Roger Price: Do You Really Have Asthma?

Why is breathing through the nose so important? What is the difference between bronchoconstriction and asthma? Today, Roger Price, joins us.

Roger Price is a Functional Medicine and Integrative Health Educator. He has more than 60 years of experience in multiple areas of the health profession, giving him a broad and well-rounded view of the entire field.

Widely regarded as ‘The Father of Airway in Dentistry’, having been the first person to introduce this concept more than 20 years ago, he is credited with being the mentor of many of the more well-known and reputable individuals in today’s world of Dental Sleep Medicine.

In this fascinating conversation, we discuss breathing well; the importance of nose breathing, carbon dioxide levels and the role of nitric oxide.

Roger Price: Do You Really Have Asthma? Introduction

Well, today, we are continuing our exploration of breathing, and it’s a little bit of revision and a little bit more of a focus on asthma as we started to talk about this with Professor Pete Smith a few episodes ago.

My guest today has returned. We’ve spoken to him prior. I’ve known him for many years. Roger Price is functional medicine and integrative health educator. He’s got more than 60 years of experience in multiple areas of the health profession, and this has given him a very broad and well-rounded view of the entire field. 

Roger has been involved in bringing knowledge of the airway in dentistry to Australia and has been one of the first to introduce this concept more than 20 years ago. He’s credited with being the mentor of many, including myself, in today’s world of Dental Sleep Medicine and breathing retraining. I hope you enjoyed this conversation I had with Roger Price.

Podcast Transcript

Dr Ron Ehrlich: [00:00:01] I’d like to acknowledge the traditional custodians of the land on which I am recording this podcast, The Gadigal People of the Eora Nation, and pay my respects to their Elders – past, present, and emerging.

Hello and welcome to Unstress. My name is Dr Ron Ehrlich. Well, today, we are continuing our exploration of breathing, and it’s a little bit of revision and a little bit more of a focus on asthma. As we started to talk about this with Professor Pete Smith a few episodes ago. [00:00:43][19.4]

Dr Ron Ehrlich: [00:00:44] My guest today has returned. We’ve spoken to him prior. I’ve known him for many years. Roger Price is functional medicine and integrative health educator. He’s got more than 60 years of experience in multiple areas of the health profession, and this has given him a very broad and well-rounded view of the entire field. 

Roger has been involved in bringing knowledge of the airway in dentistry to Australia and has been one of the first to introduce this concept more than 20 years ago. He’s credited with being the mentor of many, including myself, in today’s world of Dental Sleep Medicine and breathing retraining. I hope you enjoyed this conversation I had with Roger Price.

Dr Ron Ehrlich: [00:01:33] Welcome back, Roger.

Roger Price: [00:01:34] Thanks, Ron. Always nice being with you. We have a lot of fun with these things.

Dr Ron Ehrlich: [00:01:39] We do. We do. And we’re talking always about something that is so basic and yet so profound and that is breathing. And today, we’re going to dive into asthma as well. In fact, that’s what our focus is going to be. But I wondered if, before we started, we might just do a little bit of revision for our listeners and remind them about why we breathe and what the potential for it is. So getting it right and wrong.

Roger Price: [00:02:05] Well, we breathe for a very simple reason. It’s survival. And life really is nothing other than a breath-to-breath survival. Because if you don’t take the next breath, it’s all over. So that tops everything. And it’s something where the survival instinct is so strong that it will cause us to develop whatever compensations we need should something get in the way of the next breath. 

So this is why people hold their breath or gasp or take a deep breath or sigh or stop breathing. So many people don’t realise they stop breathing during the day. And they wonder, “Why do I stop breathing?” Well, the reason they stopped breathing is for the chemical system to reset itself because they’ve upset the balance

So, to make it very simple. Breathing controls the pH of the body. Not what we eat and what we drink. It’s the way we breathe. And the brain is ever vigilant that if it senses there is a shift in pH that is going to cause us bodily harm, it changes our breathing pattern. And there is very, very, very, very little change in oxygen pH or oxygen content of the body that affects because oxygen doesn’t affect the pH. 

PH Is controlled by carbon dioxide levels and if the brain detects that the carbon dioxide levels drop and the pH starts to move into the alkaline range, it will do what it has to do to prevent us from losing even more. This is why you become breathless. If you overexert yourself, this is why people say I can’t catch my breath or my chest is tight. It’s not like you’re wearing a shirt four times too small for you.

What is happening in the brain is detecting that the carbon dioxide is dropping. And in the absence of being able to make more, its only solution is to prevent the loss of any more. So bronchoconstriction, which is the constriction of the bronchioles, the tubes in the lung, is the defense mechanism against over breathing. In so many, many, many cases, it is mistaken for asthma because the symptoms are very similar. And I think that brings us into our discussion today. What is the difference between bronchoconstriction and asthma? 

Dr Ron Ehrlich: [00:04:59] Hmm. It does. And I think it’s worth mentioning that and reminding people, as we’ve just done, that breathing is about delivering oxygen to the cell. But it’s the acid-alkali balance in the body that determines how well or how efficient that is. Is that a fair statement?

