The future belongs to asthmatics or is bronchial asthma a disease?
Professor Buteyko Konstantin Pavlovich (1923-2003) was the first scientist, physiologist, and excellent clinical doctor, who already in 1960’s showed the crucial contribution of “excessive” lung ventilation (“deep” breathing) in the development of bronchial asthma, primary hypertension and stenocardia.
“Deep” breathing, producing carbon dioxide (CO2) deficiency in the lungs, is the cause of feeling of suffocation for bronchial asthma. In cases of hypertension and stenocardia, lack of CO2 leads to spasms of blood vessels and elevated blood pressure.
It can be expected, that appearance of hyperventilation is due to dietary factors, life style, ecology and even thought pattern.
Evolution of our views on the cause of the disease
Lack of CO2 was, as it was originally thought and as it seemed normal from the first view, the result of noisy, “deep” breathing. Such breathing is “visible and audible” when observing a sick patient. This seemingly obvious fact caused that, in early times, the Buteyko method had the following explanation:
“Deep” breathing, producing CO2 deficiency, is the main cause of bronchial spasm (bronchial asthma) and vascular spasms (hypertension).
CO2 is continuously produced in the cells. From there it moves to the blood. The blood transmits carbon dioxide to the lungs. Finally, CO2 is breathed out from the lungs during respiration. The term “breathing” itself means one of the vital functions – gas exchange between the cell and the outside air. From the evolutionary viewpoint, the respiratory system formed at the times when the Earth had no oxygen. The main life processes took place in anaerobic (oxygen-free) medium, which contained large concentrations of carbon dioxide. The respiratory system regulated exchange of carbon dioxide and other ions for maintaining the acid-base equilibrium. This ancient purpose of breathing has been preserved in higher animals, human included. Therefore, carbon dioxide is a very important part of normal life.
There are no other sources of CO2, apart from our metabolism, in the human organism. It became obvious soon that the intensity of metabolism, due to lack of physical activity, is reduced. As a result, CO2 production, due to “sluggish” metabolism, has decreased leading to a mismatch between low metabolism and usual (or standard) ventilation of the lungs. Absolutely “normal” lung ventilation became “excessive”, since “excessiveness” of ventilation is defined due to appearance of lack of CO2. As a result, passive metabolism has been considered the main cause of CO2 deficiency.
Experimental physiology has accumulated many facts, which demonstrate an important role of carbon dioxide as a regulator of many life functions, first of all, breathing.
Although physiology irrefutably proved that CO2 is the main factor in the control of breathing, traditional medicine views CO2 only as a final product, which is necessary to expel from the organism. However, normal life needs certain amounts of carbon dioxide in the tissues and cells of the organism. The less the CO2 concentration, in relation to its norm, the more disharmonies in the organism and the stronger they are. CO2 deficiency can be the cause of problems in the respiratory, endocrine, cardiovascular, gastrointestinal, sceleto-muscular systems, any metabolic problems and allergic reactions.
The history of the discovery, as it told by its author Buteyko KP
"While being a student of the First Moscow Medical Institute named by IM Sechenov, I had a medical practice," said Professor KP Buteyko, "I noticed a fact that breathing of a sick patient is different from that of the healthy person and I started to investigate this problem. "Noisy and deep" breathing of an asthmatic had always been considered an outcome of his disease. Nobody could even suspect that "deep breathing" was the cause of bronchial asthma, and increased depth of breathing could provoke the appearance of the symptoms of the disease. Vice versa, during a crisis, the doctor usually suggested to an asthmatic to breathe as deeply as possible, so that, as they thought at those times, to increase oxygen supply for the organism during the period of breathlessness. That was a fact that, as a result of such practice, the health state of the asthmatic got worse and worse, while some of them were simply dying while being supervised by doctors. This fact obviously caused some confusion, but nobody could get an idea that the asthmatic felt worse exactly due to deep breathing.
How attentiveness resulted in a scientific discovery
Once, during a patient's visit, I was sitting with my back to the room's entrance, and, when the door opened again, before seeing a next patient, I heard his breathing. "Again an asthmatic", I thought and turned my head. That was a surprise, when I saw a tall red-faced lad, with signs, according to his appearance, of hypertension in a state of crisis. He was indeed not an asthmatic, whose noisy and deep breathing is a norm, but a hypertensive with very high blood pressure. I was surprised, "Why did he breathe so?" Such breathing should be found in an asthmatic, who has poorly functioning nose and constricted bronchi. As a result of these factors, his breathing is hard, in opposition to hypertensives, whose airways are in an excellent state. Why did the patient with hypertension have such noisy and deep breathing? The first thought, which occurred in my head, was, "Could deep breathing be connected with his disease?" The next thought was so "senseless", that it had a right to exist," Could deep breathing be the cause of hypertension?" It was necessary immediately to check the truthfulness of this assumption.
