Condition

Chronic Obstructive Pulmonary Disease (COPD)

COPD is a progressive lung disease in which long-lasting inflammation, narrowed airways, and damage to lung tissue make breathing harder, with oxidative stress and repeated infections playing big roles. The evidence is strongest for N-acetylcysteine, and a pooled analysis of trials found bronchitis symptoms improved in people with chronic bronchitis. The effect was small, though, and omega-3 fatty acids showed no clear difference in walking test performance, so the wider picture is still limited.

Sources: PMID 31598901

Updated 30 September 2026
How we grade
2 studies cited
Chronic Obstructive Pulmonary Disease (COPD) protocol

Supplements studied: 13
Graded outcomes: 10
Trials: 16
People studied: 14,139

Evidence by supplement

Strong
Moderate
Limited
Very limited

13 supplements

Nitrate

Nitrate: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People
	Blood Pressure Small Improvement	Improves (the measure goes down)	Small effect	6 studies	143 people
Studies that measured blood pressure Effect of inorganic nitrate supplementation on blood pressure in older adults: A systematic review and meta-analysisNitric Oxide · PMID 33905826 Effects of short-term dietary nitrate supplementation on blood pressure, O2 uptake kinetics, and muscle and cognitive function in older adultsAm J Physiol Regul Integr Comp Physiol · PMID 23174856 Nitrate Derived From Beetroot Juice Lowers Blood Pressure in Patients With Arterial Hypertension: A Systematic Review and Meta-Analysis.Front Nutr · PMID 35369064 and 3 more on the Nitrate page
	Exercise Capacity	Improves (the measure goes up)		5 studies	175 people
Studies that measured exercise capacity The Effect of Dietary Nitrate Supplementation on Endurance Exercise Performance in Healthy Adults: A Systematic Review and Meta-Analysis.Sports Med · PMID 27600147 Nitrate supplementation improves physical performance specifically in non-athletes during prolonged open-ended tests: a systematic review and meta-analysis.Br J Nutr · PMID 29553034 Factors that Moderate the Effect of Nitrate Ingestion on Exercise Performance in Adults: A Systematic Review with Meta-Analyses and Meta-Regressions.Adv Nutr · PMID 35580578 and 2 more on the Nitrate page
	Heart Rate	Improves (the measure goes down)		2 studies	159 people
Studies that measured heart rate Effect of beetroot juice on lowering blood pressure in free-living, disease-free adults: a randomized, placebo-controlled trialNutr J · PMID 23231777 Absence of an effect of high nitrate intake from beetroot juice on blood pressure in treated hypertensive individuals: a randomized controlled trialAm J Clin Nutr · PMID 26135348
	Vascular Function	Improves (the measure goes up)		2 studies	158 people
Studies that measured vascular function Dietary nitrate supplementation to enhance exercise capacity in patients with COPD: Evidence from a meta-analysis of randomized controlled trials and a network pharmacological analysis.Respir Med · PMID 38158139 Evaluating the impact of short-term nitrate-rich dietary supplementation on endothelial function in COPD: A randomized crossover study.Respir Med · PMID 39053520
	Rating of Perceived Exertion	Improves (the measure goes up)		1 study	93 people
Studies that measured rating of perceived exertion Whole beetroot consumption acutely improves running performanceJ Acad Nutr Diet · PMID 22709704
	Dyspnea	Improves (the measure goes up)			145 people
	Oxygen Uptake	Improves (the measure goes up)			97 people

N-Acetylcysteine

N-Acetylcysteine: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People
	Bronchitis Symptoms Small Improvement	Improves (the measure goes down)	Small effect	1 study	968 people
Studies that measured bronchitis symptoms Effect of Orally Administered N-Acetylcysteine on Chronic Bronchitis: A Meta-analysis.Adv Ther · PMID 31598901
	Chronic Bronchitis No effect		NoneNo effect		1,564 people
	COPD Symptoms	Improves (the measure goes down)		5 studies	905 people
Studies that measured copd symptoms New developments in the treatment of COPD: comparing the effects of inhaled corticosteroids and N-acetylcysteineJ Physiol Pharmacol · PMID 16204787 Systematic review and meta-analysis of the efficacy of N-acetylcysteine in the treatment of acute exacerbation of chronic obstructive pulmonary disease.Ann Palliat Med · PMID 34237968 Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trialLancet · PMID 15866309 and 2 more on the N-Acetylcysteine page
	Neutrophil Activity	Improves (the measure goes up)		1 study	50 people
Studies that measured neutrophil activity Induced sputum of patients with chronic obstructive pulmonary disease (COPD) contains adhesion-promoting, therapy-sensitive factorsInflamm Res · PMID 10778915
	Glutathione (GSH)	Improves (the measure goes up)			645 people
	Lung Function	Improves (the measure goes up)			50 people

