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    Chronic Obstructive Pulmonary Disease

    Chronic Obstructive Pulmonary Disease

    Alternative Medicine

    Alternative Medicine
    The following information is specific for alternative and complementary medicine. For additional evidence-based information on diseases, conditions, symptoms, diagnosis, treatment and wellness issues, continue searching the Healthwise Knowledgebase.

    Need to Know

    COPD
    Breathe easier if you have COPD, a disease that leaves you winded and worn out. According to research or other evidence, the following self-care steps may be helpful.
    • Steer clear of smoke

      Kick the smoking habit, and avoid secondhand smoke and other respiratory irritants

    • Get to know NAC

      Take 200 mg of the supplement N-acetyl cysteine three times a day to help break down mucus and supply antioxidant protection to lung tissue

    • Add L-carnitine to your fitness routine

      Improve breathing during exercise by taking 2 grams of this nutritional supplement twice a day

    • Find relief with ivy leaf

      Ease symptoms naturally by taking 50 drops of a concentrated alcohol extract twice a day

    About

    About This Condition

    Chronic obstructive pulmonary disease (COPD) refers to the combination of chronic bronchitis and emphysema, resulting in obstruction of airways and poor oxygen transport in the lungs, respectively.

    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 may even be fatal.

    Symptoms

    Symptoms of COPD develop gradually and may initially include shortness of breath during exertion, wheezing especially when exhaling, and frequent coughing that produces variable amounts of mucus. In more advanced stages, people may experience rapid changes in the ability to breathe, shortness of breath at rest, fatigue, depression, memory problems, confusion, and frequent waking during sleep.

    Holistic Options

    Negative ions may counteract the allergenic effects of positively charged ions on respiratory tissues and potentially ease symptoms of allergic bronchitis, according to preliminary research.1 , 2

    Eating Right

    The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

    Recommendation Why
    Uncover your allergies Chronic bronchitis has been linked to food allergies in many reports. An elimination diet can help you uncover problematic foods.

    Uncover your allergies

    Chronic bronchitis has been linked to allergies in many reports.3 , 4 , 5 In a preliminary trial, long-term reduction of some COPD symptoms occurred when people with COPD avoided allergenic foods and, in some cases, were also desensitized to pollen.6 People with COPD interested in testing the effects of a food allergy elimination program should talk with a doctor.

    Supplements

    What Are "Star" Ratings?

    3star   Reliable and relatively consistent scientific data showing a substantial health benefit.

    2star   Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

    1star   For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

    Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

    For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.


    Supplement Amount Why
    N-Acetyl Cysteine 200 mg three times daily 3 stars  N-acetyl cysteine helps break down mucus and supplies antioxidant protection to lung tissue.

    3 stars  N-Acetyl Cysteine

    200 mg three times daily

    NAC (N-acetyl cysteine) 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.7 Oral NAC, 200 mg taken three times per day, is also effective and improved symptoms in people with bronchitis in double-blind research.8 , 9 However, NAC was ineffective in one study.10 Results may take six months. NAC does not appear to be effective for people with COPD who are taking inhaled steroid medications.11

    What Else Is This Supplement Used For?
    See Drug Interactions

    Supplement Amount Why
    Creatine Monohydrate 5 grams three times a day for two weeks, and then 5 grams once daily 2 stars  Creatine has been shown to increase muscle strength, muscle endurance, and overall health status.

    2 stars  Creatine Monohydrate

    5 grams three times a day for two weeks, and then 5 grams once daily

    In a double-blind study, people with COPD received creatine or a placebo for 12 weeks. After the first 2 weeks of supplementation, all participants underwent an outpatient pulmonary rehabilitation program. Compared with the placebo, creatine significantly increased muscle strength, muscle endurance, and overall health status, but not exercise capacity.12 The amount of creatine used in this study was 5 grams three times a day for 2 weeks, and then 5 grams once a day for 10 weeks.

    What Else Is This Supplement Used For?

    Supplement Amount Why
    Ivy Leaf 50 drops of a concentrated alcohol extract twice per day 2 stars  One double-blind trial found an ivy leaf extract to be as effective as the mucus-dissolving drug ambroxol for treating chronic bronchitis, which is a component of chronic obstructive pulmonary disease.

    2 stars  Ivy Leaf

    50 drops of a concentrated alcohol extract twice per day

    One double-blind trial found an ivy leaf extract to be as effective as the mucus-dissolving drug ambroxol for treating chronic bronchitis.13

    What Else Is This Supplement Used For?

