Dietary supplements can play an important role for some high-risk groups, particularly those that are not able to eat a healthy balanced diet or those that have increased need for certain nutrients due to their disease condition. Supplements can help support normal functioning of the body, boost immunity, help fight inflammation and promote tissue repair. 

  1. Vitamins:

Vitamins are among some of the most beneficial supplements available for pulmonary fibrosis patients. Below are examples of some vitamins, including A, C, D, and E, as well as their benefits, research surrounding them, and food sources.

(i) Vitamin A is critical when it comes to maintaining the functioning of your immune system, and may be helpful for individuals who have pulmonary fibrosis. Further, Vitamin A allows for your cells to grow and mature, meaning that getting enough of this vitamin through food or supplements can help the body initiate its natural repair process, specifically in the lungs. However, it is important to not overdose on the vitamin, as this could pose a stress on the body.

Food Sources of Vitamin A: dairy products, liver, fish, and fortified cereals, carrots, broccoli, cantaloupe, and squash

(ii) Vitamin C plays a significant role in many of the body’s processes; most importantly, it acts as an antioxidant, which is a function that is especially beneficial for the lungs. Oftentimes, those who have pulmonary fibrosis and/or other chronic lung conditions, have extended lung damage caused by free radicals and toxins. How can Vitamin C help? It actually has properties that allow for the body to fight against these free radicals and toxins, thus allowing the body to flush them out. In one study, men and women with diets high in vitamin C were found to have greater lung capacity. Vitamin C supplementation may be especially important for smokers, as smoking has been found to reduce Vitamin C content in your body.

Food Sources of Vitamin C: plums, cherries, citrus fruits including oranges, guava, thyme, parsley, kale, and spinach

(iii) Vitamin D. Epidemiologic studies have suggested a link between Vitamin D deficiency and risk for developing chronic lung diseases. A Vitamin D deficiency has also been linked with more severe symptoms as well as higher mortality rates in people with idiopathic pulmonary fibrosis. Further, animal studies have also shown that Vitamin D has the potential to partially prevent the onset of lung fibrosis to begin with. The research, “Vitamin D prevents experimental lung fibrosis and predicts survival in patients with idiopathic pulmonary fibrosis,” was published in the Pulmonary Pharmacology & Therapeutics Journal. Some other benefits associated with Vitamin D include the regulation of calcium and phosphate in the body, being protective over cells and having both anti-inflammatory and anti-bacterial properties.. Given that research has shown pulmonary fibrosis patients are potentially at a higher risk for being Vitamin D deficient, it may be  beneficial to add a Vitamin D supplement to their treatment regimen. Researchers continue to explore the therapeutic potential of adding Vitamin D to PF patients’ care plans.

Food Sources of Vitamin D: fatty fish, egg yolks, cheese, and soy milk

(iv) Vitamin E is another powerful antioxidant that protects against free radicals and toxins in the body, including in the lungs, thus reducing inflammation. It also boosts the immune system, thus helping fight off infections and keeping the body healthy. One study showed that people with diets high in Vitamin E had less phlegm. 

Food Sources of Vitamin E: green leafy vegetables, avocado, vegetable oil, sunflower seeds, and nuts (i.e. almonds and peanuts)

It is important to stay within the range recommended for each supplement to reap the benefits and avoid harmful effects. Taking excess doses of some vitamins beyond what is recommended can also overload your kidneys that have to work extra hard to eliminate what is not needed. 

  1. Probiotics and Prebiotics: 

Microbiota is a community of microorganisms including bacteria, fungi and viruses that live in certain parts of our body and affect normal inflammatory and immune responses – they are essentially different groups of microorganisms all throughout our bodies that serve different functions in order to keep us healthy. Each individual has a unique microbiota that plays a role in nutrient metabolism, maintenance of cell and tissue structure and protection against disease causing microorganisms. Probiotics and prebiotics both have a large impact on our microbiota. While they may sound similar, these supplements play different roles in the digestive system.

