Integrative Treatment Options for The Most Common Pulmonary Disorders: Specialty Testing, Nutrition, Supplements

The lungs are unique organs in the body; because of their structure, they are the only organs that can float! They are also of utmost importance in the body in that they are the primary organ of respiration. This article will discuss what the lungs are, including their role in the body and the top medical conditions associated with the lungs. We’ll then discuss how these conditions are diagnosed and functional medicine labs that can aid in the investigation of the root cause of these conditions. Lastly, conventional therapies, as well as integrative and complementary therapies, will be discussed.

What is Pulmonology?

Pulmonology is the study of the respiratory system. The lungs, two large organs in the chest, make up a large portion of the respiratory system which enables us to breathe. There are differences between the two lungs. The right lung comprises three parts: the superior, middle, and inferior lobes. The left lung has two parts: the superior and inferior lobes. In order to accommodate the heart, the left lung is smaller than the right lung.

Another part of the respiratory system is the trachea, a tube that sits behind the throat in the neck. When we breathe air in, it goes down through our trachea, which will divide into two bronchial tubes, one that enters into each lung. The bronchial tubes will then split into smaller tubes called bronchi, which will also divide into clusters of alveoli; these clusters resemble grapes.

What Are The Lungs Role in The Body?

The lungs are responsible for gas exchange in the body. When we breathe air in, it goes down through our trachea, into our bronchial tubes, to the bronchi, and then to the alveoli. In the alveoli, oxygen is extracted from the air into the blood, which will then be transported to the heart and then pumped around the body via arteries to deliver oxygen to the tissues. A byproduct of oxygen use is carbon dioxide, which is toxic to the body. When tissues use oxygen and produce carbon dioxide, it is sent back to the lungs through blood carried in the veins. Your lungs will then send the carbon dioxide out of the body through exhalation. This exchange of gasses occurs frequently, 12 to 20 times per minute.

What are the Top Medical Conditions Associated with the Lungs?

There are many medical conditions associated with the lungs. Let’s look at lung conditions that are commonly treated with integrative medicine.

Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease, commonly referred to as COPD is a group of disorders that are characterized by difficulty inhaling and exhaling. Bronchitis, or inflammation of the lungs, is usually the culprit of problems with inhalation, while emphysema, which is damage to the structure of the lungs, causes the loss of ability to exhale. COPD is usually the combination of these two conditions. Symptoms of bronchitis include shortness of breath, wheezing, chronic cough, mucus production, and tightness in the chest. Emphysema symptoms include shortness of breath, worse with activity, wheezing, cough, rapid breathing, heart problems, sleep issues, weight loss, and depression or anxiety. The primary underlying cause of COPD is tobacco use, although environmental factors such as toxic fumes may also play a role. These offending agents damage the lining and, thus, the structure of the lungs and lung tissue. It is thought that impaired antioxidant defense may make some people more vulnerable to the damage of the offending agents.

Sleep Apnea

Sleep apnea is a condition that causes breathing to stop and then restart when sleeping. Symptoms of sleep apnea can include trouble falling asleep, snoring, frequent waking at night, fatigue and daytime sleepiness, mood changes including depression, anxiety, irritability, memory problems, difficulty concentrating, headaches and dry mouth upon waking, and sexual dysfunction. Causes of sleep apnea can be neurological, with difficulties in the signaling to the lungs from the brain. Additionally, relaxation of specific muscles can cause airway constriction during inhalation, and thus lower than normal amounts of oxygen are taken in. This lower oxygen level can cause alarms to go off in the body and cause the person to wake. Risk factors for sleep apnea include medical conditions such as strokes, heart failure, type 2 diabetes, high blood pressure, chronic lung disease, hypothyroidism, and more. Certain medications may also increase the risk for sleep apnea, including opiates such as codeine and morphine. Lastly, certain cases of sleep apnea are due to anatomical blockages.

Asthma

Asthma is a condition characterized by chronic inflammation in the airways leading to difficulty breathing. People with asthma have a hyper-immune response to certain stimuli. This response causes immune cells to produce inflammatory molecules, and the muscles around the airways tighten, causing inflammation and constriction. Additionally, cells in the airways produce mucus, and it's the presence of mucus, inflammation, and constriction that leads to difficulty breathing. People with asthma can have attacks and exacerbations after coming in contact with an offending agent that causes these types of reactions in the body. Symptoms of asthma include shortness of breath, chest tightness, pain, coughing, and wheezing. While the exact cause of asthma is unclear, certain things do play a role in the development of asthma, including air pollution, allergies, smoking, viral infections, obesity, chemicals, molds, and genetics. Additionally, the gastrointestinal microbiome, a collection of microbes that affect digestion, absorption, immune and inflammatory modulation, hormones, neurotransmitters, and more, may play a role in the development of asthma. The lungs have a microbiome, too, and it’s thought that there is cross-talk between these two microbiomes, and thus, they can both affect each other. A dysbiosis, or imbalance between good and bad microbes, in the gut microbiome has been associated with asthma risk and symptomatology.

How is Lung Disease Diagnosed?

There are many tests, along with physical exams, medical and family history, and symptom discussion, that can be used in the diagnosis of lung diseases.

COPD

In order to be diagnosed with COPD, a chronic cough with mucus must be present for three months out of the year, for two consecutive years. A physical exam that involves listening to the lungs will be performed. Additionally, a spirometry test will be done. Spirometry tests entail breathing air into a tube that is connected to the machine. The machine can tell how the amount and rate of air being breathed out. Other tests can also help diagnose COPD, including chest X-rays and exercise testing.

Sleep Apnea

Sleep apnea is diagnosed through a sleep study called a polysomnography. During the sleep study, obstructive respiratory events will be recorded and counted, and diagnosis will be based on the number and, in some cases, symptoms.

