A case demonstrating sustained remission of exercise-induced asthma, allergic oropharyngeal symptoms, and recurrent respiratory infections in an adolescent following constitutional homeopathic care.
This case report describes the resolution of exercise-induced asthma, food-triggered oropharyngeal allergy symptoms, and recurrent respiratory infections in a 16-year-old male following individualized homeopathic treatment. The outcomes highlight a naturopathic approach focused on immune regulation, constitutional assessment, and treatment of underlying susceptibility rather than symptom suppression.
Dr. Michael Knapp, ND, DHANP
Abstract
Background: Exercise-induced asthma and allergic airway symptoms are common in adolescents and may significantly impair athletic performance and quality of life. Conventional management often focuses on symptom suppression rather than addressing underlying susceptibility and immune dysregulation.
Case Presentation: A 16-year-old male presented with long-standing exercise-induced asthma, recurrent upper respiratory infections, chronic sinus congestion, and acute throat constriction and pruritus triggered by raw fruits and vegetables. Symptoms were exacerbated by heat, exertion, and environmental allergens, and were accompanied by anxiety in social settings. The patient had a history of frequent childhood infections, antibiotic exposure, and increased symptom severity following vaccination during adolescence.
Interventions and Outcomes: Based on a comprehensive naturopathic and homeopathic assessment, a single dose of the homeopathic medicine individualized to the characteristic symptoms of the patient was administered in a 200C potency. Marked improvement was observed within 24 hours, including improved nasal airflow, reduced asthma severity, improved mood, and restored sense of smell. After transient relapse, a second dose was given, resulting in sustained resolution of throat reactions, near-complete remission of exercise-induced asthma, elimination of recurrent infections, and improved overall vitality. Benefits persisted through 10-month follow-up.
Conclusion: This case illustrates the potential role of individualized homeopathic treatment in addressing asthma and associated allergic and immune dysfunction in adolescents, supporting the naturopathic principle of treating the whole person and the underlying susceptibility rather than isolated symptoms.
Introduction
Asthma affects approximately 8–10% of adolescents and is a leading cause of exercise intolerance and school absenteeism. Exercise-induced bronchoconstriction is particularly prevalent among young athletes and is often exacerbated by environmental allergens, infections, and psychological stress. Conventional management typically relies on bronchodilators and corticosteroids, does not address underlying immune imbalance, constitutional predisposition, or comorbid allergic phenomena.
Naturopathic medicine emphasizes identification and treatment of the root causes of disease, including immune dysregulation, environmental sensitivity, and constitutional factors. Homeopathy, as a vitalistic system within naturopathic medicine, aims to stimulate the body’s inherent self-regulatory capacity through individualized remedy selection. This case is noteworthy for the rapidity of resolution of asthma, food-related oropharyngeal symptoms, and recurrent infections following individualized single remedy homeopathic treatment in an adolescent male.
Case Presentation
Patient Profile
The patient was a 16-year-old male competitive soccer player. Family history was notable for autoimmune disease (lupus) in maternal relatives. Developmental milestones were normal, though childhood was marked by frequent infections starting after swine flu infection at about 18 months old. He takes no medications.
Presenting Symptoms and Examination
Primary Concerns:
- Exercise-induced asthma, characterized by progressive wheezing and shortness of breath with minimal exertion, worsened by heat and improved by cold air.
- Oropharyngeal itching and throat constriction triggered by raw fruits and vegetables (apple, pear, banana, citrus, strawberry, celery, carrot), associated with dyspnea and wheezing, lasting about 60 minutes. During this time, any food or drink causes uncomfortable scratching in the throat.
- Recurrent upper respiratory infections, frequently progressing from allergic rhinitis to sinusitis and bronchitis, occurring 1–2 times per month. Frequent infections started after swine flu infection at about 18 months old. He would be sick 3-4 times per month as a baby.
Associated Features:
- Environmental allergies (dogs, cats, pollen)
- Chronic postnasal drip with thick discharge during acute sinusitis
- Diminished sense of smell
- Excessive perspiration with exertion, particularly of the scalp and forehead
- Strong preference for cold environments and cold water. He wears shorts in snowy weather.
- Anxiety related to social interaction and fear of judgment
- History of frequent childhood infections, including swine flu in infancy
- Approximately eight lifetime courses of antibiotics
Physical Examination:
- Well-developed, well-nourished adolescent male
- Nasal mucosa pink with yellow posterior discharge
- Pharyngeal erythema without tonsillar enlargement
- Lungs clear to auscultation at rest
- Mild generalized abdominal guarding
- Alert, oriented, and cooperative, with noted anxiety
Etiological Factors
This patient demonstrated multiple factors contributing to disease expression:
- Possible disruption of immune regulation following early-life infections and repeated antibiotic exposure leading to recurrent infections and prolonged illness
- Atopic tendency, with allergic rhinitis, asthma, and food-related oropharyngeal reactions
- Environmental sensitivity, particularly to heat and aeroallergens
Timeline
- Early childhood: Frequent infections, swine flu, recurrent antibiotic use
- Middle school: Onset of throat itching and food reactions
- Adolescence: Worsening asthma, recurrent sinus infections, impaired athletic performance
Diagnostic Assessment
Diagnosis was based on clinical presentation and previous historical diagnosis consistent with exercise-induced asthma, allergic rhinitis, and recurrent respiratory infections. Homeopathic case analysis incorporated physical generals, modalities, mental-emotional state, and characteristic symptoms to determine constitutional remedy selection. The following rubrics were taken from the Synthesis Repertory 2009 and combined into 6 super-rubrics that cover the important features of this case:
- THROAT – CONSTRICTION
- RESPIRATION – ASTHMATIC – exertion; from slight
- RESPIRATION – DIFFICULT – exertion – after – agg.
