Coffee & Black Tea: Can Your Caffeine Wake Up Also Help You Breathe Better?

Discussions on the Potential Clinical Applications of Coffee and Black Tea for Asthma as compared to Traditional Chinese Medicine Formulas

By: Matthew Sabey Smith, DACM, MSOM, LAc., Dipl.Ac., CPT

***Disclaimer: The information provided in this article is not meant to be used as medical advice or the treatment/cure of any disease. If you are considering using any of the following information, first consult your medical provider. ***

Introduction
       Quite often, like any person, you may have searched the internet for ideas about how to deal with your asthma. Between your wheezing and whistling, your little thumbs are typing as fast as possible to find a solution because you happened to forget your inhaler before you got on the plane. Well, now you’re stuck, your doctor isn’t available over the phone and you need relief in order to get the seemingly unattainable oxygen into your lungs while all you want is to lie down in peace. Well maybe you came across caffeine as a quick, fast acting relief? Let’s check it out.

Asthma
     As you probably already know, asthma is a very common condition that is everywhere. Asthma can have a number of triggers such as environmental factors, poor air quality, allergens, colds and flu as well as dietary factors. But while you are having an asthma attack, you don’t care about any of that, you just want to breathe in peace. An asthma attack is commonly when a person is wheezing (whistling sounds coming from the lungs) and it is hard to catch a full breath. Asthma is commonly known as an inflammatory condition that creates a closing of the airways and bronchial tubes.

Asthma in Traditional Chinese Medicine (A Very Brief Overview)
     To a Traditional Chinese Medicine (TCM) practitioner, there are different types as asthma. Commonly in TCM, asthma is typically caused from an excess or deficiency condition deficient condition. With asthma there are a few factors that play a role in TCM. The lungs, kidneys, liver and spleen systems all need to be working properly in order to keep asthma from affecting someone. When there is an issue with any of these systems, it commonly can create asthmatic conditions. The lungs need to be functioning for what reason? So that they can retain the air properly and correctly work with the entire pulmonary respiratory system in order to use oxygen and exhale carbon dioxide. When the lungs do not work properly, people will experience abnormal sweating, excessive dryness in the throat and skin and struggle breathing in. For an excess lung condition the lungs will feel hot, the person may have a cough and it could be accompanied by yellow phlegm or sputum (not fun at all!). Deficient patients will likely have a runny nose, and won’t be able to stop cold sweats and will feel physically cold. 
       Patients who have signs of asthma relating to the kidneys would likely be more due to a deficiency issue. When the kidneys are weak, then in TCM the kidneys cannot grasp the “lung qi” downward and the patient will also experience wheezing, may have low back pain or weak knees associated with it.
     Patients who have signs of asthma relating to the spleen function, there is likely a lot of fluids (dampness) associated with the asthma. When asthma is associated with a lot of mucus buildup, typically this is a sign the spleen is not able to transform and transport fluids properly and the result is excess “dampness” and mucus that is in the lungs. 
     Patients who have issues with asthma relating to the liver system will have stress and frustration. Stress and frustration, while an emotional component, can create wheezing and constriction on the airway and as a result this emotional factor will inhibit proper breathing. 
In TCM it is common for these organ systems to need to be balanced for proper breathing to occur. Therefore, it is a responsibility of the practitioner to put all the pieces of the puzzle together.

So Can Caffeine from Coffee or Black Tea Help My Asthma Attack?
      The quick answer is yes it is possible- but it depends. There is more to understand before we start swimming in our coffee to have a continuous, forever supply of caffeine (Don't do this- horrible idea!). The bottom line is that caffeine can be a quick fix that is similar to bronchodilator Beta-2 Agonist medications like Theophylline (Welsh et al., 2010). It has been shown that caffeinated coffee or black tea can typically provide around four hours of relief for a person experiencing an acute asthma attack (Gotter A, n.d.). This would obviously be more effective for someone who does not normally use caffeine because there will not be a built up tolerance to it to begin with. It is important to note that overuse of caffeine can overly tax the adrenal system (which sit right on the kidneys...hint hint) and should not be dependently used. This is where your newfound understanding of TCM can help. If we continuously tax our kidneys then our kidneys will not be able to assist properly in our breathing in the future! Therefore- this is only an idea for when in a pinch!

