Buteyko therapy: For your
escape from Asthma
By Peter Kolb
Over the past few years a novel new drug-free
treatment for asthma has swept through Australia and has already made an impression in the
United Kingdom. Buteyko therapy is, in fact, a very well developed treatment for Chronic
Hyperventilation Syndrome (CHVS). That it is so universally successful in the treatment of
all "forms" of asthma suggests that western medicine has underestimated the
significance of CHVS as serious disorder in our community.
The treatment was developed in the 1950's in
Russia by medical doctor and scientist Professor Konstantin Buteyko. A double blind
controlled clinical trial held in Brisbane in 1995 demonstrated a reduction in the use of
bronchodilators by 96% and a reduction in steroids by 49% after 12 weeks of Buteyko
therapy . The figures are particularly remarkable considering that the treatment relies
100% on patient compliance. These findings support the substantial body of anecdotal
evidence available from thousands of former asthmatics who have attended Buteyko clinics
in the west, that Buteyko therapy is very effective at removing the cause of asthma. The
treatment has not yet been taken up by the medical profession although former patients are
forming pressure groups to change this much as they did in Russia where the treatment now
has official approval.
The theory goes back over a century to 1871
when Da Costa discovered a strange symptom complex suffered by American soldiers during
the civil war . The condition was called "soldier's heart" and later "Da
Costa's syndrome". These symptoms were later shown to form part of a very large and
bizarre group of symptoms collectively known as Chronic Hyperventilation Syndrome .
Many of these appear to be unrelated with each other. They include: Loss of blood supply
to the brain, migraines, spasm of the coronary blood vessels to the heart, angina pains,
heart attacks, muscular stiffness and aching, irritable bowel syndrome, hiatus hernia,
high blood pressure, extreme fatigue and intolerance of any exertion such as is found in
chronic fatigue syndrome, excessive sweating, asthma, seizures, visual and auditory
disturbances, sleep disturbances, phobias, panic attacks, flue like symptoms...and the
list goes on [3,4,5]. CHVS is a condition in which the patient has habituated to breathing
too much. The symptoms developed depend entirely on an individual's genetic
While CHVS is well described in the medical
literature, it is not well understood by most doctors and rarely diagnosed correctly
[3,5]. Although the prevalence has been given as between 6 and 11%  the Buteyko
experience would suggest that it is considerably higher than this.While hyperventilation
is always seen in asthmatics [6,7] it has generally been assumed that this is the result
rather than the cause of asthma.
The way Buteyko therapy works is by reversing
the process by which normal episodes of acute hyperventilation become chronic. It is a
treatment that aims at curing the hyperventilation disorder. When successfully applied the
symptoms of asthma disappear along with the myriad of other symptoms often accompanying
asthma. Patients sleep better, require less sleep, feel better, have more energy and have
an improved quality of life .
Normal healthy people have an arterial carbon
dioxide content (PaCO2) of 40mmHg. Respiration is regulated to maintain this level by the
respiratory center in the brain stem. For normal healthy individuals under normal
conditions there is more than enough oxygen available to keep the blood pretty much
saturated, so lack of oxygen is not normally the driving force for breathing.
Now consider a young child breathing normally.
His mother is a little over concerned about him getting cold and tends to over dress him
when he is put to bed at night. The normal basal metabolic activity produces heat that has
to be dissipated. If he can't get it out through his skin (he might even have been dressed
with a bonnet), the child has to breathe more to get rid of the heat. This lowers his CO2
level which tends to make his blood more alkaline, a condition know as respiratory
alkalosis. To restore the acidity (pH) back to normal, the kidneys excrete bicarbonate
ions through the urine. This is a very slow process. If this over breathing is sustained
all night, the gradual compensation by the kidneys leads to a restoration of pH but a loss
of both carbon dioxide and Bicarb. This is part of the reason the respiratory center
adapts to CO2 levels that are too low (3,4,5). The other part has to do with the slow
diffusion of bicarbonate ions across the blood/brain barrier.
The lost Bicarbonate is accompanied by
valuable minerals such as magnesium, sodium and calcium [2,4]. The loss of Bicarbonate is
also very significant in terms of a loss to the pH buffering capacity of the blood. This
means small changes in respiration will cause relatively larger pH swings when the buffer
has been depleted.
On top of this, the oxygenation of the tissues
is directly affected by low CO2. The release of oxygen from hemoglobin for the oxygenation
of metabolically active tissues depends on the CO2 environment. This is known as the Bohr
effect and is well understood by physiologists [4,5]. If there is insufficient CO2, less
of the oxygen is released and simply returns to the lungs. What it means is that all the
organs and tissues including the brain get less oxygen than they would if CO2 levels were
normal. Breathing more doesn't help; in fact it only makes oxygenation worse because you
further depress the Bohr effect with the loss of even more CO2.
