Coffee and asthma attack

The effect of caffeine in people with asthma

Caffeine is found in coffee, tea, cola drinks and cocoa. Caffeine is a drug that is very similar to theophylline. Theophylline is a bronchodilator drug that is taken to open up the airways in the lungs and therefore relieve the symptoms of asthma, such as wheezing, coughing and breathlessness. Scientists are interested in finding out whether caffeine has the same effect on the lungs as theophylline.

There are two major reasons why it is important to know if caffeine is a bronchodilator. The first is because it may be beneficial for asthmatics to take caffeine in order to relieve the symptoms of asthma. The second is because consuming caffeine may affect the results of important tests that determine how bad someone’s asthma is.

If caffeine acts as a bronchodilator and widens the airways, then a patient who has consumed caffeine before taking the test would show a better result in a lung function test than they would have if they had not consumed any caffeine. The potential problem with this is that if the test results are better than expected doctors may prescribe a lower dose or a weaker drug than is really necessary, which can lead to problems with asthma management.

This review carefully examines all the available high-quality clinical trials on caffeine in asthma. This review was conducted to discover if people should avoid consuming caffeine before taking lung function tests.

This review found that even small amounts of caffeine can improve lung function for up to four hours. Therefore caffeine can affect the result of a lung function test (e.g. spirometry) and so caffeine should be avoided before taking a lung function test if possible, and previous caffeine consumption should be recorded.

It is not known if taking caffeine leads to improvements in symptoms. It may be that in order to improve the symptoms of asthma, caffeine is needed in such large amounts that the drug’s adverse effects would become a problem, so more research is needed.

Another clinical trial looked at the effect of caffeine on exhaled nitric oxide levels and found that there is no significant effect, so it appears unlikely that patients would need to avoid caffeine before taking this type of test. However, this is the result of just a single study so more research is needed to clarify this.

This post discusses claims that caffeine can be used to treat asthma symptoms. It is part of our “AAFA Explains” series looking at complementary and alternative medicine (CAM) aimed at asthma and allergies. The Asthma and Allergy Foundation of America (AAFA) wants to guide you as you decide between choices that may be “likely safe” or “potentially unsafe.”

What is asthma?
Asthma is a chronic disease that causes your airways to become inflamed, making it hard to breathe. There is no cure for asthma. The best way to manage asthma is to avoid triggers, take prescribed medicine to prevent symptoms, and be prepared to treat asthma episodes if they occur.

Common symptoms of asthma are coughing, shortness of breath, wheezing and chest tightness. Asthma may lead to a medical emergency. It is important to know the signs of a severe asthma attack, and know how to treat it if it occurs.

What is caffeine?
Caffeine is an ingredient found in coffee, tea, cola drinks and cocoa and in over 60 plants. Drinks that contain caffeine are called “caffeinated” or “energy” drinks.

Caffeine stimulates the central nervous system. It can temporarily make you feel more awake, energetic and focused.

What does science tell us about caffeinated drinks and asthma?
Clinical studies have shown that caffeine is a weak bronchodilator, improving lung function for two to four hours after it is consumed. However, it is not as strong or fast acting as rescue bronchodilators like albuterol.

This would make it unsafe to use caffeine as an asthma treatment. This is because when consumed in very large doses, caffeine can cause unwanted side effects. These include insomnia, headaches, shakiness, upset stomach, bone thinning and more. In addition, in rare cases an overdose of caffeine can result in death due to convulsions or irregular heartbeat.

Is it safe to drink coffee and caffeinated drinks?
For most people it is safe to drink low to moderate amounts of coffee and other caffeinated drinks. However, at this point in time caffeine is not recommended as an asthma treatment.

Is it okay to consume caffeine before taking lung function tests?
No. Even small amounts of caffeine can affect the results of spirometry, a pulmonary (lung) function test, sometimes called PFTs. Spirometry is a common test that is done in the doctor’s office or in a lab. It is used to determine the severity of your asthma or the level of your asthma control.

