Posted by on Oct 30, 2018 in Uncategorized

Scientific aspects of Buteyko

science diagram
Theory of the Buteyko Method

A good explanation of the theory of the Buteyko Method (written by Professor KP Buteyko and translated into English) is available on the website of ‘Breathing Center’ (Colorado, USA). You may access this explanation via the link below. The same explanation is also included in the book titled ‘Breathe to Heal’ by Sasha Yakovleva, K.P. Buteyko MD, PhD and A.E. Novozhilov MD (pages 63 to 66). There is a small error in both texts in that they both state that Christian Bohr was a Swedish scientist. This was not the case, because Christian Bohr (1855-1911) was a Danish scientist and physician. He was the father of the physicist and Nobel laureate Niels Bohr and the grandfather of the physicist and Nobel laureate Aage Bohr.

The following short summary of the theory and its main postulates has been provided by Eugenia Malyshev.

  • Most patients with a variety of modern chronic health problems (degenerative diseases or “diseases of civilization”) chronically hyperventilate. They continuously breathe volumes of air, which are significantly above normal minute ventilation volume (3-6 l/min).
  • The most harmful physiological effect of hyperventilation is a loss of carbon dioxide (CO2) in the lungs
  • Loss of CO2 causes a number of negative physiological effects, e.g. shift in PH balance, constriction of blood vessels and smooth muscles, and poor tissue oxygenation (Bohr Effect).
  • Continuing hyperventilation and loss of CO2 leads to the development of the disease and its further progression.
  • The particular condition your body acquires might be influenced by your genetic predisposition and by the environment.
  • Severity of the disease is proportional to the degree of hyperventilation.
  • Factors that contribute to over-breathing are mostly rooted in our modern lifestyle, e.g. unhealthy diet, lack of physical exercise, stress, toxins, medications over-use, belief that deep (big) breathing is good for you and so on.
  • Restoration of normal breathing leads to elimination of symptoms and reversal of the disease.

Other theoretical perspectives

In more recent times, Professor Buteyko’s theory, particularly its emphasis on the role of CO2, has been criticised by other physicians and scientists with a specialist interest in breathing and breathing re-education. This is hardly surprising considering that Professor Buteyko developed his theory and method just after the end of the Stalin regime and didn’t have the equipment or support that Western scientists have today to fully investigate their other theories and the underlying science.

It is not known exactly why/how Buteyko works, but there are a number of theoretical perspectives and ideas. Chronic hyperventilation certainly seems to have a role, and this condition has been discussed in detail in medical literature for a long time. Central to the Buteyko method is the theory that respiratory illnesses are a subset of illnesses caused by habitually breathing excessive volumes of air – what Professor Buteyko called “hidden hyperventilation”. In particular, Professor Buteyko claimed that the blood of asthmatics contained too little carbon dioxide, but evidence for the role of carbon dioxide as a clinically significant bronchodilator is mixed and its role in asthma disputed.

However, when considering any treatment for any disease, it’s very important to be cognizant of the fact that it’s really of little relevance whether the theory for how the treatment might work is plausible or not. Of much more significance is whether there is scientific evidence to indicate the treatment works in practice. In the pharmaceutical domain, researchers have come a long way in understanding how many drugs work at the molecular level. However, there are still many effective drugs in common use whose mechanisms of action remain uncertain at best. To quote Professor Peter Imming (a pharmaceutical chemist) at the Martin Luther University of Halle-Wittenberg in Germany:

“If we threw out all the drugs for which we do not know the molecular mechanisms, we wouldn’t be left with a lot.”

There is now considerable evidence from clinical trials to support the efficacy of breathing re-training, in particular, the Buteyko Method. To view the extent of the evidence that’s published in the English language CLICK HERE. To view the extent of the evidence that’s published in the Russian language CLICK HERE.

Knowing how/why a drug works has historically trailed the treatment, sometimes by decades. For example, some well known drugs e.g. acetaminophen (paracetamol) for pain relief, penicillin for infections, and lithium for bipolar disorder are still scientific mysteries today.

