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Asthma

Asthma diet: Things to eat and what to avoid

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While there are no clear dietary guidelines for people with asthma, research has shown that certain foods help lung function, strengthen the body’s immune system, and reduce asthma symptoms. However, some foods can exacerbate asthma symptoms or increase the risk of it developing.

Asthma is a chronic disease that is common. Just under 25 million people in the United States have asthma, with children making up about a fifth of that figure, according to the Centers for Disease Control and Prevention ( CDC).

An article in Nutrition Reviews notes that in African Americans and individuals of lower socioeconomic status, asthma is more common.

This article looks at what foods people with asthma may wish to avoid, what foods may enhance or even prevent asthma symptoms from developing, and lifestyle factors that may help a person control this chronic condition.

Foods to avoid

A lady buying foods

Key foods and drinks that people with asthma may wish to avoid because they may exacerbate symptoms of asthma have been identified by the American Lung Association (ALA).

They include:

Foods that contain sulfites

Sulfites, such as alcohol, pickled foods, bottled lemon and lime juice, and dried fruits, are a form of preservative frequently found in preserved foods and beverages.

The symptoms of asthma can worsen in people with asthma who have high levels of sulphites in their diet. The ALA warns that sulphite-containing foods, particularly wine, may even cause an asthma attack. A 2018 study confirms that in people with asthma, white wine can contribute to intolerance responses.

Salicylates

Salicylates are compounds found in herbs-flavoured teas, coffees, spicy foods or foods. Though uncommon, these compounds are often susceptible to people with asthma and may be more likely to experience a flare-up of symptoms.

Two research in 2014 and 2016 showed that asthma in certain individuals was aggravated by aspirin, which contains salicylate.

Find out more here about the dangers and benefits of aspirin.

Fast food

A 2013 study investigating fast food intake in children and adolescents found that those who consumed fast food three or more days a week were more likely to develop extreme asthma, as well as other health conditions.

Foods that may help

For people with asthma, the following foods can have some advantages.

Vitamin D foods or supplements

Report suggests that low vitamin D levels are related to an increased risk of childhood and adult asthma attacks. It also suggests that taking a vitamin D supplement every day will dramatically reduce the risk of a serious asthma attack from hospital admission.

Vitamin D can also promote the function of the lungs and decrease upper respiratory infections, such as colds.

In just a few foods, vitamin D exists naturally, so most people in the United States get their nutritious vitamin D from fortified foods, such as breakfast cereals, yogurt, and orange juice.

Good food sources of vitamin D include:

  • fatty fish, such as salmon, tuna, and mackerel
  • mushrooms
  • egg yolks
  • cheese
  • liver

Learn more about the benefits of vitamin D here.

Fresh fruit and vegetables

The risk of developing asthma can be decreased by a healthy , balanced diet rich in fruit and vegetables.

The 2020 article notes that many studies have shown that high fruit and vegetable intake decreases the risk of asthma in adults and children.

A 2017 study of over 80 studies found connections between high fruit and vegetable consumption and decreased symptoms of asthma, such as wheezing.

Vitamins

Rich sources of antioxidants, such as vitamin C , vitamin E, and beta carotene, are fresh vegetables that help the body combat toxins that can damage tissues.

In turn, this can help improve the function of the lungs and control the symptoms of asthma.

Rich sources of vitamin C include:

  • citrus fruits, such as oranges and grapefruit
  • kiwi fruit
  • strawberries
  • cantaloupe
  • red and green peppers
  • broccoli
  • baked potatoes
  • tomatoes

Good sources of vitamin E include:

  • nuts, such as almonds, peanuts, and hazelnuts
  • sunflower seeds
  • broccoli
  • fortified foods such as breakfast cereal, fruit juice, margarine, and spreads

Beta carotene

Orange and red fruit and vegetables contain beta carotene.

Examples include:

  • carrots
  • sweet potatoes
  • squash
  • red and yellow peppers
  • cantaloupe
  • apricots
  • dark leafy greens, such as kale and spinach

Flavonoids and selenium

Antioxidants called flavonoids and selenium, which have anti-inflammatory benefits, are also present in fruit and vegetables.

