Belief in Asthma Attacks | Natural Health Blog

Date: 08/12/2014    Written by: Beth Levine

Asthma Triggered By Expectations

Asthma sufferers usually become quite adept at knowing what can potentially trigger an attack. They do their best to avoid those triggers, but in certain situations it may be impossible to stay away from dust, pollen, or some airborne chemicals. And now, new research shows that it may not only be the exposure to these allergens that can set off an asthma attack, but also the mere belief that exposure to a potential trigger took place.

The study, which was conducted at the Monell Chemical Senses Center in Philadelphia, Pennsylvania, found that people with asthma can experience a symptomatic reaction simply from thinking that an odor they smell may be potentially harmful as an asthma attack trigger.1 The subjects were 17 individuals who had been diagnosed with moderate asthma. Each of the participants was exposed to a harmless chemical with a floral scent, known as phenylethyl alcohol, that is actually used in some perfumes. While not typically a cause of lung irritation, phenylethyl alcohol does have a noticeable odor.

To discern how the mind influences the body, nine of the volunteers were informed that the odor they smelled could elicit a mild respiratory response. The other eight subjects were instead told that the odor might have some therapeutic value. Just before their exposure to the phenylethyl alcohol, tests were conducted on each person to evaluate their lung function and whether there was any inflammation present in the airways. As they were inhaling the chemical, they were told to give a rating to the intensity, irritancy, and annoyance of the odor. Then, immediately after the exposure, two hours later, and 24 hours later, the same tests were conducted measuring lung function and airway inflammation.

Those participants who were made to believe that the odor was potentially detrimental rated it higher in the categories of both irritation and annoyance than did their peers who believed the odor possibly helpful. Even more importantly, the airways responded differently depending on which group the volunteer had been a part of. Those told it was harmful had markedly more inflammation in their airways right after smelling the phenylethyl alcohol, and the inflammation was still present even 24 hours later. Conversely, those told the odor might be beneficial showed no increase at all in airway inflammation levels.

This negative mental influence could be very troublesome for people with asthma, as the inflammation produced in the air passages can take several days to resolve. And sufferers are more likely to react to other triggers--even if they are relatively mild and might not normally affect them--when their airways are already swollen and constricted. Plus, asthma is a very common disease and is on the rise. According to the American Academy of Allergy, Asthma, and Immunology, approximately 20 million people had asthma in 2001, and by 2009 the number increased to 25 million.

While the size of the study makes it difficult to consider the findings definitive, it is not really much of a surprise that this experiment demonstrates how much your mind influences your body. As we already know, stress has been found to impact our health in numerous ways, including aggravating allergies, which are closely related to asthma. A 2013 study at Ohio State University in Columbus determined that experiencing stress could set off a flare up of seasonal allergies.2 And, just as we can take a placebo and report feeling better, the opposite--thinking that something is harmful and having a bodily reaction as a result--just might make sense as well.

Therefore, those with asthma should take precautions to not only avoid their potential triggers as much as possible, but do what they can to optimize their health and minimize any possible inflammation so that triggers--real or perceived--won't have as much of an effect. That can include the use of ginger compounds3 and vitamin D,4 both of which have been found in recent studies to naturally relieve asthma symptoms. Even better, they do so without the side effects that pharmaceutical asthma drugs may cause.

  • 1. Dallas, Mary Elizabeth. "Even Thinking an Odor is Harmful May Spur Asthma Symptoms." U.S. News & World Report. 30 July 2014. Accessed 4 August 2014.
  • 2. Patterson, Amber M.; et al. "Perceived stress predicts allergy flares." Annals of Allergy, Asthma & Immunology. 8 August 2013. Accessed 5 August 2014.
  • 3. "Ginger Compounds May Be Effective in Treating Asthma Symptoms." Columbia University Medical Center. 20 May 2013. Accessed 5 August 2014.
  • 4. Poon, AH; et al. "Vitamin D deficiency and severe asthma." Pharmacology and Therapeutics. November 2013. Accessed 5 August 2014.

