Tag: tianeptine

After years of suffering from adult-onset asthma, I promised myself that if I ever found a way to cure myself, I would share that information with the world.  In a way, it’s the reason I started this blog.  It’s taken me until now to write this post because it’s a difficult subject to write about.

I started to experience asthma symptoms on a daily basis in 2001, at the age of 32.  The symptoms (chest tightness, and the annoying feeling that when you take a deep breath it doesn’t “catch” — like you’re not actually getting the air) started immediately after we replaced our cloth shower curtain with a plastic one.  It took me awhile to make the connection, but the toxic PVC fumes released by the hot steam were causing my breathing problems (or at least aggravating an underlying condition to the point where I experienced symptoms).  It probably didn’t help that our house was also full of mold; the upstairs neighbors had flooded their bathroom, the water had dripped down into our kitchen, and our property manager refused to repair the damage (we were renting at the time).  Moldy ceiling tiles — yuck!

We got rid of the offending shower curtain, but my asthma symptoms persisted.  The degree of severity would fluctuate — sometimes I would feel almost normal, other times my breathing was so bad that it was difficult to sleep.

At times I felt helpless and depressed.  Would I ever breathe normally?  At other times I felt determined — I would figure out a way to improve my health and quality of life.

A Little History

I grew up in the 70’s, and, like most kids of the 70’s, inhaled my fair share of second-hand smoke.  Now we know that’s a risk factor for asthma.  I forgive my parents and their friends — they knew smoking wasn’t good for them but they had no idea they were hurting the kids.  (The equivalent challenge for my generation, as parents, is to not expose your family to bisphenol-A, which is everywhere).

Once I thought about it, I realized I had experienced asthma symptoms as a teenager, at times.  I had always had a misconception that people with asthma couldn’t take a deep breath; since I could fill my lungs completely, I didn’t think I had asthma.  But the symptoms — chest tightness and that feeling that your lungs aren’t full (even when they are) — were there, even when I was in high school.  But they were intermittent, only lasting a few days at most.

I went to college at UC Davis.  The air in Yolo county is filled with dust and pollen, and I experienced bad hay fever throughout my college years.  No asthma, but lots of sneezing.  It was also during this time, having moved out of my family home, that I realized I was allergic to cats.  I had grown up with cats as pets my entire life.  I had also spent a great deal of time sneezing, and with watery eyes.  Go figure.

What I Tried — SUPPLEMENTS

Starting in 2001 (when I started experiencing asthma symptoms every day) I experimented with a large number of supplements.  Most had no effect on my asthma symptoms.  Some made my symptoms worse.  A few helped to some extent.  Supplements are not the “cure” I’m referring to in the post title, but some are worth mentioning anyway.

Multivitamins — Multi-vitamin/mineral supplements tended to aggravate my symptoms, and I haven’t been able to figure out why (too many ingredients, and too many brands to do any kind of controlled experiment).  It could have something to do with the complex synergies that exist among different vitamins and minerals — too much of one ingredient might prevent absorption of another ingredient that is helpful to asthma.  Or maybe one of the ingredients in multi-vitamins catalyzes one of the many possible inflammatory chain reactions that are possible in the human body.  I don’t think it’s an allergic reaction to a filler or a coating, as I’ve tried out many high quality and hypoallergenic brands, all with the same adverse effect.  I suspect one or more of the B vitamins is to blame, since high-potency doses of B-complex also have an adverse effect on my breathing.

Vitamin C — There’s a great deal of research that supports the use of Vitamin C as a treatment of asthma, especially against exercise-induced asthma.  My own experience was that vitamin C provided some relief, and did help reduce asthma symptoms.  It wasn’t a cure, but it helped.  For me, positive benefits seemed to top out at about 500mg/day.

Vitamin B6 — Some research has been conducted on the effect of vitamin B6 supplements on asthma, with mixed results.  My own experience was also mixed; sometimes taking B6 seemed to help, other times not.  B6 may help prevent the overproduction of histamine, and may be more effective at controlling allergies than asthma.

Magnesium — Magnesium helps keep smooth muscle fibers (the kind in your lungs) relaxed.  I’ve noticed a beneficial effect on my breathing from taking magnesium.  Magnesium citrate is a better bet than magnesium oxide — too much of the latter can make you run to the bathroom.  If you want to try taking magnesium, start with a 200mg dose (or less, and work your way up to see how much you can tolerate).  There has been a great deal of research concerning magnesium and asthma.

Evening primrose oil — This oil supplies a fatty acid (GLA) which can have a positive anti-inflammatory effect.  It’s a traditional treatment for asthma in some cultures.  Supporting clinical evidence is weak, but I’ve noticed a beneficial effect from a 1000mg dose.