A wide variety of fruits contain flavonoids, including:

  • apples
  • berries
  • grapes
  • black and green teas

Foods that contain selenium include:

  • seafood
  • meat
  • poultry
  • eggs
  • dairy products
  • bread
  • cereals

Learn more about food and antioxidants here.

Whole grain foods

Whole grain foods can also play a role in decreasing asthma symptoms.

A 2017 study showed that there were less asthma symptoms and greater regulation of their condition in individuals who enjoyed a balanced diet, including whole-grain food.

Whole grain foods include whole oats, wholewheat pasta, buckwheat, and bulgur wheat.

Other triggers to avoid

People with asthma need to recognise causes that can make symptoms worse or cause another asthma attack and prevent them. The ALA provides guidance and specifics on common causes, including:

  • over-the-counter (OTC) medicines, such as aspirin or non-steroidal anti-inflammatory drugs
  • common food allergies, such as peanuts and shellfish
  • smoke, such as cigarette smoke, campfires, or wood-burning fireplaces
  • adverse weather, such as stormy, windy, cold, or humid weather
  • air pollution, smog, vehicle exhaust fumes, or chemical fumes
  • dander and saliva from animals with fur or feathers
  • environmental exposure to dust mites, mold, or spores

Lifestyle tips

The ALA recommend managing asthma proactively. Working with a healthcare provider will help individuals with asthma create an action plan to successfully and at the right time prevent triggers and use their prescription medication.

Keeping an eye on and recording symptoms can assist individuals with asthma to determine what precautions they should take to avoid foods, behaviors, or environments that can induce an asthma attack.

Obesity can exacerbate the symptoms of asthma. Staying active and eating a diet that is low in fat and high in fruit and vegetables will help maintain a healthy body weight for people with asthma.

A 2019 study suggests that asthma symptoms can also be caused by viral infections. It can help to minimize the risk by taking easy measures to prevent infection, such as washing hands and having flu shots.

Summaryposition

Although there is no clear diet to decrease or avoid asthma, there are many foods that can affect the symptoms of asthma positively or negatively.

A diet that is high in fruit and vegetables and low in fast, fatty, or fried foods can help regulate the symptoms of asthma.

It can allow people with asthma to manage their condition more effectively by keeping track of causes and symptoms, and collaborating with a healthcare provider.

Asthma

Is it possible for me to enlist in the military if I have asthma?

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Many people want to join the military, but the military has severe enrollment standards and qualifications. Good general health and adequate physical fitness are two of the most important conditions.

In the United States, most people with asthma are ineligible to join any branch of the military. However, a person may be granted a waiver to enlist based on their medical history, general outlook, and the severity of their condition.

Asthma is a chronic respiratory condition that affects the airways and makes breathing difficult. Symptoms can be triggered by a variety of causes, including changes in the weather and severe physical exertion. About 20 million adults in the United States suffer from the condition.

Enlisting with asthma

usa army
Luke Sharrett/Getty Images

People with asthma who are over the age of 13 are banned from joining the military, according to the Department of Defense’s 2018 Medical Standards for Military Service: Appointment, Enlistment, or Induction. Those who have not had asthma or received treatment for it by this age, however, are eligible to enroll.

People who are currently suffering from asthma symptoms are automatically excluded. An asthma evaluation will search for indications of persistent cough, wheezing, chest tightness, or shortness of breath that has lasted longer than 12 months, according to the Army Medical Department.

People with asthma who are older than 13 years old may still be able to join the military, but a medical waiver will be necessary. A waiver is granted based on the length of time since a person last experienced symptoms or received treatment, the severity of their asthma, and their overall outlook.

Although the rules are the same for all branches of the military, how the medical waiver process is handled varies. The following are the processes to potentially receiving a medical waiver:

  • Send the recruiter a completed medical prescreen form, which will be forwarded to the Military Entrance Processing Station (MEPS).
  • The form is reviewed by a doctor at MEPS. They have the power to disqualify someone on the spot or schedule them for a medical check.
  • A person may only be requested to produce a signed declaration verifying that they have not had asthma or received treatment for it after their 13th birthday during their visit to MEPS. Those who have had asthma since they were 13 years old must submit all of their medical documents, including hospital and outpatient treatment records.
  • A person will be subjected to examinations, including a physical examination and a pulmonary function test (PFT), in addition to presenting their medical records . Following the examination, the doctor will determine if the person is medically qualified or will be temporarily or permanently disqualified.
  • Anyone who has received a permanent disqualification will have their records and medical recommendation sent to the recruiting commander or a representative of the service by MEPS. This person will decide whether or not to obtain a waiver.
  • If the recruiting commander requests a waiver, the waiver request will be reviewed by military medical officials from various levels of the organization. They will vote yes or no until the request reaches a high-ranking doctor, who will make the final decision.