- THROAT – CONSTRICTION etc.*
- RESPIRATION – DIFFICULT – cold – air – amel.
- GENERALS – COLD – air – amel.
- GENERALS – WARM – air – agg.
- GENERALS – WARM – air – agg. etc.*
- HEAD – PERSPIRATION OF SCALP
- HEAD – PERSPIRATION OF SCALP – Forehead
- HEAD – PERSPIRATION OF SCALP – Forehead etc.*
- NOSE – DISCHARGE – Posterior nares
- NOSE – CATARRH – Postnasal
- NOSE – DISCHARGE – thick
- NOSE – DISCHARGE – thick etc.*
- GENERALS – COLD; TAKING A – tendency
- MIND – ANXIETY – crowd; in a
- MIND – FEAR – crowd, in a
- MIND – CONVERSATION – agg.
- MIND – FEAR – crowd, in a etc.*
Interventions
Treatment Overview
The patient received Sulphur 200C, two pellets, administered once orally.
Rationale
Sulphur is indicated for individuals with reactive immune systems and was selected based on the characteristic features: heat aggravation, preference for cold air, exercise-induced respiratory symptoms, recurrent infections, allergic tendencies, and marked scalp perspiration. Twenty-four additional remedies cover all the symptoms in the repertorization, but the physical generals and modalities best fit Sulphur.
This intervention aligns with the naturopathic principles of Vis Medicatrix Naturae, treating the whole person, and addressing the individual susceptibility rather than suppressing symptoms. The goal was to restore immune balance and respiratory resilience rather than rely on bronchodilators or corticosteroids.
Outcome and Follow-Up
Patient Response
Within 24 hours of initial treatment, the patient experienced improved nasal airflow, reduced asthma severity, improved sleep, enhanced mood, and partial return of olfaction. At 1.5 weeks all symptoms significantly relapsed without identifiable antidoting factors. Sulphur 200C, 2 pellets, was repeated. Following the second dose, throat itching resolved completely, asthma severity decreased to negligible levels, and recurrent infections ceased. When it was clear the patient was experiencing sustained and continued improvement, a 3-month period of supplementation was initiated with DHA/EPA essential fatty acids daily, quercetin and Urtica dioica daily, and a digestive enzyme combination including HCl, pepsin and ox bile with each meal.
Long-Term Follow-Up
At 10 months, the patient no longer experienced exercise-induced asthma symptoms, tolerated travel to high-allergen environments, had not experienced recurrent or prolonged respiratory infections and remained free of food-triggered throat reactions. He had one episode of throat constriction during a mild upper respiratory infection. Athletic performance improved substantially.
Discussion
Contextualization
This case aligns with existing observational literature suggesting individualized homeopathy may benefit patients with asthma and allergic disease and also illustrates my, albeit limited, general clinical experience that many cases of asthma can benefit or be resolved with commonly prescribed homeopathic medicines that are well within the purview of the generalist naturopathic physician (Arsenicum album, Sepia, Silicea, Sulphur, etc.).
Key Insights
- Addressing immune dysregulation may reduce both asthma and infection frequency
- Individualized treatment may offer durable outcomes beyond symptom control
- Improvement can be rapid, gentle, profound and permanent
Limitations
Interestingly, Sulphur was able to address the most limiting physical symptoms which were the chief complaints, but it did not improve the anxiety. In this situation, §168 of the Organon of Medicine instructs the physician to consider the remaining symptoms combined with any newly arisen symptoms and administer the most appropriate homeopathic medicine. Therefore, when the allergic symptoms were resolved, anxiety became the chief complaint and was addressed with a different homeopathic medicine.
Conclusion
This case demonstrates sustained improvement of exercise-induced asthma, allergic throat symptoms, and recurrent respiratory infections following individualized homeopathic treatment in an adolescent male. The outcomes support a naturopathic approach that prioritizes constitutional assessment and immune regulation, suggesting potential benefit for similar patients with complex allergic and respiratory presentations.
Dr. Michael Knapp, ND, DHANP is a licensed naturopathic physician with advanced board-level training in homeopathic medicine and over a decade of clinical experience integrating naturopathic principles into complex case care. He graduated from the National University of Natural Medicine in Portland, Oregon and completed a one-year teaching and clinical residency focused on the interconnections between digestive, stress-related, hormonal, and immune system complaints. Dr. Knapp is a Diplomate of the American Board of Homeopathic Medicine and is recognized for individualized, pattern-based homeopathic prescribing within comprehensive naturopathic practice. He has served as President of the Homeopathic Academy of Naturopathic Physicians and teaches mindfulness and integrative care, extending his passion for healing to diverse populations including underserved communities. He can be reached at https://purehomeopathy.com/
