Chronic obstructive pulmonary disease ( COPD )

Chronic obstructive pulmonary disease (COPD) (also called chronic obstructive lung disease or COLD) refers to the combination of chronic bronchitis and emphysema resulting in obstruction of airways.

Although chronic bronchitis and emphysema are distinct conditions, smokers and former smokers often have aspects of both. In chronic bronchitis, the linings of the bronchial tubes are inflamed and thickened, leading to a chronic, mucus-producing cough and shortness of breath. In emphysema, the alveoli (tiny air sacs in the lungs) are damaged, also leading to shortness of breath. COPD is generally irreversible and can be fatal.

Smoking is the underlying cause of the majority of cases of emphysema and chronic bronchitis. Anyone who smokes should stop, and although quitting smoking will not reverse the symptoms of COPD, it can help preserve the remaining lung function. Exposure to other respiratory irritants, such as air pollution, dust, toxic gases, or fumes, can aggravate COPD and should be avoided when possible.

The common cold or other respiratory infections can aggravate COPD. Avoiding exposure to infections or bolstering resistance with immune enhancing nutrients and herbs can be valuable.

Supplements and herbs

N-acetyl cysteine (NAC) helps break down mucus. For that reason, inhaled NAC is used in hospitals to treat bronchitis. NAC may also protect lung tissue through its antioxidant activity. Oral NAC (200 mg taken twice per day) is also effective, improving symptoms in people with bronchitis in double-blind research. Results may take 6 months.

Vitamin C has mucus-thinning properties and may be helpful to respiratory conditions. A review of nutrition and lung health reported that people with a higher dietary intake of vitamin C were less likely to be diagnosed with bronchitis. Vitamin C was also shown to be related to greater volume of air expired from the lungs-a sign of healthy lung function. As yet, the effects of supplementing with vitamin C in people with COPD have not been studied.

Antioxidants in general are hypothesized to be important for neutralizing the large amounts of free radicals associated with COPD. However, use of antioxidant supplements (synthetic beta-carotene and vitamin E did help people with COPD in a double-blind trial despite the fact that people who ate higher amounts of these nutrients in their diets appeared to have lower risk.

A greater intake of the omega-3 fatty acids found in fish oils has been linked to reduced risk of COPD, though research has yet to investigate whether fish oil supplements would help people with COPD.

Many prescription drugs commonly taken by people with COPD have been linked to magnesium deficiency, a potential problem because magnesium is needed for normal lung functioning. One group of researchers reported that a magnesium deficiency was found in 47% of people with COPD (as determined by muscle biopsy) but was not reflected in blood levels of magnesium. In this study, magnesium deficiency was also linked with increased hospital stays. Thus it appears that many people with COPD may be magnesium deficient, a problem that could worsen their condition; moreover, the deficiency is not easily diagnosed.

Carnitine has been given to people with chronic lung disease in trials investigating how the body responds to exercise. In these double-blind reports, 2 grams of camitine taken twice per day for 2 to 4 weeks led to positive changes in breathing response to exercise.

Researchers have also given coenzyme QI0 (COQI0) to people with COPD after discovering their blood levels of COQI0 are lower than those found in healthy people. In that trial, 90 mg of COQI0 given for 8 weeks led to no change in lung function, though oxygenation of blood improved, as did exercise performance and heart rate. Until more research is done, the importance of supplementing with COQI0 for people with COPD remains unclear.

Mullein is classified in the herbal literature as an expectorant (to promote the discharge of mucus) and demulcent (to soothe and protect mucous membranes) herb. Historically, mullein has been used as a remedy for the respiratory tract, particularly in cases of irritating coughs with bronchial congestion. Other herbs commonly used as expectorants in traditional medicine include elecampane, lobelia, yerba santa, wild cherry bark, horehound, gumweed, anise, and eucalyptus. Animal studies have suggested that some of these increase discharge of mucus. However, none of these herbs have been studied for efficacy in humans.

Ephedra sinica (Ma huang) has been used by the Chinese for medicinal purposes for over 5,000 years, including for lung and bronchial constriction, coughing, and shortness of breath. However, this herb has the potential for serious side effects and is best used only with the guidance of a nutritionally oriented physician.

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