Most people have had a brush with bronchitis–an inflammation of the bronchi or the breathing tubes–at some time in their lives. And 7 million people, virtually all of them smokers, experience the symptoms of bronchitis every single day for years. Bronchitis comes in two versions. Acute bronchitis occurs when an infection, usually a virus or bacteria, inflames the bronchial tubes. It produces a raw, hacking, painful cough that can sometimes be relieved with self-care measures but often requires antibiotics.
The other bronchitis is called chronic, meaning it’s a long-term affair. The daily phlegm coughed up is not in response to an infection but to irritation, usually from smoke. Not only does chronic bronchitis make you more susceptible to severe cases of colds and flu, but also your lungs can eventually develop an irreversible condition called emphysema. That’s real trouble.
Our recommendations at WholeHealth Chicago can offer help for both forms of bronchitis. But right up front you need to know that chronic bronchitis will never go away unless you stop smoking–now, for good.
What is Bronchitis?
Bronchitis is a usually temporary inflammation of the windpipe (trachea) and the bronchial tubes, the large air passages leading from the windpipe into the lungs. When an infection or an irritant inflames these airways, they thicken and swell, immobilizing the tiny hairs called cilia that line the respiratory tract and sweep foreign matter out of it. The resulting build-up of germs and dust in the airways leads to excess mucus production and the heavy cough that is the main symptom of bronchitis develops as the body’s way of coping with this mucus. Bronchitis occurs in two forms: acute and chronic. The far more common acute bronchitis usually develops after a severe viral cold or the flu, although it can also be caused by a bacterial infection or environmental pollutants. Its symptoms are a low fever that lasts for a few days and a cough that usually goes away within a few weeks. Although acute bronchitis is not a major health problem in most cases, it can lead to serious complications in the very young, the elderly, smokers, and people who have congestive heart failure or chronic lung diseases, such as asthma or emphysema.
The main symptoms of chronic bronchitis are similar to those of acute bronchitis, except that they last longer and can recur. Bronchitis is considered chronic when a patient has a mucus-producing cough on most days during a three-month period, for two years in a row. Primarily a disease of smokers, chronic bronchitis can lead to (and often occurs with) emphysema, a potentially life-threatening disease that causes progressive and permanent damage to the lungs. While over-the-counter medications, supplements and home-care remedies can ease bronchitis symptoms, the main treatment for chronic bronchitis is quitting smoking.
Heavy coughing that produces white, yellowish, or green phlegm
Low-grade fever (100°F or less)
Wheezing and shortness of breath; harsh breath sounds (rhonchi) that change or go away when coughing
Chest muscle pain caused by coughing Chronic bronchitis:
Persistent phlegm-producing cough (phlegm can be yellow, white, green or gray) that lasts for at least three months in each of two consecutive years
Wheezing and shortness of breath
Coughing triggered by even mild exertion
What Causes Bronchitis?
Acute bronchitis is most often the result of a cold or flu virus. Bacterial infections and respiratory irritants such as chemical fumes, dust, smoke, and other air pollutants may also cause or aggravate an attack of acute bronchitis. Other factors that may increase susceptibility to acute bronchitis are cigarette smoking, asthma, poor nutrition, cold weather, chronic lung diseases, and congestive heart failure.
Chronic bronchitis is the result of persistent irritation of the bronchial tubes, caused in most cases by cigarette smoking. Chronic allergies or long-term exposure to secondhand smoke or chemical fumes may also increase the risk of developing chronic bronchitis.
Treatment and Prevention
Although acute bronchitis usually clears up on its own, aspirin or ibuprofen can help reduce fever and pain during an attack. (Antibiotics may be prescribed for the approximately 10% of cases caused by a bacterial infection.)
Other measures that can help relieve respiratory symptoms include not smoking, drinking plenty of fluids, and humidifying the air. Also beneficial are supplements, such as the herbs horehound and slippery elm, which help loosen and bring up phlegm. Antioxidant and infection-fighting supplements, such as vitamin C and echinacea, strengthen the immune system and may help prevent the colds and flu that often lead to acute bronchitis.
Chronic bronchitis is treated in much the same way as acute bronchitis, except that supplements for chronic bronchitis need to be taken long-term, while those for acute bronchitis should be taken only as long as the illness lasts.
The main preventive measures for both acute and chronic bronchitis are quitting smoking and avoiding respiratory irritants. And just remember that if you have a serious medical condition or are taking medication, it’s always a wise idea to check with your doctor before beginning a supplement program.
How Supplements Can Help
To strengthen the immune system and fight off respiratory viruses, take the following vitamins daily: vitamin C combined with flavonoids (antioxidants that also combat viral infections and inflammation) and vitamin A. The two vitamins also help heal damaged lung tissue in patients with chronic bronchitis. (Women who are pregnant or considering pregnancy should not exceed 5,000 IU of vitamin A a day.)
Magnesium glycinate helps to decrease the bronchospasm in chronic bronchitis as well as in asthma and emphysema.
Drink horehound or slippery elm tea to help thin and bring up mucus secretions during an attack of acute bronchitis. The amino acid-like substance NAC (N-acetylcysteine) also thins mucus and can be taken long-term by chronic bronchitis patients, in whom it may reduce the rate of recurrence. If you are taking NAC long-term, however, take 30 mg zinc and 2 mg copper daily as well.
