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Why Is High Altitude Negative For Emphysema?

marteagal

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Dear all, yesterday I stumbled across the following Peat quote (from the E-mail advice depository):
charlie said:
"Are there any conditions which high altitude is negative for? I think I remember saying something about asthma?"
Ray Peat said:
"I should have said respiratory diseases, meaning things like emphysema and pulmonary fibrosis. Asthma is usually improved at high altitude, above 6000 feet, for several reasons. Even in polluted Mexico City, at 7500 feet, there's very little asthma, but people who vacation in Acapulco often get asthma."

My question or concern is specifically about emphysema. Increasing the body's CO2 retention capabilities should help this condition and, in agreement, Buteyko practitioners claim that Buteyko breathing improves emphysema/COPD. From my limited understanding my initial guess was that high altitude would also help with emphysema but Peat disagrees according to the quote above. Does anybody know the specific reasons? Is it perhaps because the first few days (or weeks) after moving to high altitude are very strenuous and this would be an overkill for people with already poor lung health? Or, as @tara has put it:
From other comments he has made about altitude, I read him as saying that being adapted to high altitude is protective (because this entails retaining more CO2). But not being adapted to altitude, and being hypothyroid, can make one prone to extra problems - I assume these include what is usually described as altitude sickness (which is known be dangerous), as well as slower degenerative processes.

So, is it all about adaptation, meaning that slowly increasing and adapting to higher CO2 levels is helpful for emphysema/COPD whereas suddenly changing your environment, i.e., moving to high altitude, is not ?

Thank you very much in advance!
 

Blossom

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It's my understanding from a medical perspective that in people with emphysema the lungs have lost their elastic recoil which interferes with the ability to ventilate normally. At high altitude the problem can intensified in someone who already has increased work of breathing by further taxing the lungs and *could potentially* result in respiratory distress or possibly failure.
 

marteagal

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Thank you @Blossom. So it's more a matter of the lower air pressure at high altitude, not the CO2 per se, that causes harm, can I say this?
 

Blossom

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Thank you @Blossom. So it's more a matter of the lower air pressure at high altitude, not the CO2 per se, that causes harm, can I say this?
Some people with emphysema do retain CO2 simply because they do not blow it off effectively and often have what is called air trapping. I think of it as a structural problem and regulating CO2 can be part of the issue just as an inability to oxygenate adequately can be a factor in the disease process.
 

Blossom

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There's simply not enough capacity to compensate for the extra demand that altitude places on the lungs during the adjustment phase so someone with emphysema probably wouldn't get enough oxygen and might even build up too much CO2 where a person with healthy lungs would just be slightly uncomfortable.
 

Blossom

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You are correct about air pressure being another contributing factor @marteagal.
 

marteagal

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Some people with emphysema do retain CO2 simply because they do not blow it off effectively and often have what is called air trapping. I think of it as a structural problem and regulating CO2 can be part of the issue just as an inability to oxygenate adequately can be a factor in the disease process.

Thank you so much! Then it's probably a good idea to be also cautious when learning Buteyko breathing, in case of "air trapping". :(
 

Blossom

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Thank you so much! Then it's probably a good idea to be also cautious when learning Buteyko breathing, in case of "air trapping". :(
Not everyone with emphysema has air trapping but if you've been diagnosed with severe emphysema or copd it's always wise to be extra careful with anything that can impact breathing. I believe @ecstatichamster is knowledgeable about buteyko so he might have some helpful information.
 

marteagal

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The person having COPD is actually my mother (age: 64 years). From her descriptions a few years ago, from time to time she experiences difficulty to completely exhale, and I think this is what "air trapping" refers to. Actually "we" (i.e., she) has tried a couple of Peat-related things I conveyed to her in the last 1.5 years, but yet to no avail.

I think, the ultimate problem in her body can be tracked down to low CO2 level due to hypometabolism/estrogen dominance (for decades), and the following ways to increase CO2 came to my mind, besides going low PUFA and having good nutrition:

1. taking T3/T4
2. using other pro-metabolic substances (coffee, methylene blue, aspirin, B1, B3, magnesium, [progesterone])
3. inhaling CO2 from a canister (VoS method)
4. eating baking soda
5. learning Buteyko breathing / bag breathing

With 1. and 2. not working, and occasionally reading on the forum about the benefits of Buteyko breathing (plus reading on the internet that Buteyko is worth a try for actually treating COPD), I suggested to her to learn it. Three weeks ago she went to a Buteyko teacher (the 2nd session was last week I think) and has been practicing since. Actually she seems to do better, even after three weeks, but now I am hesitating whether my suggestion to her was (another?) "mistake".
 

Blossom

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With 1. and 2. not working, and occasionally reading on the forum about the benefits of Buteyko breathing (plus reading on the internet that Buteyko is worth a try for actually treating COPD), I suggested to her to learn it. Three weeks ago she went to a Buteyko teacher (the 2nd session was last week I think) and has been practicing since. Actually she seems to do better, even after three weeks, but now I am hesitating whether my suggestion to her was (another?) "mistake".
I don't know a lot about buteyko but it sounds pretty safe especially since she is working with a teacher. I would think it would help her develop some sense control over her breathing. Hopefully someone who knows more about buteyko will reply. What I don't think is that it's comparable to how suddenly arriving at altitude unacclimated would be with emphysema.
 