    Supplement Amount Why
    L-Carnitine 2 grams taken twice per day 2 stars  Studies have shown that when L-carnitine is given to people with chronic lung disease, breathing during exercise improves.

    2 stars  L-Carnitine

    2 grams taken twice per day

    L-carnitine has been given to people with chronic lung disease in trials investigating how the body responds to exercise.14 , 15 In these double-blind trials, 2 grams of L-carnitine, taken twice daily for two to four weeks, led to positive changes in breathing response to exercise.

    What Else Is This Supplement Used For?
    See Drug Interactions

    Supplement Amount Why
    Anise Refer to label instructions 1 star  Anise is used traditionally to promote mucus discharge.

    1 star  Anise

    Mullein is classified in the herbal literature as both an expectorant, to promote the discharge of mucus, and a demulcent, to soothe and protect mucous membranes. Historically, mullein has been used as a remedy for the respiratory tract, particularly in cases of irritating coughs with bronchial congestion.16 Other herbs commonly used as expectorants in traditional medicine include elecampane, lobelia, yerba santa (Eriodictyon californicum), wild cherry bark, gumweed (Grindelia robusta), anise(Pimpinella anisum), and eucalyptus. Animal studies have suggested that some of these herbs increase discharge of mucus.17 However, none have been studied for efficacy in humans.

    What Else Is This Supplement Used For?

    Supplement Amount Why
    Coenzyme Q10 Refer to label instructions 1 star  CoQ10 levels have been found to be low in people with COPD. Supplementing with CoQ10 improved blood oxygenation, exercise performance, and heart rate in one study.

    1 star  Coenzyme Q10

    Researchers have also given coenzyme Q10 (CoQ10) to people with COPD after discovering their blood levels of CoQ10 were lower than those found in healthy people.18 In that trial, 90 mg of CoQ10 per day, given for eight 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 CoQ10 for people with COPD remains unclear.

    What Else Is This Supplement Used For?
    See Drug Interactions

    Supplement Amount Why
    Elecampane Refer to label instructions 1 star  Elecampane is used traditionally to promote mucus discharge.

    1 star  Elecampane

    Mullein is classified in the herbal literature as both an expectorant, to promote the discharge of mucus, and a demulcent, to soothe and protect mucous membranes. Historically, mullein has been used as a remedy for the respiratory tract, particularly in cases of irritating coughs with bronchial congestion.19 Other herbs commonly used as expectorants in traditional medicine include elecampane, lobelia, yerba santa (Eriodictyon californicum), wild cherry bark, gumweed (Grindelia robusta), anise(Pimpinella anisum), and eucalyptus. Animal studies have suggested that some of these herbs increase discharge of mucus.20 However, none have been studied for efficacy in humans.

    What Else Is This Supplement Used For?

    Supplement Amount Why
    Eucalyptus Refer to label instructions 1 star  Eucalyptus is used traditionally to promote mucus discharge.

    1 star  Eucalyptus

    Caution: Do not use eucalyptus oil internally without supervision by a healthcare professional. As little as 3.5 ml of the oil taken internally has proven fatal.

    Herbs commonly used as expectorants in traditional medicine include eucalyptus, elecampane, lobelia, yerba santa (Eriodictyon californicum), wild cherry bark, gumweed (Grindelia robusta), and anise(Pimpinella anisum). Animal studies have suggested that some of these herbs increase discharge of mucus.21 However, none have been studied for efficacy in humans.

    What Else Is This Supplement Used For?

    Supplement Amount Why
    Evening Primrose Oil Refer to label instructions 1 star  Evening primrose oil contains gamma-linolenic acid, a type of omega-3 fatty acid that has been linked to reduced risk of COPD.

    1 star  Evening Primrose Oil

    A greater intake of the omega-3 fatty acids found in fish oils has been linked to reduced risk of COPD,22 though research has yet to investigate whether fish oil supplements would help people with COPD. In a double-blind trial, people with COPD received a fatty acid supplement (providing daily 760 mg of GLA [gamma-linolenic acid], 1,200 mg of ALA [alpha-linolenic acid], 700 mg of EPA [eicosapentaenoic acid], and 340 mg of DHA [docosahexaenoic acid]) or a placebo (80% palm oil and 20% sunflower oil) during an eight-week rehabilitation program. Compared with the placebo, the fatty acid supplement significantly improved exercise capacity.23 While two of the fatty acids supplied in this supplement (EPA and DHA acid) are found in fish oil, it is not known which components of the supplement were most responsible for the improvement. Gamma-linolenic acid is found in evening primrose oil, black currant seed oil, and borage oil; alpha-linolenic acid is found in flaxseed oil and other oils.

