If you get bronchitis, the last thing you’d think might be causing it is diabetes. But one woman’s story demonstrates that diabetes can manifest itself in surprising ways.
This case study has lessons for anyone experiencing chronic infections that don’t respond to conventional care such as antibiotics. It also has specific takeaways for anyone with prediabetes or diabetes. And it illuminates the many ways that body functions such as metabolism and immunity, which we often think of in isolation, are in reality inseparably connected.
We’ll let the doctor—Mona Morstein, ND, naturopathic physician and director of Arizona Integrative Medical Solutions in Tempe, Arizona—take it from here.
A MYSTERIOUS CASE OF BRONCHITIS
Several years ago, a 52-year-old woman came in to see me when her bronchitis did not get better.
Bronchitis is a common lower-respiratory condition. It’s an infection of the bronchial tubes that lead to the lungs, and the symptoms are coughing with mucus, chest discomfort, wheezing and shortness of breath, sometimes accompanied by a low-grade fever. The same viruses that cause the common cold or influenza can cause bronchitis, and it can also be caused by bacteria. The usual conventional care is rest, plenty of fluids, humidifying the air and, if needed, medications to help fight the infection, control cough and reduce bronchial inflammation. Bronchitis usually gets better in a week or so.
The first time I had seen “Isabella” (not her real name) was two years earlier. At that time, I cured her of gastroesophageal reflux disease by removing food from her diet based on sensitivities we discovered in some specialized testing.
This time, Isabella called my office and told me that she had been having an episode of bronchitis every year, usually in early March as the weather was changing into spring. Usually, she called her primary care practitioner, who prescribed antibiotics over the phone—and usually she promptly recovered.
But this year was different. She had gotten her typical bronchitis, but the antibiotic that typically worked hadn’t. Her doctor had then prescribed another, stronger antibiotic, but it, too, had not eradicated her bronchitis. So she called me up asking if I could treat bronchitis. She wondered whether, as with her MD, she could just stop by and pick up some medications—but I told her she’d have to come in for a formal office visit.
As I connected her with my office coordinator to schedule, I wondered what was going on this year with her that made the antibiotics ineffective? Of course, as a naturopathic physician, I do not like using antibiotics for illnesses like that, as our natural medicines will work fantastically, stimulating the immune system to allow the patient’s own body to overcome the illness. However, if in all the other years, one dose of antibiotics had worked for her, what obstacle had kept it from working this year?
I spotted the first indication that some other condition might be negatively impacting her immune system when I first saw her come into my office. She had gained more than 100 pounds over those two-plus years! Her weight was all around her abdomen, and immediately I wondered about her blood sugar status. In the office, I did a finger prick, and her glucose was at 334 mg/dL! Any random draw over 200 mg/dL can lead to a diagnosis of diabetes.
Further blood work showed that she did indeed have type 2 diabetes. Her A1c, a lab test that monitors where glucose levels have been over the last three months, was 8.3%. A normal, nondiabetic A1c is around 5%, and diabetes can be diagnosed when A1c is at or above 6.5%.
This was the “obstacle to overcome”—the reason Isabella was not healing quickly from her bronchitis.
THE BRONCHITIS/DIABETES CONNECTION
When diabetes is not treated, the excess glucose (sugar) that circulates in the blood leads to oxidative stress, which can cause damage to the retina, kidneys, nerves, heart and other organs. High glucose levels are also very harmful to the immune system and allow patients with uncontrolled diabetes to get more infections and to have a harder time overcoming them.
Specialized white blood cells that normally take action against bacteria and other pathogens don’t work as well after periods of high blood sugar (hyperglycemia). Example: Studies have shown that blood cells called neutrophils, which engulf and digest bacteria, are weakened by hyperglycemia, so they don’t put up the first line of defense that they should. Other studies have shown that lymphocytes, the cells that create the antibodies that are necessary to fight infections, die prematurely when living in hyperglycemic conditions.
When a person doesn’t have fully functioning neutrophils and lymphocytes, infectious bacteria—such as those that may have been causing Isabella’s recurrent bronchial infections—take hold. The fact that Isabella got bronchitis one time a year in early March was not a symptom of diabetes, but her not being able to overcome the infection with antibiotics was.