Roger Price: [00:05:20] It’s even easier to say that it’s the carbon dioxide, which is the facilitator, to allows the oxygen that is bonded to the blood to release from the blood and get to the brain and the rest of the cells. It’s almost like an ATM card to get your money out of your account so that you can pay your bills. There’s no point in having money in the account if you can’t get it out. 

And Ron, I doubt that 1% of people, ambulatory people, people walking around does if you have to check their oxygen saturation. I doubt you would find one out of 100 below 95%. 

Dr Ron Ehrlich: [00:06:06] Hmm.

Roger Price: [00:06:07] But if you had to check the carbon dioxide levels of those same hundred people, I know from 30 years of experience doing this that less than 10% would have functional carbon dioxide levels.

Dr Ron Ehrlich: [00:06:20] Hmm. Which brings us to the topic of asthma because we did a programme a few weeks ago with Professor Pete Smith on allergies and chemical sensitivity, and he made a statement which actually prompted this discussion which said that at least 30% of asthma diagnosis is misdiagnosed.

And that kind of alerted us, and we began a conversation. Thank you for the article you sent me. And I’ll have it attached to the show notes about that being a much bigger problem. Before we dive into that, just remind us about what asthma actually is.

Roger Price: [00:07:00] Okay. Well, I’m going to read you verbatim. 

Dr Ron Ehrlich: [00:07:03] Okay.

Roger Price: [00:07:04] The definition of asthma in Australia. It says asthma is a common lung disorder in which inflammation causes the bronchi to swell and narrow the airways, creating breathing difficulties that may range from mild to life-threatening.

Dr Ron Ehrlich: [00:07:26] Hmm.

Roger Price: [00:07:26] So let’s have a look at the detail of this definition. It’s a disorder in which inflammation causes the bronchi to swell. Where does the inflammation come from? The lungs are not designed to self-inflame. Well yes, if there is inflammation in the bronchi, they will swell. Because the immediate reaction of the histamines on the cytokines and the bradykinins and all of those things is to rush to the site of the inflammation, to address the enemy, so that portion of it is correct, but what it doesn’t say is why the lungs become inflamed?

Dr Ron Ehrlich: [00:08:13] Hmm.

Roger Price: [00:08:14] And that is the key point to this whole thing. This is that beautiful medical term, “Idiopathic.” Idiopathic means I don’t have a clue. It means of unknown origin. It’s not of unknown origin. It’s a very simple thing. The lungs become inflamed because people breathe through their mouths and they bypass the six stages of filtration that are designed to come into effect using the nose before the air gets into the delicate linings of the lungs. So I’ve handled tens of thousands of asthma attacks in my career. I do not treat asthma. I don’t treat asthmatics. I teach them how not to have an attack.

Dr Ron Ehrlich: [00:09:16] Hmm.

Roger Price: [00:09:17] And my question is very simple. Have you been diagnosed with asthma? Yes. Can you imagine having an asthma attack, sitting quietly in a chair, reading a book, and breathing through your nose? The answer is no. 

So tell me, when do you have an asthma attack? When I’m upset when I’m excited, when I’m exercising, when I’m rushing around. So well. So that’s when you’re breathing through your mouth, right? 

Dr Ron Ehrlich: [00:09:48] Yes.

Roger Price: [00:09:50] Do you think it’s possible that the contaminated air that you are not letting go through the six-phase filtration cycle is getting into your bronchioles causing that inflammation?

Dr Ron Ehrlich: [00:10:03] Yes.

Roger Price: [00:10:04] So it’s not of unknown origin, is it? But you now going to look at me like a stunned mother to this it. Why didn’t my doctor tell me this?

Dr Ron Ehrlich: [00:10:17] Remind us of the six levels of filtration because we say nasal breathing, mouth breathing, and it rolls off the tongue very quickly, very easily, and people might blink and miss it. But I think it’s worth pausing and reminding us why we have noses. 

Roger Price: [00:10:34] Level one. Well, first of all, so that you can wear glasses. I mean, that’s the main reason I think that’s all have is okay. But level one is the hairs. And the hairs in the nose are there to trap the floating stuff. 

And if you look at a shaft of sunlight coming through your window, what’s dancing in that shaft of sunlight? 60 million things. When the sun goes down, do you think they’ll go away? So the hairs trap the floaty stuff.

Roger Price: [00:11:08] Then we have the mucus. And the mucus contains an enzyme. That enzyme is called lysozyme. And in fact, that was the origin of the name ‘Lysol’ in the early days of the disinfectant because lysozyme kills contact viruses and bacteria. So that’s level number two.

Level number three is the turbinates. And the turbinates are cone-shaped, shell-shaped structures here inside the nose that swirls the air over them as it goes through the nose. And that is to bring it to body temperature. So it will either warm the air or cool the air so that what it enters our lungs is not inhospitable. Okay. So then we go via the turbinates, which also have a slight moisturising effect on the air. And we go into the sinus. And the sinus cavity produces one and a half litres of fluid a day. 

That’s a lot of fluid. And the reason for that is to wash the air. But to humidify it. Because of those who’ve done the science and who are familiar with a law called Smith’s Law. Smith’s Law pertains to the exchange of gases across a membrane. And you cannot exchange the air across a membrane if the membrane is dry. So the sinuses moisturise the air so that you can get the exchange in the lungs.