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HDD

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@marteagal I came across this today, I'm guessing you have heard this before since you said she's tried progesterone?

RP: Yah. Every tissue has it’s response to progesterone; all nerves are stabilized by progesterone, [as well as] the skin, and connective tissue, joints... For example, in animal experiments, as well as in people I’ve seen, they can create emphysema artificially in an animal and then cure it with progesterone. I've seen it happen in a week with a person just supplementing progesterone; and they can breathe very nicely.
Cholesterol Is An Important Molecule, KMUD, 2008
 

tara

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Three weeks ago she went to a Buteyko teacher (the 2nd session was last week I think) and has been practicing since. Actually she seems to do better, even after three weeks, but now I am hesitating whether my suggestion to her was (another?) "mistake".
Great that she's doing better. If she feels and functions better, that would seem like a very good sign. I would expect a good Buteyko practitioneer to be able to assist with keeping training at an appropriate rate to allow useful adaptation, rather than overwhelming distress. You can do it in limited time frames, and quit or ease up immediately if it gets too much. Being in high altitude would make this much harder. If the training helps her avoid bouts of more extreme hyperventilation, that could be helping reduce distress.
 

marteagal

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I am really overwhelmed by your help. Thank you all!

@marteagal I came across this today, I'm guessing you have heard this before since you said she's tried progesterone?

RP: Yah. Every tissue has it’s response to progesterone; all nerves are stabilized by progesterone, [as well as] the skin, and connective tissue, joints... For example, in animal experiments, as well as in people I’ve seen, they can create emphysema artificially in an animal and then cure it with progesterone. I've seen it happen in a week with a person just supplementing progesterone; and they can breathe very nicely.

Thank you, I didn't know this particular quote but a few weeks ago I searched specifically for what Ray Peat has to say about treating emphysema/COPD ... Progesterone was the most frequently mentioned substance. In the video posted by @raypeatclips as well as in Ray Peat - Life Supporting Substances - It's Rain Making Time, 2011-07-04, Ray Peat mentions the successful treatment of an old man in Mexico (office; no elevator; improvement after two weeks) using pregnenolone (instead of progesterone), which is particularly interesting, since my mother already takes the maintenance dose of Progest-E. She started the whole progesterone thing about 14 months ago, according to the standard procedure described in the manual: intial high doses (IIRC 3 drops 5 times per day) and then (after a few weeks) decreasing the dose until a maintenance dose of 3 drops once or twice daily is reached. I don't know how far she can go with progesterone. She has never felt anything from it, btw. Haidut said that taking more than 100 mg (?) of progesterone has direct metabolism-boosting effects. Sure, this would be worth a try. However, I don't know how safe that would be, at least in comparison to pregenolone. And taking into account Peat's own experiment of using a few grams of pregnenolone daily for several months, I thought pregnenolone would be "safer". Therefore I decided in favor of pregnenolone, ordered 50 g of it which is hopefully arriving these days, and will then give it to my mother, beginning with a low dose of 10 or 20 mg per day and then working the way up. All other things like thyroid medication, her maintenance dose of progesterone, EstroBan, Energin, and Mitolipin will remain constant. Hope, this will finally work out, also for all the other symptoms she has (emphysema being just one of many).

Peat also talked about emphysema in one of his newest interviews here, which I have created a clip of:

Thanks, this was also helpful, especially the first story of the woman. The story of the man can be found as transcript also here:
Ray Peat said:
Well after I saw that it [pregnenolone] was harmless, I started giving it to my friends. One friend who was 82 or so at the time was purple when I visited him at a high altitude town in Mexico, and all of his functions were slow. He had trouble even standing up and was panting from emphysema - professionally diagnosed emphysema - . And all of his tissues were starved for oxygen. I gave him probably an average of 500 mg [pregnenolone] a day for a week or two, and when I came back two weeks later; his skin color was normal. His office was upstairs, very steep climbs on the stairs to get to his office every day. He took me to his office and then insisted on walking around the city, showing me various projects that he had. He had hardly been able to stand up two weeks before, he was now making me pant with the exertion [chuckles].

Great that she's doing better. If she feels and functions better, that would seem like a very good sign. I would expect a good Buteyko practitioneer to be able to assist with keeping training at an appropriate rate to allow useful adaptation, rather than overwhelming distress. You can do it in limited time frames, and quit or ease up immediately if it gets too much. Being in high altitude would make this much harder. If the training helps her avoid bouts of more extreme hyperventilation, that could be helping reduce distress.

Yes, hyperventilation was a big problem for her. Now she takes great care to breath through the nose all the time (incl. taping her mouth at night) and to stop "exercise" timely before needing to hyperventilate.
There was just one alarming thing that sometimes happens to her. First time it happened was roughly two weeks after her first Buteyko session: She told me that sometimes she experiences all of a sudden a kind of reflex to breath, in the sense of a quick, involuntary breath which becomes conscious after it happens. Not a planned breath. She asked her teacher, but the teacher said she has never heard of such a thing and that my mother shouldn't worry. Personally I think, it might be a sign that my mother has overdone the Buteyko thing a litte. The neuronal circuits in her brain stem controlling breathing probably currently re-wire, and the sudden involuntary breaths might continue until she has re-learned proper breathing, that is, after rewiring has been completed. I don't know if that's silly, just my thoughts.
 

smith

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Dies anyone remember Peat's quote on the specific altitude which switches the human body to a "growing machine"?
 

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