Every biosynthetic process in the body relies
on carbon dioxide . There is a minimum level of CO2 below which an individual cannot
survive. Between this minimum level and the normal level required for good health, there
must be a gray area in which normal metabolic functions are impaired. As a result, if CO2
levels are too low, the body does not function properly affecting the production of all
hormones . According to Buteyko, asthmatics with hypereactive airways run Cortisol
deficits. One of the functions of Cortisol is to dampen the immune response and prevent it
from overreacting following a meal or the inhalation of minor non-pathogenic foreign
particles. In the case of asthmatics such disturbances to the immune process cause hyper
According to Buteyko, arthritis too is caused
by such immune process disturbances.
Finally, the small bronchioles leading to the
alveolar air sacs in the lungs are surrounded by smooth muscle. The function of this
muscle tissue is to prevent local over ventilation of the lungs by reducing the diameter
of these little tubes. By this action the lungs become ventilated more evenly. Lack of CO2
is well known to cause spasming of this smooth muscle [3,4,5]. Since hyperventilators are
low in CO2, each part of the lungs is independently trying to prevent over ventilation in
its area. Asthmatics have smooth muscle in the bronchioles which is up to 2.5 times
thicker than normal . The Buteyko theory has it that their bronchioles are genetically
predisposed to constrict very much more effectively in response to over ventilation than
The same effect can be seen in people who
suffer from migraines, except in their case the problem lies with low CO2 causing a
reduction in the arterioles to the brain. . The same can be said of some people
suffering with angina pains  with their coronary arteries being affected by
Stress is a well-known stimulant for
hyperventilation. When our ancestors were startled by the proverbial lion, their
respiration would increase. This got rid of CO2, which made room for the rapid build up
during the subsequent effort at escaping the lion. But this stress was short-lived. If you
weren't eaten by the lion you would escape to your cave and the stress would disappear.
But twentieth century living has seen an increase in chronic stress... a boss that's
harassing you, concerns about the mortgage, concerns about whether your kid would make the
finals etc. These lingering stresses span the sort of time period required for your
hyperventilation to become chronic.
Professor Buteyko discovered that both lack of
exercise and over eating are factors leading to over-breathing. It's so easy to get food
that we no longer eat because we're hungry, but because we enjoy eating and because food
is so accessible. We sit in front of TV after sitting at a computer all day and ring up
for a pizza instead of going outside to catch a rabbit.
Sleeping in stuffy rooms, breathing through the mouth (something many of us do when
asleep,) all encourage over breathing. Even physical stresses such as infected tonsils,
bad teeth and other infections produce hyperventilation according to professor Buteyko.
How Buteyko therapy works.
In the same way that lingering stresses
sustain hyperventilation for long enough for the respiratory center to adapt to lower
levels of CO2, so too Buteyko therapy works by sustained under breathing over a long time.
The basis of the treatment is a program in which you spend about 90 minutes a day
deliberately reducing your breathing by relaxing all your respiratory muscles, and
developing and sustaining a slight hunger for air. It sounds simple but it can be hard to
do at first. The idea is that this should become a habit so that you unconsciously reduce
your breathing in the train, in the car and at boring meetings. The formal part of the
exercises is no longer required once the habit has been instilled and the hyperventilation
has disappeared. The basic technique can take anything from a few minutes to a few days
for people to learn to do effectively. Assistive techniques are taught to help you ensure
that you always breathe through your nose, even in your sleep and when playing sport.
As the CO2 levels rise and the body's
biochemistry changes, the individual will see physical changes taking place. Bronchospasm
reduces immediately to the point where often on the first day of the therapy the patient
is free of bronchodilators. Inflammation of the lungs as well as hay fever symptoms take
longer to disappear, since the changes in the biochemistry such as increased production of
Cortisol can take a while to pick up. Occasionally chronic inflammations that have been
dormant can flare up because of heightened biochemical activity. There is always an
improvement in sleep with the disappearance of snoring and sleep apnea. Over weight
individuals will feel their appetite suppressed, resulting in weight loss. Patients report
that they "feel better", more energetic, more active and healthier. In time they
become tolerant to their allergens.
People on conventional asthma management plans
do not have to make any changes to their drug regimes. Bronchodilators are taken as rescue
medication as and when needed, while steroid medication is taken as prescribed. The only
change they have to make is to try the breathing therapy when they feel an asthma attack
coming on. With this and the routine breathing exercises they will find that there is a
reduced need for bronchodilators and usually the need disappears altogether within days.
Once asthma symptoms have disappeared, they can consult with their doctor on reducing
Occasionally an individual will have a relapse
following severe exposure to a mass allergen assault. Cortisol production has not fully
recovered and the immune system reacts vigorously. At this time the individual won't be
able to control his breathing and his pulse will race. This will require a visit to the
ER. If he is given just sufficient steroids to overcome the deficit then within an hour
his breathing will return to being controllable and his pulse will return to normal.
