The bad and the ugly of chronic inflammation in COPD
Those of us with COPD must learn to listen to what our body is telling us
Inflammation is having a moment. It’s the buzzword behind turmeric lattes, elimination diets, and supplement stacks. But for those of us living with chronic obstructive pulmonary disease (COPD), inflammation isn’t a trend. It’s the smoldering undercurrent in our lungs; the flare that shapes our breath, our energy, and our days.
In COPD, what started as an immune response to infections or tobacco, poor air quality, or other irritants becomes a chronic inflammatory response. Neutrophils, macrophages, and cytokines flood the airways, aiming to clear out irritants and repair damage. It’s like firefighters responding to a call. But in COPD, the fire isn’t entirely extinguished and continues to smolder long after the fire department has left.
The bad
Over time, this inflammation becomes chronic in COPD. The inflammation lingers even after the irritant (such as tobacco smoke) is removed. This leads to the narrowing of airways, overproduction of mucus, and destruction of alveoli, the tiny air sacs where oxygen exchange happens. The tissue of the lungs also becomes less elastic and less forgiving of triggers.
For those of us with COPD, this means fatigue, breathlessness, and frequent exacerbations of symptoms. It means that we must plan our day according to how much tightness we feel in our chests, how much energy we have, and how short of breath we are. We learn to read our bodies like a weather map.
Speaking of the weather, it can negatively affect our breathing. Very cold air constricts the bronchial tubes and makes breathing more difficult. Add wind to the equation, and we get that feeling of having our breath taken away. Hot, humid air feels like it’s too heavy to breathe.
The ugly
Contrary to what your news feed says or what you see on TV and social media, the wholesale shutdown of the inflammatory process is not the answer. The reason is that inflammation is part of the body’s immune response. Totally shutting down inflammation derails the train cars of immunity and leaves us susceptible to all kinds of viruses and bacteria.
Anti-inflammatory treatments like corticosteroids, phosphodiesterase-4 inhibitors, and biologics can reduce airway inflammation, but they come with trade-offs and need to be closely monitored by your healthcare team. Also, not everyone responds well to treatment. Corticosteroids, especially systemic ones, broadly suppress the immune system. While inhaled corticosteroids are considered to be safer, they can alter local immunity in the lungs.
Those of us with COPD must learn to listen to what our body is telling us and not simply chase the latest healthcare fad.
Note: COPD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of COPD News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to chronic obstructive pulmonary disease.
About the Author
Richard Jerome DesJardins
My inflammation results in excess phlegm AFTER I eat, not from what I breathe. (Eat anything, not just diary products, etd.) What helps --- Fisetin (Novusetin) immediately AFTER eating, 100mg. I get NO side effects. Roflumilast also helps, but it has a lot of undesirable side effects---- I sue only 250mcg every other day to keep the side effects to a minimum. Nothing is perfect, but it usually keeps me from excerbating coughing after every meal. I still can get some action from what I breathe, like sudden change in temperature of what I breathe, but it is not the major cause of excessive phlegm. Your case may be different, and since this is not FDA approved your doctor may not even want to talk about it. Swanson has the cheapest fisetin these days.
Karen Shandor
Great article. My stomach can't handle po steroids and I constantly have to guard against oral esophageal yeast infections with Trelegy. I rinse and gargle well after use but still end up with a raw esophagus and throat.Im thinking of going back to Anoro to make life easier. Everyone reacts differently to drugs. Having an immune deficiency also, I receive steroids IV every month before my infusion. Im desperately trying to quit smoking. Sometimes I'm not sure it's worth living like this. Then I realize God has some work for me to do and I trudge ahead. Just for today I can enjoy the sunshine fall flowers and my bluebirds. Enjoy today!
David A Sylvester
Great advice Caroline-as usual- Thanks
Jim V
Very informative post. Thank you!
Thomas Krueger
Caroline.
I love your stories. I can relate to then. Thank you.
Love Tom Krueger.
Marieta Diane Golding
THE WEATHER! Am a slave to it......26C with the sun shining & my breathing is easier in fact i worship the sun as it feels so liberating & beneficial. Rain almost paralyses me & any humidity over 45 degrees is uncomfortable & has me checking IPhone weather report hourly to plan my day.
Having great success with prescription THC-CBD gummies to lift mood & assist with inflammation, works a treat.
Corticosteroids have had horrid affect on bone density & now about to have shots twice a year to combat it not to mention the skin damage it causes tissue paper thinning.
Sadly side effects are not mentioned when prescribing. Salbutamol causes night cramps but my complaints to Chemist is met with 'well i guess the doctors want you to keep breathing'.
Omega 3 capsules are recommended to counteract inflammation advised by Lung Specialist. All in all after 14 years of being diagnosed my COPD is well managed. Constant positive self talk really helps. Strength & courage to all.
Susan Rebagliati
I am 65 years old . And have just experienced a COPD Flare up 2 times within 2 months . I had to read to understand what was happening to me ..It started the heck out of me both times .
Last night was my second time and I am still trying to get my breath ,be calm ,drink water, use my puffer and try to rest .
I have to throw out my ultra light cigarettes which will be hard but a serious necessity...
I just put a humidifier in my room before I had a flare up so I guess my body & mind knew it would be helpful.
I am rather tired so I will try and rest ..
I read a few of your stories concerning COPD which was very mind opening for me so thank you very much..
Susan