Introduction
Chronic
obstructive pulmonary disease (COPD) is a permanent lung
condition most often caused by cigarette smoking. The disease begins with a
wheezing cough and gradually progresses to a shortness of breath that accompanies
even the slightest exertion, such as dressing or eating. COPD encompasses both
emphysema and chronic bronchitis.
Emphysema consists of the destruction of the tiny air sacs (alveoli) in the lungs and the weakening of the support structure around them. This leads to a collapse of the small airways in the lungs, especially on inhalation, and reduces the body’s ability to take in oxygen and expel carbon dioxide.
Chronic bronchitis consists of chronic inflammation of the airways, causing a
persistent productive cough. This inflammation also impairs the body’s ability to
exchange new air for old. COPD also involves spasm of the airways similar to what
occurs in asthma. Finally, occasional flare-ups occur when bacteria
grow in the lungs, leading to acute exacerbation of symptoms.
Because cigarette smoking contributes to both emphysema and chronic bronchitis,
smokers who have COPD should stop smoking. Quitting smoking will not reverse the
condition, but it might stop COPD from getting worse. Airborne irritants such as
chemical fumes exacerbate symptoms and should also be avoided. Standard treatment
for COPD includes using bronchodilators, such as ipratropium and albuterol, to
reduce muscle spasms and taking corticosteroids to control inflammation
in the airways. Acute flare-ups are treated with antibiotics.
Severe COPD may require continuous oxygen therapy.
Malnutrition is common among people with COPD and seems to
correspond to the severity of the condition. It has been suggested that the
caloric needs of people with COPD increase as the disease progresses. Because
malnutrition in turn can worsen lung function and make people more prone to
infection, many researchers now recommend that persons with COPD receive
supplemental nutrition as part of their treatment.
Principal Proposed Natural Treatments
N-acetylcysteine (NAC) may improve breathing in people with COPD. NAC is a
specially modified form of the dietary amino acid cysteine. Regular use of NAC may
diminish the number of severe bronchitis attacks. A review and meta-analysis
of available research focused on eight reasonably well-designed double-blind,
placebo-controlled trials of NAC in COPD. The results of these studies, involving
about fourteen hundred persons, suggest that NAC taken daily at a dose of 400 to
1,200 milligrams (mg) can reduce the number of acute attacks of severe bronchitis.
However, a subsequent three-year, double-blind, placebo-controlled study of 523
people with COPD failed to find benefit with the use of 600 mg of NAC daily.
NAC was once thought to aid lung conditions by helping to break up mucus. However, continuing research casts doubt on this explanation of its action.
Other Proposed Natural Treatments
Evidence from three double-blind, placebo-controlled studies that enrolled forty-nine persons suggests that the supplement L-carnitine can improve exercise tolerance in COPD, presumably by improving muscular efficiency in the lungs and other muscles.
Eucalyptus is a standard ingredient in cough drops and in oils sometimes added
to humidifiers. A combination essential oil therapy containing
cineole from eucalyptus, d-limonene from citrus fruit, and alpha-pinene from pine
has been studied for a variety of respiratory conditions. Because these oils are
in a chemical family called monoterpenes, the treatment is called essential oil
monoterpenes. A three-month double-blind trial of 246 persons with chronic
bronchitis found that oral treatment with essential oil monoterpenes helped
prevent acute flare-ups of chronic bronchitis. A previous double-blind study, too
small to provide reliable results, hints that oral use of essential oil
monoterpenes can enhance the effects of antibiotics for acute flare-ups once they
do occur. It is thought that essential oil monoterpenes work by improving the
lungs’ ability to clear secretions.
A mixture of extracts from echinacea, wild indigo, and white cedar has shown promise for treating a variety of respiratory infections. A well-designed double-blind, placebo-controlled trial of fifty-three people tested its benefits in acute exacerbations of chronic bronchitis. All participants in this trial received standard antibiotic therapy. The results showed that people receiving the herbal medication experienced more rapid improvements in lung function than those given placebo.
In one poorly designed and reported study, the use of an Ayurvedic herbal combination appeared to offer some benefit. It also has been suggested that the sports supplement creatine might improve muscle strength in people with COPD, but results from small double-blind studies have been inconsistent. Slight evidence from a small open trial suggests that coenzyme Q10 improves lung function in persons with COPD.
The herbs ivy leaf and plantain have been suggested for chronic bronchitis, but there is no meaningful evidence that they actually help. Another study failed to find pomegranate juice helpful for COPD.
Observational studies suggest a correlation between respiratory problems and
diets low in antioxidants from food, such as vitamin A, vitamin E,
vitamin C, and beta-carotene. However, such studies do not prove that taking
supplements of such nutrients will help. A double-blind study of vitamin E and
beta-carotene supplementation found no effect on COPD symptoms. The effects of
other antioxidant supplements on COPD have not been studied.
Evidence from several studies suggests that the standard approved diet, low in fat and high in carbohydrates, worsens exercise performance and lung function in people with COPD, whereas a low-carbohydrate diet may improve COPD symptoms. Carbohydrates cause the body to produce increased amounts of carbon dioxide, and people with COPD have trouble getting rid of carbon dioxide.
Herbs and Supplements to Use Only with Caution
Various herbs and supplements may interact adversely with drugs used to treat chronic obstructive pulmonary disease, so one should be cautious when considering the use of herbs and supplements.
Bibliography
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Deacon, S. J., et al. “Randomised Controlled Trial of Dietary Creatine as an Adjunct Therapy to Physical Training in COPD.” American Journal of Respiratory and Critical Care Medicine 178 (2008): 233-239.
Decramer, M., et al. “Effects of N-acetylcysteine on Outcomes in Chronic Obstructive Pulmonary Disease.” The Lancet 365 (2005): 1552-1560.
Faager, G., et al. “Creatine Supplementation and Physical Training in Patients with COPD.” International Journal of Chronic Obstructive Pulmonary Disease 1 (2006): 445-453.
Fuld, J. P., et al. “Creatine Supplementation During Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease.” Thorax 60 (2005): 531-537.
Hauke, W., et al. “Esberitox N as Supportive Therapy When Providing Standard Antibiotic Treatment in Subjects with a Severe Bacterial Infection (Acute Exacerbation of Chronic Bronchitis).” Chemotherapy 48 (2002): 259-266.
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Sridhar, M. K. “Nutrition and Lung Health: Should People at Risk for Chronic Obstructive Lung Disease Eat More Fruit and Vegetables?” British Medical Journal 310 (1995): 75-76.
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