Medical history and current requirements

Previously, anyone with a history of asthma, regardless of age, was automatically barred from joining the military. However, in 2014, the Department of Defense changed its policy to exclude just individuals who had had asthma since they were 13 years old.

People with a childhood history of asthma did not contribute significantly to military attrition or hospitalizations due to asthma, according to a 2008 study.

Branch-specific requirements

Although the requirements for applying for a waiver are the same for all branches, each branch has its own set of guidelines.

Army

Only people who have not had asthma after their 13th birthday are eligible to enroll, as is the case with the general criteria. In addition, if any of the following apply, the army will not deploy present soldiers:

  • repetitive intake of oral corticosteroids
  • a recent visit to the emergency room
  • the inability to wear protective gear

Air Force

The Air Force said in 2017 that individuals with a questionable history of asthma would be considered for a waiver provided they passed the methacholine challenge, a sort of test that determines whether a person’s airway is susceptible to spasms.

Navy

Any history of asthma, even a mild form, can disqualify a candidate for aviation training and duties, according to the Navy’s Aeromedical Reference and Waiver Guide (ARWG). They can, however, get a waiver if they meet all of the following criteria:

  • normal methacholine challenge within 1 year of the waiver application
  • an accomplished ARWG worksheet
  • currently has no symptoms and has had no symptoms and no medication for at least 5 years
  • normal PFT within 1 year of the waiver application

Marines

For health waiver applications, the Marine Corps follows the same guidelines as the Army. Because the branch is known as the most elite arm of the US military, it must always maintain its high standards.

Coast Guard

People who have been approved by MEPS, according to the Coast Guard, do not need to be reviewed again. Recruiters who believe an applicant has been disqualified incorrectly can send any appropriate paperwork to the commander for examination.

Common myths

There are many fallacies about the military, not just in terms of health. Some of these are debunked below.

Those who get asthma while serving in the military will be discharged

The military’s Medical Standards for Retention state that a person will only be discharged if their condition persists despite treatment and prevents them from executing their duties satisfactorily. Some people, however, may receive an alternative assignment that is less likely to cause asthma.

People join the military to supplement their income.

The military “no longer primarily recruits those from the most disadvantaged socioeconomic situations,” according to a 2020 research.

People with less talent join the military.

According to the same 2020 survey, the majority of candidates had ordinary to slightly above-average cognitive abilities. Despite popular belief that increased technology necessitates lower skill levels, studies contend that people with greater skill levels are better equipped to work with complicated and sophisticated technology.

Women find it difficult to enter the military.

Except for the marines, where women make up only 8% of the officers, women make up about one-fifth of all officers in every branch. Furthermore, in most branches, the proportion of women officers was larger than that of enlisted personnel.

People who join the military after high school do not have the opportunity to further their education.

Members of the military are eligible for tuition help under the Military Tuition Assistance Program, which pays up to 100% of tuition and school expenses, according to the Department of Defense’s stated limits.

Other “top-up” programs, such as the Montgomery GI Bill Active Duty and the Post-9/11 GI Bill, reimburse the costs not covered by tuition assistance.

The ASVAB is not necessary.

The Armed Services Vocational Aptitude Battery (ASVAB) establishes a person’s eligibility to join the military in the United States. Furthermore, to qualify for specific military roles, a high score on particular ASVAB areas is required.

Support services

Because asthma is a chronic condition, people who have had it before may experience symptoms again as they get older. Furthermore, people who already have asthma may notice that their symptoms increase over time.

According to a 2018 longitudinal study, combat-experienced individuals had a 24–30 percent higher risk of getting asthma than those who had not been deployed.

According to a 2015 study, it is critical that military members receive the proper diagnosis, treatment, and follow-up. To validate whether the diagnosis is correct, the authors propose performing both PFT and bronchoprovocation testing, such as the methacholine challenge test.