Click for Related Articles


    Submitted by Heidi Boudro on
    September 11, 2014 - 10:50pm

    This article's source is an article in US News and World Report. I get no sense that Beth Levine read the actual study. The US News and World Report article appears to be a rewrite of a press release from the Monell Chemical Senses Center, which you can read on their website. Neither US News nor Monell link to the study. Monell does say on its website: "Currently, more than 50 leading international corporations from the food, beverage, fragrance, pharmaceutical, chemical, and other industries provide unrestricted annual support to Monell." You think? So a fragrance industry-funded "study" (which no one writing about it has actually read) in the Journal of Psychosomatic Research has concluded "The findings suggest that some fragrance effects on asthma symptoms may be related to the expectation of harm as opposed to chemical properties of the odor." (from the press release above).
    Surprise! Even if the study were well done and if the results were as stated, the results would be open to interpretations other than "wow! so-called asthmatics inflamed their own lungs because they were scared of perfume!" Of course we can't get a clue if the study was well done or if the results were as stated, because the original "journal" article is behind a paywall. So no one at all has actually read it! By the way, to say that phenylethyl alcohol is "harmless" because it doesn't "typically" cause lung irritation is ridiculous. Shame on you for publicizing a silly fake "study" by corporate shills who are trying to prove that perfume doesn't cause illness.None of this is in the spirit of "Lessons from the Miracle Doctors."

    Submitted by BaselineFoundation on
    September 16, 2014 - 9:04am

    While we appreciate your sentiment, your reading of the blog is more than a bit selective in its interpretation. In truth, the study was quite well vetted by the Baseline of Health Foundation staff and was published on a number of scientific sites, not just in USA today. The following points should be noted.

    • The Monell Center is not funded by corporate sponsors. As they point out on their site, they are funded by a triad of government grants, private donations, and corporate sponsorship. In that, they are no different than virtually all major universities and other non-profit research groups such as the American Heart Association and the American Cancer Society—and yes, I realize there are things that could be said about their biases.
    • You might want to check out Monell’s faculty. There are no corporate people on staff. They are mostly professors from universities around the world.
    • The study wasn’t promoting any corporate products. It was merely exploring the concept that odors could trigger asthmatic attacks.
    • In fact, this particular study was funded by a grant from the National Institute on Deafness and Other Communication Disorders, which is part of the National Institutes of Health. No corporate sponsorship at all was involved.
    • The results of the study were published in both Science Daily and on Medline Plus, which is part of the NIH
    • The blog itself pointed out the primary limitation of the study: it’s size.
    • In fact, the study itself was used merely as a discussion point to launch into one of Jon Barron’s favorite discussions: how much of a role the mind plays when it comes to your health. Jon devoted an entire chapter in “Lessons from the Miracle Doctors” to that exact topic. In that sense, it is quite in the spirt of LFMD.
    • And finally, the blog concludes by pointing people in the direction of natural alternatives for dealing with asthma, which is miles away from where we started.

    Hope that helps.

    Submitted by Heidi Boudro on
    September 18, 2014 - 8:49am

    Beth Levine's blog post references an article by Mary Elizabeth Dallas in US News and World Report (not USA Today). I stated that correctly in my comment. Her US News and World Report article is reference no. 1 in the list of references to this blog post.

    When I followed the links in your response to Science Daily and Medline Plus, I found… the same article by Mary Elizabeth Dallas. On the Science Daily site, her article is correctly noted as "The above story is based on materials provided by Monell Chemical Senses Center."

    You can compare Mary Elizabeth Dallas's article to the press release that is on Monell's website. You will see the similarities. The comment system does not allow me to post links, which I attempted to post in my original comment.

    It was Monell's press release that led me to the original journal article, which is not referenced in Beth Levine's blog post. It is "Asthma and odors: The role of risk perception in asthma exacerbation" by Pamela Dalton and Cristina Jaen, an article in press at the Journal of Psychosomatic Research, at which site I read the abstract. The full article (or "study") is behind a paywall.

    You say the "study" was "vetted" by the Baseline of Health Foundation. Did Beth Levine or anyone else at the Baseline of Health Foundation read the original journal article in full (not the abstract, not a press release, not a news article on Science Daily)?

    The "study" was not "published" "on a number of scientific sites." A journal article (which could be called the study) was published online by the Journal of Psychosomatic Research. The Journal of Psychosomatic Research is indexed by PubMed, but this article is not yet in the index. The article by Mary Elizabeth Dallas about the study was published on a number of sites (Science Daily, Medline Plus) that carry "news" type articles about health topics; that is not the same thing as publishing a study.

    It is a good practice to read the journal article rather than the abstract (much less a press release or an article on Science Daily) in order to write about a study or decide its merits, such as what its "primary limitation" might be.

    Is Monell "funded by corporate sponsors" or not? Monell's website, which I quoted from, is explicit about corporate sponsorship.

    A company profile on the Royal Society of Chemistry's "Chemistry World" site says this about Monell's funding:
    "Monell benefits from diverse funding sources. Around half the money comes from government grants, usually from the National Institutes of Health. A further 35 per cent is drawn from a corporate sponsorship programme. Monell also partners on collaborative research projects with companies - normally the food, fragrance or other sense-orientated industries. 'We are independent from, but supported by, industry,' says Beauchamp, pointing out that Monell scientists retain the right to publish any useful research that comes out of a collaboration. Remaining funding comes from the original Monell Foundation, and by private donation. "

    You can (and should) draw your own conclusions about Monell's relationship to the food and fragrance industries.

