Ira Packman MD about the Buteyko Breathing Method
I have personally been asthmatic most for my adult life. The Buteyko Method works! As a Board Certified Internal Medicine Physician for 32 years, I have treated hundreds of asthmatic patients. The obvious questions with asthmatics are always:
* Are you overweight?
* Do you have gastro-esophageal reflux GERD?
* Is there concurrent bronchitis?
* Is there a new antigen (allergy trigger) in your life?
* Are you under stress?
* Is this exercise or cold temperature induced wheezing?
I had never asked anyone if they were chronically hyperventilating. Obviously, even if they were, they wouldn’t know they were. This method of asthma control and theory of the physiologic basis of asthma has a tremendous amount of anatomic, physiologic and pathologic support. The important thing to understand about how the body works is the concept of homeostasis (i.e. keeping everything as it is).
The body controls a number of factors very carefully:
* Glucose control via insulin
* water and electrolyte control via the kidneys
* temperature control via the lungs and the skin (sweat)
* acid-base control via the lungs and kidneys
The most closely controlled factor is acid-base. The lungs can quickly change the PH of the body by holding onto carbon dioxide (CO2) or getting rid of CO2. As CO2 goes up the PH drops (more acid). As CO2 goes down, the PH goes up (more basic or alkalotic). It is CO2, not Oxygen (O2) that drives our respiratory system and determines the rate at which you breathe. The body delivers Oxygen to the organs and tissue by attaching the oxygen to the hemoglobin molecule of the blood. The blood circulates around the body and gives up the oxygen to the tissues. The ease with which the oxygen is released to the body tissue is determined by the oxygen/hemoglobin dissociation curve, which is greatly controlled by body PH.
As CO2 levels go up, the PH drops (becomes more acid or acidotic). The body likes to be slightly on the acid side because as the blood PH shifts to the acid side of the equation, there is a shift in the oxygen/hemoglobin dissociation curve which allows oxygen to be delivered more easily to all the organs and muscle tissue of the body. When the CO2 level drops, the opposite happens and the body doesn’t get the oxygen off the blood hemoglobin molecules as easily and you feel tired, achy and just plain lousy. So, the concept that asthmatics are chronically hyperventilating thus lowering CO2 levels and raising the PH is very interesting. This means that asthmatics are always a little on the basic/alkalotic side of the equation thus making it harder for our bodies to get the oxygen out of the blood.
The Buteyko method is really very simple – it says that because the body very closely monitors PH, as asthmatics hyperventilate and lower their blood CO2 levels and raise their PH, the bodies natural response is to retain CO2, drop the ph and give more O2 to the tissues. The easiest way to do this is to constrict the airways so the lungs can’t blow out the CO2. (Even though it feels like we can’t get a good breath in, asthma is really a disease of restricted expiration, not inspiration) This can be corrected by slowing down the breathing rate, thus increasing CO2 levels in the lungs and blood, therefore, alleviating the bronchial constriction, raising the CO2 level, and lowering the PH so more oxygen is released to the body’s tissues.
If you start to feel “tight” and do these breathing exercises, you will immediately feel relief. IT WORKS – but more importantly – it makes perfect Physiologic sense.
Dr. Ira Packman M.D. Internal Medicine
Camp Hill, PA