06/08/2026
COPD: Are We Treating the Cause, or Just Managing the Symptoms?
⚠️ This is a long read, but I genuinely believe it's worth taking the time to read to the end.
I've been away for a couple of weeks, but I haven't been on holiday. I've completed yet another course to expand my knowledge of natural ways to support lung health, and alongside that I've spent many hours researching COPD, respiratory health and the treatments so many people with COPD are routinely prescribed.
For a long time, something has been playing heavily on my mind: if what we're doing is working, why are so many people with COPD still declining?
I recently asked this question in the group, and response after response came back from people saying their lung function had continued to decline despite years of maintenance inhalers. I also heard from people who had stopped them and subsequently experienced improvements.
No, that isn't a clinical trial. But when I see the same pattern repeatedly, I become curious. That's what self-awareness is about: asking why rather than simply accepting.
And this subject is very personal to me. For eight years after my COPD diagnosis, I followed the conventional route. At one point I was taking nine different medications for various health issues and using three inhalers. During those years, my measured lung function didn't improve. It went in the opposite direction, eventually falling to 22%.
Eventually I asked myself a very simple question: why would I continue doing exactly the same thing while watching myself get worse?
That was the beginning of a completely different journey for me.
While researching over these past couple of weeks, I discovered several things I think people living with COPD deserve to understand.
1. COPD is NOT simply a smoker's disease
This one really bothers me because smoking dominates almost every conversation surrounding COPD.
Research shows that a substantial proportion of people living with COPD have never smoked. The international BOLD study found that never-smokers accounted for 23.3% of moderate-to-very-severe COPD, while broader epidemiological research estimates that globally around 25–45% of people with COPD may never have smoked.
Occupational exposure, air pollution, childhood respiratory illness and other factors can contribute. Then there's something fascinating called dysanapsis, which describes a mismatch between the size of the airway tree and the size of the lungs.
Research has associated smaller airways relative to lung size with poorer lung function and increased COPD risk. In other words, some people's susceptibility may begin with the way their respiratory system developed long before anyone ever lit a cigarette.
Perhaps we need to stop looking at every person with COPD through exactly the same lens.
2. From smoking straight to an inhaler
Something else kept coming back to me throughout my research, particularly when I looked back at my own diagnosis.
I smoked for over 40 years. For more than four decades, my lungs were exposed every single day to cigarette smoke and the thousands of chemicals and irritants that come with it.
Then I was diagnosed with COPD. I stopped smoking and was immediately prescribed maintenance inhalers.
Looking back, I now ask myself a question that I never thought to ask then:
When did I actually give my lungs a break?
After more than 40 years of exposing them to smoke and irritants, I finally removed that burden, but I went directly from inhaling cigarette smoke every day to inhaling medication into those same already damaged and sensitive airways.
There was no period where I simply stopped putting smoke into my lungs and observed what happened. No opportunity for me to discover how my lungs would respond once that enormous daily burden had been removed before another inhaled substance was introduced.
Our lungs are designed first and foremost for the exchange of gases from the air we breathe. They weren't designed for decades of cigarette smoke, pollution and the countless medicated substances we expose them to. And that made me question why, after finally removing such an enormous burden, there wasn't far more emphasis on creating the cleanest, least inflammatory environment possible for my lungs and supporting my body's natural recovery processes.
Where was the conversation about clean air, reducing inflammation, nutrition, hydration, breathing properly, strengthening the respiratory muscles, movement, stress, sleep and rest?
I'm not saying that somebody in respiratory distress shouldn't receive treatment. That's a completely different situation.
I'm questioning why medication became the immediate long-term answer while supporting my lungs and my body after 40+ years of smoking was barely part of the conversation at all.
Knowing what I know today, I would have wanted to ask: What happens if we remove the burden, support the body properly and give those lungs every possible opportunity to function at their best?
And that question leads directly into what I discovered when I began researching what inhaled medications themselves can do inside already compromised lungs.
3. Mucus isn't simply an inconvenience
Mucus is part of the lungs' natural defence system. It traps particles and pathogens so they can be moved out through mucociliary clearance and coughing.
