of sex, a parental history of atopy, and a variety of environmental factors known to be associated with atopic sensitization within this cohort.

There also appeared to be a dose-response relationship for atopic sensitization at age 13: those who had both oral habits had a lower incidence of atopic sensitization than those who had only 1 (Fig 1). This dose-response was not apparent at age 32, however (not shown). When habits were assessed individually, it appeared that thumb-sucking and nail-biting had similar associations with reduced prevalence of atopic sensitization; however, when multiply-adjusted, nail-biting on its own did not reach statistical significance (Table 2). Post hoc analyses showed little evidence that having these oral habits at >1 age was associated with a lower risk of allergic sensitization than at just 1 age. Nor did we find that the association was substantially different for different ages, with the exception that oral habits at age 11 appeared to have weaker associations with a reduced risk of sensitization.

By contrast, we did not find any association between thumb-sucking and nail-biting with asthma or hay fever at either age 13 or 32 years. The reasons for this inconsistency are unclear. Although asthma and hay fever are often associated with atopy, there are other contributing factors. Only approximately one-third of childhood asthma is attributable to atopy in this and other studies.23 The development of asthma is less clearly linked to immune function than atopy.24 In addition, both asthma and hay fever were based on reported diagnoses and symptoms and are therefore more subjective than the outcomes of skin-prick tests.

The findings of this study are consistent with those of the pacifier study by Hesselmar et al,13 who found that children whose mothers sucked their pacifiers clean were less likely to develop allergies. Although the mechanism and age of exposure are different, both studies suggest that the immune response and risk of allergies may be influenced by exposure to oral bacteria or other microbes. It is known that the gut microbiome can alter the function of TH cell subsets and thereby influence TH-1 and TH-2 responses and the development of immune tolerance.25 Our findings lend support to the hygiene hypothesis that avoiding oral environmental microbial exposures increases the risk for allergic sensitization to inhaled allergens.

Strengths of this study include multiple assessments of exposure in a large population-based cohort of children with a high rate of follow-up. We are able to adjust for a wide range of potential environmental and familial confounding factors. We have data on thumb-sucking and nail-biting habits only during primary school ages (5–11 years) and not for the preschool years and we do not know whether children had already developed atopic sensitization before information on these oral habits was gathered. However, it seems unlikely that childhood sensitization would influence subsequent thumb-sucking and nail-biting habits. Hence, we believe that the findings are unlikely to be explained by reverse causation. In addition, our primary outcome measure, atopic sensitization, was objectively assessed by skin-prick tests. Habit status, however, was based on parental reports and there will be some errors in these. Although only those who “certainly” sucked their thumbs or bit their nails frequently were considered to be exposed, some parents may have been unwilling to report that their child sucked his or her thumb, or bit his or her nails. The choice of answers provided to the parents, “not at all,” “somewhat,” and “certainly,” are also open to interpretation by the individual. However, it seems unlikely that misreporting would be systematically different between parents whose children did or did not have atopic sensitization, and nondifferential reporting errors would tend to bias the associations toward the null value. A limitation is that at age 13 years, only 70% of the participants consented to skin-prick tests; however, those who were not tested at age 13 had a similar prevalence of atopic sensitization at age 32 years compared with those who were tested (56% vs 60% P = .22).19

Thumb-sucking and nail-biting are often seen as undesirable habits and are discouraged by many parents,26 and numerous studies have assessed interventions to stop these habits.27There is some evidence that these habits are associated with dental malocclusion2830 and gingival injury,31 and that they can also cause local hand infections.3234 Spontaneous correction of some oral malocclusions can occur if thumb-sucking habits are stopped before dental development progresses,35,36 but there is limited research on the long-term effects of these habits on oral health. Our findings suggest that these habits also may have some beneficial effects: although we did not find an impact of these habits on asthma or hay fever, the reduction in atopic sensitization may have long-term health benefits. Further investigation of the long-term effects of these childhood habits is warranted.

To our knowledge this is the first study to explore the association between the effects of thumb-sucking and nail-biting and the prevalence of atopic sensitization and asthma. We found that there was a lower prevalence of atopic sensitization among teenagers and adults who had had these habits during childhood. These results contribute to the body of evidence supporting the hygiene hypothesis. Although we do not suggest that children should be encouraged to take up these oral habits, the findings suggest that thumb-sucking and nail-biting reduce the risk for developing sensitization to common aeroallergens.