Waiting to Exhale

Health Sciences Institute e-Alert, September 13, 2004

 

Dear Reader,

If your doctor recommends that you use inhaled steroids to treat chronic obstructive pulmonary disease (COPD), take a deep breath and say... Let’s talk about it.

 

COPD is an umbrella term, commonly used to refer to asthma, emphysema, chronic bronchitis, or any combination of the three. These conditions are quite different from one another, but their effect is the same: long-term deterioration of the respiratory system.

One of the most common ways to treat COPD is with the use of an inhaler, also known as inhaled corticosteroids (ICS). But for the millions of people who suffer from COPD, the use of ICS has one noteworthy side effect that can create more and more problems as time goes by.

Now for the men... 

Doctors have known for some time that taking steroids in pill form contributes to bone loss in both men and women. But until recently, research on the association of inhaler use and bone loss has been less revealing.

In the e-Alert "Could Your Asthma Inhaler Cause Osteoporosis?" (10/3/01), I told you about a Harvard study that showed how the regular use of inhaled steroids causes bone loss at the hip in women between the ages of 18 and 45. The more "puffs" taken each day, the greater the rate of bone loss. And while the study specifically focused on premenopausal women, it noted that continued ICS use after menopause could contribute to even more bone deterioration and greater risk of fracture.

 

That study didn’t address the risks for men who use inhaled steroids, so I promised to keep an eye out for information about the effects of ICS on bone health in men, and now I’ve found it.

 

Earlier this year, researchers at an Illinois Veterans Administration hospital reported on a review of medical records for more than 40,000 subjects diagnosed with COPD. Almost 95 percent of the subjects were male, and the average age was 63 years. The VA team identified about 1,700 cases of COPD patients with nonvertebral fractures, and matched them with more than 6,800 control subjects.

 

After a one-year follow-up, general ICS use was not associated with a higher fracture risk compared to patients who didn’t use inhalers. But fracture risk was found to be significantly elevated among those who used the highest dosages of ICS.

 

In their conclusion, the authors of the study wrote: “Evidence from this and other epidemiologic studies of ICS dose and the risk of fractures indicate that providers should consider prescribing the lowest effective dose of ICS in the management of COPD."

 

Lung-loving nutrients

The Illinois VA study found no fracture risk from normal doses, but further testing will need to be done to determine possible long-term risks. Nevertheless, the basic message from these two studies is clear: The less ICS used, the better. Fortunately there are alternative treatments and supplements that can be used to address COPD symptoms.

 

In the e-Alert “Heavy Breathing" (5/19/04), I told you about a condition called dyspnoea, characterized by shortness of breath or labored breathing, and is a typical symptom of COPD. Researchers in Taiwan conducted a study to examine the effects of acupressure in treating dyspnoea, and found pulmonary function and dyspnoea symptoms were considerably improved after just four weeks of acupressure.

 

And these improvements might be enhanced if patients take the right supplements. HSI Panelist Allan Spreen, M.D., sent me the information about the VA study along with a note that read: “Pity we can't get all the asthmatics on food-allergy rotation diets, magnesium, and vitamins B-6, B-12, and C!"

 

In the e-alert "C-ing Stars" (6/12/02) I told you about a Nottingham University (UK) study that investigated the relationship between lung function and the intake of magnesium and vitamin C. Researchers surveyed more than 2,500 subjects to assess the relationship between diet and COPD. After nine years of follow-up, subjects who consumed higher amounts of vitamin C had better lung function than those with lower levels of C intake, and higher amounts of vitamin C and magnesium intake were associated with significantly improved lung function in the cases of those suffering from COPD.

 

Inhale this

COPD symptoms can also be managed with the use of a nebulizer, an apparatus that produces an ultrasonic mist that moisturizes the respiratory system.

In the August 2002 issue of his Nutrition & Healing newsletter, Jonathan V. Wright, M.D., discusses COPD at length, and states that nebulized, inhaled glutathione is “the No. 1 natural treatment for COPD in my practice." Regular e-Alert readers will recognize glutathione as the powerful antioxidant and amino acid molecule that I've written about many times.

 

Dr. Wright cautions that by the time a COPD diagnosis is made, lung tissue is usually so badly damaged that nutritional treatments alone can't cure most cases of COPD. But he adds, “I can safely say that this type of therapy usually stops and at least partially reverses the progression of the disease. Often, improvement can be quite significant."

 

Dr. Wright's article (available online to his subscribers at wrightnewsletter.com) contains a 13-point checklist of the vitamins and nutrients essential to treating COPD-related disorders. And it’s not a surprise that his list parallels Dr. Spreen’s recommendation and the Nottingham University research with suggested daily doses of both vitamin C and magnesium.

 

To Your Good Health,

Jenny Thompson
Health Sciences Institute

 

Sources:

“Fracture Risk Associated with Inhaled Corticosteroid use in Chronic Obstructive Pulmonary Disease" American Journal of Respiratory and Critical Care Medicine" Vol. 169, No. 7, 4/1/04, ncbi.nlm.nih.gov

“Panel Issues Final Recommendations for Food Pyramid" The Associated Press, 8/27/04, cnn.com

 

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