Subsequent to Buteyko’s work other researchers have expressed the view that the effectiveness of the Buteyko Method is unlikely to be based mainly or entirely on increasing levels of carbon dioxide. A leading Australian breathing therapy researcher (Dr. Rosalba Courtney) has expressed the view that it is unlikely that increased levels of carbon dioxide is the sole reason for the health improvements seen in patients who learn and practise the Buteyko method. According to Dr. Courtney, the mechanisms of the Buteyko method are likely to be complex and include psychophysiological, neurological and biomechanical mechanisms in addition to biochemical mechanisms centred on carbon dioxide.

In his book titled ‘Normal Breathing: The Key to Vital Health’ Dr. Artour Rakhimov asks and answers the question ‘Is carbon dioxide the only cause of success for the Buteyko method?’ Briefly, his answer is that there are many other factors and he cites the following ones:

(a) Psychological factors – individuals who learn and practise the method “learn how to stop their symptoms and prevent attacks, and how to pay attention to stress and other factors that cause hyperventilation. Hence, they acquire a sense of control over their health.”

(b) Nasal breathing helps the body to use its own nitric oxide that is produced in nasal passages.

(c) Emphasis on diaphragmatic breathing and relaxation of chest breathing muscles should favour the elimination of possible abnormalities in the regulation of breathing by the autonomic nervous system.

(d) Passive relaxed exhalation during breathing sessions should also have good effects on the balance between the parasympathetic and sympathetic branches of the autonomic nervous system.

(e) Deliberate attention to posture and relaxation of body muscles should also influence the autonomic nervous system. When we relax we elicit the relaxation response which acts as an antidote to an overactive sympathetic nervous system that’s associated with the stress (fight or flight) response.

Reduced breathing decreases oxygen levels in the lungs and blood creating temporary hypoxia (deficiency in the amount of oxygen reaching the tissues). This is beneficial because modern air has too much oxygen. Free oxygen in our bodies generates free radicals causing cellular damage and aging. This damage is greater during hyperventilation. The health effects of mild intermittent hypoxia induced by Buteyko breathing are good (just as the reverse is true i.e. the health effects of chronic hypoxia or acute, high frequency, intermittent hypoxia are bad). With the passage of time, repeated episodes of mild, intermittent hypoxia improve the tone of the upper airway dilator muscles, increase vagal nerve activity, improve oxygen metabolism, increase antioxidant status, and reduce inflammation.

Mild, intermittent hypoxia and nasal breathing increase levels of nitric oxide within the body. Nitric oxide is one of the most important molecules in the human body and is crucial for health and well-being. I have provided more information about this miraculous molecule by pasting immediately below a copy of an article I wrote that was published in Irish Pharmacist in 2015.


Your nose’s free ‘wonder drug’

by Dr. Alan Ruth

Research findings from around the world have demonstrated that nitric oxide is one of the most important molecules in the human body and is crucial for health and well-being. Indeed, the difference between health and dysfunction is often related to the level and activity of nitric oxide in the body.

In 1992, nitric oxide was named “Molecule of the Year” by the journal Science and in 1998 three American scientists were jointly awarded a Nobel Prize for their discoveries concerning nitric oxide as a signalling molecule in the cardiovascular system. According to one of these Nobel laureates, Dr. Louis Ignarro:

“Though nitric oxide’s structure is simple, nitric oxide is now regarded as the most significant molecule in the body, absolutely crucial to your well-being.” Dr. Ignarro also referred to nitric oxide as the body’s internally manufactured “wonder drug”.


Nitric oxide deficiency

Although nitric oxide is abundant in the body, it is unstable and short-lived, and must be renewed continuously. As we age, the process that produces nitric oxide becomes less efficient and the body produces less of it. By age 40 the majority of men only produce half or less of the nitric oxide they did in their teens or twenties. In women, by age 50, their available nitric oxide levels are generally only about 35% of women in their twenties.


Health benefits and applications of nitric oxide

Nitric oxide has been found to play a significant part in many systems and functions within the human body. Some of these are reviewed briefly below.


• Cardiovascular system

Nitric oxide is very important in maintaining the health of the cardiovascular system. The effect of nitric oxide that has received most attention is its ability to relax the smooth muscle layer in blood vessels. The resulting vasodilation increases blood flow, decreases blood pressure, and relieves angina. Nitric oxide also contributes to the health of the endothelial lining in arteries thereby reducing the risk of atherosclerosis. In addition, it supports the maintenance of normal triglyceride levels, lowers serum cholesterol levels, prevents the oxidization of “bad” LDL cholesterol, and acts as an anticoagulant. Nitric oxide-eluting coronary stents are used to help prevent a coronary arteries narrowing again after angioplasty.


