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Chronic Obstructive Pulmonary Disease

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.


Rating Nutritional Supplements Herbs
N-acetyl cysteine (for bronchitis)
Ivy leaf

Coenzyme Q10
Fish oil (EPA/DHA)
Vitamin C

Wild cherry
Yerba santa
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.


What are the symptoms of COPD?

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.

Medical treatments for chronic obstructive pulmonary disease

Over the counter guiafenesin (Robitussin®) may help to thin mucous.

Bronchodilators, such as albuterol (Proventil®, Ventolin®), salmeterol (Serevent®), ipratropium (Atrovent®), and metaproterenol (Alupent®); oral corticosteroids, including prednisone (Deltasone®); and inhaled corticosteroids, such as fluticasone (Flovent®), triamcinolone (Azmacort®), flunisolide (AeroBid®), and budesonide (Pulmicort®), are commonly used prescription drugs. Mucolytics such as Acetylcysteine (Mucomyst®) are prescribed to help thin mucus secretions.

People with COPD should stop smoking and avoid secondhand smoke in order to slow the rate of lung function decline. Individuals with COPD should receive yearly pneumococcal (pneumonia) and flu vaccinations. Supplemental oxygen therapy and breathing rehabilitation programs are recommended in some situations. Severe cases might require lung volume reduction surgery or a lung transplant.

Dietary changes that may be helpful for chronic obstructive pulmonary disease

Malnutrition is common in people with COPD and may further compromise lung function and the overall health of those with this disease.1 However, evidence of malnutrition may occur despite adequate dietary intake of nutrients.2 Researchers have found that increasing dietary carbohydrates increases carbon dioxide production, which leads to reduced exercise tolerance and increased breathlessness in people with COPD.3 On the other hand, men with a higher intake of fruit (which is high in carbohydrates) over a 25-year period were at lower risk of developing lung diseases.4 People with COPD should, therefore, consider eliminating most sources of refined sugars, but not fruits, from their diet.

Chronic bronchitis has been linked to allergies in many reports.5 6 7 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.8 People with COPD interested in testing the effects of a food allergy elimination program should talk with a doctor.

Lifestyle changes that may be helpful for chronic obstructive pulmonary disease

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 may help preserve the remaining lung function. Exposure to other respiratory irritants, such as air pollution, dust, toxic gases, and fumes, may aggravate COPD and should be avoided when possible.

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

Nutritional supplements that may be helpful for chronic obstructive pulmonary disease

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.9 Oral NAC, 200 mg taken three times per day, is also effective and improved symptoms in people with bronchitis in double-blind research.10 11 Results may take six months.

L-carnitine has been given to people with chronic lung disease in trials investigating how the body responds to exercise.12 13 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.

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

A greater intake of the omega-3 fatty acids found in fish oils has been linked to reduced risk of COPD,15 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 function.16 One group of researchers reported that 47% of people with COPD had a magnesium deficiency.17 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.18 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.19 The effect of oral magnesium supplementation in people with COPD has yet to be investigated.

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.20 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.

Antioxidants in general are hypothesized to be important for neutralizing the large amounts of free radicals associated with COPD. However, use of two antioxidant supplements (synthetic beta-carotene, 20 mg per day, and vitamin E, 50 IU per day) did not help smokers 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.21

Are there any side effects or interactions with chronic obstructive pulmonary disease?

Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful for chronic obstructive pulmonary disease

One double-blind trial found an ivy leaf extract to be as effective as the mucus-dissolving drug ambroxol for treating chronic bronchitis.22

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.23 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.24 However, none have been studied for efficacy in humans.

Are there any side effects or interactions with chronic obstructive pulmonary disease?

Refer to the individual herb for information about any side effects or interactions.

Holistic approaches that may be helpful for chronic obstructive pulmonary disease

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.25 26