Bromelain — This is an enzyme extracted from pineapple.  It has a strong anti-inflammatory effect that lasts a few hours.  I found that putting half a pill (250mg) under my tongue (to more quickly absorb the enzyme into my bloodstream) would make me breathe easier within half an hour.  At least one mouse study has found bromelain to be effective against asthma.  On the other hand, if I take too much bromelain, it makes my heart race.

Note on bromelain: A few years ago there was an “asthma cure” going around the internet that recommended megadoses of Blue Bonnet Super Quercetin.  I don’t think quercetin does a thing for asthma, but in my experience bromelain is effective, and that particular formulation contains bromelain.

Fish oil — Keeping a favorable dietary Omega-3 to Omega-6 fatty acid ratio is extremely important in managing inflammatory conditions.  I’ll go into more detail later, but I recommend fish oil for pretty much everyone (not just to people with asthma, but also to improve heart health and to prevent depression and seasonal affective disorder).  To avoid fish burps, keep fish oil in the refrigerator, and take it with food.  I generally take about 4g of fish oil and/or cod liver oil (in winter) daily, in capsule form.  Here is a summary of research regarding fish oil and asthma.

Raw garlic — In my experience, eating raw garlic is effective against asthma.  Unfortunately, raw garlic comes with its own side effect — garlic breath and even garlic body odor if you eat too much.  To minimize garlic breath, you can chop up a small clove (or half a large clove) into small pieces, swish those pieces around in a small amount of water, and then swallow the whole thing quickly.

Some supplements I found to be effective against allergies (like black seed, nettle, and MSM), but not helpful in controlling asthma symptoms.

What I Tried — DRUGS

I’ve always been wary of using powerful drugs to treat illness — too many side effects and not enough research.  However I quickly grew desperate enough to get over my drug hang-ups and try them all.  Here’s a brief summary of my experience with using drugs to treat asthma.

Albuterol — Albuterol is one of the most commonly used asthma drugs, and works by relaxing smooth muscle in the lungs, thus easing bronchospasm (airway constriction).  For me, albuterol provided zero relief, and did nothing to improve my PEF.  This was a strong indication that the underlying cause of my symptoms was primarily airway inflammation (more so than airway constriction).  This made sense to me — I had never ended up in the ER with acute breathing problems (many of my friends with asthma have).  My symptoms were less severe, but more chronic.

Steroids (glucocorticoids) — I tried several brands of steroid inhalers, and found that they provided quick, lasting relief.  I remember distinctly at one point taking a normal breath, feeling it “catch,” and experiencing a powerful combined sense of emotional relief, and outright joy.  I would be able to breathe normally again!

I would have been willing to tolerate some of the side effects of glucocorticoid use (weight gain, reduced immunity, muscle weakness, weakened bones), but there was one side-effect I could not tolerate.  Each time I tried inhaled steroids, I would start experiencing severe mood swings within a few days.  One time I even felt suicidal — the first time I had ever experienced that feeling in my life.  Glucocorticoids lower both plasma and brain serotonin levels, and are linked to depression and feelings of aggression.  My violent mood swings stopped as soon as I stopped using them.  Back to the drawing board.

Leukotriene Inhibitors — Leukotrienes are fatty molecules that play a role in immune function and inflammation.  I found the effect of taking a leukotriene inhibitor to be intensely drying (an anti-histamine effect), but not helpful to my asthma symptoms.  This class of drugs is probably more effective for allergic rhinitis (the other condition it is prescribed for).  A very effective, but cheaper (and probably better for you) alternative that does more or less the same thing is black seed (black cumin).  Black seed is very effective against both seasonal allergies and coughs — according to this site black seed oil contains chemicals which inhibit leukotriene synthesis.

Tianeptine — tianeptine (Stablon) is an antidepressant drug that works via increasing serotonin uptake (the opposite action of antidepressents like Prozac, which inhibit serotonin reuptake; SSRI = selective serotonin reuptake inhibitor).  Tianeptine has long been known to decrease asthma symptoms; the drug reduces plasma serotonin (high plasma serotonin can induce bronchoconstriction).

I didn’t try tianeptine until I was fairly desperate.  I ordered some from a mail-order company of dubious legality.  I took some, starting with one pill a day, and found that it worked.  Not as well as steroids — but better than most of the supplements I had tried.

There were a few problems with tianeptine; after a few days of taking it I would notice a drop in energy, and well as wonky moods (ups and downs unrelated to my life circumstances).  It’s a powerful drug.  If you’re severely depressed and asthmatic, I would definitely recommend it over any SSRI (for one thing, tianeptine has no sexual side effects).  But for less severe cases of both conditions, there are safer, simpler modes of treatment (keep reading).