Drinking coffee or other caffeinated drinks within four hours before performing spirometry can lead to incorrect test results. It might look like your lungs are working better than they really are. This can cause your doctor to prescribe a lower dose or a weaker drug than what you need to manage your asthma.

The bottom line:
You should avoid caffeine for at least four hours before any medical appointment that might include a lung function test.

Do not use coffee or other caffeinated drinks as a way to manage or treat asthma .

Key definitions:

  • Randomized controlled trials: Participants are randomly placed into two groups. One group does not receive any treatment. The other group receives the treatment under consideration. Researchers follow both groups over time. At the end of the study, they compare results.
  • Efficacy: Whether or not a treatment works, and by how much.


Medical Review October 2016.

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Coffee and Other Natural Remedies for Asthma

Q1. Can you recommend some natural remedies for asthma? For example, I’ve tried strong black coffee, which has helped me with my wheezing and shortness of breath during an asthma flare-up. Thanks!

First and foremost, conventional medicine offers excellent anti-inflammatory inhalers that control airway inflammation, the culprit of asthma.

Caffeine has similar properties to theophylline, a second-line medication used for more than 30 years in the treatment of asthma. There are also some other natural remedies like pycnogenol, a mixture of flavonoids, which might reduce the need for rescue medications, as seen in one study performed in a group of children.

However, I have not come across consistent, repeated positive outcomes for asthma treated with natural supplements. Since asthma is a potentially fatal disease, all asthmatics should be evaluated by an allergist to gain clarity of what they are allergic to, so they can avoid those triggers and get started on a proper medical regimen.

Q2. Would a child with a touch of asthma/allergies fare better in a warmer environment in which the weather doesn’t change as much as it does in New York, where it goes from hot to cold all the time?

— Jennifer, New York

This is a commonly asked question, so I’m glad to have the chance to respond. The short answer is that moving to a warmer environment does not seem to result in dramatic improvement for most people with allergies and asthma. I have met people who claimed that they were better in a specific place, so it may help certain individuals, but over all it is not a reliable strategy. In addition, climate does not seem to prevent the condition from worsening, as these problems are evident in people all over the country, living in all types of environments.

I understand why you might think that moving to a warmer environment where the temperature doesn’t shift so suddenly and dramatically (as it does in New York, for example) would help alleviate the sinus and asthma flares that accompany those weather changes. But it seems that people who are prone to asthma and/or allergies simply develop symptoms in response to other triggers, like the pollens and molds that are present year-round in warmer environments. And keep in mind that people still suffer from colds and viral infections at certain times of year, regardless of where they live. The bottom line: Unfortunately, the tendency to become asthmatic or allergic to things in one’s environment does not change, even though the environment might.

Q3. I am using Singulair (montelukast), albuterol, Pulmicort Respules (budesonide), Spiriva (tiotropium) and Foradil Aerolizer (formoterol fumurate) for my asthma. I have to constantly clear my throat and seem to have excessive mucus all of a sudden. Could any of these medications be causing this problem? My pulmonologist says I don’t have allergies according to a RAST blood test, although skin testing several years ago showed I did.

The combination of Pulmicort Respules (a nebulized corticosteroid), Singulair (a leukotriene receptor antagonist), albuterol (a short-acting bronchodilator), and Spiriva is an excellent regimen since each medication has a unique action and those actions work together in a way that makes them more effective. None of these medications should lead to increased mucus secretions.

A radioallergosorbent test, or RAST, measures the level of certain antibodies in the blood. It is not as sensitive as skin testing, so I would recommend repeat skin testing by an allergist. Depending on the results, an antihistamine and or allergy shots may be the missing piece in your treatment puzzle and could help with the mucus.

Q4. Every time it’s humid, I seem to have problems with my asthma. I get very congested and lose my voice. Is the weather causing the problem? How can I stop this before I get sick and have to go to the doctor?

Weather can definitely contribute to your asthma. At the earliest sign of increasing humidity, rinse your sinuses twice a day. That will alleviate some of your nasal congestion and probably help you. Mold is a common allergen, and it thrives in humid and moist environments. Often patients with allergy to mold will complain of nasal congestion as well as chest tightness, wheezing and cough.