Okay. So as the air travels over the sinuses, it triggers the release of a magical gas called nitric oxide. Nitric oxide is a very powerful anti-microbial, but it is also a very powerful vasodilator, which means that it dilates blood vessels and other vessels in the body and bronchioles and alveoli.

And the fact that nitric oxide helps keep them dilated means that our exchange of air is so much simpler. So once you’ve released the nitric oxide, the air, which has been triple filtered, warmed, cooled, and humidified, then goes over the adenoids. And the adenoids are the second finest filters in the body. And finally, after the adenoids, they go over the tonsils. And the tonsils are microfine filters. 

Microfine. Because that’s the last stage before the air enters the lungs. Well. Shut that system down and breathe through your mouth, and you’re loading the microfine filters with all the other five stages of things which should have been removed. Wonder why people have inflamed tonsils.

Dr Ron Ehrlich: [00:14:24] Yeah. Yeah. I mean, I heard one thing. Dr Rosalba Courtney was a guest on a podcast, and she said something to me that I thought was a real aha moment, and that was that 60% of the body’s nitric oxide.

And I’ve heard higher proportions than that. 60 to 90% of the body’s nitric oxide is produced in the sinuses, in the paralysed sinuses, only when you breathe through your nose.

Roger Price: [00:14:51] Well, it’s produced constantly in the paranasal sinuses but only released as the fine stream of air through nasal breathing passes over the sinuses, triggering the release of nitric oxide. You couldn’t have it building up to 60% or whatever it is, and sitting there. Your head would explode. And so it’s a very fine balance. It’s the gentle flow of nasally inspired air that trickles over the sinuses that triggers that flow. Hmm. And, of course, nitric oxide is made everywhere in the body, not only in the nasal sinuses.

Dr Ron Ehrlich: [00:15:35] Mm hmm. Okay. It’s a really, I mean, it’s really important I mean, there was a Nobel prise, and given for the discovery of nitric oxide, and it’s a really important body regulator. Is it also a bronchodilator?

Roger Price: [00:15:48] Oh, absolutely.

Dr Ron Ehrlich: [00:15:49] Yeah. Yeah. Because one of the paradoxes people experience when they stop to breathe through their nose is when they think their nose is blocked. But miraculously, when they breathe through their nose, slowly, calmly, their nose unblocks. 

Roger Price: [00:16:05] Yes, but the prime reason for that is they’re inhaling gently and slowly, so their carbon dioxide levels are building up. And carbon dioxide is a very powerful broncho and vasodilator as well.

Dr Ron Ehrlich: [00:16:22] Hmm. 

Roger Price: [00:16:23] So there’s a very simple trick. If your nose is blocked, if you regularly have a massage and you lie face down with your face through that hole that you block up and you can’t breathe, just bring your hand around, pinch your nose closed, and hold your breath for 20 or 30 seconds, then breathe very gently, and then your nose opens magically. Ron, these things are so simple. We’re just. Well, that’s complicating life.

Dr Ron Ehrlich: [00:16:52] Well, that dovetails into a message that is a recurring theme on this podcast. And that is the world we live in becomes increasingly more complex. The solutions are remarkably simple and accessible, and effective. Which brings us back to a discussion about asthma. So I think we’ve laid the foundation here for why breathing is so important and that it’s much more than just a function of oxygen. It’s about a whole balance of body chemistry. 

So asthma. So let’s come back to asthma. And it is how in your estimation, I know you’ve written on it, and we’ll have links to it in our show notes. But what in your estimation, what percentage of people who are diagnosed with asthma are misdiagnosed?

Roger Price: [00:17:41] Well, fasten your seatbelts. In my experience, it’s close to 90%, Ron. And yes, Ron, there is asthma. And yes, it can be fatal. And yes, people do die from it. But the very diagnosis of asthma is what’s causing its misdiagnosis. One of the fundamental laws of scientific measurement is that the measuring methodology you use should not change the parameters of the thing you’re trying to measure.

Dr Ron Ehrlich: [00:18:18] Mm hmm.

Roger Price: [00:18:18] And the beautiful example of that is trying to take the temperature of water in a thimble by using a bulb thermometer. Because when you put the thermometer into the thimble, the ambient temperature of the glass is going to change the temperature of the water before the mercury can measure it.

Dr Ron Ehrlich: [00:18:43] Mm hmm.

Roger Price: [00:18:44] That is the classic example that we used when I was studying. Well. The tests for asthma. Both of them – Spirometry and Peak Flow – involve the rapid exhalation of all air in your lungs to calculate something called the FEV1, which is the forced expiratory volume. Okay.

Dr Ron Ehrlich: [00:19:12] So Roger, just, just to stop you there, you demonstrate that you have this a measurement here which you’re going you’re breathing in and out, in and out, in and out, and then you’re breathing out.

Roger Price: [00:19:23] You have to breathe out forcibly three times.

Dr Ron Ehrlich: [00:19:28] Yes. So you’re getting rid of all your carbon dioxide. Exactly. 

Roger Price: [00:19:34] And what do you think happens to the bronchioles when it detects a loss of carbon dioxide? They go into spasms. So after the third blow, when you near expiration, they slap a mask on your face with some Ventolin in it, they artificially open the bronchioles and they say blow again. As you blow the fourth time in there. So you see, you’ve got asthma. The answer is no. You caused it. You provoked the bronco constriction by getting me to empty my lungs.