Quick Note:
The part that modern research does not mention is the fact that caffeine is naturally a "warming" substance in TCM. Therefore any condition that is not "deficient" would not be properly aided by caffeine and could potentially be exacerbated!

TCM Alternatives For Heat (Excess) Associated Asthma 
      As we have discussed, TCM has different ways to identify causes and issues associated with asthma attacks. Asthma associated with heat conditions (commonly excess conditions) would likely be relieved from the treatment of the heat condition itself. Formulas such as Gan Mao Ling, Yin Qiao or an herb such as Luo Han Guo (one of my absolute favorites that tastes great!) are useful at removing heat from the lungs to relieve the hot, inflammatory irritation associated with heat conditions like many types of colds, flu, and bronchitis. For these conditions, caffeine would be contraindicated for the asthma treatment. Caffeine is “tonifying” and warming in TCM so we would be making the condition potentially worse over time! Acute stress would also fall into this category! Therefore, if we treat just the stress in this situation with something such as Xiao Yao San, then the wheezing could potentially be mitigated or completely removed.

TCM Alternatives for Cold (Deficient) Associated Asthma
        It is common that asthma usually has some underlying deficiency associated with it in TCM. These types of conditions are why asthma could be relieved by caffeine. For TCM there are some options that will not have the same taxation on the adrenal system however. A formula such as Ding Chuan Tang could be a typical good option. Also known as “Arrest Wheezing Decoction” Ding Chuan Tang helps with asthma associated with spleen and lung deficiencies. This formula would help strengthen the spleen to transform and transport fluids properly to prevent the buildup of mucus and phlegm in the lungs. The lungs are also strengthened by this formula by dispersing the “cold” (cold creating deficiency) and stopping the wheezing within the lungs. 
       A second common option to treat deficient asthma through TCM relates to asthma typically associated with a disorder of the Kidney system. The combination of Dong Chong Xia Cao and Ge Jie commonly is used to treat asthma. This would be a situation where the "lung qi cannot be grasped by the kidneys." Meaning essentially that the person cannot take a full breath that feels satisfying. This combination however would strengthen the kidney system function in order for this to occur. This would not be appropriate for a person who has any cold or flu like symptoms (American Dragon, 2017).

Dryness, Moisture & Dehydration
     One aspect that is typically overlooked in the management of asthma is the factor of dryness. Dryness means there is not enough moisture within the lungs to keep them well lubricated. Think of it this way- when something is dried out, it heats up. Well- same thing here. This is why proper hydration and moistening herbs would be essential for someone who presents as very dry (dry cough, dry skin, dry throat). This is when we could employ something like the Luo Han Guo once again alongside a common formula like Liu Wei Di Huang Wan. These help moisten the lungs, keep the body well lubricated and thus mitigate asthma associated and triggered from the dryness (which could be as simple as a dry climate or having the heat on in the house!).

Conclusion
      Overall, the use of caffeine from black tea or coffee can, in certain cases as you now know, likely and effectively relieve asthmatic wheezing symptoms. As we discussed, it is not a fix-all for long term asthma, but it can help in certain cases in a pinch. As a TCM practitioner however, the use of any of the discussed formulas (depending on the condition) would be more specific and effective for asthma, especially for longer term relief. In the end, in order to properly get asthma under control, the TCM herbs would likely be more effective in relieving both acute asthma and long term asthma and a practitioner would be needed to properly diagnose and treat the condition.

References:

American Dragon. (2017). Ding Chuan Tang. Retrieved April 13, 2019, from https://www.americandragon.com/Herb Formulas copy/DingChuanTang.html 

Gotter, A. (n.d.). Emergency Home Remedies for Asthma Attacks: What You Can Do Now. Retrieved April 13, 2019, from https://www.healthline.com/health/emergency-home-remedies-for-asthma-attacks#mustard-oil

Welsh, Bara, Barley, & Cates. (2010, January 20). The effect of caffeine in people with asthma. Retrieved April 13, 2019, from https://www.cochrane.org/CD001112/AIRWAYS_the-effect-of-caffeine-in-people-with-asthma