Rhodiola Rosea

C-Reactive Protein (CRP): improves
Lung Function: improves
Total Antioxidant Capacity (TAC): improves

Rhodiola Rosea: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People
	C-Reactive Protein (CRP) Small Decrease	Improves (the measure goes down)	Small effect	1 study	196 people
Studies that measured c-reactive protein (crp) Extract of Rhodiola rosea radix reduces the level of C-reactive protein and creatinine kinase in the bloodBull Exp Biol Med · PMID 15514725
	Lung Function	Improves (the measure goes up)		1 study	259 people
Studies that measured lung function Efficacy and safety of three species of L. in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis.Front Pharmacol · PMID 37089935
	Total Antioxidant Capacity (TAC)	Improves (the measure goes up)		1 study	202 people
Studies that measured total antioxidant capacity (tac) The effect of Rhodiola rosea supplementation on endurance performance and related biomarkers: a systematic review and meta-analysis.Front Nutr · PMID 41080184
	Glutathione (GSH)	Improves (the measure goes up)			202 people
	N-terminal Prohormone of Brain Natriuretic Peptide	Improves (the measure goes up)			196 people
	Oxidative Stress Biomarkers	Improves (the measure goes down)			202 people
	Superoxide Dismutase Activity	Improves (the measure goes up)			202 people

Resveratrol

Blood Urea Nitrogen (BUN): improves
Kidney Function: improves
Serum Albumin: improves

Resveratrol: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People
	Blood Urea Nitrogen (BUN) Small Decrease	Improves (the measure goes down)	Small effect		894 people
	Kidney Function	Improves (the measure goes up)		2 studies	135 people
Studies that measured kidney function Resveratrol may mildly improve renal function in the general adult population: A systematic review and meta-analysis of randomized controlled clinical trials.Nutr Res · PMID 36996691 Effects of resveratrol supplementation on renal function in adults: a systematic review and dose-response meta-analysis.Naunyn Schmiedebergs Arch Pharmacol · PMID 40580309
	Serum Albumin	Improves (the measure goes up)			516 people
	Uric Acid	Improves (the measure goes down)			353 people

Curcumin

Blood glucose: improves
Triglycerides: improves
Low-density lipoprotein (LDL): improves

Curcumin: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People
	Blood glucose Small Improvement	Improves (the measure goes down)	Small effect	18 studies	48 people
Studies that measured blood glucose The Effect of Antioxidant Polyphenol Supplementation on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis.Nutrients · 2024 · PMID 39683599 Curcumin alleviates postprandial glycaemic response in healthy subjects: A cross-over, randomized controlled studySci Rep · 2018 · PMID 30209353 Effects of Curcuma longa (turmeric) on postprandial plasma glucose and insulin in healthy subjectsNutr J · 2010 · PMID 20937162 and 15 more on the Curcumin page
	Triglycerides	Improves (the measure goes down)		9 studies	48 people
Studies that measured triglycerides Effect of different curcuminoid supplement dosages on total in vivo antioxidant capacity and cholesterol levels of healthy human subjectsPhytother Res · 2011 · PMID 21796707 Effect of NCB-02, atorvastatin and placebo on endothelial function, oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus: a randomized, parallel-group, placebo-controlled, 8-week studyDrugs R D · 2008 · PMID 18588355 Curcuminoids modify lipid profile in type 2 diabetes mellitus: A randomized controlled trialComplement Ther Med · PMID 28735818 and 6 more on the Curcumin page
	Low-density lipoprotein (LDL)	Improves (the measure goes down)		5 studies	48 people
Studies that measured low-density lipoprotein (ldl) The effects of curcumin supplementation on liver enzymes, lipid profile, glucose homeostasis, and hepatic steatosis and fibrosis in patients with non-alcoholic fatty liver diseaseEur J Clin Nutr · PMID 30610213 Treatment of Non-alcoholic Fatty Liver Disease with Curcumin: A Randomized Placebo-controlled TrialPhytother Res · PMID 27270872 Nano-curcumin improves glucose indices, lipids, inflammation, and Nesfatin in overweight and obese patients with non-alcoholic fatty liver disease (NAFLD): a double-blind randomized placebo-controlled clinical trialNutr Metab · PMID 30705687 and 2 more on the Curcumin page
	Weight	Improves (the measure goes down)		5 studies	48 people
Studies that measured weight Does Turmeric/curcumin Supplementation Change Anthropometric Indices in Patients with Non-alcoholic Fatty Liver Disease? A Systematic Review and Meta-analysis of Randomized Controlled Trials.Clin Nutr Res · PMID 31384598 The effect of turmeric/curcumin supplementation on anthropometric indices in subjects with prediabetes and type 2 diabetes mellitus: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.Nutr Diabetes · PMID 40813857 The effect of curcumin supplementation on weight loss and anthropometric indices: an umbrella review and updated meta-analyses of randomized controlled trials.Am J Clin Nutr · PMID 36898635 and 2 more on the Curcumin page
	Blood Pressure	Improves (the measure goes down)		2 studies	48 people
Studies that measured blood pressure Substantial Variability Across Individuals in the Vascular and Nutrigenomic Response to an Acute Intake of Curcumin: A Randomized Controlled TrialMol Nutr Food Res · 2018 · PMID 29034576 Effect of endurance exercise training and curcumin intake on central arterial hemodynamics in postmenopausal women: pilot studyAm J Hypertens · PMID 22421908
	Uric Acid	Improves (the measure goes down)		2 studies	48 people
	HbA1c	Improves (the measure goes down)			48 people
	High-density lipoprotein (HDL)	Improves (the measure goes up)			48 people
	Kidney Function	Improves (the measure goes up)			48 people