Unfortunately, antibiotics are the only tools conventional medicine has against bronchitis, and they also work against patients. Frequent infections lead to frequent use of antibiotics which, in turn, can cause microorganism resistance against those antibiotics so they no longer work against the bronchitis they were brought in to treat.
Plus, there is growing evidence that chronic use of antibiotics may actually make the development of type 2 diabetes more likely. Antibiotics damage the intestinal microbiome, the collection of trillions of bacteria, viruses, yeast and other microorganisms that live in the human intestinal tract (mostly in the colon). Harming the microbiome repeatedly can upset its balance and damage the lining of the intestinal tract, allowing toxins to infiltrate and cause inflammation, which can lead to insulin resistance—the core problem of Type 2 diabetes.
That is why it is very helpful to seek care from a naturopathic or integrative physician for these types of infectious illnesses. Natural medications, vitamins, nutraceuticals, botanical medicines and homeopathy can almost always effectively treat colds, flus, bronchitis, ear infections, strep or other sore throats—without the use of antibiotics.
If you have recurrent infections or difficulty fighting infections off—and have some abdominal weight—you may need a full work-up to look for other conditions, including diabetes, that interfere with your body’s immune response.
If you know that you have diabetes, controlling blood sugar is the first step to staying healthy and avoiding infections. People who have diabetes should—as always—make the lifestyle changes needed to keep blood sugar within a healthy range. When a diabetes medication is necessary, take it as prescribed.
There are additional steps you can take to avoid infections. Start by joining the Low Carb Diabetes Association. This nonprofit educational organization, which I founded, is designed to support the prevention and treatment of all types of diabetes using comprehensive integrative care. It is free to join. And taking the eight steps below will help you control your diabetes and boost your immune system to minimize infections:
- Eat a low-carb, whole-foods diet.
- Get exercise regularly, including aerobic, resistance/weight training and “soft” exercises such as yoga and tai chi that work on balance, flexibility and agility. Exercise increases the functioning of the immune system (unless you overexercise!).
- Get enough sleep. Your immune system functions better when you’re well-rested. That’s true for everyone. But getting enough sleep also helps you avoid insulin resistance and weight gain, so it’s an even more important part of taking care of yourself if you have diabetes.
- Manage stress. Being in good mental/emotional balance is a great way to maintain and even enhance your immune system. There are many ways to train yourself to be calm and happy during all of life’s ups and down—including meditation, mindfulness, gratitude journaling, prayer, hobbies, creative endeavors, socializing and volunteering.
- Heal your gut and microbiome. As mentioned above, a healthy gut means the rest of the body is healthier! Work with a naturopathic or integrative physician to identify the best regimen for you.
- Detoxify your personal environment. Try to be as “green” as possible at home and at work…reducing exposure to toxic chemicals in toiletries and cleaning supplies…eating organic food…and engaging in detoxification practices such as saunas. Environmental chemicals are associated with causing damage all over the body, including to the immune system.
- Use supplements. Many are great at enhancing the immune system, including vitamins A, C and D, carotenoids, zinc and many botanicals such as goldenseal, garlic and echinacea. Also, supplements that help reduce your glucose levels will help strengthen your immune system. Work with your doctor to identify the best immune-boosting and glucose-reducing supplements for you.
- Take medication if you need it. If necessary, diabetes medications can be used to reduce glucose levels in people with type 2 diabetes. For those with type 1, insulin is required.
Isabella did wonderfully on the diabetic protocol I initiated, following the guidelines of the above “eight essentials” such as eating low carb, exercising, sleeping, doing saunas at her gym for detoxification and taking the supplements that I prescribed. She lost 80 pounds in the first year and kept them off. Her A1c went down to 4.8% after the first three months and stayed in excellent control for the next five years. She was also able to get off her blood pressure medication while maintaining normal blood pressure—and she never needed to be put on any diabetes medications. I treated her initial bronchitis with natural medications, and she recovered. After she lost the weight and got her glucose levels under terrific control, she stopped getting those yearly bronchitis attacks.