But when the airways are chronically inflamed, as they often are in COPD, that inflammation can contribute to increased mucus production and changes in the mucus itself. It can become thicker, stickier and much harder for the lungs to clear. When mucus isn't moving effectively, it can contribute to obstruction and create an environment where infections become more of a problem.
This was another area where I began asking a different question. Rather than only asking, “How do I get rid of this mucus?”, I started asking, “Why is my body producing so much thick mucus in the first place?”
For me, inflammation became a major part of that answer.
When I changed my lifestyle and consistently incorporated all six elements of Back to Breathing, one of the changes I noticed was in my mucus. As I worked on reducing the inflammatory burden on my body through nutrition, breathing exercises, movement, meditation, mindset, self-awareness and proper rest, the thick mucus I had lived with disappeared.
That's my personal experience, but it completely changed the way I looked at mucus. I stopped seeing it simply as another COPD symptom that needed suppressing and started seeing it as information about what was happening within my body.
So yes, hydration and learning effective mucus-clearance techniques can be important, but I believe we also need to look further upstream and ask what may be contributing to the inflammation in the first place.
That question became far more important to me than simply trying to manage the mucus once it appeared.
4. But what is happening inside the lungs?
Anyone using a steroid inhaler will probably have been told to rinse their mouth afterwards.
Why?
Because some of the inhaled corticosteroid remains in the mouth and throat, where its local immune-suppressing effect can encourage oral thrush.
But that made me ask another question: what about the steroid that travels in the other direction, deep into the lungs?
We can rinse our mouths but we cannot rinse our lungs.
And this is where my research became particularly interesting.
Inhaled corticosteroids work partly by suppressing inflammatory and immune activity within the airways. That anti-inflammatory action is one of the reasons they're prescribed.
But this brought me to another question. If inhaled corticosteroids are reducing inflammation, why does that effect require continued treatment?
There is an important difference between suppressing an inflammatory response and addressing what may be contributing to that inflammation in the first place.
The medication can suppress inflammatory activity while it is being used, but it doesn't necessarily remove the factors contributing to that inflammation. And this was a huge turning point in how I began looking at my own COPD.
I didn't only want to suppress inflammation. I wanted to understand why my body was constantly inflamed and what I could change to reduce that inflammatory burden.
The same distinction applies to bronchodilators. They can temporarily relax the muscles surrounding the airways and open them, but once their effect wears off another dose is needed. Opening an airway isn't the same thing as resolving the processes happening within it.
And for me, the mucus was a very visible example. I had lived with the thick mucus and coughing so familiar to COPD. When I changed my lifestyle and consistently practised all six elements of Back to Breathing, reducing inflammation became one of my priorities. Over time, my thick mucus and constant coughing disappeared.
That made me question the difference between continually managing what inflammation produces and looking at everything within my control that might be contributing to the inflammatory burden in the first place.
And then we come to pneumonia.
People with COPD are already vulnerable to respiratory infections, yet large analyses of randomised COPD trials have repeatedly found an increased risk of pneumonia associated with inhaled corticosteroid treatment.
One large analysis involving almost 50,000 participants found an increased relative risk of pneumonia and severe pneumonia, although importantly the degree of risk varies according to the particular corticosteroid, dose and individual circumstances.
So, when I hear how many people with COPD experience repeated chest infections, pneumonia and hospital admissions, I think it's important that we at least ask whether medication could be one contributing factor rather than automatically assuming every infection is simply another inevitable part of COPD.
That doesn't mean an inhaler caused every case of pneumonia, nor does it mean everyone using a steroid inhaler will develop pneumonia.
I'm not questioning the need to treat pneumonia or a serious exacerbation. Of course, when someone is acutely ill, appropriate treatment may be necessary. What I'm questioning is why so much attention is placed on treating each episode once it happens, while seemingly far less attention is given to asking why the cycle keeps happening and what can be changed to help prevent it.
