Why are men more susceptible to pneumonia?

With cold and flu season upon us, it's important to boost the immune system to avoid any of those infectious bugs lurking around the corner.

Cold and Flu


Owen Wiseman
@AVogel_ca


22 October 2019

What is pneumonia?

Pneumonia is an infection of the lungs where the tiny air sacs responsible for gas exchange, known as alveoli, become inflamed.

What are the symptoms?

As one may imagine, if the site of gas exchange becomes compromised, this leads to extreme difficulties breathing. Due to this difficulty, the heart often works harder to circulate blood leading to increased heart rate and reduced blood pressure.

Since oxygenated blood isn't circulating properly to nourish tissue and remove waste products, those afflicted will begin to experience muscle weakness, joint pains, and fatigue.

The lungs will begin secreting fluid to dampen the inflammation and lead to worsening shortness of breath and the feeling of needing to get something out as the alveolar spaces fill with the fluid. One of the scariest symptoms is the breakdown of lung tissue as a result of the severe inflammation, which could lead to blood in the sputum of a cough.

It is also important to note that the pathogens causing pneumonia can morph into a variety of complications, including those that could turn fatal. This includes septic shock, delirium, respiratory failure, and metastatic infections such as meningitis or endocarditis.

Why do men seem to be more prone to pneumonia?

A 2008 study by the University of Pittsburgh analyzed a total of 2,220 patients with pneumonia and discovered that men present to emergency care at a later stage of the illness. More frightening is these gentlemen were at a 30% increased risk of dying within the coming year, despite forceful medical treatment. The inevitable follow-up question was why is this happening?

Researchers dove a little deeper and discovered distinct differences in immune markers such as antithrombin III, D-dimer, Factor IX, interleukin-6, interleukin-10, plasminogen activator inhibitor-1 and tumor necrosis factor. These differences then open the door for investigating differences in how autoimmune conditions affect biologic male's vs females.

In an animal study, female mice seemed to show a greater immunological resistance to pneumococcal pneumonia which got researchers involved wondering whether it had anything to do with estrogen. Male mice were then injected with estrogen to see if they would demonstrate the same immunological advantage to which there were benefits including reduced inflammation in the lungs, and improved bacterial clearance and survival of the mouse. Human female immune cells known as macrophages, sampled specifically from the lungs, also showed benefit in protecting against the development of pneumonia. Does this mean every male is going to start getting estrogen injections if doctors suspect pneumonia? No. However, it does lend further credit to a natural immunological advantage in biological females.

What are the approaches to manage pneumonia?

Medicinal methods to alleviating respiratory tract infections involve medications or herbs that play roles as anti-inflammatories, bronchodilators, expectorants, mucolytics, and anti-tussives.

The most critical step is to eradicate the pathogen to halt it from causing any further infections. This can be difficult as many different pathogens can trigger pneumonia including virus', bacteria, parasites, and certain strains of fungus that set up camp in the lungs. This involves a variety of tests to ensure the most appropriate approach is taken and to avoid unnecessary and ineffective treatments.

That darn wet, sticky cough! What can I do to get rid of this feeling?

Mucus provides a naturally protective function by helping to create a barrier that pathogens must pass through in order to access the tissues of the respiratory tract. Mucin is the main component and forms links with other mucin molecules to form large branched chains. Mucolytic agents work by breaking down the disulfide bonds that exist between the molecules, helping to thin the mucous and allow the individual to breathe a little easier. No need to target the weakest link if they are all susceptible to breaking!

A molecule known as N-acetyl-cysteine (NAC) is an extremely effective mucolytic. Additional benefits of the molecule include its role to product potent antioxidant impacts which could help to control the free radicals generated by the immune cells fighting the inflammation of the airways. Of note though, higher doses of NAC can induce spasms in the airways, and as such, those with asthma or sulphite sensitivities should have a discussion with their primary care provider.

Another product you may consider is one with expectorant properties such as Bronchosan. As the phlegm in the throat builds up, a plant like fresh Ivy Leaf (Hedera helix) could be just the ticket for some symptomatic relief. The European Medicines Agency also acknowledges the ability of ivy leaf to dilate the bronchi or the airways and in studies with children, it has been shown to be as effective as acetylcysteine for acute bronchitis.

I'm tired of taking a band aid approach to my symptoms though! How can I reduce my risk of developing pneumonia?

Taking care of the body with a diet rich in diverse foods and heavy on vegetables and fruit ensures you meet your dietary needs. The Echinaforce line that is available as a tincture, tablets, or hot drink has been clinically proven to reduce the risk of secondary infections such as bronchitis and pneumonia in those experiencing cold and flu. The largest clinical trial conducted on Echinaforce recruited 755 healthy adults at the Common Cold Center at Cardiff University and followed them over a 4-month period through cold and flu season. Those taking the herbal formulation experienced significantly fewer incidences of cold or flu symptoms, fewer recurrences, and fewer need for over-the-counter medications. The study also demonstrated that the Echinaforce is safe to take up to 4 months with few cases of side effects. Most importantly in this case was the ability of the product to reduce the risk of secondary infections such as pneumonia and bronchitis in those with a cold or flu. When you have loved ones to take care of or income to make, getting back on your feet sooner than later is critical to your function in daily life, so knock that pneumonia back.

References

https://www.drugbank.ca/drugs/DB06151
https://www.ema.europa.eu/en/documents/herbal-summary/ivy-leaf-summary-public_en-0.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2707813/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760065/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3457740/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215537/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
https://www.ncbi.nlm.nih.gov/pubmed/22155201