It is important to be evaluated by an allergist and find out your allergic triggers. Once you are aware of what causes your discomfort, you can protect yourself against it. In the case of mold, you can minimize the moisture in your environment, take antihistamines and use sinus rinses to prevent and decrease congestion. Nasal steroids will also reduce nasal inflammation and, of course, there are always allergy shots that reduce allergic symptoms in 85 percent of patients.

Q5. I have heard so many bad things about steroid inhalers. Is it possible to use herbal remedies for your asthma? Do you know if they will help or hurt you?

– Cherie

There is a Chinese herbal remedy referred to as ASHMI (antiasthma herbal medicine intervention) that seems to be effective, and researchers at Mount Sinai Hospital in New York City are currently studying it. But it is important to know whether it is safe for regular and long-term use before ASHMI can be recommended.

There are many other herbal remedies that are commercially available, but they have not been shown to be effective or ineffective in scientific studies. A few years ago, a review was performed of the medical literature in an attempt to pull together all the information about herbal remedies for asthma. The conclusion was that there was not enough information to say that any of them was helpful, so unfortunately, we are still largely in the dark about these types of treatments.

Dietary supplements have also been proposed to help in the treatment of asthma. Specifically, fish oil, which contains omega-3 fatty acids, and antioxidants such as vitamins E and C have been studied. Most research on vitamin supplementation shows no effects or only slight benefits. An analysis of fish oil for all types of asthma showed no significant effects, although there was one recent study that showed clear benefit in a small group of people with exercise-induced asthma.

Please remember, the FDA does not regulate herbal remedies and dietary supplements, so consumers have no real way of knowing what these things do, good or bad. So you need to be careful. My experience with steroid inhalers is that almost all patients find them very effective and do not require high doses of medication, in which case the side effects are minimal, even with years of use. If I have a patient who wants to try herbal remedies, I suggest that they first get their asthma into a well-controlled state using standard therapies. Then, with the help of their doctor, they can add an herbal remedy and see if they can gradually lower the dose of the other medicines. Sometimes this seems to work, but sometimes not. I hope that helps.

Q6. Sometimes when my asthma worsens due to a viral illness, I find that I cough up a lot of mucus in the shower and when using my peak flow meter. Is it helpful or harmful to aggressively clear my lungs? Do you recommend using an expectorant?

Coughing up mucus and clearing your lungs is important. A wonderful natural expectorant effect can be achieved by having another person cup their hands and clap up and down your back to bring up mucus.

Q7. I’m always looking for a new way to help me breathe better. I thought about trying acupuncture for asthma. Does acupuncture work for asthma?

Acupuncture is a wonderful additional treatment to conventional western medicine. It results in the release of endorphins which make people feel good. If you want to add acupuncture to your current treatment, that’s great, but don’t stop using your inhalers, which will ultimately save your life.

Q8. I have suffered from asthma for 30 years. My asthma attacks are worse when it’s cold out than when it’s hot. Why is this?

The majority of people with asthma notice that cold, dry air causes more symptoms than mild-temperature or hot, humid air — just as you describe. This is believed to be mostly due to the dryness of cold air, which irritates the lining of the tubes in the lungs. In people with asthma, the muscle fibers that adjust the diameter of the tubes react to any irritating situation by tightening, which in turn causes cough, chest tightness, and sometimes wheezing.

There are a couple of things you can do to help minimize asthma attacks if you know that you’ll be out on a day when the air is very cold (and therefore dry). Try to breathe through your nose, as the nasal passages are designed to warm and moisturize the air before it reaches your lungs. Also, you can cover your nose and mouth with a scarf. Or if you are trying to exercise or stay out for a while, consider buying a face mask with a special cartridge that warms the air.

Q9. I am a big “do-it-yourselfer,” partly because of finances but mostly because I like doing these things. I am now thinking of repainting my bedroom using water-based paints, good ventilation, a mask for me and not sleeping there until the smell has abated. Is this a foolish thing for me to do? I am currently not experiencing any asthma symptoms. When I do run into trouble it’s mostly my eczema that kicks up. I plan to check with my dermatologist too. Thank you.