The herbs echinacea and astragalus are immune-system boosters with antibacterial and antiviral effects. Take them at higher doses to treat an episode of acute bronchitis. For chronic bronchitis, alternate the following herbs for as long as needed, taking each herb for a week at a time before switching to the next one: echinacea (200 mg twice daily), astragalus (200 mg twice daily), pau d’arco (250 mg twice daily), and reishi (1,500 mg daily) or maitake mushrooms (600 mg daily).
Quit smoking, and try to avoid secondhand smoke.
Drink at least eight glasses of water or other nonalcoholic beverages, such as herbal teas and diluted fruit juices, every day. Drinking plenty of fluids helps to thin mucus, making it easier to cough up. Avoid dairy products and sugar because these weaken the immune system and promote mucus formation.
If you have a persistent dry cough that is interfering with your sleep and daily activities, take an over-the-counter cough suppressant containing dextromethorphan.
If you have a mucus-producing cough, do not take a suppressant. Impeding a productive cough may cause a mucus buildup that can lead to serious complications, such as pneumonia. The herb anise (as a tea or tincture) can help break up the thick mucus, allowing the clearance of the secretions.
Stay away from antihistamines or decongestants. These can make your condition worse by drying up and thickening mucus, which makes it more difficult to cough up. Historically, pepper, cinnamon, and garlic have been used as natural mucolytics (breaking up mucus).
Breathing humidified air helps keep the bronchial tubes moist. Take hot, steamy showers and use a humidifier or a vaporizer. (If you use a humidifier, however, make sure to keep it meticulously clean because home humidifiers can breed fungi. Change the water daily and replace filters as often as directed.)
Stay away from paints, dust, smoke, or chemical fumes–all are possible respiratory tract irritants. Don’t use aerosol products, such as hair sprays, deodorants, and insecticides, which can also irritate air passages.
Adjust your activity level to the air quality. If you are prone to attacks of acute bronchitis, don’t exercise or do strenuous work outdoors when air quality is poor. If you have chronic bronchitis, try not to go out at all when air quality is poor or the temperature outside is below freezing.
People with bronchitis often have trouble breathing while eating. Therefore, avoid difficult-to-chew foods, like meats and raw vegetables.
When to Call a Doctor
If the symptoms of bronchitis do not ease within 48 hours
If coughing keeps you awake or interferes with your daily routine
If the mucus you cough up becomes darker, thicker, or much more abundant
If you run a fever above 100°F
If you have a lung disease or congestive heart failure and develop acute bronchitis
If you cough up blood or your breathing becomes increasingly labored
From David Edelberg, M.D.at WholeHealth Chicago: Supplements can both strengthen your body’s immune system and help loosen and bring up mucus, a problem present in both acute and chronic bronchitis. At WholeHealth Chicago, the supplements we suggest for acute bronchitis should be taken until you recover. With chronic bronchitis (with or without emphysema), the supplements need to be used on a regular basis, with the immune-stimulating herbs taken on the rotational schedule described below.
How to Take the Supplements
For acute bronchitis
Start with the higher dose of vitamin A for the first five days, then taper to the maintenance dose. At the same time, take the antioxidants, vitamin C and flavonoids, which help combat viral infections and inflammation, as well as the immune-stimulating herbs, such as echinacea and astragalus and the herbal antibiotic pau d’arco.
To thin thickened mucus, open bronchial tubes, and control cough, alternate drinking horehound or slippery elm tea. If you can’t find the herbal tea commercially, simply add 1/2 to 1 tsp. of the liquid extract form of either herb to a cup of hot water and sweeten to taste. In the hospital, inhalations of the amino acid-like substance N-acetylcysteine (NAC) are routinely used by respiratory therapists to thin mucus. Although research is lacking in the area, nutritionally oriented physicians believe the oral version of NAC may also be beneficial and is worth a try.
For chronic bronchitis
With this recurrent condition, your main goals are to prevent flare-ups and to keep your lungs functioning as efficiently as possible under the circumstances. Obviously, smoking is out of the question, and passive smoke should be avoided as well. And getting vaccinated against both pneumonia and different influenza strains is an essential preventive measure.
In addition to a daily high-potency multivitamin and an antioxidant, for chronic bronchitis you need to take extra amounts of both vitamin A and vitamin C with flavonoids. All are natural immune stimulants, with antiviral and antibacterial properties; they are also involved with healing chronically inflamed lung tissue.
Along with plenty of fluids and steam inhalation, regular use of N-acetylcysteine (NAC) may be useful to thin chronic mucus. This amino acid-like compound has a second use as well: It’s one of the most powerful antioxidants, capable of raising levels of glutathione, an antioxidant already within each cell.
To this group, add the immune-stimulating herbs on a rotational basis, including echinacea, astragalus, pau d’arco, and medicinal mushrooms (reishi and maitake). Use one herb per week and then switch to the next; when you have covered all four herbs, start the cycle again.
Both acute and chronic bronchitis are characterized by spasms of the bronchial tubes. Either during an acute infection or on a maintenance basis, taking magnesium can be very useful for controlling bronchial spasms.
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700, ext. 2001.
David Edelberg, MD