    What Else Is This Supplement Used For?

    Supplement Amount Why
    Fish Oil Refer to label instructions 1 star  The omega-3 fatty acids found in fish oil have been linked to reduced risk of COPD.

    1 star  Fish Oil

    A greater intake of the omega-3 fatty acids found in fish oils has been linked to reduced risk of COPD,24 though research has yet to investigate whether fish oil supplements would help people with COPD. In a double-blind trial, people with COPD received a fatty acid supplement (providing daily 760 mg of gamma-linolenic acid, 1,200 mg of alpha-linolenic acid, 700 mg of eicosapentaenoic acid, and 340 mg of docosahexaenoic acid) or a placebo (80% palm oil and 20% sunflower oil) during an eight-week rehabilitation program. Compared with the placebo, the fatty acid supplement significantly improved exercise capacity.25 While two of the fatty acids supplied in this supplement (eicosapentaenoic acid [EPA] and docosahexaenoic [DHA] acid) are found in fish oil, is not known which components of the supplement were most responsible for the improvement. Gamma-linolenic acid is found in evening primrose oil, black currant seed oil, and borage oil; alpha-linolenic acid is found in flaxseed oil and other oils.

    What Else Is This Supplement Used For?
    See Drug Interactions

    Supplement Amount Why
    Gumweed Refer to label instructions 1 star  Gumweed is used traditionally to promote mucus discharge.

    1 star  Gumweed

    Mullein is classified in the herbal literature as both an expectorant, to promote the discharge of mucus, and a demulcent, to soothe and protect mucous membranes. Historically, mullein has been used as a remedy for the respiratory tract, particularly in cases of irritating coughs with bronchial congestion.26 Other herbs commonly used as expectorants in traditional medicine include elecampane, lobelia, yerba santa (Eriodictyon californicum), wild cherry bark, gumweed (Grindelia robusta), anise(Pimpinella anisum), and eucalyptus. Animal studies have suggested that some of these herbs increase discharge of mucus.27 However, none have been studied for efficacy in humans.


    Supplement Amount Why
    Lobelia Refer to label instructions 1 star  Lobelia is used traditionally to promote mucus discharge.

    1 star  Lobelia

    Mullein is classified in the herbal literature as both an expectorant, to promote the discharge of mucus, and a demulcent, to soothe and protect mucous membranes. Historically, mullein has been used as a remedy for the respiratory tract, particularly in cases of irritating coughs with bronchial congestion.28 Other herbs commonly used as expectorants in traditional medicine include elecampane, lobelia, yerba santa (Eriodictyon californicum), wild cherry bark, gumweed (Grindelia robusta), anise(Pimpinella anisum), and eucalyptus. Animal studies have suggested that some of these herbs increase discharge of mucus.29 However, none have been studied for efficacy in humans.

    What Else Is This Supplement Used For?

    Supplement Amount Why
    Magnesium Refer to label instructions 1 star  Magnesium is needed for normal function, supplementing with it can make up for the magnesium deficiency commonly caused by prescription drugs taken by people with COPD.

    1 star  Magnesium

    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 function.30 One group of researchers reported that 47% of people with COPD had a magnesium deficiency.31 In this study, magnesium deficiency was also linked to increased hospital stays. Thus, it appears that many people with COPD may be magnesium deficient, a problem that might worsen their condition; moreover, the deficiency is not easily diagnosed.

    Intravenous magnesium has improved breathing capacity in people experiencing an acute exacerbation of COPD.32 In this double-blind study, the need for hospitalization also was reduced in the magnesium group (28% versus 42% with placebo), but this difference was not statistically significant. Intravenous magnesium is known to be a powerful bronchodilator.33 The effect of oral magnesium supplementation in people with COPD has yet to be investigated.

    What Else Is This Supplement Used For?
    See Drug Interactions

    Supplement Amount Why
    Mullein Refer to label instructions 1 star  Mullein is traditionally used for its ability to promote the discharge of mucus and to soothe mucous membranes.

    1 star  Mullein

    Mullein is classified in the herbal literature as both an expectorant, to promote the discharge of mucus, and a demulcent, to soothe and protect mucous membranes. Historically, mullein has been used as a remedy for the respiratory tract, particularly in cases of irritating coughs with bronchial congestion.34 Other herbs commonly used as expectorants in traditional medicine include elecampane, lobelia, yerba santa (Eriodictyon californicum), wild cherry bark, gumweed (Grindelia robusta), anise(Pimpinella anisum), and eucalyptus. Animal studies have suggested that some of these herbs increase discharge of mucus.35 However, none have been studied for efficacy in humans.