Exposing oneself to irritants usually results in disaster. While it is possible to protect yourself against asthma triggers like paint fumes with a mask, inhaled steroids and bronchodilators, eczema is extremely difficult to prevent and equally difficult to treat. I’m sorry to tell you this, since painting is an activity you enjoy, but if there is a way to avoid do-it-yourself home renovations, it would be prudent to do so.

Learn more in the Everyday Health Asthma Center.

A large dose of coffee before exercise could help prevent asthma sufferers from having an attack.

A team of American and British scientists has found that consuming caffeine an hour before exercising can reduce the symptoms of exercise-induced asthma (EIA).

After studying ten asthmatic subjects – all of whose symptoms were brought on by exercise – they report that 9 milligrams of caffeine per kilogram of body weight was as effective as the albuterol inhalers commonly used to prevent attacks. To put this into context, somebody weighing ten stone (64kg) would need to consume 570mg of caffeine and there are 240mg in a tall Starbucks coffee.

The participants were given 3, 6, or 9mg of caffeine per kilogram of body weight, or a placebo, an hour before running on a treadmill. They underwent pulmonary function tests 15 minutes before the exercise and then 1, 5, 10, 15 and 30 minutes afterwards.

The team found that large doses of caffeine had the same effect as an inhaler while smaller doses of 3mg and 6mg per kilogram of body weight reduced wheezing, coughing and other symptoms of EIA.

Martin Lindley, of Loughborough University, Timothy Van Haitsma, from the University of Utah, and David Koceja and Joel Stager, from Indiana University, have also been researching whether diet can help ease the symptoms of EIA. They report that a diet high in fish oil and antioxidants and low in salt has the potential to reduce the severity of EIA.

However, while some caffeine can be a good thing – not only for ashthma sufferers but also for athletes and even premature babies – too much can de detrimental. The Lancet has released a report on a 13-year-old Italian boy who was hospitalised after ingesting too much caffeine.

The boy, who was treated in the Second University of Naples and Monaldi Hospital, was admitted with a rapid heartbeat, prickling sensations in his legs and raised blood pressure.

He was diagnosed with caffeine intoxication and admitted that he had eaten two packets of “energy” chewing gum. According to The Telegraph, he had ingested 320mg of caffeine.

Dr Francesco Natale, who treated the boy, said: “Our patient…presumably had high caffeine sensitivity in view of his low habitual caffeine intake, so 320mg was a substantial amount of caffeine.

He added that these chewing gums could be behind other cases of childhood caffeine intoxication: “The risk of intoxication is high in children and teenagers in view of general caffeine-naivety, and the unrestricted sale of these substances.”

Treating Asthma with Coffee

Caffeine that is found majorly in your cup of coffee has been found to widen the bronchial tubes that otherwise constrict during an attack. Besides, caffeine has chemical properties that are similar to the drugs prescribed to an asthma patient. Coffee was an ancient way of treating asthma in Britain in the 1800s though that does not certify the authenticity and efficacy of this treatment. If you want to accommodate coffee as a treatment option for asthma, make sure that you discuss about its dosage with your doctor.

Choose your Coffee Type

Considering that every asthma case is unique, you must choose your coffee type carefully before sipping it entirely. There are a few fine brands of coffee in the market that grind you fresh beans as per your taste. You may also get two types of flavours or a quality of coffee mixed as per your personalized blend. Carry a small amount of different kinds of coffee and observe how your asthma symptoms respond to each. Prepare one third of a cup of coffee. Consumption of coffee in the mentioned quantity is enough for an asthmatic to introspect the difference. Once you have had a few sips of the coffee, wait for a few minutes until you observe any change in your condition. Breathe through the nose, purse your lips and exhale slowly. If you feel any relief sinking in, drink the rest of the coffee slowly.

