Bronchitis
A constant, nagging cough may point to a case of acute or chronic
bronchitis. According to research or other evidence, the following self-care steps may get
those lungs back in shape:
- Fill up on fruits and veggies
- Help keep your lungs healthy by getting the antioxidant nutrients
you need from fruits and vegetables
- Take some extra C
- Help recovery from acute bronchitis by supplementing with 200 to
2,000 mg a day of vitamin C
- Get to know NAC
- Taking 400 to 600 mg a day of the supplement N-acetyl cysteine may
reduce the thickness of lung secretions and improve symptoms of chronic bronchitis
- Soothe the symptoms
- Try over-the-counter remedies, such as guaifenesin (Robitussin,
Mucinex) to thin mucus, and the cough suppressant dextromethorphan found in combination
products (Robitussin DM, Mucinex DM, Vicks 44 Cough Relief)
- Steer clear of cigarette smoke
- Kick the habit to improve recovery
- Talk to your doctor
- Ask about antibiotics to fight infection, and antitussives
containing codeine (Robitussin A-C, Phenergan with Codeine) or hydrocodone (Vicodin Tuss,
Hycodan, Tussionex) to stop the cough
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full bronchitis article for more
in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About bronchitis
Bronchitis is an inflammation of the mucous membranes of the deep inner lung passages
called the bronchial tree.
Bronchitis may be either acute or chronic. Acute bronchitis is frequently caused by a viral
or bacterial infection. Acute bronchitis may
also result from irritation of the mucous membranes by environmental fumes, acids, solvents,
or tobacco smoke. Bronchitis usually begins with a dry, nonproductive cough. After a few hours
or days, the cough may become more frequent and produce mucus. A secondary bacterial infection
may occur, in which the sputum (bronchial secretions) may contain pus. People whose cough
and/or fever continues for more than seven days should visit a medical practitioner.
Chronic bronchitis may result from prolonged exposure to bronchial irritants. Cigarette
smoking, environmental toxins, and inhaled
allergens can all cause chronic irritation of the bronchi. The cells lining the bronchi
produce excess mucus in response to the chronic irritation; this excess mucus production can
lead to a chronic, productive cough.
Bronchitis can be particularly dangerous in the elderly and in people with compromised immune systems. These people should see a doctor
if they develop a respiratory infection.
Product ratings for
bronchitis
| Science Ratings |
Nutritional Supplements |
Herbs |
 |
NAC
Thymus extracts
Vitamin C
|
|
 |
Vitamin A (for
deficiency only)
Vitamin E
|
Geranium (Pelargonium sidoides)
Ivy leaf
Plantain
|
 |
|
Anise
Chinese scullcap
Echinacea
Elecampane
Eucalyptus
Horehound
Horseradish
Lobelia
Mullein
Pleurisy root
Thyme
|
| See also: Homeopathic Remedies for Bronchitis |
What are the symptoms?
Acute infectious bronchitis is often preceded by signs of an upper respiratory tract
infection: stuffy or runny nose, malaise, chills, fever, muscle pain, and sore throat. The cough is initially dry and does not
produce mucus. Later, small amounts of thick green or green-yellow sputum may be coughed
up.
Chronic bronchitis is characterized by a productive cough that initially occurs only in the
morning.
Dietary changes that may be helpful
Dietary factors may influence both inflammatory activity and antioxidant status in the body. Increased inflammation
and decreased antioxidant activity may each lead to an increased incidence of chronic
diseases, such as chronic bronchitis. People suffering from chronic bronchitis may experience
an improvement in symptoms when consuming a diet high in anti-inflammatory fatty acids, such
as those found in fish. In a double-blind study of children with recurrent respiratory tract
infections, a daily essential-fatty-acid supplement (containing 855 mg of alpha-linolenic acid
and 596 mg of linoleic acid) reduced both the number and the duration of
recurrences.1
In people with bronchitis, lipids in the lung tissue may undergo oxidation damage (also
called free-radical damage), particularly when
the bronchitis is a result of exposure to environmental toxins or cigarette smoke. A diet high
in antioxidants may protect against the free
radical-damaging effect of these toxins. Studies comparing different populations have shown
that increasing fruit and vegetable (and therefore, antioxidant) consumption may reduce the
risk of developing chronic bronchitis.2 3
Food and environmental allergies may be
triggering factors in some cases of chronic bronchitis.4 Cows’ milk allergy
has been associated with bronchitis in children,5 6 7 and
some doctors believe that dairy products may increase mucus production and, therefore, that
people suffering from either acute or chronic bronchitis should limit their intake of dairy
products. Ingestion of simple sugars (such as sucrose or fructose) can lead to suppression of
immune function;8 therefore, some
doctors believe simple sugars should be avoided during illness.