Nicotinamide Riboside

Interleukin 8: improves

Nicotinamide Riboside: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Interleukin 8 Small Decrease	Improves (the measure goes down)	Small effect	1 study	58 people
Studies that measured interleukin 8 Effect of nicotinamide riboside on airway inflammation in COPD: a randomized, placebo-controlled trial.Nat Aging · PMID 39548320

Creatine

Body Fat: improves
Weight: improves
Exercise Tolerance: improves

Creatine: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People
	Body Fat Small Decrease	Improves (the measure goes down)	Small effect		25 people
	Weight	Improves (the measure goes down)		10 studies	105 people
Studies that measured weight Creatine monohydrate supplementation on body weight and percent body fatJ Strength Cond Res · PMID 14636103 Reliability and detecting change following short-term creatine supplementation: comparison of two-component body composition methodsJ Strength Cond Res · PMID 17530953 Effects of creatine supplementation on aerobic power and cardiovascular structure and functionJ Sci Med Sport · PMID 16248471 and 7 more on the Creatine page
	Exercise Tolerance	Improves (the measure goes up)		3 studies	151 people
Studies that measured exercise tolerance Creatine supplementation for patients with COPD receiving pulmonary rehabilitation: a systematic review and meta-analysisRespirology · PMID 20497386 Effect of high-dose creatine therapy on symptoms of exercise intolerance in McArdle disease: double-blind, placebo-controlled crossover studyArch Neurol · PMID 11790236 Creatine therapy in myophosphorylase deficiency (McArdle disease): a placebo-controlled crossover trialArch Neurol · PMID 10891977
	Subjective Well-Being	Improves (the measure goes up)		3 studies	105 people
Studies that measured subjective well-being Effect of creatine supplementation and sleep deprivation, with mild exercise, on cognitive and psychomotor performance, mood state, and plasma concentrations of catecholamines and cortisolPsychopharmacology · PMID 16416332 Creatine supplementation, sleep deprivation, cortisol, melatonin and behaviorPhysiol Behav · PMID 17046034 Creatine supplementation improves muscle strength in patients with congestive heart failurePharmazie · PMID 16599263
	COPD Symptoms	Improves (the measure goes down)			256 people
	Lung Function	Improves (the measure goes up)			23 people