Dr Ron Ehrlich: [00:20:12] Mm hmm.

Roger Price: [00:20:12] And here’s the disconnect. The FEV1 is a very valuable measurement because it measures lung function. Lung function has nothing to do with what triggers asthma. Lung function should be measured when there is a disease of the lung, when there’s deterioration in lung tissue, and when the exchange within the lungs has been compromised to the point that people physically cannot breathe. This is not a physical challenge. This is a biochemical challenge which is shutting down the bronchioles while you trying to measure how open they are.

Dr Ron Ehrlich: [00:20:56] Hmm. And tell me, how should one, do you think, assess asthma? How should one how what would be a good diagnostic approach to asthma?

Roger Price: [00:21:06] My very, very first question is historical. Who in your family has asthma? Do your siblings do your parents, do your grandparents? Because there is a strong genetic component to asthma, and it’s got nothing to do with asthma.

It’s to do with the structure of the bands of smooth muscle around the lungs, around the tubes. If those bands of smooth muscle are genetically thicker and tighter and stronger when they are triggered to close, they don’t open that easily. And that is when people with inherited asthma genes have trouble when they over-exercise or when they get triggered into bronchoconstriction. They don’t dilate as easily as people who don’t have those genes. 

Dr Ron Ehrlich: [00:22:04] Mm hmm.

Roger Price: [00:22:04] And the second…

Dr Ron Ehrlich: [00:22:06] Yeah. Okay. Yeah. Sorry. Go on because I was going to say yes. Let me just say there. The problem with that, of course, is that this is how asthma has been diagnosed for a very long time.

Roger Price: [00:22:18] Forever.

Dr Ron Ehrlich: [00:22:20] Forever. So a “family history” (I’m putting inverted commas up) may be a misdiagnosis. 

Roger Price: [00:22:26] Yes.

Dr Ron Ehrlich: [00:22:27] Okay.

Roger Price: [00:22:29] So that is why we have to look a little deeper than that. And of course, the second factor is the range of triggers. That you’re sensitive to, and that varies from person to person. Bring a cat near me, and one cat here can drive me nuts. One of my sons has cats. He can bury his face in the cat. It doesn’t bother him. It bothers the cat, but it doesn’t bother him. 

Dr Ron Ehrlich: [00:23:02] It would bother me watching him do that. But anyway, that’s okay. That’s another programme.

Roger Price: [00:23:06] It is. So we now have to look and see what has happened in the asthma industry. In 2021 the asthma market was worth $18 billion. And it’s projected to grow to $27 billion by 2027, in five years’ time. In my career, which now spans 60-plus years. I have never found one person who gets cured of asthma by taking puffers. So when somebody says, “My asthma’s controlled.”

Dr Ron Ehrlich: [00:23:57] Yes.

Roger Price: [00:23:58] Well, what’s the definition of controlling? You’re taking more and more medication and stronger and stronger as the new drugs come out.

Dr Ron Ehrlich: [00:24:06] Well, Roger, I remember you introducing me when we first met, probably 15 or more years ago, to a wonderful book called Selling Sickness by Ray Moynihan, who’s now a professor up at Bond University. And, you know, this model of creating as many patients as possible and managing their health for as long, managing, not curing, managing their health for as long as possible is a wonderful economic model. It’s clear what was very much… 

Roger Price: [00:24:36] Objection. It’s not managing their health. It’s managing their disease. 

Dr Ron Ehrlich: [00:24:39] Managing their disease. Correct. So disease management is a wonderful economic model. It just doesn’t happen to be a very good health model. And this is a good example of it. 

Roger Price: [00:24:49] Perfect example of it. 

Dr Ron Ehrlich: [00:24:51] Mm hmm.

Roger Price: [00:24:52] And the other thing that’s even worse, Ron, is that when people are put onto a protocol, sometimes they stay on it for five years, never being checked. They never go back. Oh, my doctor told me to take the blue puffer for this and to take the red puffer for that and the green puffer for this. And I just get repeats all the time, and I just do what I’m told. 

Dr Ron Ehrlich: [00:25:18] Hmm.

Roger Price: [00:25:18] The trouble with these medications they can remodel the airway. 

Dr Ron Ehrlich: [00:25:24] How so?

Roger Price: [00:25:25] Well, if you interfere with the body function long enough, the body says, “I’ve forgotten what to do because I’m doing what you’re making me do.” So if you are consistently propping the lungs open, they forget to close. So when you look at a reliever medication. The reliever medication there is to break the spasm that was caused by a drop in carbon dioxide.

Well, if you take the long-acting ones now, the only reason they make long-acting ones that the short-acting ones can be dangerous. In the early seventies, there was a drug called Phenotarol, which was released by Boehringer-Ingelheim. And New Zealand took to it with a vengeance.

Dr Ron Ehrlich: [00:26:18] Now. Boehringer-Ingelheim… Now, for our listeners, Boehringer Ingelheim is a big pharmaceutical.

Roger Price: [00:26:23] It’s a big German drug company.

Dr Ron Ehrlich: [00:26:26] Yeah.