    The "odor" used in the study is a fragrance chemical.

    The study's design and conclusions assume that this particular fragrance chemical does not cause asthma reactions by physiological means. IF this study is a well-done study, which cannot be decided from its abstract or press release, THEN you would still not be able to conclude from this study alone that this fragrance chemical does not cause asthma reactions by physiological means. That reasoning is circular.

    Were there to be a corporate purpose to such a study, it would be to muddy the waters about whether fragrance chemicals in general are "chemicals" or "odors."

    Submitted by BaselineFoundation on
    September 22, 2014 - 10:46pm

    You’re either misstating or misinterpreting a number of facts.

    First, US News and World Report was not the “source” article. The source article was the press release on the report. Press releases are frequently used by educational institutions to announce research presented or published by researchers from their institution. The fact that there are similarities in articles is not because of US News and World Report, but because everyone is drawing from the same source—the Monell Chemical Center press release. Beth linked to the US News and World Report precisely because it is not hidden behind a paywall.

    The vetting was to confirm that the press release was an educational press release from academic sources—not a “company” press release. Monell is an independent, non-profit scientific institute dedicated to basic research on taste and smell.  As for publication, many studies are not initially “published.” Some are released at live presentations. And some are handled in press releases. In fact, MIT has a website actually dedicated for this purpose. Check it out., And here’s a site dedicated to the press releases from Johns Hopkins. Once again, press releases are a standard means for getting research results out to the publc.

    We previously answered the questions about corporate sponsorship. Like any educational institution, they are primarily funded by grants, then individual donations, and finally corporate grants. If one were to take your position literally, then you could trust no study conducted by a University, since all the major universities have corporate sponsors. Here’s a list for the MIT Media Lab. And for that matter, you couldn’t trust NEJM or the JAMA since they accept advertising revenues from corporations, or alternative sites such as Natural News since they sell different companies products on their sites.

    Similarly, we answered the question about the bona fides of Monells faculty.

    The fact that the “odor” used was a fragrance chemical is irrelevant to the conclusions of the study: that asthma can be triggered by the expectation  that an odor will trigger it. It was a study about the brain’s influence on asthma—not the actual odor. When they changed the expectation, the results changed. It had nothing to do with the chemical. It was all about the brain and its expectation.

    By searching so hard for nits to pick, you missed the entire point of the study…and the blog.

    Submitted by Heidi Boudro on
    September 30, 2014 - 5:35pm

    When I said I would let you have the last word, I was not withdrawing my submitted, unpublished comment in which I for the third time correctly referenced the study:

    "Asthma and Odors: The Role of Risk Perception in Asthma Exacerbation" by Cristina Jaen and Pamela Dalton, published online on July 11, 2014 on the site of the Journal of Psychosomatic Research.

    I correctly said that I made no misstatements.

    I also said that I expected all studies, no matter where published, to be looked at critically and not "trusted."

    Once again I suggest reading the original study before defending it.

    Submitted by BaselineFoundation on
    October 5, 2014 - 8:45pm

    Hi Heidi,

    We didn't get any other posts from you, but we posted this one here, as you can see. 

    Submitted by Heidi Boudro on
    September 25, 2014 - 7:17pm

    You know, I think I'm willing to let you have the last word, except that I want to add one more thing, something more personal. I know I have been rather curt during this discussion.

    The study's conclusions made me angry. The study's conclusions are, "Oh, asthmatics get themselves all worked up when they smell a fragrance chemical and that could be their whole problem."

    Can you understand how dangerous that line of thought is for people who have asthmatic reactions to volatile chemicals? How it encourages the purveyors and consumers of recreational volatile chemicals to just continue on as they please and ignore the real needs of asthmatics? Many of whom are children? Some of whom have life-threatening asthma?

    (For the record, I do not have asthma.)

    How a single experiment (which I suspect to be deeply flawed in any case, just from common sense) could possibly come to such a sweeping (and circular) conclusion is beyond me. If only we could read the study.

    Submitted by Dr.P.K.Chhetri on
    September 29, 2014 - 7:22am

    Is Asthma curable?

