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COPD and micronutrients

What exactly is COPD?

COPD stands for “Chronic Obstructive Lung Disease” and is a chronic obstructive lung disease, of which around 384 million people worldwide currently suffer, in Germany approx. 10.6 million people are affected.

It is a slowly developing chronic lung disease with persistent cough, mucus, sputum, shortness of breath (v.a under strain) and tightness in the chest. The airways are permanently narrow and inflamed.

The starting point is usually chronic obstructive bronchitis.

As a result of COPD, infections and the development of pulmonary emphysema (“bloated lung”) with overinflation and destruction of the lung tissue, especially the alveoli and possibly also to cor pulmonale (right heart failure).

In COPD, inflammation, oxidative stress and mucus hypersecretion cause the symptoms.


What are the possible causes of COPD?

  • Predominantly pollutant particles (e.g.b through smoking, fine dust) or gases
  • Genetic alpha-1-antitrypsin deficiency (AAT breaks down tissue destroyed by inflammation)


What is the classic therapy for COPD?

Classical therapy primarily knows...a the following measures:

  • Lifestyle change and quitting smoking
  • Breathing training and physiotherapy
  • Bronchodilators, corticoids, mucolytics, oxygen
  • Operation (e.g.b Removal of destroyed alveoli, lung transplantation)


What can micronutrients do for COPD?

A fifth of patients with chronic obstructive pulmonary disease are malnourished, with severe COPD the figure is almost half . The causes are increased energy consumption due to the disease (more energy is required for breathing due to the narrowing of the airways), insufficient food intake due to a lack of appetite and lower energy production in the mitochondria because there is less oxygen available for “burning” than in healthy people .

It could also be shown (cf. ESPEN 2006) that muscle loss occurs in COPD patients in the early stages. This can include lack of exercise due to breathing problems, lack of nutrients (seeO) and/or in chronic inflammatory processes caused by COPD. Therefore, Magnesium, which is directly involved in muscle function, is a standard component in the context of micronutrient therapy for COPD. In addition, protein intake should be slightly increased: to build muscle 2.5 g of protein per kilogram of body weight, to maintain 1.9 g/kg (cf. Bargon J, Müller U; Nutrition for COPD; Nutrition Survey 2012; 2:96).


Finally, around 1/3 of all COPD patients have osteoporosis (cf. The cause has not yet been conclusively clarified, but it is suspected that there is a connection with the therapy of inhaled cortisone (ICS) (cf. COPD guidelines 2018). A useful supplement for accompanying osteoporosis is Calcium and Vitamin D3 & K2 , which is central to the regulation of calcium balance.

Since COPD causes chronic inflammation in the airways and lung tissue, two components play a central role in micronutrient therapy:

  • Omega 3 fatty acids with a high EPA content (therefore no algae oil should be used, as here i.dR there is only a relevant DHA content, but not EPA content) (cf. Wey S; Orthomolecular therapy for obstructive airway diseases; EHK 2018; 67(05): 291-300)
  • Antioxidants (e.g. an antioxidant complex such as ANTI-OX) as a radical catcher, because chronic inflammation leads to free radicals, which in turn lead to chain reactions and damage to tissue


In addition to the studies on Omega 3 and antioxidants already cited in the Academy article on chronic inflammation (, there are also studies that have a clear focus on diseases of the respiratory tract, such as::

  • "Omega 3 fatty acids increase pneumonia resistance (due to Klebsiella) in mice through anti-inflammatory effects and upregulation of the non-specific and specific immune system" (cf. Sharma S et l.; Dietary Supplementation With omega-3 Polyunsaturated Fatty Acids Ameliorates Acute Pneumonia Induced by Klebsiella Pneumoniae in BALB/c Mice. Can J Microbiol 2013, 59 (7), 503-10)
  • “Omega 3 fatty acids improve survival, bacterial invasion and inflammation in the lungs in mice. The data can be transferred to humans and improve patient outcomes and pneumonia risk” (cf. Hinojosa CA et al.; Omega-3 Fatty Acids in Contrast to omega-6 Protect Against Pneumococcal Pneumonia. Microb Pathog 2020, 141, 103979)


The amino acid L-cysteine also plays an important role in the micronutrient supply in COPD, for example. will be included as a central component in the new edition of CLEAN . Here too there is a good body of research, such as::

  • “Cysteine ​​1500 mg significantly reduces the exacerbation rate by 25% in COPD compared to placebo, but only after at least 3 months of therapy. In addition, quality of life and activity improved significantly” (cf. Zheng JP et al.; Effect of carbocisteine ​​on acute exacerbation of chronic obstructive pulmonary disease (PEACE Study): a randomized placebo-controlled study; Lancet 2008; 371, 2013-2018)


Also flavonoids such as Quercetin is known to have an immune-modulating effect. And there are already meaningful studies regarding respiratory diseases, such as:: Flavonoids (0.2-1.2 g/dg) reduce the incidence of upper respiratory tract infections by 33%. The number of sick days fell by 40% (cf. Sommerville VS et al.; Effect of flavonoids on upper respiratory tract infections and immune function; Adv Nutr 2016).



The two medicinal mushrooms Hericium & Reishi also represent an exciting combination. We have written our own Academy article about their importance for the microbiome in the intestine: . And like the lungs, the intestines also have a barrier function and microbiota, although less than the intestines:


The more than 100 known microbiota species (bacteria, viruses, bacteriophages, fungi) “sit” on the epithelium of the lungs. They come mainly from the throat (the main germs there are Neisseria, Prevotella and Veillonella) and more rarely from the nose or intestines (e.g.b through microaspiration).


The composition differs from the microbiota in the throat/nose and intestine (e.g.b are not digestive bacteria, but contain germs from the upper respiratory tract). But as in the intestine, the same applies to the lungs: The higher the germ diversity and the better the balance of germs, the better the protection and lung function.

Dysbiosis can occur with a decrease in the diversity of bacteria (e.g.b with COPD only 28% of a healthy person!) and an increase in potentially pathogenic germs (e.g.b Pseudomonas), e.g.b as a result of

  • cystic fibrosis, COPD, asthma, allergies, infections
  • Use of medication (e.g.b Antibiotics, corticoids)
  • Exposure to pollutants (e.g.b Smoking, fine dust)

Dysbiosis affects barrier function and immunity. They trigger inflammation, increase the risk of disease, and worsen the disease stage and lung function. See also Engel M et al.; Influence of lung CT changes in chronic obstructive pulmonary disease (COPD) on the human lung microbiome; Plos One 2017; doi: 10.1371/journal.pone0180859): In chronic obstructive pulmonary disease (COPD), structural changes in the lungs and dysbiosis can occur over time, which promotes the colonization of potentially pathogenic bacteria.


And a healthy microbiome in the intestine is also of great importance for the microbiome in the lungs, because the lungs and intestines are connected via the so-called “Intestine-lung axis” linked. The lungs are formed in 4. week of embryonic development as the folding of the foregut and, as with the intestinal microbiome, the development of the lung microbiome also takes place in early life (“neonatal window of opportunity”). Similar measures as with the intestinal microbiome are effective here, i.e.H va Breastfeeding and healthy eating.

The intestinal flora and oral probiotics influence the microbiota of the lungs, e.g.b via “cross talk” (information exchange) and protect e.g.b from allergies:

  • Direct effects e.g.b by microaspiration in lungs
  • Indirect effects etc.a via short-chain fatty acids (SCFA), which improve the reactivity of the lung immune system


Therefore, measures in the intestine (such as through medicinal mushrooms) also relevant for the lungs.

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