Self-testing and creation of the method of treatment
In the case when "deep breathing" is the cause of hypertension, elimination of "deep breathing" should immediately result in reduction and gradual disappearance of the symptoms. How to eliminate "deep breathing"? That is very easy: try to make own breathing less noisy and less noticeable, or, in other words, breathe in such a manner that it would not be visible and, moreover, audible for outsiders that I breathe.
In those times, when I started to work as a doctor and had this medical practice of patients, I myself had hypertension with its normal symptoms: headache, pain near the right kidney, etc.
The easiest way to check my assumption about the leading role of "deep breathing" in development of hypertension was to self-test it. I tried to decrease the depth of my breathing, that is to make it less noticeable or, at least, to stop sniffing and panting.
Almost immediately did I experience the feeling of lack of air since I breathed essentially less volume than usually. However, I continued to endure this unusual and not very pleasant state. To my amusement, my headache, which I had for several days, first, got worse, but later started to ease and, in a few minutes, while I was keeping myself in the state of air hunger, completely disappeared. The pain near the right kidney got milder and almost vanished. I measured my blood pressure and found that, according to a manometer, it was smaller. I was shocked.
My next step was the desire to check, "Was I not wrong?" Was deep breathing indeed the cause of all symptoms of my hypertension? How to check that? Nothing could be simpler: I started to breathe deeper and noisier. Some seconds later all symptoms returned: the head started to ache, again the pain near the right kidney started to grow. I again reduced the depth of my breathing. However, this time I did not try very hard since I did not like that the previous time all symptoms, first became more acute. The headache soon was gone.
In the hospital, where I worked as a doctor, there were many patients with acute symptoms of bronchial asthma and hypertension. I suggested to many of them to decrease the depth of breathing. Many of them could immediately experience observable relief. Later I understood how many dangerous underwater stones could suddenly appear, if one interferes with own breathing. Hence, it should be done under supervision of the specially trained doctor. However, at those times, I was inspired by the success of the unusually effective treatment, which did not need drugs, or expensive equipment, or financial investments. Later I also realized, that it was easy to eliminate a symptom, but it was very difficult to get rid of the disease. This way required so many efforts from the sick patient himself that few of them would agree to complete this journey. "The way of true cleansing - the destiny of the strong", at one Chinese proverb says.
Creation of theory and priority of our country
What would happen with a person who breathes deeply and noisily? Why could "deep breathing" be the cause of the disease?
I started to spend whole days in the Central Medical Library. I found that by those time there were enough knowledge in the areas of respiratory physiology and blood circulation in order to explain destructive action of the deep breathing or so called "hyperventilation of the lungs". Ventilation of the lungs, in excess to current needs of metabolism, causes deficiency of carbon dioxide in the lungs and arterial blood. What next?
Then it was years of scrupulous research work in the Institute of Experimental Biology and Medicine of the Siberian branch of the USSR Academy of Sciences (Akademgorodok, Novosibirsk). It became clear that low concentration of carbon dioxide in the air of the lungs promotes swelling of the mucus membrane of the bronchi and its hyper secretion (that is laboured breathing and abundance of mucus), and also increases the tone of the smooth muscle located near the walls of the bronchi (that is a real asthma attack for an asthmatic).
Then there were times of scientific publications, debates in the Scientific Counsel of the Health Ministry of the USSR, permission of investigations, ban of investigations, period of unofficial work with human masses, large number of similar investigations abroad, especially in the USA and Great Britain, and, finally, either due to a public demand, or due to fear to lose priority of the USSR in these areas, in 1985 Minister of Health of the USSR issued a directive about the use of the "Buteyko method" in wide medical practice and organization of further investigations. Our country preserved its priority, while my investigations proved the existence of "hypocapnic bronchoconstrictive effect" and we were first to create the "hypocapnic theory of development of bronchial asthma".
Therefore, I managed to prove the mechanism of bronchial spasms (asthma attack) and spasms of blood vessels (rise in blood pressure), which were based only on changes in value of CO2 in the lungs and blood, respectively. Discovery of this relationship made it possible to create a method of treatment, which is intended to increase CO2 in the lungs (for bronchial asthma) and in the arterial blood (for hypertension and stenocardia) till the certain threshold values. These values make further existence or development of these diseases impossible.