    Is bronchial asthma curable? It is a million dollar question, usually in medical parlance, it is not fully curable, and therefore, to counteract its intensity and to provide emergency relief to a patient during an asthmatic attack, usually a doctor resorts to symptomatic treatment. But if the doctor is not available or the hospital is not at a suitable location, then what will happen to a patient with serious dyspnoea, the symptom, it is not unlikely, if prolonged may prove fatal also, who can tell? Unfortunately, a great pioneer in heart transplant surgery, Dr.Christiian Barnard, also died of fatal asthmatic attack. Since there is no permanent relief in allopathy, therefore, sometime people turn to quacks or to herbal practitioners. It is said that in some place in South India, some herbal medicines embedded in a small live fish is given to asthmatic patients to swallow. Every year people throng in thousands to partake of that herbal remedy. Its efficacy in treatment of asthmatic symptoms are better known to a patient only, but still annual rush of patients to that spot, which has almost become a spot of pilgrimage, is ever on the rise.
    Asthma is a spasmodic disease characterised by paroxysms of dyspnoea or difficult breathing and severe wheezing. However, this condition is quite distinct from renal or cardiac dyspnoea. It commonly commences under the age of ten and may persist to old age, if symptomatic treatment is continuously provided. It is more frequent in males, though females are not excluded fully, and is very often associated with neurotic family history. It is sometimes the result of nasal polyps or bronchitis or smoking. In fact, asthma is an allergic condition associated with an abnormal response of the body to some substance, such as pollen, mould, fumes, odours, some chemicals, as well as some foods or drugs, but foods or drugs associated asthma are easily preventable, if such foods or drugs are completely avoided from diet. I have seen many people allergic to penicillin related drugs; intake of penicillin causes severe bouts of allergy in such patients. Once my uncle almost died due to penicillin injection, he had developed severe dyspnoea. Since hospital was in the vicinity, he was saved; in fact, all of us were helplessly watching his constantly deteriorating condition before he was rushed to hospital. However, asthmatic conditions may also be noted during severe bronchitis or pneumonia, but they can be excluded from the causes of asthma, because they are curable diseases. Smoking related asthmatic symptoms can be easily tackled provided the patient gives up smoking completely. Similarly many asthma patients may also suffer from emphysema, a condition in which there is over distension in small air sacs in the lungs or tubes that carry air to the lungs. But my question is: Why should we allow a patient to develop that condition? Why couldn’t we treat a patient fully, before the disease develops such serious complications? If you ever see a patient under asthmatic attack, observing his helpless condition tears will simply well up in your eyes; because the attack is so severe that one will bound to feel the patient is dying. But unfortunately medical science has no permanent cure.
    In fact, modern medical science has no permanent cure for many ailments afflicting mankind, but it does not accept its discomfiture, nor does it allow the patient to try out some other alternative remedies. I faced such a situation once in a very big hospital at night, where I had gone for some advice. The attending doctor was trying to retrieve the constantly falling blood pressure of a female patient, but despite his all possible attempts, he was finding himself utterly helpless. Though I was carrying an emergency medicine in my pocket, if administered the patient could have been easily saved, because several times with that remedy I had given a new lease of life to many patients, including a doctor, with constantly falling blood pressure symptoms irrespective of the causes, but excluding severe blood loss. I tried to offer my help, but I was ignored. I could not stand that sight, for no reason a patient was gradually sinking because of the reservation of a doctor.
    Be that as it may, the attacks of asthma are more frequent at night usually during winter, but there is no such specific certainty. At any time it may attack, when exposed to some offending substances. At midnight the patient suddenly wakes up with a sense of suffocation, either springs up in bed or assumes various postures. Even he may rush to the open window, and leans forward on his arms employing all the muscles of the neck, back and chest to inhale fresh air, but wheezes loudly from great obstruction to the entrance or exit of air. He greatly labours for breath as if he is struggling for life after being gagged for some time. It is evident that he is in great distress, his eyes protrude, his skin appears cold and clammy, pulse small and feeble, and the perspiration stands in large drops on the forehead, or sometimes runs down the face. He very often looks around imploringly and sometimes impatiently at the people or medical attendant, to provide him relief from his misery. In fact, one cannot stand the sight of a patient under asthmatic attack. It is so pathetic. At length, after some uncertain time, it may be one hour or after a couple of hours, remission comes, then cough ensues followed by profuse expectoration of mucus, and relief comes to paroxysm, and patient expresses his desire to go into slumber. Generally the attack is never attended by fever, but frequently preceded by disturbance of digestion. Under normal situation also, colds and cough symptoms are preceded by digestive disturbance. With good digestion, one seldom catches cold. Therefore, in ayurveda, it is suggested to avoid intake of fruits at night, because it triggers symptoms of colds and cough.