    What Else Is This Supplement Used For?

    Supplement Amount Why
    Vitamin C Refer to label instructions 1 star  In one study, people who got more vitamin C from their diet were less likely to be diagnosed with bronchitis, however, vitamin C has not been studied in relation to COPD.

    1 star  Vitamin C

    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.36 As yet, the effects of supplementing with vitamin C in people with COPD have not been studied.

    What Else Is This Supplement Used For?
    See Drug Interactions

    Supplement Amount Why
    Wild Cherry Refer to label instructions 1 star  Wild cherry bark is used traditionally to promote mucus discharge.

    1 star  Wild Cherry

    Mullein is classified in the herbal literature as both an expectorant, to promote the discharge of mucus, and a demulcent, to soothe and protect mucous membranes. Historically, mullein has been used as a remedy for the respiratory tract, particularly in cases of irritating coughs with bronchial congestion.37 Other herbs commonly used as expectorants in traditional medicine include elecampane, lobelia, yerba santa (Eriodictyon californicum), wild cherry bark, gumweed (Grindelia robusta), anise(Pimpinella anisum), and eucalyptus. Animal studies have suggested that some of these herbs increase discharge of mucus.38 However, none have been studied for efficacy in humans.

    What Else Is This Supplement Used For?

    Supplement Amount Why
    Yerba Santa Refer to label instructions 1 star  Yerba santa is used traditionally to promote mucus discharge.

    1 star  Yerba Santa

    Mullein is classified in the herbal literature as both an expectorant, to promote the discharge of mucus, and a demulcent, to soothe and protect mucous membranes. Historically, mullein has been used as a remedy for the respiratory tract, particularly in cases of irritating coughs with bronchial congestion.39 Other herbs commonly used as expectorants in traditional medicine include elecampane, lobelia, yerba santa (Eriodictyon californicum), wild cherry bark, gumweed (Grindelia robusta), anise(Pimpinella anisum), and eucalyptus. Animal studies have suggested that some of these herbs increase discharge of mucus.40 However, none have been studied for efficacy in humans.

    References

    1. Gualtierotti R, Solimene U, Tonoli D. Ionized air respiratory rehabilitation technics. Minerva Med 1977;68:3383–9.

    2. Jones DP, O’Connor SA, Collins JV, et al. Effect of long-term ionized air treatment on patients with bronchial asthma. Thorax 1976;31:428–32.

    3. Businco L, Businco E. Allergic pathogenesis in chronic bronchitis. Allergol Immunopathol (Madr) 1975;3:1–8.

    4. Krawczyk Z. Role of allergy of the immediate type in the pathogenesis of chronic bronchitis in adults. Pneumonol Pol 1976;44:829–36 [in Polish].

    5. No author listed. Preliminary study on the relation between allergy and chronic bronchitis. Chin Med J 1976;2:63–8.

    6. Rowe AH, Rowe A Jr, Sinclair C. Food allergy: its role in the symptoms of obstructive emphysema and chronic bronchitis. J Asthma Res 1967;5:11–20.

    7. Van Schayck CP, Dekhuijzen PN, Gorgels WJ, et al. Are anti-oxidant and anti-inflammatory treatments effective in different subgroups of COPD? A hypothesis. Respir Med 1998;92:1259–64.

    8. Boman G, Bäcker U, Larsson S, et al. Oral acetylcysteine reduces exacerbation rate in chronic bronchitis: a report of a trial organized by the Swedish Society for Pulmonary Diseases. Eur J Respir Dis 1983;64:405–15.

    9. Multicenter Study Group. Long-term oral acetylcysteine in chronic bronchitis. A double-blind controlled study. Eur J Respir Dis 1980;61:111:93–108.

    10. Schermer T, Chavannes N, Dekhuijzen R, et al. Fluticasone and N-acetylcysteine in primary care patients with COPD or chronic bronchitis. Respir Med 2009;103:542–51.

    11. Decramer M, Rutten-van Molken M, Dekhuijzen PN, et al. Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trial. Lancet2005;365:1552–60.

    12. Fuld JP, Kilduff LP, Neder JA, et al. Creatine supplementation during pulmonary rehabilitation in chronic obstructive pulmonary disease. Thorax2005;60:531–7.

    13. Meyer-Wegner J. Ivy versus ambroxol in chronic bronchitis. Zeits Allegemeinmed 1993;69:61–6 [in German].

    14. Dal Negro R, Pomari G, Zoccatelli O, Turco P. L-carnitine and rehabilitative respiratory physiokinesitherapy: metabolic and ventilatory response in chronic respiratory insufficiency. Int J Clin Pharmacol Ther Toxicol 1986;24:453–6.