If someone is experiencing ongoing inflammation, thick mucus, repeated chest infections and hospital admissions, surely, we should be looking further upstream. What is contributing to that inflammatory burden? What can be changed in nutrition, breathing, movement, stress, sleep, hydration and everyday lifestyle to support the body and lungs before another crisis develops?
The aim shouldn't simply be to recover from one episode and wait for the next. The aim should surely be to do everything within our control to reduce the inflammation and other contributing factors that may be helping to drive that cycle in the first place.
This is what I mean when I talk about stepping outside the treatment cycle. For me, it wasn't about continually dealing with the next symptom, infection or health problem as it appeared. It was about asking why they were happening at all, changing what I could change and supporting my body as a whole.
But if pneumonia is a recognised risk of a treatment, surely people deserve to know that, so they can properly consider the benefits and risks?
And that's what struck me most while researching this. We hear plenty about rinsing the mouth and preventing thrush, but how often are ordinary patients encouraged to understand what that same medication is doing once it reaches the organ it was actually intended to reach? Do the lungs get thrush too?
5. Steroids and muscle weakness
This particularly interested me because breathing isn't performed by the lungs alone. We need muscles to breathe.
The diaphragm and other respiratory muscles work continuously, and people with COPD already place enormous demands upon them.
Corticosteroid-induced myopathy is a recognised medical condition. Research has documented that corticosteroids, particularly prolonged or higher systemic exposure, can cause skeletal muscle weakness and can involve respiratory muscles too. Studies in COPD patients with steroid-induced myopathy have documented weakness of both peripheral and ventilatory muscles.
That doesn't mean every steroid inhaler destroys the diaphragm. It doesn't.
But it reinforces something I've come to believe very strongly: muscle health matters enormously when we're trying to breathe better.
And that is why nutrition, movement and maintaining or rebuilding strength are such important parts of Back to Breathing.
6. And what about everything else we're taking?
Another part of this picture that I don't think we can ignore is the number of other medications many people with COPD are taking alongside their inhalers.
At one point I was taking nine different medications for various health issues, as well as three inhalers. Every medication has an intended purpose, but medications can also have side effects. When several are being taken together, that's a lot for one body to deal with and a lot for us as individuals to understand.
We talk openly about the consequences of smoking, eating highly processed food, being inactive, living under constant stress or not getting enough sleep. So, I believe we should be equally comfortable talking about the potential unwanted effects of the medications we put into our bodies.
For me personally, statins were one of the clearest examples. I experienced extreme body pain while taking them and felt that my breathing was being suppressed. My experience became severe enough that I genuinely felt extremely unwell. That was what happened in my body, and it taught me never to assume that every new symptom was automatically another illness or simply my COPD getting worse.
At that stage of my life, I seemed to have one health issue after another, with medication being added for different problems. Eventually I made the personal decision to stop the medications I was taking and completely change the way I lived through what became the six elements of Back to Breathing.
What happened afterwards was extraordinary for me. The health problems I had been dealing with disappeared and I no longer needed those medications. That is my personal history; it is not an instruction for anybody else to stop theirs.
But it left me with a question that I still believe everyone taking multiple medications should ask:
Do I know what each medication is for, what its possible side effects are, how it may interact with everything else I'm taking, and whether I still need it?
Because self-awareness isn't only about noticing what food, stress or lack of movement does to our bodies. It means paying attention to everything we put into them.
So, what changed for me?
When my lung function reached 22%, I stopped asking only, “What can I take?” and started asking, “What does my body actually need?”
I made a personal decision to change my life completely. Not gradually and not one little thing this week and perhaps another next month.
I committed to what eventually became the six elements of Back to Breathing: Self-Awareness & Mindset, Meditation, Breathing Exercises, Nutrition, Gentle Movement and Rest.
Every single one. Every single day.
What I have since found particularly interesting is that research supports many of these individual elements in COPD care, including breathing exercises, physical activity, nutrition, psychological wellbeing, self-management and pulmonary rehabilitation. Research into multi-component COPD self-management also supports looking beyond medication and addressing different aspects of a person's health together. Back to Breathing brings these areas together through my six elements, with the emphasis on consistently supporting the whole person rather than concentrating on the lungs in isolation.