    In fact, there is an intimate connection between deranged digestion and distress in respiratory organs, though it may also be produced by changes in weather conditions, or by the introduction of subtle poisonous materials floating in the atmosphere by inspiration or by the mere odour, or by the vapour of sulphur, sulphuric acid gas, or chlorine, the list may be endless. Even excessive exertion or mental emotion frequently brings on a paroxysm. Emphysema may be a different symptom, but frequent fits may also trigger emphysema, and also sometime dilatation of the right cavities of the heart associated with general displacement of that organ, which has been noticed in persons with long history of asthma. If this happens, then the patient also faces laboured breathing. Slight exertion causes severe stress. However, the disease may also be hereditary. It is always advisable to have an X-ray of the chest and other requisite blood tests to rule out any other unforeseen complications, such a tumour or fibrosis in the lungs or an aortic aneurism (bulging or rupture of blood vessel wall) etc.
    Drugs are selected with an objective to relax bronchial smooth muscle or decrease bronchial hyperactivity, which means dilatation of the respiratory passages. In order to tackle an emergency, when the patient is away on some works, nebulizer is also prescribed, so that inhalation of drugs may relax the bronchial muscles. Sometime in severe prolonged attacks of asthma, oxygen may also be required, but severe cases are always best treated in hospitals. Anti-inflammatory drugs are mainly steroids. Sometime spirometer also helps to diagnose the nature of obstructive lung disease. But whatever be the nature of treatment, its main object is to provide symptomatic relief; in fact there is no permanent cure for asthma in allopathy. For finding or ascertaining asthma, it is better to rule out other causes, such as nose, throat or lungs infections, and proper treatment should be prescribed, because sometimes asthma-like symptoms may be marked in patients with other infections. Therefore, if associated causes are different, treatment of those causes simply removes the asthmatic symptoms. But actual asthma is difficult to cure, except for providing temporary relief.
    Usually what is termed as lung symptoms due to inhalation of some allergic causing agents are mainly associated with wrong treatment of cough with antibiotics in the childhood, antibiotics simply removes infection, but at the same time it also dries up the sputum. So the symptoms are only removed, cough is not fully treated. Even the lungs of children are not that mature like adults, hence normally they cannot cough out sputum with ease. What actually happens is due to suppressed cough, slight inflammation always remains in the lungs, therefore, inhalation of dust or pollen always causes irritation in such children or subsequently in adults, this is randomly diagnosed as dust allergy. I have treated such cases of dust allergy successfully simply by prescribing some potent lung clearing homeopathic drugs.
    Similarly, in homeopathy, asthma is fully curable. I have applied such potent drugs for the first time randomly making selections, in fact my finding was accidental, a teaspoonful of which made a patient normal during asthmatic attacks simply within a couple of minutes. This is no exaggeration; it is a fact, because I recorded its similar effect in several patients later on, though medicines had to be continued for some time for complete cure. For the benefit of mankind, I am writing down their names, they are: 1)Blatta Orientalis Q, and 2)Passiflora Incarnata Q. Simple mixture of twenty drops of first remedy and forty drops of the second in a cup of water, and administering a teaspoonful to the patient every five minutes will definitely bring instant relief to paroxysm. With this remedy, I have saved for the first time a girl at one dead winter night. In her, asthmatic attack was so severe that when she saw me she could not even utter a single word, except blinking at me with tears in her eyes. I prayed to God and administered the remedy for the first time, and within two minutes she sat up on the cot instantly and said:”Uncle I am okay!” For the first time I observed the miraculous effect of these remedies. Though to cure her fully, intermittently I also prescribed Bacillinum 200 and Sulphur 200 for some time. She was under my observation for two months, and when I found her fully cured I left her. After almost a year, she was married also. But my one small advice is: self-medication should not be resorted to, because there may be various associated factors related to the disease, therefore, a doctor has to be consulted. Last but not the least; I would like to put a question to my allopathic brothers, who said asthma is not curable? Please give up your prejudice as regards your medicines, because it relates to human life. Humankind is above any system of medicines! The World Health Organisation can also pick up the names of these medicines for the benefit of mankind, and remove her/his unnecessary suffering and premature death. Even the WHO may conduct further research on these medicines, because neither have I the means nor time to observe its modus operandi in the blood, but their efficacy in providing instant relief to an asthmatic patient is unquestionable!

    Submitted by Jeff on
    January 15, 2017 - 9:55am
    Seattle , Washington

    Phenethyl Alcohol is definitely a mucous membrane and respiratory irritant, just like ethanol is a respiratory irritant. I found out accidentally when I used fluticasone OTC. Flonase, which is the brand name of fluticasone does not contain PEA and doesn't trigger my asthma/sneezing. Why the heck to products made to improve breathing contain this stuff?!?!

Add New Comment