    15. Dal Negro R, Turco P, Pomari C, De Conti F. Effects of L-carnitine on physical performance in chronic respiratory insufficiency. Int J Clin Pharmacol Ther Toxicol 1988;26:269–72.

    16. Hoffman D. The Herbal Handbook: A User’s Guide to Medical Herbalism. Rochester, VT: Healing Arts Press, 1988, 67.

    17. Boyd EM. Expectorants and respiratory tract fluid. Pharmacol Rev 1954;6:521–42 [review].

    18. Fujimoto S, Kurihara N, Hirata K, Takeda T. Effects of coenzyme Q10 administration on pulmonary function and exercise performance in patients with chronic lung diseases. Clin Investig 1993;71(8 Suppl):S162–6.

    19. Hoffman D. The Herbal Handbook: A User’s Guide to Medical Herbalism. Rochester, VT: Healing Arts Press, 1988, 67.

    20. Boyd EM. Expectorants and respiratory tract fluid. Pharmacol Rev 1954;6:521–42 [review].

    21. Boyd EM. Expectorants and respiratory tract fluid. Pharmacol Rev 1954;6:521–42 [review].

    22. Shahar E, Folsom AR, Melnick SL, et al. Dietary n-3 polyunsaturated fatty acids and smoking-related chronic obstructive pulmonary disease. Atherosclerosis Risk in Communities Study Investigators. N Engl J Med 1994;331:228–33.

    23. Broekhuizen R, Wouters EFM, Creutzberg EC, et al. Polyunsaturated fatty acids improve exercise capacity in chronic obstructive pulmonary disease. Thorax 2005;60:376–82.

    24. Shahar E, Folsom AR, Melnick SL, et al. Dietary n-3 polyunsaturated fatty acids and smoking-related chronic obstructive pulmonary disease. Atherosclerosis Risk in Communities Study Investigators. N Engl J Med 1994;331:228–33.

    25. Broekhuizen R, Wouters EFM, Creutzberg EC, et al. Polyunsaturated fatty acids improve exercise capacity in chronic obstructive pulmonary disease. Thorax 2005;60:376–82.

    26. Hoffman D. The Herbal Handbook: A User’s Guide to Medical Herbalism. Rochester, VT: Healing Arts Press, 1988, 67.

    27. Boyd EM. Expectorants and respiratory tract fluid. Pharmacol Rev 1954;6:521–42 [review].

    28. Hoffman D. The Herbal Handbook: A User’s Guide to Medical Herbalism. Rochester, VT: Healing Arts Press, 1988, 67.

    29. Boyd EM. Expectorants and respiratory tract fluid. Pharmacol Rev 1954;6:521–42 [review].

    30. Rolla G, Bucca C, Bugiani M, et al. Hypomagnesemia in chronic obstructive lung disease: effect of therapy. Magnesium Trace Elem 1990;9:132–6.

    31. Fiaccadori E, Del Canale S, Coffrini E, et al. Muscle and serum magnesium in pulmonary intensive care unit patients. Crit Care Med 1988;16:751–60.

    32. Skorodin MS, Tenholder MF, Yetter B, et al. Magnesium sulfate in exacerbations of chronic obstructive pulmonary disease. Arch Intern Med 1995;155:496–500.

    33. Okayama H, Aikawa T, Okayama M, et al. Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma. JAMA 1987;257:1076–8.

    34. Hoffman D. The Herbal Handbook: A User’s Guide to Medical Herbalism. Rochester, VT: Healing Arts Press, 1988, 67.

    35. Boyd EM. Expectorants and respiratory tract fluid. Pharmacol Rev 1954;6:521–42 [review].

    36. Sridhar MK. Nutrition and lung health. BMJ 1995;310:75–6.

    37. Hoffman D. The Herbal Handbook: A User’s Guide to Medical Herbalism. Rochester, VT: Healing Arts Press, 1988, 67.

    38. Boyd EM. Expectorants and respiratory tract fluid. Pharmacol Rev 1954;6:521–42 [review].

    39. Hoffman D. The Herbal Handbook: A User’s Guide to Medical Herbalism. Rochester, VT: Healing Arts Press, 1988, 67.

    40. Boyd EM. Expectorants and respiratory tract fluid. Pharmacol Rev 1954;6:521–42 [review].


    Last Review: 03-10-2010

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    The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2011.



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