According to the WHO, tuberculosis (TB) is the leading infectious disease in the world.1 In 2023 an estimated 10,8 million people were infected and 1,25 million died from the disease. Unfortunately TB has developed drug resistant strains, making it difficult to treat with conventional antibiotics. Multi drug resistance has resulted in TB being seen a a global health crisis and a threat to health security. Most TB cases occur in low- and middle-income countries, with half concentrated in eight nations: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, the Philippines, and South Africa. However TB affects people all over the world, irrespective of financial status. In the USA the CDC2 recorded 9633 cases and about 600 deaths from TB in 2023 .
Causes of TB
TB is caused by bacterial infection and is passed from person to person when an infected person sneezes and another inhales droplets from the air. It is not very virulent and one has to be in close proximity to the infected person. Most infections occur in domestic and workplace situations, where people are in the presence of the infected person for extended periods. It’s unlikely that one will pick up infection in public places. When infected, most healthy people will show no symptoms and are classed as latent carriers. Some authorities estimate that it’s possible that 25% of the world population may be in this category! Those that exhibit symptoms are termed active carriers and require treatment.
Symptoms of TB
TB either affects the lungs (pulmonary) or other organs (extra-pulmonary)
Symptoms and signs of active TB include the following:
- Persistent cough
- Chills
- Fever
- Profuse night sweats
- Weight loss
- Loss of appetite
- Malaise
- Weakness
- Fatigue
- Poor growth in children
- Swollen glands
Apart from death, complications of TB include the following:
- Permanent lung damage
- Pneumothorax: collapsed lung
- Hemoptysis: coughing up of blood from the lungs
- Increased risk of developing lung cancer
- Chronic pulmonary aspergillosis: a persistent fungal lung infection
- Septic shock following an infection that has moved into the blood
- Acute respiratory distress syndrome (ARDS): a severe lung injury causing fluid leakage into the lungs
- Empyema: the accumulation of pus in the space between the inner chest wall and the lungs
- Fibrothorax: the thickening of the pleura, restricting lung movement
- Severe spinal deformity: this is a complication of spinal TB
Conventional treatments for TB
Treatment is usually antibiotics, generally a combination of four different ones, until lab tests determine the ones most effective. As a result of multi drug resistant TB, medical practitioners are now also using other drugs, in combination with antibiotics, as part of the treatment protocols. Pulmonary and extra-pulmonary TB are generally treated with the same regimens. Treatment lasts six months to one year as TB bacteria have a slow death rate. The long treatment duration is the reason the multi drug resistant strains have developed. People start feeling better and stop taking their medication, wrongly thinking that they are cured. It’s vital that the entire course of medication(s) be completed to ensure complete destruction of the TB bacteria.
Alternative Treatments for TB
As a result of the difficulty in treating the multi drug resistant strains of TB, there has been increased interest in alternative treatments. A number of studies have highlighted the effectiveness of natural remedies, including:
- Garlic. A number of studies3,4,5,6 show the effectiveness of garlic in combating the TB bacteria. Allicin, the active ingredient in garlic, is a potent natural antibiotic and has been used for centuries to treat wounds and infections. In one study4 the researchers concluded that “Allicin/garlic extract alone or as an adjunct to classical antibiotics holds great promise for treatment of drug-sensitive as well as drug-resistant TB.” When choosing a garlic supplement look for one that has an enteric coating to protect the allicin from the stomach acids and has a guaranteed allicin potency.
- Curcumin. A component of the spice turmeric, curcumin has potent anti-oxidant, anti-viral and anti-baterial properties. In studies7,8,9 it has been shown to be effective in combating TB bacteria.
- Vitamin D. One of the most studied vitamins since covid, Vit D has been shown to be effective in combating TB bacteria. A major review of studies12 lists over 20 studies showing the benefits of Vit D in preventing and treating TB.
Some of the researchers’ conclusions were:
– Low vitamin D levels appear to be a risk factor for developing both Mycobacterium tuberculosis (MTB) infection and active tuberculosis (TB).
– Higher serum vitamin D levels are significantly associated with a lower probability of acquiring both MTB infection and active TB.
– One prospective study found 800 IU of vitamin D supplementation/day for 6 months caused a 59% reduction in MTB infection.
Another study13 with Vit A (retinoic acid) and Vit D found that, in combination, they reduce the risk of infection and inhibit the growth of TB bacteria in the body.
Diet
Diet plays a crucial role in the prevention and management of tuberculosis (TB). Consuming the right foods can boost the immune system, helping to prevent infection, aid recovery and prevent further complications. Here are some dietary guidelines to consider:
TB patients need higher than normal amounts of certain nutrients to assist the body’s recovery:
- Protein. Protein is needed by every cell and organ in the body to assist with repair and renewal. High quality protein like eggs, lean meat, poultry, fish, beans, lentils and nuts can help prevent muscle loss, promote healing and strengthen the immune system.