Lifestyle changes that may be helpful
Breast-feeding provides important nutrients to an infant and improves the functioning of
the immune system. Studies have shown that breast-feeding prevents the development of lower
respiratory tract infections during infancy.9 10 Whether that protective
effect persists into adulthood is not known. Exposure to environmental chemicals, including
passive smoke, can increase the incidence of respiratory illness among
children.11
Chronic bronchitis is frequently associated with smoking and/or environmental exposure to
chemicals or allergens. These exposures should
be avoided to allow the cells of the bronchi to recover from chronic irritation and to
decrease the burden on the immune system.
Other therapies
Rest and increased fluid intake are recommended in the fever stage of acute bronchitis.
Treatment of chronic bronchitis includes smoking
cessation and a variety of drugs directed at relieving symptoms and treating superimposed
bacterial infections.
Vitamins that may be helpful
In a double-blind study of elderly patients hospitalized with acute bronchitis, those who
were given 200 mg per day of vitamin C
improved to a significantly greater extent than those who were given a placebo.12
The common cold may lead to bronchitis in
susceptible people, and numerous controlled studies, some double-blind, have shown that
vitamin C supplements can decrease the severity and duration of the common cold in otherwise
healthy people.13
Vitamin C and vitamin E may prevent
oxidative damage to the lung lipids by environmental pollution and cigarette smoke exposure.
It has been suggested that amounts in excess of the RDA (recommended dietary allowance) are
necessary to protect against the air pollution levels currently present in North
America,14 although it is not known how much vitamin E is needed to produce that
protective effect.
A review of 39 clinical trials of NAC
(N-acetyl cysteine) found that 400 to 600 mg per day was a safe and effective treatment for
chronic bronchitis.15 NAC supplementation was found to reduce the number of
aggravations of the illness in almost 50% of people taking the supplement, compared with only
31% of those taking placebo. Smokers have also been found to benefit from taking
NAC.16 In addition to helping break up mucus, NAC may reduce the elevated bacterial
counts that are often seen in the lungs of smokers with chronic bronchitis.17 In
another double-blind study, people with chronic bronchitis who took NAC showed an improved
ability to expectorate and a reduction in cough severity.18 These benefits may
result from NAC’s capacity to reduce the viscosity (thickness) of
sputum.19
Vitamin A levels are low in children with
measles,20 an infection that can result in pneumonia or other
respiratory complications. A number of studies have shown that supplementation with vitamin A
decreased complications and deaths from measles in children living in developing countries
where deficiencies of vitamin A are common.21 However, little to no positive
effect, and even slight adverse effects, have resulted from giving vitamin A
supplements to prevent or treat infections in people living in countries where most people
consume adequate amounts of vitamin A.22 23 24 25
26 27 Therefore, vitamin A supplements may only be useful for people
with bronchial infections who are known to be deficient in vitamin A.
The thymus gland plays a number of important roles in the functioning of the immune system. Thymus extract from calves, known as
Thymomodulin®, has been found, in a double-blind study, to decrease the frequency of
respiratory infections in children who were prone to such infections.28 The amount
of Thymomodulin used in that study was 3 mg per kg of body weight per day.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Several types of herbs may help people with bronchitis, either by treating underlying infection, by relieving inflammation, or by
relieving symptoms such as cough. For clarity, the table below summarizes which herbs are in
each category of action. Some herbs have more than one action. Herbs listed in the table have
not necessarily been proven to be effective. The herbs are discussed in more detail following
the table.
| Action |
Botanicals Supported by Clinical Trials |
Botanicals Used Traditionally |
| Expectorant (helps remove mucus) |
|
Anise, horehound, horseradish, mullein,
pleurisy root |
| Anti-inflammatory |
Chinese scullcap, ivy leaf,
plantain |
Elecampane, marshmallow, mullein,
slippery elm |
| Fights infection |
Echinacea (by stimulating immune system),
lavender, thyme |
Eucalyptus, horseradish |
| Antitussive (relieves cough) |
|
Lobelia, marshmallow |
| Relieves bronchospasms or spasmodic cough |
|
Lobelia, thyme |
Expectorant herbs help loosen bronchial secretions and make elimination of mucus easier.