The Military Health System (MHS) guarantees that all active duty and reserve soldiers are healthy and prepared to perform their duties. Medical benefits and treatment are also provided by the MHS to its members and beneficiaries, such as family members and retirees.

Conclusion

People with active asthma are not allowed to join the military. Those who have a history of asthma but haven’t had any symptoms after the age of 13 might request a medical waiver to prove their eligibility.

A medical waiver is granted on a case-by-case basis. It depends on a number of circumstances, including the person’s age when they last experienced symptoms and the severity of the condition.

Furthermore, the United States military has stringent medical requirements for recruitment, with each branch having its own set of requirements. People who want to enroll should read the conditions carefully to verify that they are eligible.

Sources:

  • https://www.health.mil/About-MHS
  • https://www.aafa.org/asthma-facts/
  • https://media.defense.gov/2018/Jul/05/2001939216/-1/-1/0/CIM_6000_1F.PDF
  • https://www.cfr.org/backgrounder/demographics-us-military
  • https://www.qmo.amedd.army.mil/asthma/militaryspecificissues.pdf
  • https://www.medicalnewstoday.com/articles/can-i-enlist-in-the-military-with-asthma
  • https://academic.oup.com/milmed/article/173/4/381/4557665
  • https://www.va.gov/education/about-gi-bill-benefits/montgomery-active-duty/
  • https://www.va.gov/education/about-gi-bill-benefits/post-9-11/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375480/
  • https://academic.oup.com/aje/article/187/10/2136/5035668?login=true
  • https://www.officialasvab.com/

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Allergy

Low histamine diet: What to know

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People who get symptoms like sneezing, itching, or hives in reaction to histamine-containing meals may benefit from a reduced histamine diet. Histamine is a substance found in the human body and some foods.

The low histamine diet can assist a person in determining which foods are responsible for their symptoms. They may notice a difference if they avoid such items. This procedure can be helped by the assistance of a nutritionist.

This page discusses how histamine affects the body, what histamine intolerance is, and which foods people should avoid. It also includes a sample meal plan as well as grocery shopping and preparation advice.

Histamine

 low histamine diet

Histamine is a chemical that controls how the body reacts to external objects and injuries.

Histamine is released when the body reacts to something it considers to be toxic. This causes inflammation and dilation of the blood vessels in the body, resulting in symptoms such as:

Despite the discomfort that these sensations might produce, histamine plays an important and complicated part in the body’s defenses.

Histamine has a ‘paradoxical nature,’ according to a 2018 study, because it can both increase and reduce inflammatory levels.

Experiments in the lab Histamine, according to the scientists, may aid wound healing and limit tumor development. However, these findings have yet to be duplicated in people.

Intolerance to histamine

Foods that contain or release histamine might cause symptoms in certain people. Histamine intolerance is the medical term for this condition.

Histamine intolerance has symptoms that are similar to those of an allergic response and can impact several body systems.

Among the signs and symptoms are:

The enzyme diamine oxidase (DAO) is responsible for the breakdown of histamine in the body.

People with lower DAO levels have greater histamine levels and are thus more likely to develop allergies.

A short research found that DAO activity was reduced in 10 of 14 people who visited an allergy clinic. In addition, 13 people said DAO supplementation helped them with at least one symptom.

DAO activity was shown to be lower in 316 people with probable histamine intolerance than in those who did not have the condition. After 6–12 months on a reduced histamine diet, 20 of the participants’ symptoms improved or eliminated.

Histamine has different effects based on age, sex, and heredity. Histamine intolerance appears to be linked to the gut lining and gut flora.

People with histamine intolerance were compared to those with food intolerances and those with no intolerances at all in a 2018 study. Histamine intolerance was associated with a reduction in bacterial diversity in the gut as well as a compromised gut lining.

Histamine is produced by several bacterial species found naturally in various foods and probiotic supplements, which may exacerbate symptoms of histamine sensitivity.

Is a low-histamine diet beneficial?

The low histamine diet tries to alleviate histamine sensitivity and allergy symptoms. The diet may be beneficial for certain people, however there is insufficient evidence to support this claim.

A short 2018 research found that a low-histamine diet for four weeks helped individuals with hives feel better.