Roger Price: [00:26:26] So New Zealand prescribed hundreds of thousands of Phenotarol. And their death rate shot through the roof. And for seven or eight years, the New Zealand death rate from asthma was the highest in the world. In 1989, they discontinued it. And the death rate dropped by 50%.

Dr Ron Ehrlich: [00:26:51] Hmm.

Roger Price: [00:26:52] Literally within weeks.

Dr Ron Ehrlich: [00:26:53] Wow. It’s just it’s quite frightening.

Roger Price: [00:26:57] So that’s when the drug companies overlook, “Let’s not make the short-acting that much. Let’s not make a long-acting one.” Which is a long chain which doesn’t act as quickly. But it sticks around all day just in case.

So you’re propping the door open all day to stop it from slamming, and you’re forgetting about the dust that’s blowing into your house all day because the door has been propped open. Well, they did that. There was a drug called Serevent, which came out maybe 15, 20 years ago, and people started dying from Serevent.

Dr Ron Ehrlich: [00:27:44] Hmm.

Roger Price: [00:27:45] So they said oops. You know, we’d better stop this. Why don’t we add a steroid? To counter the inflammation that the open airways creates.

Dr Ron Ehrlich: [00:27:56] Mmm-hmm.Because the open airway will promote inflammation, and so we can do something to dampen that.

Roger Price: [00:28:07] Because it should shut down. Nature once the airway to shut down, but it’s being chemically propped open, so it’s becoming inflamed. So that’s why you have to have a steroid. So one of the things that just doesn’t make sense. Traditionally, if you use a reliever like Ventolin four times a week, your asthma is not controlled. And taking Ventolin so many times poses a heart risk because it is basically adrenaline.

Dr Ron Ehrlich: [00:28:46] So.

Roger Price: [00:28:48] That’s when you were meant to take an inhaled steroid as a preventer. So that you don’t…

Dr Ron Ehrlich: [00:28:57] Like Pulmicort or something like that.

Roger Price: [00:28:58] Like Pulmicort. Like, yeah. The variety of them.

Dr Ron Ehrlich: [00:29:02] Yeah. 

Roger Price: [00:29:06] So, then you come to the situation. Well, now what do I do? I’m told that if I take a reliever more than four times a week, my asthma is out of control. Now I’m taking a long-acting reliever twice a day for the rest of my life. But I have to add a steroid to it to counteract the inflammation. 

Dr Ron Ehrlich: [00:29:29] Mmm-hmm.

Roger Price: [00:29:29] So I’ve had a number of debates over the years with fairly prominent asthma specialists. And the one comment I had, and of course, I won’t mention who it was from. I challenged, and I said, can you explain this to me? And the answer was, well, all we know is that it works. 

Dr Ron Ehrlich: [00:29:53] Hmm.

Roger Price: [00:29:55] And to me, that was enough.

Dr Ron Ehrlich: [00:29:57] Hmm. So, Rogie, I mean, you’ve laid out here, and it’s great that you’ve picked these various pharmaceutical products and how trial and error occurs out in the community. I think we’ve experiencing that over the last few years as well. But let’s come back to asthma, and well, let’s put the asthma in inverted commas and say, how should one treat to cure asthma?

Roger Price: [00:30:24] Okay, let’s put to one side those people who have genetic asthma. 

Dr Ron Ehrlich: [00:30:30] Mmm-hmm.

Roger Price: [00:30:30] They are to be looked after by the pulmonary specialists. They are people – people with brittle asthma. These people are seriously at risk, and they need to be medically managed. And I have no argument with that at all. But when you mentioned that you had a discussion recently where the comment was made that 30% of asthma is misdiagnosed, I have a list here of the journals in which these articles were published. The first one was published in The Lancet in March 2017.

Dr Ron Ehrlich: [00:31:09] That’s five years ago.

Roger Price: [00:31:10] And yet nothing has changed. It was picked up by the Journal of American Medicine, JAMA, by the British Medical Journal in 2017, by the Medical Journal of Australia in 2018. The European Journal of Respiratory Science, 2019. The NCBI, 2019. The British Medical Journal Paediatrics repeated it in 2020, and WebMD reprinted the article in 2020. Nothing has changed.

Dr Ron Ehrlich: [00:31:43] And that article outlined how common misdiagnosis, yes, asthma is.

Roger Price: [00:31:49] And primarily, and these are my words because nobody dared say it. The methodology of testing is flawed. It is a flawed assumption. And if you specialise in a flawed assumption. All that means is that you know more about the flawed assumption than everybody else does. It doesn’t mean that the assumption is somehow valid because you’re a specialist. It’s wrong.

Dr Ron Ehrlich: [00:32:24] Mm-hmm.

Roger Price: [00:32:24] As so many other things are in disease management.

Dr Ron Ehrlich: [00:32:28] It’s well. We could, we may touch on some of that in, you know, in a few minutes. But yeah, but now someone’s come to you and said, look, I’ve just got this diagnosis of asthma. But Roger, I don’t want to take all these puffers. What should I do? 

Roger Price: [00:32:44] The very first thing I do is to measure their carbon dioxide retention. 

Dr Ron Ehrlich: [00:32:50] Mmm-hmm.

Roger Price: [00:32:52] And then I put them through a series of challenges.