Also read: Exercises for Asthma Treatment

Know When to Stop the Consumption

If coffee does not bring any change in your condition, stop having it right away. Continuing to drink coffee may worsen your condition. If your asthma symptoms persist, rush to your doctor immediately. Remember to try coffee in the presence of a family member or peer. If you have any other medical condition such as gestational diabetes or are pregnant, it is highly advisable to consult the doctor for a coffee treatment for asthma. You never know what might make your health worse!

Pick the Prescribed Inhaler

If coffee does not lower your breathing difficulties, pick the prescribed inhaler. If coffee has already been herbal and is not known to cause any side effects or symptoms of asthma. Green tea can be taken twice a day without any sugar or milk.

Also read: Dangers of untreated asthma

Try Organic Coffee

You can also try organic coffee to treat asthma. Processed coffee contains pesticides and chemicals that can heighten the asthmatic conditions. This has been proven as an effective cure for asthmatic conditions. Organic coffee has theophylline in it, which is also present in drugs prescribed for asthma, but do remember that if you have an appointment with your doctor for lung tests, it is best to abstain from coffee for at least two to three days prior to the test.

Read more articles on Asthma Treatment.

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Can Coffee Help Asthma?

Written by Courteney

Posted on May 19, 2016 at 4:48 pm

In short, yes, drinking enough coffee can help ease some of the symptoms of asthma such as wheezing and coughing because it contains caffeine, which acts like a bronchodilator. Specifically, caffeine mimics the effects of an older asthma medication called theophylline, which relieves breathlessness and wheezing by opening the airways.

Don’t Switch Your Meds For Perk

Studies have shown that drinking 2-3 highly caffeinated beverages such as coffee (coffee and tea are among the most caffeinated, followed by certain sodas) may help alleviate some asthma symptoms for even up to hours after initial onset. However, others argue you’d need too much coffee to see a significant benefit. Furthermore, coffee is not as effective as actual asthma medications so people certainly shouldn’t be putting down their puffers in place of a cup of joe. In an emergency where a asthmatic has no access to puffers, 2-3 cups of coffee could potentially help keep the stabilize their condition until emergency care is in place, but this isn’t foolproof. Some medical professionals do suggest a couple cups a day as preventative asthma care. Besides, most current asthmatic puffers work better and for longer than theophylline (with fewer side effects), so while coffee would be an okay substitute in a pinch, the effects may pale in comparison to today’s emergency asthma medications.

Can Coffee Interfere With Lung Function Tests?

Quality clinical trials have been conducted to look into just how closely caffeine mimics the effects of asthma medications, specifically when it comes to lung function tests. Many of these studies have shown that drinking certain amounts of coffee can actually sway a lung function test, making the person perform better than if they would have without the coffee. So the benefits may not be enough to stop an attack mid-wheeze, but there must be some merit to the coffee cure if asthmatics should avoid caffeine before performing a respiratory test!

Coffee Beans And Scents

There is little to no empirical research to back up this next claim, but many homeopathic and some medical professionals have suggested sniffing coffee beans for asthmatics who react very badly to scents. Taking a little baggie full of fresh coffee beans in public and having a little sniff could potentially block some scents from effecting you quite as adversely as without the blockers. Is there any truth to it? It is hard to say, but consider this: coffee beans have long been used to neutralize the nostrils between perfume testings, so why wouldn’t they be effective for blocking scents you may breeze by while shopping? Anything is worth a try even if it helps that tiny little bit.

The Bottom Line

So it seems having a few cups of coffee during a bout of wheezes can have a moderate bronchodilation effect, but it shouldn’t be something you rely on too heavily, and you certainly shouldn’t be replacing any puffers with coffee. However, it is good information to know and could indeed help someone in an emergency who doesn’t have access to medication and a couple cups of black coffee a day may well provide some day-to-day asthma relief. Just to note, a much more effective alternative medication for asthma attacks which many people unfortunately don’t know about is an adrenaline autoinjector. EpiPens may be for allergies, but they can save the life of an asthmatic having a serious attack just as effectively.

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Tags: alternative treatment, asthma, coffee, health, lifestyle, lungs, prevention, treatment, wheezing,

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