(i) Probiotics are essentially microorganisms that provide health benefits for our bodies and are commonly found in foods that are fermented; supplements are also available for those who prefer them. Look for probiotics containing Bacillus subtilis, Bacillus coagulans and Bacillus clausii strains as these have been shown to have a positive effect on the gut microbiota and contribute to various health benefits. Dynamic Enzymes’ Biome Ultra probiotics supplement has been shown to be extremely stable. This is important as probiotics can “die” easily, in which case they cannot provide any benefits. 

Foods that are a great source of probiotics: yogurt, kefir, kimchi, miso, kombucha, pickles, and some cheeses including gouda, mozzarella, cheddar and cottage cheese.

(ii) Prebiotics are the non-digestible part of foods that pass undigested through the upper part of the digestive tract. They act like fertilizers that stimulate the growth of beneficial or “good” microorganisms that exist in the lower digestive tract. Prebiotics help enhance the gut microbiota and contribute to improved immunity and health. Prebiotics are found in many high-fiber foods such as fruits and vegetables. 

Prebiotic foods that are a great source of dietary fiber: whole grains, beans, celery, apples, bananas, onions, artichoke and garlic, to name a few.

As pulmonary fibrosis research continues to grow, researchers have been learning about microbiota in the lung and how it connects to the microbiota in the gut, a term that experts refer to as “cross-talk.” Because of this, researchers believe that what we eat and drink could influence our lungs; this is why preliminary research has been focused on how probiotics and prebiotics could be used to potentially treat lung disease. Newly established research has indicated that incorporating pro- and prebiotics show promise in helping improve lung diseases and infections. A study conducted in Italy in 2014 and published in the Journal of Pediatric Gastroenterology and Nutrition actually found that children and adults with mild to moderate fibrosis who were given drops of a lactobacillus probiotic for six months ended up experiencing fewer disease flare-ups and upper respiratory tract infections when compared with those who did not. 

However, it is important to note that there is still a lot of research to be done on the impacts and benefits of incorporating pre- and probiotics as a method for improving symptoms associated with pulmonary fibrosis or even potentially serving as a future cure.

  1. Herbs:

Products made from plants that are used to treat diseases or maintain health are called herbal supplements. Traditionally, herbal medicines have been used for the prevention and treatment of various diseases. They are available as pills, capsules, powers, teas, ointments and oils.   

(i) Turmeric is an ancient herb that has been used for centuries in various parts of the world for both edible and medicinal purposes. Curcumin, which is an antioxidant found in turmeric, has been shown to effectively help reduce lung inflammation. It acts by reducing chemicals in the body involved in inflammation, and was shown to prevent fibrosis in animal experiments. Turmeric can be easily incorporated into a daily diet by adding to curries, soups, smoothies etc. or even taken orally as a supplement.

(ii) Studies have shown that licorice extract is also anti-inflammatory and has the ability to decrease the expression of certain genes that are associated with fibrosis that negatively impact the health of lung tissue. It also relieves symptoms of acid reflux which is an added benefit, since a large percentage of people with pulmonary fibrosis also suffer from gastric esophageal reflux disease (GERD).

(iii) Ginseng is another herb that demonstrates the ability to help relieve the fatigue associated with pulmonary fibrosis and other chronic lung conditions. Ginseng has also been recognized for its benefits in improving the immune system, providing an energy boost, reducing stress, and promoting relaxation.

(iv) Oregano is an antiseptic herb that has antibacterial, antiviral, and antifungal properties. It can be used as a cure for common infections, but is also especially helpful in healing the lungs due to its ability to fight inflammation and clear the bronchial passages and airways. It also has some compounds that act as a natural decongestant and histamine reducer. Oregano is a common herb used in many cuisines.

(v) Chinese herbs have been used for many years to treat a variety of ailments, including those affecting the lungs. Some of the most commonly used herbs include astragalus, which helps to boost the immune system, Nan Sha Shen (also known as the American silvertop root) which acts as an antibiotic, anti-inflammatory, and helps clear phlegm in the lungs, and Poria, which has diuretic effects, may reduce production of phlegm, and may help individuals who are struggling with rest due to their symptoms to be able to sleep better. 

People have reported remarkable benefits in terms of their symptoms and lung health after taking herbal supplements. However, herbal supplements can have strong effects and can interact with conventional medicines. They are also not standardized or closely regulated by the FDA or other governing agencies. You must consult with your doctor before adding herbal supplements to your regimen.

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