• Male Sexual functioning

Drugs such as Viagra and Cialis for erectile dysfunction are effective because they affect the nitric oxide pathways, which allows for blood vessel relaxation and improved blood flow in the corpus cavernosa for penile erection.


• Central nervous system

Nitric oxide generated in the brain is involved in neurotransmission and thought to play a critical role in memory and learning. Research and scientific speculation also suggest it has several other roles in the brain e.g. promotion of angiogenesis (the growth of new capillary blood vessels). Also, recent research findings suggest that in individuals suffering from a stroke, an increased production of nitric oxide can decrease the chances of brain damage.


• Immune system

Nitric oxide plays a critical role in the function of the immune system by combating toxins and helping to provide a strong internal defence system. It defends against a broad spectrum of microbial pathogens. It has also been shown to inhibit the replication of influenza viruses.


• Gastrointestinal system

In the gastrointestinal tract, nitric acid relaxes smooth muscle and helps regulate intestinal peristalsis. It also acts as a defence against acidic digestive juices. It has also been found to lessen the formation, continuation, and pain of stomach ulcers.


• Cancer Biology

There is considerable controversy concerning the role of nitric oxide in the biology of cancer. It has been reported to have tumouricidal as well as tumour promoting effects depend on location, concentration, and timing. Researchers are currently investigating ways to manipulate in vivo production and exogenous delivery of nitric oxide for therapeutic gain. Additional studies are needed to develop new strategies for nitric oxide to be used in cancer prevention and treatment.


• Sports performance

It’s thought that nitric oxide may improve blood flow to active muscle cells thereby increasing oxygen and nutrient delivery. This has been reported to improve exercise endurance and enhance sports performance. Recent research suggests that nitric oxide supplementation may improve sports performance in untrained or moderately trained subjects, but not in highly trained subjects.


• Respiratory System


According to Dr. Robert Fried, in his book titled Breath Well, Be Well, research has demonstrated that:

  • The mechanism which keeps bronchioles open is controlled largely by nitric oxide.
  • Nitric oxide production occurs in the lining of the airways.
  • Nitric oxide is produced in insufficient quantity in asthma sufferers.
  • Increasing nitric oxide availability by inhaling it has therapeutic effects in other lung and lung-related diseases such as pulmonary hypertension adult respiratory distress syndrome.

Exogenous inhalation of nitric oxide is of crucial importance in the treatment of different types of pulmonary hypertension. In addition, research indicates that new born babies with respiratory failure improve significantly when given nitric oxide to inhale.

Research to explore the numerous health benefits of nitric oxide is ongoing. Although at an early stage, research is currently exploring its potential role in areas such as bone health, cognitive function, mitochondrial function, and reducing the risk of diabetes.


Boosting nitric oxide – your nose knows!

The best known ways of increasing nitric oxide in our bodies are: (a) exercise, (b) consuming foods rich in nitrates and nutrients like L-arginine and citrulline, and (c) nutritional supplementation. Foods rich in L-arginine include soy products, fish, nuts, chickpeas, oats, wheat germ, lean meats and dairy products. Citrulline can be found in vegetables such as cucumbers and cantaloupe. Watermelon also contains a high level of citrulline. Nitric oxide precursors include kale, spinach, cabbage, cauliflower, and broccoli.

A much less well known and free way of acquiring nitric oxide is by nose breathing, as opposed to mouth breathing. Nitric oxide is produced by the nose and paranasal sinuses. Therefore, on inhalation (through the nose) nitric oxide follows the air into the lungs. It may be regarded as an ‘aerocrine hormone’ because it is produced in the nose and paranasal sinuses and transported with every inhalation, to a distal site of action, resulting in enhanced pulmonary oxygen uptake via vasodilation of the arterioles in contact with alveoli.


Can nitric oxide increase lifespan?

A U.S. study reported in the journal Cell in 2013 found that when roundworms commonly used in laboratory studies of aging were fed bacteria that produced nitric oxide, they lived “significantly longer”. Whilst this finding obviously cannot be extrapolated to humans, it is interesting nonetheless.