Hyperventilation and lack of physical activity are the causes of asthma
What was told by Professor K. P. Buteyko became the foundation for creation of the modern, safe and efficient, drug-free method of treatment, used not only for bronchial asthma or hypertension, but also for a group of other diseases. These other diseases are characterized by CO2 deficiency and they can be united in a single group of “CO2 deficient diseases.” Nowadays the role of CO2 deficiency for these conditions is well investigated. The method, which is based on these investigations, is the method of VEDB (volitional elimination of deep breathing) and individually adjusted physical training.
The result of this complex approach is a gradual increase in CO2 concentration of the lungs. This rise, in case of bronchial asthma, would cause quick elimination of hyper-secretion of mucus in mucosal surfaces of the bronchi and reduced tone of the smooth muscles of the bronchi. Moreover, with time, when CO2 content increases till a certain value, there would be no allergic inflammation in the bronchi. That leads to complete elimination of clinical symptoms of asthma. Maintenance of the CO2 level during half of the year results in a full remission of the allergic inflammation in the bronchi, destruction of the reflexive mechanism of spasm development. That makes the asthma attacks impossible even in conditions of deliberate CO2 reductions in the lungs. In order to form the repeated mechanism of bronchoconstriction, one may need 10-15 years. That is a guaranteed term of the clinical remission.
Asthma is not a disease, but a mechanism of adaptation
It is impossible to eliminate the constriction of bronchi (difficulties in breathing, breathlessness) in conditions of CO2 deficiency. At the same time, increasing CO2 level in the lungs always causes bronchodilation. These facts indicate the existence of the mechanism of regulation of the bronchial gap with the main role played by the CO2 concentration in the lungs.
Any activities, which result in CO2 reduction in the lungs, can cause bronchoconstriction and an asthma attack. Since metabolism is the only cause of CO2 production in the human organism, reduced metabolism should necessarily cause lack of CO2 in the cell, blood and lungs.
Maintaining CO2 concentrations near the norm is a condition of normal metabolism and immunity. The organism acts in response to CO2 changes with more sensitivity than to other changes. CO2 deficiency unavoidably causes local and global physiological processes with the goal to keep CO2 values near the norm. One of such CO2-protective mechanisms is bronchoconstriction. The physiological sense of bronchoconstriction is the mechanical restriction of lungs’ ventilation. That reduces the rate of CO2 elimination through the lungs during respiration. Hence, bronchial spasm, by reduction of ventilation, leads to quick accumulation of CO2 in the lungs and elimination of the asthma attack.
The main cause of reduced metabolism and, hence, primary CO2 deficiency is nowadays lack of physical activity. Bronchial asthma, which is based on periodical bronchoconstriction, as well as hypertension, which is based on periodical constriction of blood vessels, is a mechanism of adaptation to lack of physical activity or adaptation to changes in conditions of lifestyle of the modern man. That is a current stage of evolution of the human organism.
What about athletes-asthmatics who exercise?
A mismatch between the alveolar ventilation and metabolism during physical exercise, namely excessive rise in alveolar ventilation in comparison with the needs of the current metabolism, is the cause of CO2 deficiency in the lungs of professional athletes and their development of asthma. This effect is amplified by the misconception that overbreathing increases tissue oxygenation (while in reality everything is exactly vice versa). Extremely awkward realization of these irrational ideas can be seen in some schools for preparation of free divers who gather pearls. These people learn how to spend more time under water. Just before diving they are suggested to make as many deep inhalations and exhalation as possible, in order, as they mistakenly believe, “to saturate the organism with oxygen”. In reality, increased ventilation of the lungs with unchanged metabolism causes significant reduction in blood CO2. That, in its turn, decreases tissue oxygenation of the organism since tissue oxygenation completely depends on CO2 level. Reduced CO2 in the blood causes apnoea (breath holding), since alveolar ventilation mainly depends on CO2 concentration.
Duration of breath holding depends on time of CO2 accumulation till the threshold, which causes the breathing centre to resume breathing. The mechanism of cessation of respiration is similar to cessation of breathing during snoring while sleeping (sleep apnoea). Snoring hyperventilation causes CO2 reduction till the values, which are incompatible with the human life. In order to preserve life, the breathing centre ceases respiration until the increase in blood CO2 values. At that moment an asthmatic can have an asthma attack at night. Hypertensives have spasms of peripheral blood vessels and elevated blood pressure. That also causes constriction of blood vessels, which supply the heart muscle, leading to a heart attack with significantly increasing chances of cardio-infraction. The damage to the organism is very significant, while the life expectancy of such pearl divers is, in average, about 30 years.
