Breathing Life Into Medical Theories by Sally Magnusson, The Herald, Scotland, Monday January 6 1997

When the BBC programme Frontline Scotland reveals the results of the two months it spent following the progress of asthma sufferers using the Buteyko breathing method, it will be reopening a medical controversy which has been simmering in Scotland for some months. Ever since the practitioners of the method, developed by the Russian professor Konstantin Buteyko, began their breathing classes in Glasgow, heralded by the astounding claim asthma can be corrected by shallow breathing, opinion has been sharply divided.

Doctors by and large feel the theory that all asthmatics breathe incorrectly doesn’t hold water. They say only the tiny percentage who hyperventilate acutely are likely to be helped by changing their breathing. Prof Buteyko, however. argues all asthmatics breathe more than they should , the degree of over-breathing determines the severity of the asthma, and that by improving their breathing they will improve their asthma.

It’s a theory passionately supported by the growing numbers of asthmatics who have persevered with the method and found their asthma improving, sometimes dramatically. Since every course brings together all types of asthma, whether exercise induced or allergy based, mild or severe, acquired in childhood or later in life, and since the majority of sufferers appear to benefit, a far higher proportion than the 4% or so of acute hyperventilators are seeing an improvement in their asthma. Four months ago, The Herald followed the progress of several people who took part in the first Buteyko workshop in Scotland. At the end of the five evening-course, the diaries they kept chartered, in every case, a reduction in symptoms. The real challenge, however, would be in the weeks ahead, as they sought to persevere with a breathing method that requires considerable effort.

With Frontline Scotland set to reveal the results of another such course, it seemed appropriate to chart the progress of that first group. Pam Duncan, from the Isle of Arran, says it has changed her life. She has been able to start a new job, after being unable to cope with the last one because of her asthma. Her family have insisted she change her message on the answer-phone because she sounds so different from the wheezy character who recorded the original one.

“I was on so much medication I can barely remember it all. Now I’m off everything except Uniphyllin (which I’ve reduced from 400mg twice a day to 300mg once a day ) and the steroid inhaler Flixotide which will be the last one to go. I’m also off Prozac which I was on for the depression I was getting because I was always so ill with asthma. “I’ve had three chest infections since the course, which I had to be on antibiotics for, but I haven’t needed to increase the asthma medication, which is amazing”

Meridith Cooper from Rhu has found the breathing exercises extremely hard work. “If I stick at it, I’m well. If I lapse, the asthma returns. But I am very, very impressed . I haven’t used Ventolin in four months an I’m ready now to half my dosage of steroids”.

The huge reserves of willpower required to sustain the Buteyko method seems to be the main reason it doesn’t work for everyone. In a culture hooked on instant remedies, the physical effort and mental stamina it takes to recondition a lifetime’s breathing habit comes as a shock. A hospital physician who enrolled four of his NHS patients on a Buteyko course was extremely disappointed with the results. Two did not even finish the course.

Meredith Cooper’s brother Guy Nelson was also on the first course. He had asthma induced solely by exercise, which in a sports lover was a major handicap. He found it difficult at first to play hockey with his mouth tightly closed, but eventually began to experience definite improvement. He now feels in control of his asthma.

One of several children on the course, Amy Birchard, 9, has persevered with the exercises and feels much better. Her father, Paul Birchard said “I feel it’s a truthful theory and it works”.

Joanne Webster, 16, from Angus, has also been able to reduce her medication, she has more energy and feels warmer. Her consultant was very impressed by the improvement in her condition. Alasdair, 18, Fearghas, 8 and their mother, Fiona Lyon, did the course together as a family. Alasdair reports that they have not used their inhalers at all since then. They can all now go into houses where there are cats and dogs without suffering. “It’s very hard work,” said Alasdair, “but it’s worth it.

Elaine Gillespie, 17, from Greenock, was a severe asthmatic on high doses of drugs, who looked and felt ill all the time. She is amazed at how much better she has been. She was able to come off most of the drugs and has felt hugely better without the shakiness and the fluctuating heart-rate she had been experiencing as side effects. Her one set back has been a bout of pneumonia, but she intends to restart the breathing method once she recovers. “I think everybody should be able to do this” she said. “It should be on the NHS”

Whether the Buteyko method ever makes it on to the NHS, which currently spends hundreds of millions of pounds on asthma drugs, depends on clinical trials which may take years to carry out. So far the only controlled study has been staged in Australia, where 40 asthmatic patients were divided into two groups which followed either a Buteyko regime or standard asthma treatment and relaxation techniques. After six weeks there was a 90% reduction in the symptomatic medication in the Buteyko group compared with a 5% reduction in the other. There was also a significant improvement in the quality of life of the Buteyko group. Australian respiratory physicians expressed surprise at the results. The Buteyko practitioners in this country, Alexander Stalmatski and Christopher Drake, operate out of London’s Hale Clinic. Research studies are under way but it may be a long time before the clinical trials that could prove or disprove the Buteyko theory are up and running.