What I Tried — DIETARY RESTRICTIONS

I tried modifying my diet to see if it improved my asthma symptoms.  At various times I tried eliminating dairy products, all caffeine, red meat, wheat, red wine, all alcohol, nuts, and a number of other foods and categories of food.  Some of these food trials seemed to work; I would often go days without symptoms.

I kept trying to find the one food that was causing my symptoms.  I ordered an expensive ELISA blood test to try and discover which “hidden food allergies” I might have (I didn’t have any obvious ones — like going into anaphylactic shock if I ate peanuts).  I was surprised that the test showed I was allergic to … no foods at all.  A mild sensitivity to honey (which I rarely ate), and otherwise nothing.

Still, I felt that modifying my diet was somehow the key to managing my symptoms, and that instinct eventually proved to be correct.

What I Tried — OTHER STUFF

Avoiding environmental allergens — I went to an allergist and was tested for various allergies.  I showed strong sensitivities to a wide range of flower, weed and tree pollens.  I was also found to be highly allergic to dust mites.

I bought dust-mite proof covers for my mattress and pillows.  Those did help — with allergies.  I stopped sneezing every morning.  But it didn’t help with asthma.

I found that when I traveled, my asthma symptoms would often disappear.  The pollens I had grown up and become sensitized to weren’t present in other environments.  But I loved living in the Bay Area.  I didn’t want to move.  Air quality is better in San Francisco than in Oakland (mostly because of SF’s proximity to the ocean, and wind), but I didn’t want to move to San Francisco — too much traffic and not enough sun and open space.

In 2002 we did move out of the mold house — we bought a great house in Oakland.  My symptoms improved somewhat, but still persisted.

Buteyko method — the Buteyko method is a breathing technique that can help relieve asthma symptoms.  It works — but it’s extremely difficult!  The basic idea is to slow your breathing and boost the CO2 levels in your bloodstream.  This has the effect of opening up your airways, decreasing both bronchoconstriction and inflammation.  Eventually, you can train yourself to permanently slow your breathing and control asthma symptoms.

I don’t buy the Buteyko method premise that all asthmatics “chronically overbreathe.”  From my limited experience with scuba diving, I learned that I breathe less, or more slowly, than average, yet I still experienced asthma symptoms.  However the techniques are still useful, and can probably prevent a trip to the ER for someone experiencing an acute asthma attack.

The Water Cure — this simple, free method (drink way more water, avoid all caffeine, and include some sea salt in your diet) has no doubt worked for some people.  Some of the premises have been found to be bunk (like the idea that all caffeinated beverages — even very weak green tea — are dehydrating), but I think there’s something to the idea that chronic dehydration is closely linked to bronchoconstriction.  Since my asthma symptoms were more related to airway inflammation, rather than constriction, the water cure didn’t do much for me (except make me piss a lot).

Other Observations

Two interesting observations.

1. Whenever I had a cold, my asthma symptoms would disappear entirely.  Of course, I would be sneezing, congested, and miserable, but no breathing troubles!  This was a clue that the disease was closely linked with immune function.  Perhaps when my immune system was occupied with a real threat (a cold virus), it would ignore the environmental allergens that would trigger my asthma symptoms.
2. The same thing was true if I had hay fever.  If I was experiencing allergy symptoms (sneezing, runny nose, watery itchy eyes, etc.) my breathing would be fine.  At the same time I found that drugs or supplements that inhibited histamine would sometimes make my breathing worse.  I realize that many people experience asthma and allergies together.  While I have experienced both conditions, they’ve never occurred at the same time.

I can’t adequately explain either observation, but I wanted to share them nonetheless.

What Worked

I tried most of the above methods between 2001 and 2003.  By 2004, I was reducing my symptoms to some extent with a regular intake of fish oil, evening primrose oil, vitamin C, and magnesium.  Taking fish oil daily was a major turning point — it really helped keep my airway inflammation in check.  I think my Omega-3/Omega-6 fatty acid ratio was severely skewed towards Omega-6 (just as it is in most people in the U.S., including vegetarians and vegans).  The additional Omega-3’s (EPA/DHA) in fish oil helped correct this problem.

I noticed another consistent improvement in my symptoms when I reduced the amount of wheat I was eating.  I sharply reduced the amount of  bread, pasta, pizza, pastries, and even whole-wheat products I was consuming.  My breathing improved, and within a few months I lost about ten pounds of fat and retained water weight.