L-Carnitine

Blood Lactate (Exercise)
COPD Symptoms: improves
Weight: improves

L-Carnitine: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People
	Blood Lactate (Exercise) No effect		NoneNo effect	5 studies	16 people
Studies that measured blood lactate (exercise) Clinical Effects of L-Carnitine Supplementation on Physical Performance in Healthy Subjects, the Key to Success in Rehabilitation: A Systematic Review and Meta-Analysis from the Rehabilitation Point of View.J Funct Morphol Kinesiol · PMID 34842765 The effects of acute L-carnitine supplementation on endurance performance of athletesJ Strength Cond Res · PMID 24263659 Effect of propionyl-L-carnitine on exercise performance in peripheral arterial diseaseMed Sci Sports Exerc · PMID 11528327 and 2 more on the L-Carnitine page
	COPD Symptoms	Improves (the measure goes down)		1 study	16 people
Studies that measured copd symptoms L-carnitine as an ergogenic aid for patients with chronic obstructive pulmonary disease submitted to whole-body and respiratory muscle training programsBraz J Med Biol Res · PMID 16612469
	Weight	Improves (the measure goes down)		1 study	16 people
Studies that measured weight l-Carnitine Supplementation in Older Women. A Pilot Study on Aging Skeletal Muscle Mass and FunctionNutrients · PMID 29473908

Omega-3 Fatty Acids

6-Minute Walking Test Performance
Interleukin 6: improves
Quality of Life: improves

Omega-3 Fatty Acids: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People
	6-Minute Walking Test Performance No effect		NoneNo effect		203 people
	Interleukin 6	Improves (the measure goes down)		1 study	218 people
Studies that measured interleukin 6 Effect of omega-3 fatty acid supplementation on markers of inflammation and endothelial function in patients with chronic heart disease: A systematic review and meta-analysis.Cell Mol Biol · PMID 38836663
	Quality of Life	Improves (the measure goes up)		1 study	139 people
Studies that measured quality of life Effect of Omega-3 Fatty Acids on Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Int J Chron Obstruct Pulmon Dis · PMID 34588776
	C-Reactive Protein (CRP)	Improves (the measure goes down)			208 people

Umckaloabo

Lung Function: improves

Umckaloabo: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Lung Function	Improves (the measure goes up)		10 studies	199 people
Studies that measured lung function Treatment of acute bronchitis in adults with a pelargonium sidoides preparation (EPs 7630): a randomized, double-blind, placebo-controlled trialExplore · PMID 16781588 EPs 7630 improves acute bronchitic symptoms and shortens time to remission. Results of a randomised, double-blind, placebo-controlled, multicentre trialPlanta Med · PMID 18449849 Pelargonium sidoides preparation (EPs 7630) in the treatment of acute bronchitis in adults and childrenPhytomedicine · PMID 17184981 and 7 more on the Umckaloabo page

Glutamine

Exercise Tolerance: improves

Glutamine: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Exercise Tolerance	Improves (the measure goes up)		2 studies	13 people
Studies that measured exercise tolerance No effect of glutamine ingestion on indices of oxidative metabolism in stable COPDRespir Physiol Neurobiol · PMID 21419239 Is glutamine beneficial in ischemic heart diseaseNutrition · PMID 11844641

Vitamin D

Cathelicidin: improves

Vitamin D: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Cathelicidin	Improves (the measure goes up)		1 study	23 people
Studies that measured cathelicidin Bronchoalveolar Lavage and Plasma Cathelicidin Response to 25-Hydroxy Vitamin D Supplementation: A Pilot Study.Chronic Obstr Pulm Dis · PMID 34044475

Cannabis

Lung Function: improves

Cannabis: outcomes studied for Chronic Obstructive Pulmonary Disease (COPD)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Lung Function	Improves (the measure goes up)		1 study	5,115 people

Key findings

Blood PressureNitrateImproves (the measure goes down)
Bronchitis SymptomsN-AcetylcysteineImproves (the measure goes down)
C-Reactive Protein (CRP)Rhodiola RoseaImproves (the measure goes down)

The Chronic Obstructive Pulmonary Disease (COPD) protocol

2 primary supplements · 2 supporting supplements

N-Acetylcysteine (NAC)600–1,200 mg twice daily
Vitamin D2,000–4,000 IU daily

See the full protocol

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Support alongside medical care. These supplements are not a treatment for Chronic Obstructive Pulmonary Disease (COPD). If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.

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Studies cited

2 studies from PubMed

The efficacy and safety of herbal formulas for adults with pulmonary hypertension combined with chronic obstructive pulmonary disease: a systematic review and meta-analysis involving 1,865 participants.J Thorac Dis · PMID 39444852
Effect of repeated Waon therapy on exercise tolerance and pulmonary function in patients with chronic obstructive pulmonary disease: a pilot controlled clinical trial.Int J Chron Obstruct Pulmon Dis · PMID 24363555

Evidence by supplement

Key findings

The Chronic Obstructive Pulmonary Disease (COPD) protocol

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Studies cited

Related conditions

Supplement stack for Chronic Obstructive Pulmonary Disease (COPD)