Is Lobelia Good for Asthma? Research Review on Herbs for Asthma

October 2013
Stansbury, Jill; Saunders, Paul Richard; Zampieron, Eugene R.

 

Abstract

Lobelia is a genus of flowering plants that includes approximately 400 species and was popular in traditional Native American medicine as an emetic, expectorant and respiratory stimulant. Lobelia is currently used as an adjunctive for the treatment of asthma and other respiratory disorders.

The active constituent of Lobelia is the alkaloid lobeline, which is known for its beneficial effects on the function of the respiratory tract including stimulating breathing, supporting the cough reflex and improving vascular tone.

Lobelia is important as an alternative treatment for patients with asthma to reduce or eliminate the need for pharmaceuticals commonly associated with adverse effects. However, because of its properties as a respiratory stimulant and expectorant, Lobelia should be used at the correct dose and together with herbs that are soothing to the throat and lungs, and it is often used in a synergistic herbal formula that includes Lobelia herb and seed, Zingiber officinale (ginger), and Hyssopus officinalis (hyssop).

Lobelia should not be used as a substitute for drug therapy during an asthma attack and its use is contraindicated during pregnancy. Lobelia has no known adverse drug interactions and it is therefore a promising complementary therapy for the management of respiratory disorders, in particular in light of the recent increase in the prevalence of allergic respiratory diseases.

 

CLINICAL IMPLICATIONS

Severe asthma is on the rise and is often managed with corticosteroids and other pharmaceuticals known to be immunosuppressives. Such pharmaceutical management typically must be continued long-term, if not for life, and is often associated with side effects. Complementary Alternative Medicine (CAM) therapies, including herbs, may reduce allergic phenomena and airway reactivity such that drug therapies can be reduced or possibly eliminated altogether. Lobelia inflata is a mainstay of botanical therapy for asthma among practitioners of the previous century up to the present time. The active constituents of Lobelia are alkaloids, including lobeline. The highest amount of Lobelia alkaloids are found in the seeds and flowers, but not in the leaf. Therefore, for most effective results it is important to administer Lobelia that has been picked in seed and/or at the flowering stage.

 

PRIMARY INDICATIONS:

Asthma, Respiratory Congestion, Bronchospasm, Pulmonary Hypertension

 

ADJUNCTIVE OR STAND-ALONE TREATMENT:

Adjunctive

 

DOSE OF BIOACTIVE CONSTITUENTS:

Lobelia 975 mg twice per day; containing 180 μg of lobeline (minimum)

Synergistic Herbal Formula: Lobelia Herb and Seed, Ginger, Hyssop, tincture dose 1:2, .25-1 ml (5-20 gtt.) three times per day

 

LAB TEST TO ASSESS EFFICACY:

None known

 

TIME TO CLINICAL EFFICACY:

In high doses, effects can be seen within a week

DRUG INTERACTIONS AND CAUTIONS:

Since asthma attacks are potentially fatal, herbal treatment can not be a replacement for drug therapy during an attack. The primary side effect that is experienced when taking high doses (twice the recommended dose) of Lobelia is nausea. However, Lobelia induced nausea can be mitigated with the concurrent use of herbs such as peppermint, hyssop and ginger and it is recommended that Lobelia be taken with food. Other reported side effects include: vomiting, diarrhea, coughing, dizziness, tremors, and throat irritation. If nausea does occur, lower the dosage and or take with food or a cup of peppermint or chamomile tea. Lobelia is contraindicated in individuals with infectious or inflammatory GI conditions. Lobelia should not be taken during pregnancy. Dose dependent cardio-activity has been observed. There are no reported adverse drug interactions, thus Lobelia can be used concomitant with pharmaceutical respiratory drugs.

 

UNSUBSTANTIATED THEORETICAL CONCERNS:

Unsubstantiated claims of Lobelia toxicity date to the early 18th century from Samuel Thomson’s use of Lobelia in emetic doses with Capsicum.

 

COMMENTS:

For mild asthma cases, the capsule dose of Lobelia herb and seed should start at 975 mg (per dose) twice per day. Typically, patients can take this dose indefinitely. It is notable that some CAM clinicians have found a subgroup of patients can wean off the herb and experience a resolution of asthma symptoms for several months following, especially when other contributing diet and lifestyle factors are addressed as well.

For a patient using Lobelia along with 500 mg rosmarinic acid per day (and avoidance of all food and environmental allergens), this may be a powerful enough therapy to gradually eliminate the need for an inhaler. Other therapeutic options include Grindelia (Gumweed), Tanacetum (Feverfew), Petasites(Butterbur) Curcuma (Turmeric), Foeniculum (Fennel) and Ammi visnaga (Khella), and essential fatty acids and anti-oxidant nutrients.

Cayenne preparations may potentiate the expectorating effects of Lobelia. Avoiding all food allergens that have tested positive for IgE, IgA, and IgG should be practiced. Restoring bowel health with alterative herbs, dietary changes, and probiotic and prebiotic supplementation may also benefit some asthma patients. Avoidance of all environmental and household chemicals, solvents, and synthetic compounds possible may also complement these above-described CAM therapies.

 

DISCUSSION

The Lobelia genus, belonging to the Campanulaceae family contains nearly 400 species. The name Lobelia was derived from a Belgian botanist, Matthias de Lobel—Flemish botanist and physician to King James I. Lobelia inflata is commonly known as “Indian Tobacco” and sometimes referred to as “Pukeweed” due to the powerful emetic effect of the fresh herbs. Lobelia has a longstanding history as an expectorant and respiratory stimulant, and is used in the treatment of asthma and other respiratory conditions.