I completely changed what I ate, focusing on foods that supported rather than added to inflammation. I learned how to breathe differently, moved and strengthened my body, dealt with stress and anxiety, meditated and gave my body proper rest. Most importantly, I became incredibly aware of what my body was telling me.
Within around three weeks, I was already noticing changes in how I felt and breathed. Over the years that followed, my measured lung function went from 22% to 61%.
That's my experience. I'm not claiming everyone will achieve those numbers, nor can I scientifically separate which individual change contributed what percentage of that improvement.
But I certainly wasn't prepared to dismiss what my own body was showing me.
So, what can we do about inflammation ourselves?
This is perhaps the most important question all of this research brought me to.
If inflammation is such an important part of COPD, what can we do every single day to help reduce the inflammatory burden on our bodies rather than relying solely on medication to address it?
For me, this is where looking at the whole body becomes so important because inflammation isn't influenced by just one thing.
What we eat matters. How much we move matters. Sleep matters. Stress matters. Smoking, pollution and the air we're breathing matter. Hydration, weight, muscle health and our general metabolic health matter.
Nutrition became a huge part of my own approach. I concentrate on fresh, whole, anti-inflammatory foods, good-quality protein, healthy fats, vegetables, herbs, spices and foods rich in natural antioxidants while avoiding the highly processed, sugary and refined foods that can contribute to an inflammatory environment in the body.
Movement matters too. Gentle, regular activity helps maintain muscle, circulation and physical fitness. Stronger muscles can make everyday activities less demanding, which becomes particularly important when breathing is already compromised.
Then there is breathing itself. Learning to use the diaphragm, becoming aware of dysfunctional breathing patterns and practising breathing exercises can help us use the respiratory system more efficiently and reduce some of the unnecessary work we're asking it to do.
And we cannot ignore stress and sleep. Chronic stress can influence inflammatory processes throughout the body, while poor-quality or inadequate sleep can also affect inflammation. This is why meditation, mindset, self-awareness and proper rest aren't little extras in Back to Breathing. They're part of the same picture.
None of these things works in isolation and there is no single magic food, breathing exercise or supplement that changes everything.
That's precisely why I work with all six elements together.
And this is what all of this research has brought me back to.
The question isn't simply whether medication can open an airway or suppress inflammation. We already know it can.
The bigger question for me is: what are we doing every day to support the body that those lungs belong to?
What are we eating and how are we breathing? Are we moving and keeping our muscles strong? Are we constantly stressed? Are we sleeping and resting enough? Are we hydrated? What are we exposed to environmentally? What causes inflammation in our own body? And are we actually paying attention when our body tells us something has changed?
COPD isn't just two damaged lungs sitting separately from the rest of us. The lungs are part of an entire living system.
That's why Back to Breathing doesn't focus on one magic exercise, one food, one supplement or one treatment. It looks at the whole person.
For me, the question became less about, “What can I take to suppress this?” and much more about, “What am I doing every day that may be adding to inflammation, and what can I change to help my body carry less of that burden?”
Stepping outside the cycle of simply treating the next symptom and becoming curious about WHY my body was struggling changed everything for me.
So don't stop asking questions.
Learn about the condition. Learn about the treatments, including their benefits and their side effects. Learn about nutrition, breathing, movement, stress, sleep and inflammation.
But above all, learn about your own body. No one knows your body as well as you do, and you are the only person who can decide to make the changes necessary to support better breathing and better health. Others can guide you, educate you and support you, but no one can make those changes for you.
The decision to become curious, to listen to your body and to change what is within your control ultimately must come from you. Self-awareness is key!
Because every symptom is information. 💚
Research sources:
I have added the scientific studies and research referenced in this post to the first comment below for anyone who would like to explore them further. Don't take my word for it. Read, research, ask questions and become curious about what is happening inside your own body.
⚠️ Important: This post describes my personal experience and what I have learned through my own research. It isn't an instruction to stop prescribed medication. COPD and individual health circumstances vary enormously, and medication changes should be discussed with an appropriate healthcare professional.
