COPD remains one of the most challenging respiratory conditions worldwide, with experts warning that cases could rise to 600 million by 2050.
The researchers evaluated data from 37 randomised controlled trials (RCTs) involving nearly 2,000 patients and 21 nutritional supplements.
Their findings highlighted key players that could reshape how the industry approaches adjunct therapies for COPD.
Nanocurcumin tops the list for lung function improvement
One of the most striking results came from studies involving nanocurcumin, a highly bioavailable form of curcumin.
Nanocurcumin showed the strongest effect in slowing lung function decline — COPD patients who took it experienced a significant improvement in their Forced Expiratory Volume in One Second (FEV1) and the FEV1 to Forced Vital Capacity (FVC) ratio — two critical measures of lung function.
Traditional curcumin has long been known for its anti-inflammatory and antioxidant properties, but its poor absorption has limited clinical effectiveness.
Nanocurcumin overcomes these limitations, making it a standout option. According to the study, it achieved a 93% ranking probability for FEV1 improvement and a 94.5% ranking for FEV1/FVC, outperforming probiotics, butyrate, and other supplements.
However, the study’s authors cautioned that more large-scale clinical trials were needed before nanocurcumin could become a standard part of COPD management protocols.
Coenzyme Q10 and creatine boost exercise endurance
Reduced exercise capacity is a major issue for COPD patients, often leading to a downward spiral in health outcomes.
This new study confirmed that combining coenzyme Q10 with creatine significantly improved the six-minute walk distance (6MWD), a standard test for measuring endurance.
Patients taking this combination walked, on average, 63 meters farther than those in control groups.
Coenzyme Q10 is known to improve mitochondrial function and reduce oxidative stress, while creatine supports muscle strength and energy production.
Together, they were found to create a synergistic effect that could combat muscle fatigue and enhance endurance.
This combination ranked highest for improving exercise capacity, with a SUCRA (surface under the cumulative ranking curve) ranking of 90.8%. Nitrate supplements, melatonin (MLT), and whey proteins also showed positive effects on endurance, but fell short compared to the coenzyme Q10 and creatine combination.
Melatonin and yam-epimedium ease breathing difficulties
For patients struggling with breathlessness, the study identified two promising options: melatonin and a traditional herbal combination known as yam-epimedium. Both significantly reduced dyspnea scores on the modified Medical Research Council (mMRC) scale.
Yam-epimedium — a blend of rhizoma dioscoreae and herba epimedii — performed particularly well. Its active component, icariin, is known for its anti-inflammatory and antitussive (cough-suppressing) properties.
Yam-epimedium achieved the highest probability ranking for reducing breathlessness, at an impressive 97.4%.
Melatonin, widely recognised for regulating sleep, also showed significant improvements in reducing breathlessness and enhancing quality of life.
Its antioxidant effects could help reduce airway inflammation, and improved sleep quality could play a role in its positive impact on daily living.
Supplements also improve quality of life measures
Quality of life is a critical focus in COPD management. According to the study, melatonin again came out on top, reducing scores on the COPD Assessment Test (CAT) by eight points — a meaningful improvement.
Yam-epimedium also had a strong impact, particularly when measured using the St. George’s Respiratory Questionnaire (SGRQ), where it achieved a 99.1% ranking for quality-of-life improvement.
Vitamin D supplementation, often discussed in relation to bone health and immunity, also showed positive effects.
COPD patients taking vitamin D reported modest but statistically significant improvements in both lung function and quality of life, especially among those who were vitamin D deficient at baseline.
What’s next for research and product development?
The study’s findings could open new doors for product innovation, but industry experts must also navigate regulatory challenges and the need for robust clinical evidence.
Supplements like nanocurcumin, coenzyme Q10 with creatine, melatonin, and yam-epimedium could lead the way, but only if their safety and long-term benefits are confirmed through further studies.
In the meantime, manufacturers should focus on ensuring high bio-availability formulations, combining complementary ingredients, investing in clinical research, and targeting specific patient needs.
Products like nanocurcumin highlight the importance of overcoming poor absorption challenges, and coenzyme Q10 and creatine show that multi-ingredient formulations can produce stronger effects.
Additionally, supplements aimed at improving endurance, reducing breathlessness, or enhancing quality of life are likely to gain traction with healthcare providers.
The researchers concluded: “Despite these promising findings, further research with larger, more rigorous trials is needed to validate these results and assess the long-term benefits and safety of these supplements.”
Source: National Center for Biotechnology Information
“The effects of various nutritional supplements in patients with chronic obstructive pulmonary disease: a network meta-analysis”
https://doi.org/10.1186/s12890-025-03667-0
Authors: Jia Zeng, et al.