Published in Irish Pharmacist in February 2015


Neuroplasticity and breathing re-training


brain image

The newest theoretical perspective concerning breathing re-training/re-education relates to field of neuroscience and in particular what is called ‘neuroplasticity’. Neuroscience has been described as “the study of how the nervous system develops, its structure, and what it does. A relatively new and fast growing area of research in neuroscience is referred to as ‘neuroplasticity’ (or brain malleability).

Until relatively recently, it was believed that only young brains were plastic and thereby able to form new connections. According to the old model, our ability to generate new neural pathways decreased significantly in our twenties and stopped permanently around the age of forty. However, recent studies have shown that new neural pathways and new neurons are generated throughout life.

Neuroplasticity can be broadly classified into 2 types i.e. structural plasticity and functional plasticity. Structural plasticity refers to the brain’s ability to change its physical structure as a result of learning. Functional plasticity refers to the brain’s ability to move functions from a damaged area of the brain to another undamaged area(s).

Dr. Rosalba Courtney has noted that there are at least two breathing control centres in the brain. One is located in the motor cortex allowing voluntary control and a second near the brain stem takes over automatically when we are asleep or not paying attention to our breathing.

In order to make sustainable changes in our breathing through neuroplasticity, we need to lay down new automatic control pathways in our brain (structural plasticity) by regularly repeating and focusing on specific breathing exercises and techniques for several weeks. By utilising our voluntary control breathing centre while we’re awake, we can re-program the automatic control pathways to, for example, improve our sleep breathing patterns and improve the efficiency of our breathing when we’re awake. If you would like to learn more about the role of neuroplasticity specifically in breathing re-training, you may access a short video that features Dr. Rosalba Courtney via the link below. It’s the second video on the webpage.

If you would like to learn more about neuroplasticity in a wider context, I have pasted below, a copy of a short article I wrote that was published in Irish Pharmacist in 2015.


Neuroscience, neuroplasticity
and meditation

by Dr. Alan Ruth

Neuroscience has been described as “the study of how the nervous system develops, its structure, and what it does. A relatively new and fast growing area of research in neuroscience is referred to as ‘neuroplasticity’ (or brain malleability).

Until relatively recently, it was believed that only young brains were plastic and thereby able to form new connections. According to the old model, our ability to generate new neural pathways decreased significantly in our twenties and stopped permanently around the age of forty. However, recent studies have shown that new neural pathways and new neurons are generated throughout life.


What’s neuroplasticity?

Neuroplasticity can be broadly classified into 2 types i.e. structural plasticity and functional plasticity. Structural plasticity refers to the brain’s ability to change its physical structure as a result of learning. Functional plasticity refers to the brain’s ability to move functions from a damaged area of the brain to another undamaged area(s). provides the following brief yet informative description of neuroplasticity:

“ …….. the brain’s ability to reorganize itself by forming new neural connections throughout life. Neuroplasticity allows the neurons in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment. Brain reorganization takes place by mechanisms such as “axonal sprouting” in which undamaged axons grow new nerve endings to reconnect neurons whose links were injured or severed. Undamaged axons can also sprout nerve endings and connect with other undamaged nerve cells, forming new neural pathways to accomplish a needed function.”


Stroke victims and London cabbies

An example of functional neuroplasticity would be when a stroke victim becomes able to resume their normal activities following a period of rehabilitation. The brain compensates for the injury caused by the stroke by reorganizing or rewiring itself and establishing new connections between undamaged neurones.

London’s black cab taxi drivers provide a good example of structural neuroplasticity. These drivers have to undertake stringent training to secure their licence. They are required to pass “The Knowledge”. This test is very difficult to pass and the knowledge required to do so, has been described as “like having an atlas of London implanted in your head.” Studies of these London taxi drivers have shown that they have a larger hippocampus compared to the general population, and compared to London bus drivers. The hippocampus is important for forming and accessing complex memories, including spatial memories necessary for efficient navigation. Unlike London bus drivers, who follow defined and limited routes, London cabbies need to be able to navigate around the whole of London.

Last year, the Guardian newspaper pitted a London cabbie against a Sat-Nav equipped driver from the new international “taxi” company called UBER that allows passengers to book cars via their smart phones. The UBER driver completed the selected test journey in 22 minutes; the cabbie completed it in 18 minutes, by taking a slightly longer route he knew to be quicker.