In 2006 I began to experiment with going “all the way” with the so-called “paleolithic diet.”  For the most part, I cut out all grains, legumes, cow’s milk, and processed foods.  Instead of having “pile o’ starch” as the basis of every meal, I began to eat animal protein (seafood, poultry, eggs, and meat), fresh fruit, and non-starchy vegetables, with generous amounts of olive oil, butter, and nuts.  I also started to eat grass-fed/pastured meat and butter (much higher in anti-inflammatory Omega-3’s than grain-fed animal products), and to supplement with 5K IU of vitamin D on most days (especially during the winter).

The effects of this dietary experiments were dramatic.  My asthma symptoms virtually disappeared, and I lost an additional ten pounds of fat and retained water.

Why Does It Work?

I think there are at least five reasons why the paleolithic diet is effective against asthma:

1. The diet improves the Omega-3/Omega-6 ratio, which is effective against inflammatory conditions.
2. The diet is high in vitamin D.  Vitamin D levels are inversely correlated with asthma symptoms.
3. The diet is low in lectins, gluten, and casein a1, all of which which are associated with “leaky gut syndrome.”  Whole, undigested proteins (as opposed to amino acids) directly entering your bloodstream via your intestines can trick your immune system into attacking its own tissues (resulting in chronic inflammation).
4. The diet is relatively low in carbohydrates, which helps keep plasma serotonin levels from getting too high (which can trigger bronchoconstriction).
5. The diet is very high in phytonutrients, many of which have anti-inflammatory effects.

Asthma is primarily an allergic disease — the immune system reacts with inflammation and airway constriction to factors in the environment (pollen, bacteria, viruses, molds, proteins) that it has become sensitized to.  The paleo diet has the effect of making the immune system less “twitchy” — less prone to autoimmunity and inflammation.

Is It Hard To Eat That Way?

I don’t find it difficult, but I’m not that strict.  I follow Mark Sisson’s “primal” version of the paleolithic diet, which allows dark chocolate, coffee, tea, and some wine and beer.  I also eat some dairy products, but I try to stick to the “a2” casein varieties of dairy (milk and cheese from goats, sheep, and Guernsey cows).  Legumes (beans, peas, and peanuts) aren’t included in the paleo diet, but the lectins can be mostly soaked and cooked out, and they’re packed with antioxidants and other nutrients.  I stay away from soy  (which can mess with hormones) and red kidney beans (packed with toxic lectins), but I sometimes eat green beans, peas, pinto beans, and peanuts.

When I eat out at restaurants, I’ll order protein and vegetables instead of pasta, but if the bread is good I’ll eat a piece.  I have less of a sweet tooth than I did in my starch-binging days, but I still have one — so I eat ice cream or pie once in awhile.

Even with fairly frequent “cheats,” I now breathe easy, and I’ve kept off the extra twenty pounds.

I do need to be careful not to eat too many foods that are naturally high in serotonin, such as plums, bananas, avocados, kiwi, tomatoes and a few others.  These foods can’t raise your brain serotonin, but they can boost your plasma (blood) serotonin, thus possibly triggering bronchoconstriction and asthma symptoms.

I still take supplements — both for general health and to make sure I stay free of breathing problems.  Most important are fish oil (to keep the Omega-3/Omega-6 fatty acid balance tilted towards Omega-3), and magnesium (which has a host of other benefits, like preventing noise-related hearing loss).

What Does “Cure” Mean?

You might object to my use of the word “cure.”  Have you really cured a disease if it can come back at any time?  If you have Type-2 diabetes, and you “cure” the disease by sharply reducing your dietary glycemic load (eating less sugar and starch), and exercising regularly, is it really cured?

Take cancer, for example.  Our bodies are constantly producing cancer cells, but our immune systems generally keep them in check.  We never totally rid our bodies of cancer cells, or bacteria, or viruses, or inflammation, or any of the other factors that cause disease.

You can “cure” scurvy with vitamin C, but the scurvy will come back if you stop ingesting vitamin C for long enough.  You can “cure” a bacterial infection with antibiotics, but those bacteria still lurk in the environment (or on your skin, or in your intestines) and can reinfect you at any time.

I used “cured” in the post title, but I could have also used “healed,” or “completely manage my symptoms.”  I’m still vulnerable to asthma if I eat large amounts of the wrong foods, or inhale gigantic amounts of certain pollens.  But on the whole, I feel like I’ve cured the disease in myself.

If you (or a loved one) have experienced asthma symptoms, I feel for you, and I hope you find this post to be useful.  Even if a modified paleolithic diet doesn’t work for you (or you don’t want to try it), don’t give up.  Keep trying things — don’t settle for an inferior quality of life.  If you find the right combination of factors, the body is capable of healing itself.

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