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It would seem like the perfect medical “marriage”. Those born with asthma, a chronic respiratory disease that afflicts an estimated 29 million Americans, have lungs and bronchial passages too constricted to allow for healthy breathing. Long-acting drugs like Fluticasone are known to ease asthma symptoms, as do portable, steroid-laced inhalers, but there’s no known permanent cure. Surely yoga, an ancient mind-body discipline that facilitates deep breathing and breath control, can help?

India’s own Hindu yoga sages clearly think so. A medical ashram based in South India, near Bangalore, claims to have “normalized” tens of thousands of asthma sufferers in recent years using yoga asanas and the breathing exercises known as pranayama. And, as early as 2003, with publication of Stella Weller’s Yoga Beats Asthma, numerous American yoga teachers without extensive medical or spiritual training have proclaimed yoga a veritable “miracle cure.” Surf the web and you’ll find scads of You Tube videos with yoga teachers demonstrating their favorite poses for asthma.

But consult the latest findings of the National Center for Complementary and Alternative Medicine (NCCAM), a federal research division of the U.S. Health and Human Services Department, and you’ll find no such ringing endorsement. NCCAM, citing a 2011 review of the latest peer-reviewed scientific research, says there’s no credible evidence that yoga poses or breathing techniques can alleviate the symptoms of asthma, as there might be for arthritis or for a vast array of other conditions.

On closer examination, not all asthma studies, even in the West, say yoga is ineffective. But even those that do suggest a possible modest benefit conclude that it’s not known how and why yoga works, if it really does. If Hindu sages say it’s due to the complex and mystical ways that yoga poses work on the body’s lymphatic and digestive systems, among others, Western doctors aren’t buying it – not yet, at least.

Some of the Hindu treatments for yoga hardly seem focused on asthma at all. The South India ashram cited above recommends a full complement of poses, including Sun Salutations and other poses that comprise any standard yoga practice. In fact, even the “special” breathing or neck exercises they recommend are part and parcel of any good yoga regimen. On its face, to say there’s a distinctly — or at least, widely recognized – yoga “regimen” for asthma appears completely far-fetched.

In fact, Western skepticism is sufficiently deep that even some popular American exponents of yoga cures don’t mention asthma as a candidate for one. In her recent book, entitled Yoga Cures, for example, yoga’s leading pop-celebrity, Tara Stiles, freely prescribes asana poses the Plow and the Headstand to cure some 50 common ailments, including serious illnesses like hypothyroidism, ADHD, and depression. But she fails to deal with asthma. Neither does another rising yoga superstar, Kathryn Budig, in her own just-published treatment compendium, The Women’s Health Big Book of Yoga.

Ironically, while much of the debate over asthma still focuses on its genetic origins, the latest research suggests that environmental causes, especially the rising use of household sprayers, as well as air pollution, may be chiefly to blame for today’s skyrocketing rates of asthma. Much of the prevention literature, in fact, assumes that asthma is largely under control or at least treatable now – but that the threat of sudden attacks remains, largely due to “triggers” like dust, pollen, smoke, pet dander, or perfume. And that attack threat even extends to yoga class, apparently, where heavy incense burning, despite its documented contribution to lung cancer, is still widespread.

The upshot? Asthma, like so many modern ailments, is complicated, and that’s means there’s no quick fix. Barbara Benagh, an American yogi asthmatic writing in the industry trade publication Yoga Journal, argues that yoga’s a mixed bag: some recommended deep breathing practices can actually make the condition worse, but others can genuinely help, but only if they are carefully adapted to your condition. Consult a specialized yoga therapist, she suggests — hopefully, a fellow asthmatic. In the meantime, pending further research – with better experimental controls and a more precise yoga regimen, perhaps – hold on to your trusty inhaler. Even in yoga class, it turns out you may need it.

Stewart J. Lawrence can be reached at stewartlawrence81147@gmail.com