Peter Kolb BSc(Eng), MSc(Med), CPEng(Biomed) BIOMEDICAL ENGINEER

Q1."I understand that as an asthmatic my body is short of Oxygen. How can BREATHING LESS help me get MORE Oxygen?"

A. The amount of Carbon dioxide in your blood is directly related to how much you breathe. The more you breathe the more Carbon Dioxide you lose. In general this does not apply to the uptake of Oxygen. Your blood is pretty nearly saturated with oxygen and you would have to breathe an awful lot less before the Oxygen level goes down.

So if you've been breathing too much, your Carbon Dioxide level is low, but Oxygen is still the same. Now when the Oxygen carrying Hemoglobin reaches the tissues where the Oxygen needs to be released (Muscles, brain etc.), the extent to which the Oxygen is released depends on the levels of Carbon Dioxide in the blood. The more Carbon Dioxide is in the blood, the easier it is for the Oxygen to dissociated from the hemoglobin. This phenomenon is known as the Bohr effect and has been well known to physiologists for decades. You can look it up in any physiology text book such as Guyton, or even in Stedman's medical dictionary under "effects."

The net result is that the Oxygenating capacity of the blood is reduced by low Carbon Dioxide levels. So if you breathe less your Carbon dioxide levels go up and the oxygenating capacity of the blood improves.

This is based on standard physiology and was not invented by Buteyko.

There is another reason why more breathing provides less Oxygen, and this relates particularly to asthma attacks. During an asthma attack you will find that breathing more simply does'nt help. In fact, according to Buteyko, it makes matters worse. The reason is that (according to Buteyko) your bronchioles are all very constricted because they're trying to fight against the loss of Carbon dioxide. So when you're told to just take a deep breath, this is exactly the wrong advice. You just lose more carbon dioxide and your bronchioles constrict even further. This means no Oxygen at all can get in to the alveoli. To make matters worse, this causes you to panic. The resulting adrenalin rush makes you want to breathe even more.

Some parents have come to realise that the best they can do for their child during such an attack is to calm them down, and that this helps break an asthma attack.

Q2."I have allergy and not hyperventilation induced asthma. How can BREATHING LESS help my kind of asthma?"

A. According to Buteyko the fundamental cause of Asthma is breathing too much. There is only one kind of asthma, but there are a number of "triggers" that can elicit an asthma attack. These include acute episodes of hyperventilation, anxiety, exercise, allergies etc.

The reason we understand there to be different kinds of asthma is that they had to be invented in order to try to explain the current model of asthma. The Buteyko model explains it all without any need for such inventions. I've covered this more fully in a section on the consistency of Buteyko's theory.

Patients who suffer from allergies report that these allergies disappear after practicing Buteyko breathing. So how is this possible?

I have'nt found any explanation from Buteyko, (which does'nt mean that he does'nt have one) but we could speculate that it has something to do with the alkalinity of the lungs. It would make perfect sense, since the lungs are responsible for an excessive loss of Carbon dioxide. This would leave the lungs much more alkaline than normal. We know that alkaline agents cause "ALKALI BURNS" on the skin. We would expect the lungs to be far more vulnerable because the mucosa does'nt enjoy the protection of a Keratin covering like the skin does. So the alkalinity leads to a reddening and swelling of the lung lining, which must therefore become more vulnerable to infectious and allergic agents.

So by breathing less, Carbon Dioxide is conserved, the proper acid/alkali level of the lung lining is restored and the mucosa becomes less vulnerable to allergic triggers. Let me emphasise, however, that this explanation is not given by Buteyko, but could be a possible mechanism by which it works.

Q3."Buteyko says I have to breathe through my nose. How can I breathe through my nose when it's all blocked up as a result of allergies?"

A. By holding your breath (possibly while exercising) you can unblock your nose, allergies or no allergies. Try it sometime. I did'nt believe it either! If it doesn't work for you, please let me know. I'm still trying to find someone for whom it doesn't work.