People who suffer from such outbreaks will typically require 30% less steroids at each
successive event. Within a year to 18 months there should be no more such emergencies for
the few who experience them.
Buteyko therapy has its detractors. Doctors
have relied for decades on lung function tests to assess asthma objectively. These tests
have become a kind of "gold standard". Doctors point out that Buteyko patients,
although they don't have worse lung function without their medication, they also show no
improvement in these measurements.
From a purely scientific point of view, the
new understanding that the hyperventilation theory brings to asthma makes it clear that
those tests are fundamentally flawed. In science it is important to understand what you're
measuring. But with the lung function tests we have been measuring a disorder that has
never been understood. The hyperventilation theory explains that in the case of asthmatics
the airways constrict particularly well in response to hyperventilation maneuvers. And
since the lung function tests rely on such maneuvers, they test what is, in part, a
healthy response to an abnormal breathing process. Opposition to Buteyko based on lung
function tests is clearly driven by sentiment rather than science.
It's best to turn to a Buteyko practitioner
for help. Buteyko therapy is the only health treatment program that I know of that gives a
full money-back guarantee. If it doesn't work you get your money back, so you have nothing
to lose but your asthma!
However, some practitioners are more
experienced than others and some have better basic training than others. It is wise to
inquire about this (and the money back guarantee) especially when seeking help for
non-asthmatic disorders such as chronic fatigue syndrome (CFS). While asthma is quite easy
to treat with Buteyko therapy and results are readily achieved and observed, CFS
treatments, which rely entirely on the restoration of the body's biochemical processes,
take longer and require a great deal of support.
Buteyko therapy is usually provided on the
basis of a one time up-front fee of around US$ 350, although prices can vary quite widely.
For this you get group tuition over a week to ten days with individualized programs and
support for as long as it takes to get rid of your disorder. Private consultations are
usually provided on the basis of cost per consultation.
On the medical side, instead of dismissing the
claims of Buteyko patients as being "anecdotal", there is an urgent need for
these reports to be thoroughly investigated. Doctors should be more vigilant in detecting
CHVS and consider Buteyko therapy for those patients who are suspected of having the
As far as the general public is concerned, we
need to understand the importance of correct breathing. Parents should be vigilant about
over dressing children and ensure that they always keep their mouths closed. Teachers
should immediately stop the practice of encouraging deep breathing during exercise
classes. There is no physiological basis for the practice and according to Professor
Buteyko it is one of the chief culprits in the high incidence of CHVS related disorders in
the western world.
We have already discovered the importance of
healthy diet and exercise for healthy living. Buteyko has provided the evidence that we
also need to keep our breathing healthy.
Over the past few years a great deal of
information has become available through books, Videos, DIY/self help kits and, of course,
Buteyko Practitioners are listed in Holistic-online.com directory of providers. The
also has additional information including a directory of practitioners and links to other
Peter Kolb BSc (Eng), MSc (Med), CPEng (Biomed)
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trial", Medical J. of Australia, VOL 169, December 1998, 575-578
DaCosta JM, "On irritable heart: a
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Med Sci, VOL 61, 1871, 17-53
Nixon PGF, "Hyperventilation and
cardiac symptoms", Internal Medicine, VOL 10:12, December 1989, 67-84
Demeter SL, Cordasco EM,
"Hyperventilation syndrome and asthma", The American Journal of Medicine, VOL
81, December 1986, 989-994
Sher TH, "Recurrent chest tightness in
a 28-year-old woman", Annals of allergy, VOL 67, September 1991, 310-314
Donnelly PM, "Exercise induced asthma:
The protective role of CO2 during swimming", The Lancet, VOL 337, 19 January 1991,
McFadden WR, Lyons HA, "Arterial-Blood
Gas Tension in Asthma", The New England Journal of Medicine, VOL 278:19, 9 May 1968,
Guyton AC, Hall JE, "Textbook of
medical physiology", Chemical control of respiration, PUBLISHER: WB Saunders;
ISBN:0-7216-5944-6; 1996; EDITION: 9; PAGES: 527-528.
Kazarinov VA, "Buteyko Method: The
experience of implementation in medical practice", The biochemical basis of KP
Buteyko's theory of the diseases of deep respiration, EDITOR: Buteyko KP; PUBLISHER:
Patriot Press Moscow; 1990; PAGES: 198-218. English translation available at:
Dail DH, "Pulmonary pathology",
Eosinophilic Infiltrates, EDITOR: Dail DH, Hammar SP; 1988; PAGES: 359-362.
Information on Buteyko's cure for asthma
provided by grateful ex-asthmatics