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Health Protocols

Bronchitis (Acute)

Acute bronchitis—inflammation of the airways in the lungs—prompts about 10 million doctor’s office visits annually in the United States.

Most cases of acute bronchitis are caused by viral infections; bacterial infections cause very few cases.

The good news is that natural interventions such as Pelargonium sidosides and N-acetyl cysteine (NAC) may help ease the symptoms of acute bronchitis and make it go away faster.

Signs and Symptoms

  • productive cough persisting for 5 days or more
  • sore throat
  • wheezing
  • shortness of breath
  • fatigue
  • and low-grade fever

Causes and Risk Factors


  • Viruses, including rhinovirus, influenza virus, and some other common viruses
  • Less common causes include bacterial infections and environmental irritants

Risk Factors

  • Age (with very young and very old people being at higher risk for infections)
  • Vaccination – people who get vaccinated against influenza are less likely to get bronchitis
  • Working and living in crowded places

Diagnosis and Conventional Treatment


  • Based on clinical examination and symptoms
  • In some circumstances chest X-ray, sputum culture, or pulmonary functions tests may help differentiate acute bronchitis from other conditions.

Conventional Treatment

  • Refrain from intense activity
  • Drink lots of clear fluids (water)
  • Aspirin (for adults) or acetaminophen to treat fever

Note: Antibiotics are often hastily prescribed for acute bronchitis, which can result in the development of antibiotic resistance. This practice is ineffective because the vast majority of acute bronchitis cases in otherwise healthy adults are caused by viral infection for which antibiotics are not helpful.

Novel and Emerging Strategies

  • Procalcitonin (PCT) blood test. PCT testing may help minimize overzealous antibiotic prescribing.
  • Cimetidine. Cimetidine, an over-the-counter heartburn drug with intriguing immune-modulating properties, may support the immune response to viral infection.

Integrative Interventions

Note: In most cases, bronchitis represents a natural progression of the common cold or flu. Therefore, taking aggressive action at the first signs of the flu or common cold is one of the best ways to prevent progression to acute bronchitis. The following interventions should be used at the first signs of a cold or the flu. Readers should also review the Common Cold and Influenza protocols.

  • Zinc. Zinc has been shown to prevent viral replication, reduce histamine release, and inhibit the production of other inflammatory mediators.
  • Garlic. Garlic has demonstrated antiviral activity against rhinovirus and a variety of other pathogens.
  • Vitamin D. Vitamin D supplements, in doses ranging from 300 IU to 4000 IU daily, have been linked to a 19% reduction in risk of acute respiratory infection.
  • Melatonin. Melatonin helps combat many types of viral infections and is associated with an increased production of antibodies.

The following interventions have been studied in the context of bronchitis.

  • Pelargonium sidoides. In a randomized placebo-controlled study, an herbal compound prepared from Pelargonium sidoides called Eps 7630 was superior to placebo in relieving acute bronchitis symptoms.
  • N-acetyl cysteine (NAC). In a double-blind placebo-controlled trial, 215 people with bronchitis (84 with acute bronchitis) received 200 mg NAC three times daily for 10 days along with antibiotic therapy. NAC was found to be significantly more effective than placebo for reduction of cough, sputum volume and viscosity.
  • Eucalyptus essential oil and cineol. In a double-blind placebo-controlled study, a combination of essential oil monoterpenes containing 75 mg 1,8 cineole (combined with limonene and alpha-pinene) resulted in signs and symptoms of acute bronchitis dissipating more rapidly and completely.
  • Bromelain. Evidence has shown that bromelain may offer therapeutic benefits to individuals suffering from bronchitis and sinusitis.