Low histamine diets have also been proved to assist people with atopic dermatitis and suspected histamine sensitivity minimize symptoms.

More high-quality research on histamine intolerance are needed currently in order to better understand the condition and the best therapies.

According to an article published in the Journal of the Academy of Diet and Dietetics, people with histamine intolerance should take a personalized approach to nutrition.

Medication, stress levels, and a person’s overall health all have an impact on what works best for them.

In 2017, research suggested that dieting should be done in stages. This comprises avoiding histamine-containing meals for 10–14 days before resuming them for up to 6 weeks. This can be used to determine a person’s histamine tolerance.

People should get expert nutritional guidance before attempting any form of restrictive diet to ensure they are getting appropriate nutrients and to avoid an unwarranted deterioration in their quality of life.

Foods to stay away from

Histamine levels are greater in the following foods:

  • spinach
  • eggplant
  • tomato
  • avocado
  • some types of fish
  • aged cheeses
  • processed meats
  • wine and beer
  • sauerkraut
  • fermented products

According to studies, even if a food does not contain histamine, it might “release” it in the body. Scientists aren’t sure how this happens, however certain people may have an allergic reaction to certain meals, such as:

  • milk
  • shellfish
  • eggs
  • kiwi
  • strawberry
  • pineapple
  • plum

Foods containing amines, which are chemically similar to histamine, can also compete for DAO. This implies that if a person consumes a lot of these foods, histamine will not be broken down as rapidly, which might result in symptoms.

Foods that contain other amines include:

According to some sources, the following foods are strong in histamine or histamine-releasing enzymes, or they inhibit the DAO enzyme:

  • yeast extract
  • black tea
  • Mate tea
  • energy drinks
  • pickled and canned foods
  • chocolate and cocoa products
  • vinegars
  • wheatgerm

Example diet plan

The following is an example of a reduced histamine diet that might be followed while monitoring symptoms.

Breakfast options

  • apple, melon, and pear fruit salad with chopped pistachios
  • smoothie made with mango, coconut milk, chia seeds, and kale
  • puffed rice with coconut milk
  • oatmeal made with water or coconut milk

Lunch options

  • cottage cheese and cucumber on toast
  • quinoa and herb salad
  • chicken, lettuce, and grated carrot sandwich
  • chicken and kale salad with chopped grapes

Dinner options

  • Pasta with olive oil, garlic, herbs, and chicken or borlotti beans.
  • Low histamine fish, such as trout or cod, freshly caught and served with zucchini and roasted carrots.
  • Homemade turkey burger with sweet potato wedges.
  • Chicken with new potatoes, broccoli, and green beans.

Snacks

  • grapes
  • celery sticks
  • apple slices and natural peanut butter
  • blueberries
  • pistachios
  • carrot sticks
  • cottage cheese

Other suggestions

The amount of histamine in a dish is affected by its freshness. Learning how different methods of manufacturing and storage affect histamine levels in food is a good idea.

It’s also important to consider how a person buys for and prepares meals.

A person with histamine intolerance can keep track of their symptoms and perhaps minimize them by:

  • eating foods as soon as possible after purchase
  • keeping a food journal to record symptoms and triggers
  • planning meals in advance
  • asking restaurants about their ingredients when eating out
  • buying fresh food, shopping more often if necessary

Histamine levels are also influenced by several drugs and supplements. If a person thinks anything they’re taking is making their symptoms worse, they should talk to their doctor.

Conclusion

Someone suffering from histamine intolerance may benefit from a low-histamine diet. Planning a variety of meals, avoiding foods high in histamine, and setting aside time to make fresh foods can all help a person manage their symptoms.

If someone feels they may have histamine intolerance, they should seek medical care immediately.

When adopting a restricted diet, people must ensure that they do not miss out on critical nutrients. People should seek the counsel of a certified dietitian or nutritionist before embarking on a long-term exclusion diet.