Allergy is not a cause of asthma
What about allergens? What about the role of the allergic inflammatory processes in bronchi, which are now considered the main cause of periodic attacks of breathlessness.
The appearance of allergic reactions is the result of faulty metabolism and defective immune response. Allergic inflammation in bronchi, which significantly shape the clinical picture of asthma, is possible only in conditions of CO2 deficiency in the lungs. Interaction with an allergen accelerates swelling of the mucosal surface of the bronchi, but does not play the main role in this process. If there were no contact with the allergen, then the developing CO2 deficiency in the lungs, in spite of that, still would cause an attack of breathlessness. However, that would happen slightly later in time.
Secondary character of the allergic mechanism is especially obvious, when during high CO2 concentrations in the lungs a contact with any allergen does not cause swelling and hyper secretion of mucus since the allergens cannot cause bronchoconstriction. Moreover, achievement of large CO2 values in the lungs and its maintenance for about .5 years in average lead to elimination of the allergic inflammatory process in the bronchi. That helps to attain the duration of remission of up to 15 years while leading standard life style without any restrictions in relation to diet, sources of allergens and physical exercise. Skin tests with former allergens show absence of allergy. The test of the immune system shows normal immune response, that is absence of allergy.
Problems of drug treatment
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Allergic or immuno-deficient theory of asthma with consequent methods of the treatment is the dead-end in the investigation of the asthma mechanism. Nowadays, there are no medications to eliminate the allergy, apart from the hormonal treatment. The use of hormonal methods, after several years, creates, for the doctor and the patient, a dilemma: to die from asthma or from the results of the hormonal treatment? Today, as it is known, while seeking a pill, only hormonal steroids can have any significant influence on the allergic inflammatory process in the bronchi. However, that helps only to reduce the severity of clinical symptoms of asthma described above. The success is minor in comparison with side effects of the hormonal treatment, whereas other methods of treatment of the allergy are ineffective. Thus, elimination of the allergic inflammation in the bronchi, in conditions of CO2 deficiency in the lungs, is not possible.
What is in the foundation of successful treatment of asthma using the Buteyko method?
Based on the above, the main goal of the treatment of bronchial asthma in accordance with the Buteyko method is a gradual increase of CO2 concentration in the lungs. That allows a quick elimination of clinical symptoms of the disease. In case of achieving of the known CO2 threshold and its maintenance for 0.5 year, as practice indicates, the allergic inflammatory process in the bronchi is terminated making remission, with more than 15 years duration, possible, even in conditions of recurring CO2 deficiency in the lungs.
Liberation from fear created by the disease
The most important thing while using the Buteyko method is following:
- elimination of clinical symptoms of bronchial asthma starts from the first day of the treatment, which efficiency depends on the rate of CO2 increase till a certain number;
- ability of the patient himself, without drugs, to avoid an attack of breathlessness liberates him from fear of the disease, improves his "quality of life", helps to solve problems of social adaptation;
- in cases of light or moderately severe asthma, it is possible, practically immediately, to get rid of medical drugs treatment;
- in cases of severe asthma, it is possible to reduce the amount of the used drugs, make the method of their use simpler, and, in addition, to have, if necessary, very short, with a reduced dose, safe courses of the hormonal treatment.
Two methods of treatment of asthma using the Buteyko method
There are two natural methods to eliminate CO2 deficiency in the air of the lungs. These methods are available during everyday life and they treat any form of asthma independently from the severity and duration of the disease.
1. Increase in intensity of the total metabolism and, hence, in the amount of CO2 generated in the organism.
The main cause of CO2 deficiency in general is low metabolism due to passive life style (hypodynamia). Hence, increase in physical activity is the simplest solution of this problem.
CO2 is the regulator of main metabolic chemical reactions. It could be enough to increase the intensity of metabolism in general, and CO2 percentage values in cells, the lungs included, would be greater. The simplest and most available method to increase the general metabolism is muscular exercise, that is sport activities. It seems so that, if an asthmatic is offered to exercise, the total metabolism would increase, CO2 production rate would increase, and asthma is gone. However, increased metabolism unavoidably causes increased ventilation of the lungs. As a result, CO2, instead of accumulation, is "blown off" causing significant and quick worsening of asthma during any physical exercise. To use this method of CO2 accumulation is possible only in the conditions of strict control in relation to total ventilation of the lungs. This method was developed in Clinica Buteyko® and it allows using physical exercise during treatment of any asthma forms. Moreover, former asthmatics, previously "half- alive and dead invalids", who could not even walk without drugs and attacks of breathlessness, gradually become whole people leading active life styles and capable to get busy with any sport.
