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Tuberculosis
Not extinct but treatable — the therapy takes long yet works reliably.
Also known as: tuberculosis · TB · consumption (old term)
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A bacterial infection that most often affects the lung. It spreads through the air (fine droplets), but not every contact leads to illness: often the bacterium stays inactive in the body (latent tuberculosis) with no symptoms at all. When it becomes active, a persistent cough (often longer than three weeks, sometimes bloody), night sweats, fever, weight loss and malaise are typical. Important to know: tuberculosis is usually curable with a consistent, multi-month combination of antibiotics. The key is to complete the treatment fully.
If suspected: test, X-ray and sputum analysis — the earlier the better.
The core point: a combination of several antibiotics over several months usually leads to a cure.
Stopping too early favours resistant bacteria — so it must be seen through.
Close contacts should be examined; protective measures apply during the infectious phase.
Four drugs at once for two months, then two for four months — six in all. The number is needed because otherwise the bacteria become resistant within weeks; the duration because part of the organisms lie dormant and are reached only slowly. A person is no longer infectious after about two to three weeks of treatment — so the symptoms improve long before the end. That very feeling is the reason for most discontinuations.
About a quarter of the world’s population carries the organism dormant; in five to ten in a hundred of them the illness breaks out during their life, considerably more often with weakened defences. From infection to a positive skin test, two to ten weeks pass. Treatment lasts six months; a person is no longer infectious after two to three weeks. The culture needs two to six weeks, because the organism divides only every twenty hours.
Sometimes with bloody sputum — should be assessed.
Often a low fever over a longer period.
Unintended weight loss and lasting tiredness.
The bacterium can lie dormant for years and become active later.
Often clearly raised and staying raised over weeks. A normal value does not rule the illness out, though.
Supplements the sedimentation rate. Neither says anything about the cause — they only show that an inflammation is running.
Often an anaemia and a shifted distribution of the white cells. The proof lies in the examination of the sputum and in the imaging.
A low sodium occurs with long-drawn-out lung disease and belongs assessed too, because it explains tiredness and confusion.
Fever, sweating and faster breathing clearly raise the need. Drinking enough keeps the mucus thin and the circulation steady — in children and older people it is the most important point of all.
Low levels are common in chronic airway illnesses and go along with more infections. Correcting a deficiency is simple; for lung function itself it is no replacement for treatment.
Relaxes the smooth muscle of the airways — which is why it is also given as an infusion in an emergency. For everyday use the tablet replaces no inhaler.
Needed by the defence cells. For lozenges at the start of a cold there are hints of a slightly shortened duration; at a high dose over months zinc lowers copper.
Antibodies and defence cells are protein. After several days with little appetite it is worth at least keeping the protein up — soup with egg, quark, yoghurt, lentils.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
A dormant tuberculosis can flare again under cortisone or under modern rheumatism medicines. This is why testing happens before such treatments — one of the most important preparatory steps of all.
As with sarcoidosis the inflammatory nodules themselves make the active form of vitamin D — which is why the calcium in the blood can rise. A vitamin D supplement is not a given here but a question put to the value.
Historically tuberculosis was the most common reason for adrenal insufficiency — it destroys the adrenal glands from outside. In some parts of the world it still is today.
Treatment lasts at least 6 months. Being underweight at the start is linked with a poorer course; weight gain in the first 2 months counts as a favourable sign.
Isoniazid uses up vitamin B6 and can otherwise damage nerves. B6 is therefore usually given alongside — not an optional supplement but part of the treatment.
Historically tuberculosis was treated with sun and mountain air — vitamin D lies behind that. As an addition to today’s treatment studies found small effects on healing time.
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