Prevention
TB is difficult to treat (see "Drug Therapies") so prevention is important. Prevention of TB begins with rapid diagnosis and treatment to avoid spread to noninfected persons. In countries where TB is common, a vaccine called BCG may be administered. However, the vaccine causes a false positive on the skin test and is not very effective in adults, so it's rarely given in the U.S.
If you are at risk, you should be tested for TB every 6 months. If you test positive but have no signs of active infection, you may be given the medication isoniazid to prevent an active infection.
The most important way to keep TB from spreading is for infected people to take their medications exactly as prescribed. If you do not take all your medications, you run the risk of developing multidrug-resistant TB, which you can then spread to others. Drug-resistant TB is a major health problem in the U.S. and around the world. If you have TB, keeping all of your clinic appointments is essential so that your doctor can check for side effects from the drugs and evaluate the effectiveness of the treatment. If you are sick enough with TB to go to a hospital, you may be put in a special room with air vents that keep the TB bacteria from spreading. You will most likely be prevented from leaving your room while you are contagious (about 2 weeks after treatment begins). People who come into the room will wear special face masks to protect themselves from TB bacteria and to prevent the spread of TB bacteria to others.
Treatment Plan
If your doctor suspects TB, treatment may begin before all lab tests return. This may include more than one anti-TB drug. Emergency treatment may be necessary if, for example, you are coughing up blood.
Drug Therapies
TB bacteria die very slowly. It takes 6 months to a year for the medicine to destroy all of the TB bacteria -- longer for multidrug-resistant TB. If you have TB, you will need to take several different drugs. You will be tested first for drug resistance to determine the most effective combination of drugs to prevent the bacteria from becoming resistant to the drugs. The most common drugs used to fight TB are:
- Isoniazid (INH)
- Rifampin
- Pyrazinamide
- Ethambutol
- Streptomycin
Complementary and Alternative Therapies
TB should never be treated with alternative therapies alone -- to cure the disease, and to avoid spreading it to other people, you must be treated with prescription medications. Some CAM treatments may be useful as supportive therapies.
Even if complementary therapies are used, conventional prescription drugs must be taken exactly as directed. Complementary therapies do not allow patients to get by with less medicine or to skip doses. Skipping doses is a major cause of the development of drug-resistant strains and greater spread of the disease.
Nutrition
Poor nutrition can contribute to a weakened immune system, which can make it more likely that you'll catch TB or develop an active infection. Make sure you get enough of the following nutrients in your diet:
- Vitamin B6 -- Treatment with isoniazid can reduce levels of vitamin B6 in the blood, so your doctor may prescribe a supplement.
- Vitamin B12 (500 mcg per day)
- Vitamin C (1 - 6 g per day) -- Vitamin C may interfere with vitamin B12, so take doses at least 2 hours apart. Lower dose if diarrhea develops.
- Vitamin D -- Several studies show that low levels of vitamin D may explain why some ethnic groups tend to be more susceptible to TB. This early research is very promising, although it isn't yet known whether vitamin D can help prevent or treat TB. Talk to your doctor about taking supplemental vitamin D, so the doctor can establish the proper dose for you.
- Vitamin A (5,000 mg per day)
- Zinc (15 mcg per day)
Beta-sitosterol (60 mg per day), a compound present in some plants, may be helpful when given along with conventional medication, although results from one study were uncertain.
Animal studies suggest that TB may be more severe in persons with diets rich in omega-3 essential fatty acids. These studies are not comprehensive, and it's not clear whether there is a similar effect in humans. Until researchers know more, however, it may be wise to avoid omega-3 supplements (such as fish oil) if you have or are at risk for TB.
Herbs
Although herbs should never be used alone to treat TB, some herbs may be helpful along with conventional medical treatment.
- Garlic (Allium sativum ) -- Has antimicrobial properties and slowed the rate of growth of M. tuberculosis in animal studies. However, very high doses were used, which could prove toxic to humans. Ask your doctor about taking garlic along with conventional prescription TB medications. Do not take garlic if you take blood-thinning medication.
- Astragalus (Astragalus membranaceus, 5 - 15 g per day) -- A preliminary study indicates that astragalus may be helpful in treating TB. However, more research is needed.
Other herbs have been used traditionally for TB but lack scientific evidence:
- Agrimony (Agrimonia eupatoria)
- Ashwagandha (Withania somnifera)
- Barberry (Berberis vulgaris)
- Echinacea (Echinacea spp.)
- Elecampane (Inula helenium)
- Horsetail (Equisetum arvense)
- Mullein (Verbascum thapsus)
- Sweet coneflower ( Rudbeckia subtomentosa)
- Tamarisk ( Tinospora cordifolia)
- White horehound (Marrubium vulgare)
Homeopathy
Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend one or more of the following treatments for tuberculosis based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
- Arsenicum album -- for cough and chest pain, particularly from infectious causes. Symptoms worsen at night and are often accompanied by fever, chills, weakness, exhaustion, and restlessness. This remedy is most appropriate for individuals who often feel scared and anxious.
- Calcarea carbonica -- for chills, drowsiness, perspiration (especially at night), and swollen lymph nodes. This remedy is particularly appropriate for individuals who are susceptible to infection, tend to be stubborn, and crave eggs and cold drinks.
Acupuncture
Acupuncture can help strengthen your immune system response as well as support your lung function.
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