Dr Ron Ehrlich: [00:32:55] Well, Roger, stop. Stop right there. Because what you’re talking about is the carbon dioxide level in their lungs. I think you’ve told me that. Yes. I’m repeating in end-tidal CO2.

Roger Price: [00:33:09] Yes. And end-tidal means how much is left in the bronchioles and the alveoli at the end of the tidal breath, and the tidal breath is on the exhalation.

Dr Ron Ehrlich: [00:33:22] Mmm-hmm.

Roger Price: [00:33:23] We want to know, what are the reservoirs of carbon dioxide in the lungs? To be able to keep them open and functioning smoothly and not provoking bronchoconstriction.

Dr Ron Ehrlich: [00:33:38] And to remind our lesson of where we came to at the beginning, it is that level in the lungs, the end-tidal CO2 (carbon dioxide), which helps the body balance the acid-alkali exactly throughout the body.

Roger Price: [00:33:54] Because carbon dioxide is the buffer that shifts the pH from 7.35 to 7.45. And a lot of people have this mistaken idea that the blood becomes acid. It only becomes acid under extreme circumstances. It is always alkaline. It is less alkaline or more alkaline. 

Dr Ron Ehrlich: [00:34:23] So anything over seven is alkaline?

Roger Price: [00:34:25] Yes.

Dr Ron Ehrlich: [00:34:26] Yeah. I mean, interestingly now, Roger, interestingly, because again and I’m giving you know, I’m saying this range of 7.35 to 7.45 is really narrow. But it’s quite critical, isn’t it?

Roger Price: [00:34:44] Well, yes. It’s not as narrow as it might seem because it’s logarithmic. 

Dr Ron Ehrlich: [00:34:49] Yeah. It’s not a linear scale.

Roger Price: [00:34:51] It’s not a linear. It’s a logarithmic measurement. But the criticality of that measurement is that is what balances the pH to the point where if your pH in the lung is not 7.45, you won’t bond the oxygen. And if the pH at the cell level is not 7.35, you won’t release the oxygen.

Dr Ron Ehrlich: [00:35:15] Mmm-hmm.

Roger Price: [00:35:16] So this shift was really popularised in 1904 by Christian Bohr, who taught term that the Bohr effect B-O-H-R. And the Bohr effect is quite complex. But in one sentence it says that as the pressure of carbon dioxide in arterial blood drops, so does the bond between the oxygen and the blood get stronger. 

Less CO2, less oxygen release, not less oxygen in the body. This is what people don’t understand. You put a Pulse Ox on your finger, it reads 98, 99%. You can have all that money in your bank. If the dog ate your card, you ain’t paying any bills, and people get knocky with you.

Dr Ron Ehrlich: [00:36:15] Yeah. But come back to the patient who’s come to you now with asthma or diagnosis of asthma and come back to that now.

Roger Price: [00:36:24] Good.

Dr Ron Ehrlich: [00:36:25] So, are you going to measure their end-tidals now. I checked their end-tidal CO2 levels. Little tube under the nose, going into a capnometer showing them the picture on the screen. Mmm-hmm.

Roger Price: [00:36:37] Then I say to them, now I want you to breathe faster. I want you to open your mouth and breathe. And they watch their CO2 levels dropping. Then I say, how you feeling? I’m feeling an asthma attack coming on. Okay, stop that right away. 

Close your mouth. Breathe through your nose. And they watch the carbon dioxide rise. So how do you feel? I’m fine. No asthma. So I get them to trigger themselves. So that they can see. Then I put them through a challenge and say, What upsets you? Oh, my mother-in-law…Okay.

Visualise the last argument you had with your mother-in-law. Close your eyes and take yourself through that tension-ridden fight. Ron, when they open their eyes and look at the screen, they say, oh my God. I felt it. I felt the asthma attack coming on. 

As well as your mother-in-law in the room. No. So who did that? You are doing it by changing your breathing pattern so that you’re dropping your CO2 levels to the point that the body has to intervene and say, I’m going to shut you down. Mmm-hmm. I cannot, and I do not interfere with medication. I cannot say to somebody who’s had something prescribed by their doctor, don’t take it.

Dr Ron Ehrlich: [00:38:18] Hmm.

Roger Price: [00:38:19] All I can say is if you don’t have asthma symptoms and if you don’t have an attack, you have to decide for yourself whether you need to take the medication. 

Dr Ron Ehrlich: [00:38:32] Which brings me to the question about, and I think you’ve answered it, but it’s worth mentioning the role that stress plays because when we started this conversation, you said patients come in, and they go, well, do you get an asthma attack when you’re sitting quietly reading, breathing through your nose calmly? And said…and again, no. What about when you..So my question is, what role does stress play? And I think you kind of alluded to that, but I think it’s worth mentioning.

Roger Price: [00:39:00] Well, it’s very simple. When you’re stressed, your breathing changes. You go into fight or flight. Your whole ratio changes to cool biochemical things happen in your body. the moment you hit fight or flight and your breathing pattern becomes mouth breathing. This is where you get your maximum stress response to a threat that isn’t there.

Dr Ron Ehrlich: [00:39:27] Or a threat that they’re in.

Roger Price: [00:39:27] Yes! But largely, I haven’t met in 30 odd years. I’ve been doing this. One person who’s been chased by a sabertooth tiger?