Sources:

  • https://www.jpsr.pharmainfo.in/Documents/Volumes/vol7Issue06/jpsr07061526.pdf
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129797/
  • https://jandonline.org/article/S2212-2672(14)01454-3/fulltext
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806734/
  • https://pubmed.ncbi.nlm.nih.gov/23579881/
  • https://www.medicalnewstoday.com/articles/low-histamine-diet
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346110/
  • https://www.mdpi.com/2304-8158/7/12/205/htm
  • http://www.jpp.krakow.pl/journal/archive/08_18/pdf/10.26402/jpp.2018.4.09.pdf
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839887/
  • https://www.histamineintolerance.org.uk/about/the-food-diary/the-food-list/
  • https://www.aafa.org/allergy-symptoms/

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Asthma

Lung supplements: What to know

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Coughing, shortness of breath, wheezing, coughing up mucus or blood, and chest pain are all people of lung problems. Some companies claim that their vitamins and supplements can help boost lung health. However, medical evidence is still needed to back up these claims. Coughing, shortness of breath, wheezing, coughing up mucus or blood, and chest pain are all people of lung problems. Some companies claim that their vitamins and supplements can help boost lung health. However, medical evidence is still needed to back up these claims.

a lady taking pills

This page discusses how supplements may aid the lungs, when this may be beneficial, how to choose, and when to consult a doctor.

About lungs and supplements

Lung health is an important component of the respiratory system. They enable fresh oxygen into the body while also removing waste gases such as carbon dioxide.

According to the National Heart, Lung, and Blood Institute (NHLBI), a person can keep their lungs healthy by:

  • not smoking
  • maintaining a moderate weight
  • being physically active
  • being mindful of air pollution
  • taking cold and flu precautions

There has been minimal research into how supplements can improve lung health. However, according to one 2017 study, vitamin D aids in the promotion of respiratory health and the prevention of infections.

N-acetylcysteine

According to a 2017 review, clinicians may recommend N-acetylcysteine (NAC) to treat several illnesses caused by unstable atoms.

NAC is a safe and potent antioxidant that can aid with illnesses like asthma and chronic bronchitis when taken as a dietary supplement.

However, more research is needed to determine the entire effects of NAC on the respiratory system.

When should you take lung supplements?

A person suffering from any of the following medical issues may want to consider taking supplementary supplements to improve their lung health:

One study published in 2019 looked at the impact of supplements on the airways of people with asthma who smoked or did not smoke. The author concludes that there were no overall good impacts, and that disease rates increased in several cases.

Supplement security

The Food and Drug Administration (FDA) acknowledges that supplements are not subject to the same level of scrutiny as prescription pharmaceuticals.

The FDA’s participation in supplement safety and efficacy prior to marketing is minimal. It does, however, state that supplement makers must not sell their goods by making health claims. This implies that supplement makers are not allowed to make claims about their product’s ability to cure, treat, prevent, or diagnose sickness.

If a supplement maker creates a product with a new ingredient, they must notify the FDA, who will only assess it for safety. The EPA is still refusing to authorize the supplement or test its efficacy.

How to Make a Decision

Some supplements may help a person by replenishing important vitamins and minerals in the body. However, before using lung supplements, a person should contact with a doctor, especially if they have a verified condition. This is due to the fact that some supplements may interfere with prescription drugs.

The FDA warns that just because a supplement producer claims to have used natural components does not mean the product is safe. As a result, speaking with a doctor about vitamins and supplements may enhance a person’s general health.

When to See a Doctor

If a person has any worries about their breathing or lung health, they should consult a doctor.

Symptoms of a lung condition, according to the American Lung Association, may include:

  • breathing difficulties
  • shortness of breath
  • wheezing
  • difficulty breathing during exercise
  • a continuous cough
  • coughing up blood or mucus
  • chest pain or discomfort

Conclusion

Supplements that replace the body’s natural stores of vitamins, minerals, or other nutrients may aid people with lung issues. Furthermore, they may provide brief relief from cold or flu symptoms.

However, before using supplements, a person should consult with a doctor, especially if they are also taking prescribed medications. Because of the risk of drug interactions, this is the case.

Sources:

  • https://www.mdpi.com/2072-6643/11/4/725/htm
  • https://www.nhlbi.nih.gov/health-topics/how-lungs-work
  • https://www.womenshealth.gov/a-z-topics/lung-disease
  • https://www.medicalnewstoday.com/articles/best-supplements-for-lungs
  • https://www.bmj.com/content/356/bmj.i6583
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
  • https://www.lung.org/lung-health-diseases/warning-signs-of-lung-disease

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