2.Restriction of total ventilation of the lungs.
This method is implemented in the form of "breathing exercises" and is not physiological or natural since there are no such situations in nature when, due to natural causes, there are restrictions in the total ventilation of the lungs in relation to the current metabolic demands.
The logical permission to use this method is elimination of CO2 deficiency in conditions of low metabolism, and hence, low CO2 production rate due to the fact that "normal" ventilation of the lungs become "excessive" due to CO2 deficiency in the lungs. It is necessary to remember the simple rule: any ventilation of the lungs is excessive, if there is a lack of CO2 in the lungs. CO2 deficiency in this case is a result of low CO2 production rate and not the result of "excessive" ventilation of the lungs. Any so called "normal" ventilation of the lungs, in conditions of CO2 deficiency, will be called "excessive" ventilation.
The use of this method of elimination of CO2 deficiency looks, in practice, as simple breathing exercises. However, that often creates a misconception about necessity of "right breathing" and elimination of "wrong breathing". The terms "right" and "wrong" are only literary expressions, which do not have any sense, but promote the spread of misconceptions in relation to some "secret right" breathing of yogis, Chinese, etc. To speak about "right" or "wrong" breathing is the same as to tell about "right" or "wrong" body temperature.
Breathing is completely automatic process, which is regulated independently from our consciousness. The state of breathing depends on many parameters of the self-regulating functional system. During a day a person performs about 30,000 inhalation and exhalations, which parameters with the use of free will, to our satisfaction, is impossible to change. Any manipulations with breathing are possible for us during very limited time and in extremely limited volume. The management of breathing takes place in automatic regime. Changes in certain parameters of our breathing during certain period of time influence the whole respiratory system. Hence, these changes can also influence ventilation of the lungs.
During the first stage of treatment this method makes it possible, in a short period of time, to decrease the intensity of CO2 elimination through the lungs during the process of respiration. That causes increase in CO2 concentration in the air of the lungs at rest or during light physical exercise. This increase, in its turn, eliminates the most severe symptoms (blocked nose, cough, attacks of breathlessness, accumulation of mucus). Quick elimination of severe symptoms of asthma (in 1-2 days) makes it possible to add, to this method of treatment, adjusted, on the principle of increase, physical exercise. That is made using control of the total ventilation of the lungs, since such an approach is the most natural method of elimination of CO2 deficiency and treatment of asthma, in general.
Breathing exercises, done during a certain period of time, normalize the main parameters of breathing. That creates conditions for elimination of the most severe symptoms of the disease without drugs or with essential reduction in their dose. Increase in CO2 significantly improves oxygenation of the organism, helping to reduce the total ventilation of the lungs and the syndrome of chronic hyperventilation.
What about diet — no drinking — no smoking etc.
Before starting the treatment, the Buteyko method does not require special diets or restrictions in diet. During the process of the treatment changes in parameters of breathing involve improvements in oxygenation of the organism and blood perfusion. That significantly improves metabolic processes and increases the immunity causing different, most natural attitude to diet without any personal effort. Most of all, patients voluntarily decrease the amount of consumed food and experience changes in their dietary preferences. A "side-effect" of the treatment can be loss of excessive weight and natural gradual cessation of smoking and alcohol.
What else can we treat?
Most of all, diseases, which often accompany bronchial asthma: chronic rhinitis, bronchitis, pneumonia, hypertension, and stenocardia. Bronchial asthma and stenocardia are only 2 distinctive models, which effectively demonstrate application of the Buteyko method. However, these are, by far, not the first diseases, which can be successfully treated using the Buteyko method.
Normalization of the immune response removes appearance of various forms of allergy. Improvements in blood supply and oxygenation of the whole organism make application of the Buteyko method efficient in solving problems which are connected with toxicosis of pregnancy, sleep disturbances, insomnia, snoring, sleep apnoea, and also for a wide range of neurotic diseases of the nervous system.
Safety and efficiency of the treatment
It is important to pay attention to the fact, that the Buteyko method guarantees safety and efficiency of the treatment, especially during acute stages. That allows, literally in a few minutes, to eliminate the most severe symptoms of the disease, namely:- prevent an asthma attack for bronchial asthma:
- stop cough and decrease breathlessness;
- unblock the nose for rhinitis;
- eliminate itching for eczema and psoriasis;
- eliminate allergic symptoms;
- most importantly, to prevent appearance of these symptoms without use of medication.
What do you think about 4-5 times reduction in the fee and duration of the treatment? Do you want to experience improvements in life quality during the first days of the treatment? |