- Good Quality Carbohydrates. Unrefined carbs, like whole-grain bread, pasta and brown rice provide the body with sustained energy and help stabilise blood sugar levels, preventing spikes and crashes that can lead to fatigue and weakness.
- Good Fats. Good fats, found in fatty fish, (sardines, anchovies, salmon, tuna), avocados, cheese, full fat yoghurt, nuts, seeds and olive oil, are rich in essential fatty acids that can help improve heart health, brain function and immune system function. They help regulate inflammation in the body, which can help TB patients reduce the risk of developing complications.
- Fresh Fruits and Vegetables. Fruit and vegetables are a great source of vitamins and minerals. These can help boost the immune system and aid recovery. Dark green leafy vegetables, such as spinach, cabbage, broccoli and kale are rich in vitamins, as well as iron and calcium. Other vegetables like carrots, sweet potatoes and bell peppers are high in antioxidants and fibre, which can help prevent cell damage and improve digestive health.
Foods to avoid:
- Processed Foods. Packaged and processed foods such as convenience foods, packaged snacks and sugary cereals should be avoided as they are often high in unhealthy fats, sugars and artificial additives.
- Fried Foods. Fried foods are high in unhealthy fats and can increase inflammation in the body, making it harder to fight off TB infection.
- High-Fat Meats. High-fat meats such as red meat, sausage, polonies and bacon are filled with growth hormones, antibiotics and preservatives, which depress the immune system. They are also difficult to digest and can worsen symptoms of TB.
- Refined Carbohydrates. TB patients should avoid foods made with refined grains such as white bread, pasta and white rice. They are low in fibre, high in empty calories and cause blood sugar spikes.
- Sugary Drinks. Beverages like soda, sports drinks, and energy drinks should be avoided as they are high in sugar and can weaken the immune system.
Patients with TB should try to eat five small meals a day to ensure stable blood sugar levels and a constant supply of nutrients, which help the body fight the infection.
Supplements That Can Help TB patients
While there isn’t a lot of research on the subject there are a number of reviews14,15,16 that suggest that supplementation may help. Considering that there is ample evidence that supplementation is helpful for heart disease, cancer and mental decline17,18,19 it is logical to assume that it would also help TB patients. In addition to the supplements already mentioned the following would be beneficial for TB patients:
- Multivitamin and Mineral supplement. Look for a high quality one that is derived from organic, whole food sources.
- Carotenoids. These are the bright red, yellow and orange pigments in fruits and vegetables.They have been shown to be powerful antioxidants and immune boosters20.
- Zinc. Zinc is critical in hundreds of processes in the body. It speeds the healing process, slows viral replication and help fight infection21.
Conclusion
TB is the leading infectious disease in the world today, causing untold disruption to families and economies. It results in significant numbers of deaths. The good news is that with the simple, common sense strategies listed above, one can do a lot to reduce the risk, and improve the recovery, of TB.
References.
1. https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2024/tb-disease-burden/1-1-tb-incidence
2. https://www.cdc.gov/tb-surveillance-report-2023/tables/table-1.html
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4090836/
4. https://pubmed.ncbi.nlm.nih.gov/30537531/
5. https://pubmed.ncbi.nlm.nih.gov/21190924/
6. https://pubmed.ncbi.nlm.nih.gov/37990133/
7. https://pmc.ncbi.nlm.nih.gov/articles/PMC8876821/
8. https://pmc.ncbi.nlm.nih.gov/articles/PMC10424441/
9. https://pmc.ncbi.nlm.nih.gov/articles/PMC4794995/
10. https://journals.asm.org/doi/10.1128/aac.01641-18?
11. https://pubmed.ncbi.nlm.nih.gov/23695675/
12. https://pubmed.ncbi.nlm.nih.gov/25959993/
13. https://pubmed.ncbi.nlm.nih.gov/18327422/
14. https://pubmed.ncbi.nlm.nih.gov/27287634/
15. https://pubmed.ncbi.nlm.nih.gov/29262971/
16. https://pubmed.ncbi.nlm.nih.gov/27355911/
17. https://www.realhealth4life.co.za/4-things-you-can-do-to-improve-your-health/
18. https://www.realhealth4life.co.za/supplementation-can-help-cancer-sufferers/
19. https://www.sciencedirect.com/science/article/abs/pii/S0002916523489046
20. https://pubmed.ncbi.nlm.nih.gov/9062542/
21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247509/