Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a permanent lung condition caused, most often, by cigarette smoking. It starts 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 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 bodys ability to take in oxygen and expel carbon dioxide.

Chronic bronchitis is a persistent, mucus-producing cough caused by inflammation, scarring the lungs. This inflammation also impairs the bodys ability to exchange new air for old. Finally, COPD also involves spasm of the airways similar to what occurs in asthma.

Because cigarette smoking contributes to both emphysema and chronic bronchitis, anyone who has COPD should stop smoking. Quitting smoking wont 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 corticosteroids to control inflammation in the airways. Severe COPD may require continuous oxygen therapy.

Malnutrition is common among people with COPD and seems to correspond to the severity of the condition. Its been suggested that the caloric needs of people with COPD increase as the disease progresses.3 Because malnutrition in turn can worsen lung function and make people more prone to infection, many researchers now recommend that individuals with COPD receive supplemental nutrition as part of their treatment.

Principal Proposed Treatments for Chronic Obstructive Pulmonary Disease:

N-acetyl cysteine (NAC) may improve breathing in people with COPD.

N-Acetyl Cysteine (NAC)

N-acetyl cysteine (NAC) is a specially modified form of the dietary amino acid cysteine. NAC has been thought to help break up mucus, which was the original rationale for using it in respiratory conditions. However, continuing research has tended to cast doubt on this explanation of its action. NAC might actually work in some altogether different way that is not as yet clearly defined. In any case, evidence suggests that regular use of NAC is helpful for symptoms of chronic bronchitis.

What Is the Scientific Evidence for NAC?

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 for chronic bronchitis. The results of these studies, involving a total of about 1,400 individuals, suggest that NAC taken daily at a dose of 400 to 1,200 mg can reduce the number of acute attacks of severe bronchitis.

For more information, including dosage and safety issues, see the full NAC article.

Other Proposed Treatments for Chronic Obstructive Pulmonary Disease:

Carnitine

Evidence from three double-blind placebo-controlled studies enrolling a total of 49 individuals suggests that L-carnitine can improve exercise tolerance in COPD, presumably by improving muscular efficiency in the lungs and other muscles.

Essential Oil Monoterpenes

Eucalyptus is a standard ingredient in cough drops and in oils added to humidifiers. A standardized combination of three essential oils has been studied for effectiveness in sinus infections, acute and chronic bronchitis, and other respiratory conditions. This essential oil combination may be helpful for preventing flare-ups of chronic bronchitis as well. However, it does not appear to improve breathing ability.

The studied combination includes cineole from eucalyptus, d-limonene from citrus fruit, and alpha-pinene from pine. These oils are all in a chemical family called monoterpenes. A 3-month double-blind trial of 246 individuals with chronic bronchitis found that treatment with essential oil monoterpenes helped prevent the typical worsening of chronic bronchitis that occurs during the winter. However, another study found no improvement in objective measures of lung function during usage of essential oils.

Dietary Factors

Observational studies suggest a correlation between respiratory problems such as bronchitis and emphysema and diets low in antioxidants from food, such as vitamin A, vitamin E, vitamin C, and beta-carotene. Another population study found that high vitamin C intake was associated with better lung function. However, such studies dont prove that taking supplements of such nutrients will help. Indeed, a study of vitamin E and beta-carotene supplementation found no effect on COPD symptoms. The effects of vitamin C supplements on COPD havent yet been studied. It might be wiser to eat fruits and vegetables rather than take antioxidant supplements.

Results from another observational study suggest that a diet high in fish oil may protect cigarette smokers against COPD.

Yet another observational study suggests that dietary magnesium intake is closely related to lung function. There is also some indication that diuretic drugs and corticosteroids commonly prescribed for COPD deplete magnesium levels, so taking magnesium supplements might not hurt.

Evidence from several studies suggests that a low-fat, high-carbohydrate diet worsens exercise performance and lung function in people with COPD, whereas a high-fat, low-carbohydrate diet appears to improve COPD symptoms. The reason is that carbohydrates cause the body to produce increased amounts of carbon dioxide, and individuals with COPD have trouble getting rid of carbon dioxide.

Coenzyme Q10

Finally, slight evidence from a small open trial suggests that coenzyme Q10 improves lung function in individuals with COPD.