Dr Ron Ehrlich: [00:39:41] (Chuckles) No.

Roger Price: [00:39:41] Well, I’ve met a lot of people who believe they are all the time. So the moment you become stressed. And believe me, it’s not only shouting and yelling and crying, it’s laughing as well. How many people laugh themselves into an asthma attack?

Dr Ron Ehrlich: [00:39:58] Hmm.

Roger Price: [00:40:00] Because they laugh so heartily that they’re dropping CO2 levels, and they’re going into spasm as a defense mechanism. Ron, it is not complicated.

Dr Ron Ehrlich: [00:40:13] Hmm. I mean, it’s almost like a paper bag would be a better choice than a puffer.

Roger Price: [00:40:19] Well, yes, to a point, but I must sound a warning there. Sometimes, depending on how severe the attack is.

Dr Ron Ehrlich: [00:40:27] Yeah.

Roger Price: [00:40:27] The paper bag is not a good idea.

Dr Ron Ehrlich: [00:40:29] No, no. Roger, we’ve just gone through two years of a COVID pandemic, and it’s a respiratory issue. What has affected, what do you, how has covered affected the incidence of breathing problems in general and asthma in particular? All the again, I’m putting that into inverted commas.

Roger Price: [00:40:50] I don’t have any firm statistics.

Dr Ron Ehrlich: [00:40:52] No, but in your impression.

Roger Price: [00:40:55] I’ve noticed that the incidence of asthma has dropped.

Dr Ron Ehrlich: [00:40:59] Hmm.

Roger Price: [00:41:01] Because the mask retains some of the CO2 that people would very often lose.

Dr Ron Ehrlich: [00:41:07] Hmm.

Roger Price: [00:41:08] So once they’re might be very frustrated at what’s going on. They are still over breathing, but they’re not losing as much CO2. But here’s a very interesting thing. Many years ago, 20, 25 years ago, I think it was Merck. No, Glaxo decided they would make a sale.

Dr Ron Ehrlich: [00:41:26] Hang on. You and I know what Glaxo is.

Roger Price: [00:41:29] Okay.

Dr Ron Ehrlich: [00:41:30] Just give us a full name.

Roger Price: [00:41:31] Glaxo is a very large pharmaceutical company. It’s now officially GlaxoSmithKline French Beecham.

Dr Ron Ehrlich: [00:41:39] Right.

Roger Price: [00:41:41] It absorbed a whole lot of others. They have made a carbon dioxide puffer. Well, they said, okay, CO2 is a problem. Take it in a puffer. But it failed because the CO2 has to be in the blood. Not in the lungs. It’s an inside out, not an outside in.

Dr Ron Ehrlich: [00:42:08] Hmm.

Roger Price: [00:42:09] So they discontinued it because it made no difference.

Dr Ron Ehrlich: [00:42:12] Mmm-hmm.

Roger Price: [00:42:13] And then, of course, you get this thing that we call paradoxical bronchospasm. And that means that what should be helping is hurting. Because some people when they spray the puffer. They choke and start coughing.

Dr Ron Ehrlich: [00:42:31] Hmm.

Roger Price: [00:42:31] And the coughing drops the CO2 and puts them into bronchospasm. It’s a very complex thing, Ron.

Dr Ron Ehrlich: [00:42:41] Hmm.

Roger Price: [00:42:43] But the misdiagnosis has terrible ramifications.

Dr Ron Ehrlich: [00:42:48] Hmm.

Roger Price: [00:42:49] If you have asthma on your medical record, forget about scuba diving. Forget about the military. Forget about becoming a firefighter. Forget about the police force. Forget about anything where the powers that be deem that you might have an asthma attack for which they will become financially liable.

Dr Ron Ehrlich: [00:43:15] Hmm.

Roger Price: [00:43:16] So there are millions of people who can’t follow their dreams because they have been misdiagnosed. And I’m currently working with one of these in the United States at the moment. This young lady is 19 years old. She has never had asthma. And she wants to join the US military elite forces.

Dr Ron Ehrlich: [00:43:40] Hmm.

Roger Price: [00:43:41] And they won’t accept her because there is a diagnosis of asthma on her medical record. Now the mum and dad have mounted a challenge to the US military. And they’ve requested an expert statement from me explaining why, in my opinion, only, in my opinion, she does not have asthma.

Dr Ron Ehrlich: [00:44:07] Hmm.

Roger Price: [00:44:09] I was unable to trigger it when her end-tidal carbon dioxide was high enough. It was impossible for her to have an asthma attack when her carbon dioxide was correct.

Dr Ron Ehrlich: [00:44:23] Hmm.

Roger Price: [00:44:23] So that’s still ongoing.

Dr Ron Ehrlich: [00:44:25] Yeah. Now, listen, we’ve just been through this two-year pandemic, and Roger, we’ve touched on some pharmaceutical products which have been put out there, caused some deaths. Took a few years for things to change. 

You know, these things change very slowly out there, particularly when a pharmaceutical product is out there. How do you,u I mean, I’m curious to know how you reflect on how this pandemic has been handled by us, by the health authorities. What what’s your how do you reflect on it?

Roger Price: [00:44:58] Panic.