Numerous herbs are traditionally considered expectorants, though most of these have not been
proven to have this effect in clinical trials.
Anise contains a volatile oil that is high in the chemical constituent anethole and acts
as an expectorant.29
Horehound has expectorant properties,
possibly due to the presence of a diterpene lactone in the plant, which is known as
marrubiin.30
Mullein has been used traditionally as a
remedy for the respiratory tract, including bronchitis. The saponins in mullein may be
responsible for its expectorant actions.31
Pleurisy root is an expectorant and is
thought to be helpful against all types of respiratory infections. It is traditionally
employed as an expectorant for bronchitis. However, owing to the cardiac glycosides it
contains, pleurisy root may not be safe to use if one is taking (heart
medications.32 This herb should not be used by pregnant women.
Anti-inflammatory herbs may help people with bronchitis. Often these herbs contain complex
polysaccharides and have a soothing effect; they are also known as demulcents. Plantain is a demulcent that has been documented in
two preliminary trials conducted in Bulgaria to help people with chronic
bronchitis.33 34 Other demulcents traditionally used for people with
bronchitis include mullein, marshmallow, and
slippery elm. Because demulcents can provoke
production of more mucus in the lungs, they tend to be used more often in people with dry
coughs.35
Elecampane is a demulcent that has been
used to treat coughs associated with bronchitis,
asthma, and whooping cough. Although there have been no modern clinical studies with this
herb, its use for these indications is based on its high content of soothing mucilage in the
forms of inulin and alantalactone.36 However, the German Commission E monograph for
elecampane does not approve the herb for bronchitis.37
Geranium (Pelargonium sidoides) is an herbal remedy used in Germany, Mexico,
Russia, and other countries for the treatment of
respiratory tract and ear, nose, and throat
infections. In a double-blind study of adults with acute bronchitis, participants given an
extract of geranium had a significantly shorter duration of illness, compared with those given
a placebo.38 No serious side effects were seen. The amount of the geranium extract
used in this study was 30 drops three times per day, taken before or after meals for seven
days.
Ivy leaf is approved in the German
Commission E monograph for use against chronic inflammatory bronchial conditions.39
One double-blind human trial found ivy leaf to be as effective as the drug ambroxol for
chronic bronchitis.40 Ivy leaf is a non-demulcent anti-inflammatory.
Chinese scullcap might be useful for
bronchitis as an anti-inflammatory. However, the research on this herb is generally of low
quality.41
Antimicrobial and immune stimulating herbs may also potentially benefit people with
bronchitis. Echinacea is widely used by
herbalists for people with acute respiratory infections. This herb stimulates the immune system in several different ways, including
enhancing macrophage function and increasing T-cell response.42 Therefore,
echinacea may be useful for preventing a cold,
flu, or viral bronchitis from progressing to a
secondary bacterial infection.
Thyme contains an essential oil (thymol)
and certain flavonoids. This plant has
antispasmodic, expectorant, and antibacterial actions, and it is considered helpful in cases
of bronchitis.43 One preliminary trial found that a mixture containing volatile
oils of thyme, mint, clove, cinnamon, and lavender diluted in alcohol, in the amount of 20
drops three times daily, reduced the number of recurrent infections in people with chronic
bronchitis.44
Horseradish contains substances similar to
mustard, such as glucosinolates and allyl isothiocynate.45 In addition to providing
possible antibacterial actions, these substances may also have expectorant properties that are
supportive for persons with bronchitis.
Eucalyptus leaf tea is used to treat
bronchitis and inflammation of the throat,46 and is considered antimicrobial. In
traditional herbal medicine, eucalyptus tea or volatile oil is often used internally as well
as externally over the chest; both uses are approved for people with bronchitis by the German
Commission E.47
Lobelia contains many active alkaloids, of
which lobeline is considered the most active. Very small amounts of this herb are considered
helpful as an antispasmodic and antitussive agent (a substance that helps suppress or ease
coughs). Anti-inflammatory properties of the herb have been demonstrated, which may be useful,
since bronchitis is associated with inflammation in the bronchi.48 Lobelia should
be used cautiously, as it may cause nausea and vomiting.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
References
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