Neuroplasticity and meditation

On average, the human brain shrinks by an average of 5% per decade after the age of 40.

A review, published in Annals of the New York Academy of Sciences in 2013 reviewed the evidence from 3 studies of meditation’s neuropreservative and/or neuroplastic effects on normal age-related brain degeneration. One study found that long-term Vipassana meditators showed a lesser decrease in right frontal cortical thickness with age compared to non-meditators. Another study found that Zen meditators showed a lesser decrease in total gray matter volume with age compared to non meditators. The third study found that a mixed group of Vipassana (insight meditation), Zen and Shamatha meditators showed a lesser decrease in fractional anisotropy (a useful measure of connectivity in the brain) in 17 out of 20 brain fibre tracts compared to non-meditators.

The lead author of the review concluded that these studies provided encouraging preliminary evidence that meditation may slow, stall, or even reverse age-related brain decline. However, she stressed the need for future more rigorous studies.
In a study published this year, in Frontiers in Psychology, the researchers looked at the association between age and gray matter. They compared 50 people who had mediated for years with 50 who didn’t. People in both groups showed a loss of gray matter as they aged. However, the researchers found among those who meditated, the volume of gray matter did not decline as much as it did among those who didn’t meditate. In other words, meditation appeared to help preserve the brain’s gray matter. The researchers noted that they couldn’t make a direct, causal connection between meditation and the preservation of gray matter, because too many other variables may be involved e.g. lifestyle choices, personality traits, and genetic brain differences. However, the lead researcher commented:

“Still, our results are promising” ……………..“Hopefully they will stimulate other studies exploring the potential of meditation to better preserve our aging brains and minds.”

A study published in Psychiatry Research: Neuroimaging in 2011, showed that participation in an 8-week mindfulness meditation program appears to make measurable changes in brain regions associated with memory, sense of self, empathy and stress. Participant-reported reductions in stress also were correlated with decreased grey-matter density in the amygdala, which is known to play an important role in anxiety and stress. None of these changes were seen in the control group, indicating that they had not resulted merely from the passage of time. The lead researcher commented:

“It is fascinating to see the brain’s plasticity and that, by practicing meditation we can play an active role in changing the brain and can increase our well-being and quality of life.”

Slowing the aging process

Finally, a study published in Psychoneuroendocrinology in 2011, looked at the effect of practising concentrative meditation techniques on an enzyme called telomerase that is involved in regulating the longevity of cells. Compared with a control group, the meditators who showed the most pronounced reductions in psychological stress also had higher telomerase activity by the end of a 3 month intensive retreat. This finding suggests that mindfulness training might slow processes of cellular aging among some meditation practitioners. Researchers believe that cultivating positive mental states, and decreasing negative moods and thinking, through a regular mindfulness practice, results in a “stress-buffering” benefit for our cells.

Published in Irish Pharmacist, March 2015


More about neuroplasticity

If you would like to learn more about neuroplasticity, I would recommend you watch a 52 minute video that features Dr. Norman Doidge (Psychiatrist & Researcher) speaking at a conference in Cambridge, Massachusetts. Dr. Doidge is the author of the book ‘The brain that changes itself’. You may access the video via the link below.



Chaitow, L., Gilbert C., Morrison D., Recognizing and Treating Breathing Disorders, Chapter 8.2, Buteyko Breathing Method, Elsevier Health Sciences, 2014.

Courtney R., Strengths, weaknesses, and possibilities of the Buteyko breathing method, Biofeedback, 2008, 36(2), 59-63

Dweik R.A., Nitric oxide, hypoxia, and superoxide: the good, the bad, and the ugly, Thorax, 2005, 60, 265-267

Navarrete-Opazo A. and Mitchell G.S., Therapeutic potential of intermittent hypoxia: a matter of dose, American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2014, 307(10), R1181-1197

Rakhimov A., Dr. Buteyko Lecture at Moscow State University in 1969

Rakhimov A., Normal Breathing: The Key to Vital Health

Yakovleva, S; Buteyko KP; and Novozhilov, AE; Breathe to Heal: Break Free from Asthma, Breathing Center (USA)