image094Ask Mark …

Corrine has Interstitial Lung Disease and asks if taking predni­ sone would be of help to her.

Mark says, Interstitial Lung Disease is thankfully a slow­ progressing disease. The problem is that it affects oxygenation pretty significantly and does not have much in the way of curative medications available to treat it. Corticosteroids are one of the more effective tools to reduce inflammation and symp­ toms but have their side effects. If you are being treated with steroids (prednisone) and you find it helps, stick with it.

Be sure to use your pulse oximeter to check your saturation often and use your oxygen accordingly. You should try to keep it at or above 92% if you can.

Some have recommended N­acetyl cysteine, NAC, which comes from the amino acid L­cysteine. Amino acids are the building blocks of proteins. The recommended strength is 1200–1800 mg/day. Capsules come as food supplements in 600 mg caps. I like the NOW brand and use it myself. Keep it stored in a dark cool place such as in the refrigerator.

image095-2Some non ­medical­ profession websites also recommend taking 1000 mg of Vitamin C for every 600 mg of NAC. This is sup­ posed to counteract the tendency of metabolites of NAC from fostering formation of kidney stones but there is no data on its use in conjunction with NAC.

Jeanne from Canada heard Vita­ min A is good for your lungs. If so, how much should she take per day?

Mark explains, Vitamin A con­ tains over 300 “retinoids,” some of which are believed to benefit lung tissue growth and stimulation of growth. Several studies have been conducted with great results in mice that haven’t translated to humans. The results of several efforts have been disappointing. There are some who believe, if they can just find those retinoids that do have positive action on humans, they can bring about a potential therapy. It is expensive and tedious research that, of late, has not received as much funding and enthusiasm as it did about 10 years ago. In actuality, stem cell prospects seem a better bet and are being more actively pursued.

image097-2I cannot recommend taking large doses of Vitamin A. There is no evidence that doing so will have any effect upon lung function, let alone a positive effect. Vitamin A is one of the four fat­soluble vitamins (A, D, E and K) stored in the body’s fat. As such, they can build up to toxic levels and cause dysfunction of systems and organs. Taking doses higher than the recommended dose without specific attention and follow up from one’s doctor is dangerous. Talk to your doctor and ask about how much Vitamin A you should be taking each day.

Dick from Kansas was skeptical when a friend suggested if he would learn the “Buteyko” way of breathing, he could get off oxygen and be cured of COPD.

Mark tells us, Buteyko Breathing is a method of reduced­breathing exercises that focuses on nasal­ breathing, breath­holding and relaxation. It was named for a Ukrainian doctor, Konstantin Pavlovich Buteyko, who first formulated its principles during the 1950s.

While there may be some benefit to Buteyko for those with pure asthma, it can do harm to those with COPD! Anyone who claims it will cure COPD and get you off oxygen simply is uneducated about COPD. They do not understand pulmonary physiology and gas exchange, especially its disturbance in COPD. Your instincts served you correctly. Stay away from Buteyko!

I wish everyone a very

Happy Holiday Season!

Mark Mangus RRT, BSRC, is a member of the Medical Board of EFFORTS (the online support group, Emphysema Foundation For Our Right To Survive, www.emphysema. net). He generously donates his time to answer members’ questions.