Dr Ron Ehrlich: [00:45:00] Okay. That’s another P in my, I’ve got a list of ten P’s, and I think panic is on there, too. Along with…

Roger Price: [00:45:08] Nobody really knew what was happening.

Dr Ron Ehrlich: [00:45:10] Mmm-hmm.

Roger Price: [00:45:11] There was no history to go by.

Dr Ron Ehrlich: [00:45:15] Mmm-hmm.

Roger Price: [00:45:17] And nobody knew what to do. And in the early stages, assumptions were made that we could never test. And the one assumption is how many people would have died if we did nothing?

Dr Ron Ehrlich: [00:45:32] Yeah.

Roger Price: [00:45:33] So that is the problem. It’s very easy to point a finger. It’s also wise to remember when you point a finger, there are three pointing back at yourself. It was unfortunately politicised. It was monetised. I think the last report I read was that Pfizer, their last quarter, their revenues were USD 37 billion in one quarter from vaccines. And of course, the vaccines are all free, aren’t they?

Dr Ron Ehrlich: [00:46:09] Well.

Roger Price: [00:46:09] No, they’re not free. Generations to come would still be paying for them.

Dr Ron Ehrlich: [00:46:15] Hmm.

Roger Price: [00:46:15] So I really, I cannot point a finger. Because I don’t know, whatever I say will be guesswork.

Dr Ron Ehrlich: [00:46:25] Hmm.

Roger Price: [00:46:27] History will judge.

Dr Ron Ehrlich: [00:46:30] Yeah. Roger, I always enjoyed talking to you. And as you said, we always have fun when we talk. And I always learned something new every time we do. So thank you so much for joining us today, and thank you for sharing your knowledge and your wisdom with us.

Roger Price: [00:46:46] Always a pleasure, Ron. Always a pleasure.


Dr Ron Ehrlich: [00:46:51] Well, it’s always interesting to talk to Roger. And Roger articulates breathing. You know, we take this for granted, but it is so accessible and it’s one of the few bodily functions that we actually have voluntary control over. And not only voluntary control over, but breathing affects absolutely every system in your body, physical and mental.

And I thought it was so interesting to use this example of asthma as an example of how our health care system works in general, and that is seeing patients managing their health problems with medication. And as I’ve said many times, this is a great economic model. 

It’s why the pharmaceutical industry has revenues of $1.2 trillion a year. The only problem is it’s not a great health model. And if you are interested in your own health and taking control of it and enjoying good health rather than just being satisfied with managing chronic disease, then learning how something as simple as the breath it can transform your health.

In fact, you know, people often say they are stressed in this modern world, and we certainly many people are stressed. They have the fight or flight reaction. And as Roger correctly observed, he hasn’t met anybody in his 60 years that has been chased by a sabertooth tiger, which is often the analogy that’s drawn in the fight or flight response. 

If you are confronted by danger, then you experience the fight or flight part of your nervous system, which is called, which is a part of the autonomic nervous system called the sympathetic branch of the nervous system.

Now there’s another branch in the nervous system called the parasympathetic nervous system, which is the rest and digest. And you can control it. You can literally switch on the rest and digest parasympathetic nervous system in the space of two, three, or four. Certainly, within five breaths, you can transform a sympathetic fight and flight response into a parasympathetic rest and digest response.

When would you want to do that? Well, you’d certainly want to engage the rest and digest just before you’re about to eat something because you could be on the best start in the world. But if you are stressed, you will not be absorbing your nutrients. So just before a meal is a good time to do it. 

Certainly, just when you’re about to go to bed when you are in bed, and in fact, the first two or three minutes of my time in bed is spent when I’ve switched off the lights is I’m lying there on my back, and I will inhale through my nose for three seconds, four seconds. 

I will exhale for 3 to 5 seconds, make the exhale a little bit longer, and then I will hold the exhaled breath for a few seconds, maybe three or four seconds. And if I repeat that five times, which is no more than about a minute, then I will have switched on the rest and digest. And that’s a great time to do it just before you then roll over and go to sleep.

I think it’s also worth remembering, you know, we hear so much about acid alkali being an important thing, and we need to be more alkali. We need to be more, we need to not be in this acidic frame which puts our metabolism into a more anaerobic state and certainly promotes those kind of microbes in the body, which are far more pathogenic. 

So being in an alkaline state is really important. And as Roger pointed out, the breath or the carbon dioxide level specifically in our lungs is what balances out that body chemistry. So there was actually so much in that episode, which was a great revision of what breathing is all about. And also talking more specifically about asthma, which is a very significant problem in our community. 

But as Pete Smith, Professor Pete Smith observed many a few episodes ago, at least 30% of people diagnosed with asthma are incorrectly diagnosed, and Roger certainly increased that number. I think Roger was talking about 80 or 90% and whether it’s 30%, whether it’s 90%, it’s fair to say that a significant percentage of people diagnosed with asthma are misdiagnosed but they are managed. 

So, that is what this programme is about. Empowering you to enjoy better health and breathing is significant, and in fact, we refer to breathing and sleeping as foundational pillars for very good reason. We’ll have links to Roger’s site. Breathing will have links to his article, which prompted this discussion, which he wrote and was published in 2016. I hope this finds you well. Until next time. This is Dr Ron Ehrlich. Be well.



This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.