Asthma

Asthma is diagnosed through obtaining medical and family history and symptoms. Spirometry tests are also used to aid in the diagnosis, and in certain cases, chest X-ray and blood testing may be necessary.

Functional Medicine Labs That Can Help Individualize Treatment for Patients with Lung Disease

There are many functional medicine labs that can help to assess the root cause of lung diseases.

Advanced Oxidative Stress Profile for COPD

Since antioxidants have the potential to neutralize damage and offending agents, including toxins, which play a role in the etiology of COPD, assessing antioxidant and oxidant levels may be warranted. The Advanced Oxidative Stress Profile by Precision Point measures both oxidative stress markers as well as certain antioxidant levels, including glutathione, the primary antioxidant in the body.

Cardiometabolic Testing for Sleep Apnea

Cardiometabolic diseases, including high blood pressure and type 2 diabetes, are risk factors for sleep apnea, and thus, cardiometabolic testing is often warranted. The CardioMetabolic-Essential panel offered by Boston Heart Diagnostics assesses markers of cholesterol, blood sugar, inflammation, and more than can indicate abnormal cardiometabolic functioning.

Comprehensive Stool Analysis for Asthma

A comprehensive stool analysis, such as GI Effects by Genova Diagnostics, measures markers of digestion, absorption, inflammation, and more within the digestive tract. Additionally, they often give great insight into how the gut microbiome is functioning, including showing which microbes are present and in what amounts and if a dysbiosis is present. This can be incredibly helpful information for those with asthma since the gut microbiome affects the lung microbiome, which can then affect asthma, and the gut microbiome also independently affects the risk and symptom severity in asthmatics.

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Conventional Treatment for Lung Diseases

Conventional treatment options are often life-saving and necessary. Many types of medications are used to treat lung diseases, including medications that widen the airways, allowing more air to flow in and out, antiinflammatory medications that lower inflammation, antihistamines that block the immune reaction to certain offenders, and more. Additionally, supplemental oxygen is sometimes required. For sleep apnea, a continuous positive airway pressure (CPAP) machine is used at night. This machine keeps the airways open during sleep. In some instances, surgeries may be needed if there is an anatomical blockage causing sleep apnea.

Complementary and Integrative Medicine Treatment for Lung Diseases

Complementary and integrative medicine treatment for lung diseases may include diet, supplements, and herbs. Let’s look at some of the most evidence-based recommendations.

Nutrition for Patients With Lung Disease

It can be overwhelming to figure out which diet is appropriate for each individual person. Let’s look at some of the evidence-based nutritional recommendations for the previously discussed lung diseases.

Nutrition for Chronic Obstructive Pulmonary Disease and Sleep Apnea

There is evidence suggesting the Mediterranean diet may be beneficial for those with COPD. The Mediterranean diet consists of fatty fish, nuts, seeds, legumes, beans, fresh fruit and vegetables, herbs, spices, and minimally processed whole grains. It is void of artificial sugars and processed foods, and there is a significant emphasis placed on eating locally and seasonally.

The Mediterranean diet has also been researched and is recommended for those with cardiovascular conditions, and thus it may be helpful for those with sleep apnea. Additionally, the Mediterranean diet is shown to help with weight loss, which is also recommended for those with sleep apnea as obesity is a known risk factor.

Nutrition for Asthma

High prebiotic fiber diets may be beneficial for those who suffer from asthma. Prebiotic fibers, found in foods such as bananas, beans, seaweed, and garlic, serve as food for microbes in the microbiome of the gut. As these microbes consume the prebiotics, short-chain fatty acids (SCFAs) are produced. SCFAs can modulate the immune system and inflammatory cascades and thus have been shown to reduce the risk of asthma.  

Top Supplements and Herbs for Patients with Lung Disease

Top supplements and herbs for patients with lung disease include:

N-AcetylCysteine for COPD

N-acetyl cysteine, commonly referred to as NAC, is an antioxidant and also a precursor to the most potent antioxidant in the body, glutathione. Because of this, NAC has been shown to decrease inflammation, neutralize toxic chemicals, and also function to thin mucus, all of which are important actions for those with COPD. High amounts of NAC may reduce flares of COPD.

Dose: 600 mg 1-3x/day

Duration: Dependent upon symptoms and lab findings.

NAC may also be helpful for sleep apnea. NAC was shown to decrease apnea severity by reducing snoring and increasing oxygen saturation and thus lessening daytime sleepiness.

CoQ10 for Sleep Apnea

CoQ10 is an antioxidant involved in energy production that is naturally found in tissues of the kidneys, liver, pancreas, and heart. It has been used in cardiac conditions and thus may be helpful in the treatment of sleep apnea, where cardiometabolic issues are the underlying cause. A study done on men with sleep apnea showed that supplementation with CoQ10 and vitamins C and E improved respiratory function.

Dose: 150 mg daily

Duration: 8 weeks

Probiotics for Asthma

Probiotics are supplements that contain strains of microbiomes that may help the composition and functioning of the microbiome. There is also research to support using probiotics to strengthen the gut-lung microbiome connection and thus aid in decreasing inflammation and reactivity to offending agents. Because of the role the microbiome plays in asthma etiology, probiotics may be beneficial for asthmatics.

Dose: Dependent upon the type of probiotic used; comprehensive stool testing can help determine this.

Duration: Dependent upon symptoms and lab findings.  

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Summary

The lungs are critical organs that aid in oxygen retrieval and disbursement while also removing unwanted and harmful gasses from our bodies. Pulmonary disorders, including chronic obstructive pulmonary disease, sleep apnea, and asthma, can significantly affect a person’s quality of life. Functional medicine testing can help assess the root cause of these diseases and aid in the formation of a personalized treatment plan to help alleviate and possibly reverse symptoms.