Q4."If I hold my breath, won't the lack of oxygen kill off my brain cells?:-))"

A. You would pass out long before your brain cells are affected. Permanent brain damage occurs about four minutes after losing consciousness through completely interrupted oxygen supply. On the other hand, according to Buteyko, excessive breathing will cause your bronchioles to become blocked. This can get to a stage where even the minimal amounts of oxygen you need to keep your brain alive, can't get through to the alveoli. In Australia we have over 700 deaths a year due to asthma.

The other thing to remember is that what gives you the urge to breathe is generally not a lack of oxygen as one tends to think, but an accumulation of Carbon Dioxide. Because your brain has fixed on the wrong level of Carbon dioxide as a baseline, (according to Buteyko) you have to re-educate it. This re-training means you have to over-ride the brain's instruction on how much to breathe. You can't do that unless you force yourself to feel like you're getting too little air.

Q5."If Buteyko's idea has been around for over 40 years, why does my doctor not know about it?"

A. Western medicine has been trying to understand asthma by looking only at the triggers. Buteyko has gone a step further, told them they are wrong and pointed them to the fundamental cause of asthma.

The current asthma model is so deeply ingrained in current medical thinking, that it will be very difficult to change. If I had'nt seen the dramatic results of Buteyko therapy for myself, I would'nt have bothered to take Buteyko seriously either.

Medical history is littered with examples of good ideas that have taken decades to be accepted, usually after an enormous struggle by the proponents. Unfortunately medical doctors are not educated in the history of medicine, so the lessons of history are often lost to them.

I have devoted an entire section on why I believe doctors are "stone-walling" Buteyko.

Q6."How do I learn to breathe less?"

A. Buteyko therapy consists essentially of breath-reduction exercises that fix bad breathing habits. Everyone who has attended a Buteyko class agrees on the value of professional tuition. The DIY approach is not recommended unless you really don't have access to a practitioner. We understand that Buteyko practitioners give you a money-back guarantee, the terms of which are fully disclosed before you commit yourself. This is remarkable in itself, given that the successful outcome depends 100% on patient compliance. They generally also give free follow-up classes should you want them. As far as we know, Buteyko classes are held only in Russia, Australia, New Zealand, Israel and the United Kingdom. That means that there are millions of asthmatics who don't have access to Buteyko therapists, and who won't have in their life-times. I have compiled a separate page on my recollections of Personal Experiences in a Buteyko Class. In this article you will find the fundamentals of what they teach and how they teach it. There have subsequently been far better descriptions, particularly by Gerard O'Neill who wrote it up fresh after attending a course. Also Mark Reardon and Gali Nachmann have presented excellent reports on how they were taught.

Q7."How can changing my breathing affect the inflammation in my lungs?"

A. The cause of inflammation in the airways has been difficult to find in the very limited Buteyko literature available. I have learned from various Buteyko practitioners, however, that this is attributed to reduced natural Cortisone production resulting from lower blood Carbon Dioxide levels in Asthmatics. This also explains the tendency for asthmatics to have food allergy responses as well as eczema and other skin rashes. In other words, the allergies that cause the asthma result from over-breathing. In practice, asthmatics practicing Buteyko breathing find that their allergies, including hay fever and skin rashes, all disappear.

WARNING ABOUT MAXIMUM PAUSE: Several Buteyko practitioners have voiced concern to me about the practice of "Maximum Pause". I have heard it said that Buteyko himself no longer teaches it, that it can be quite dangerous for patients suffering from various other conditions, that it can actually trigger a re-lapse, that it discourages people from doing the Buteyko exercises and that the same results can be achieved without those dreadful, heroic breath holding exercises. On the other hand, some practitioners do still teach it. I'm not qualified to enter the debate, so I won't do any more than present this information to you. We welcome comments, queries to our FAQs and particularly people who have a story to tell about their own experiences with Buteyko. We would, with your permission, like to add your stories to our Contributors' Section.