For more info on how to do it, read these posts:. I would check out this post here for help on how to lose weight: Is there a way to reverse that and avoid weight loss or removal is the only way? I would monitor your symptoms and gradually reduce the amount you're using. Oct 22, Progesterone makes me so sleepy! I have stuck with it to give it ample time to work and regulate itself in my body and while I don't like being larger than I was to start with, it is better than living with the terrible pain I get each month. I will find out with my blood test on day
Estrogen Levels Throughout A Woman’s Life
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COPD is a progressive lung disease that makes breathing difficult due to partially obstructed airflow into and out of the lungs. It results from an inflammatory and destructive process in the lungs stimulated by exposure to toxins, primarily due to a history of smoking cigarettes.
Because the airways are partially blocked or damaged, breathing becomes difficult, and the lungs begin to lose their ability to effectively take up oxygen and remove carbon dioxide.
Other causes include long-term exposure to indoor and outdoor air pollutants, occupational chemicals, fumes, dusts, and second-hand smoking.
In rare cases, a genetic component may increase susceptibility. COPD is an umbrella term that includes both emphysema and chronic bronchitis. These patients are typically thin, often exhibiting significant weight loss due to the increased energy requirements associated with labored breathing.
The term COPD is used to refer to these two conditions because patients often exhibit features of both. Although COPD is largely preventable, it is not curable, and lung damage is irreversible. Maintaining a Healthy Weight Is Vital For most people, breathing is unconscious and perceived as effortless.
Yet, for many patients with COPD, breathing requires a conscious effort. Energy needs can be calculated using indirect calorimetry or the Harris-Benedict equation. The general recommendation is 1. In addition to increased REE, patients lose weight due to decreased dietary intake as a result of an inherent inability to eat rather than a lack of appetite. Reasons for poor nutritional intake include the following:.
The purpose of nutrition care for this population is to provide adequate energy to minimize the risk of unwanted weight loss, avoid loss of fat-free mass FFM , prevent malnutrition, and improve pulmonary status. Research shows that COPD is a disease that not only affects the lungs but can also have systemic consequences, as well as result in severe weight loss and FFM depletion. In addition, a low body mass index BMI is associated with a poor prognosis; therefore, patients must maintain energy balance in light of their increased caloric needs.
Malnutrition can impair pulmonary function, increase susceptibility to infection, lower exercise capacity, and increase the risk for mortality and morbidity. FFM depletion is defined as below 16 kilograms per meter squared for men and 15 kilograms per meter squared for women based on the FFM index FFM divided by height squared.
For those patients who are overweight, added pressure on the lungs can increase the effort required to breathe, so encouraging patients to safely lose excess weight is important.
Antioxidant, Vitamin, and Mineral Considerations Research indicates that cigarette smoke contains free radicals and other oxidants that can lead to oxidative stress, subsequent inflammation, and reduced airflow to the lungs.
For this reason, antioxidant therapy has been proposed for its ability to minimize free radical damage and reduce inflammation. Researchers have found that smokers, as well as patients experiencing acute exacerbations, had lower plasma levels of certain antioxidants eg, ascorbic acid, vitamin E, beta-carotene, selenium and that this imbalance between oxidants and antioxidants leads to oxidative stress and inflammation and could be a significant contributing factor to the systemic effects characterized by the disease.
Many patients with COPD are prescribed glucocorticoids to help reduce airway inflammation and improve breathing. However, one of the side effects of glucocorticoid use is bone mass loss and eventual osteoporosis, leading to an increased risk of fractures.
There are several risk factors that can cause osteoporosis, and patients with COPD typically have many of them, such as the use of glucocorticoids, smoking, vitamin D deficiency, low BMI, malnutrition, and decreased mobility. For this reason, patients who are starting a long-term inhaled or oral glucocorticoid therapy are encouraged to supplement it with calcium and vitamin D, since bone loss occurs rapidly upon initiating treatment. A healthy diet for patients with COPD can lead to better breathing and possibly facilitate weaning from mechanical ventilation by providing the calories necessary to meet metabolic needs, restore FFM, and reduce hypercapnia.
Carbon dioxide is a waste product of metabolism and is normally expelled via the lungs. However, patients with COPD who have limited and obstructed airflow have a compromised ability to take in oxygen and eliminate carbon dioxide.
In healthy individuals, increased carbon dioxide levels are easily eliminated. The Importance of Proper Nutrition Proper nutrition can help reduce carbon dioxide levels and improve breathing.
Specifically, it is important to focus on the percentages of total carbohydrate, fat, and protein that patients consume to see how their diet composition impacts their respiratory quotient RQ , which is defined as the ratio of carbon dioxide produced to oxygen consumed.