Diet taboos for tuberculosis

First, foods that may interact with anti-tuberculosis drugs, affect their efficacy or even aggravate their side effects.； The second is highly irritating foods that can irritate the respiratory tract and aggravate cough/inflammatory reactions. ； The third is high-oil and high-purine foods that will increase the burden on the liver, kidneys, and metabolism, and superimpose drug side effects. Apart from this, there is nothing that you absolutely cannot eat. Instead, you should put high-quality protein supplements first. Excessive dietary taboos leading to malnutrition are the biggest pitfalls in slowing down recovery.

Two years ago, I followed up a 22-year-old girl in the Department of Infectious Diseases. When she was checked for just half a month after taking medicine, everything was fine. She even happily said that her mother squeezed grapefruit juice for her to take vitamins every day. However, a month later, she was checked again and found that alanine aminotransferase had soared to 3.7 times the normal value, which scared her so much that she thought she needed to stop taking the medicine. After a round of investigation, I found that I neither stayed up late nor took other medicines. The culprit was the cup of grapefruit juice I drank every day. The furanocoumarins in it inhibited the enzyme in the liver that metabolizes anti-tuberculosis drugs. Drug components that should be normally excreted accumulated in the body, which inadvertently aggravated liver damage. Nowadays, many clinicians directly ask patients not to touch all citrus fruits while taking medicine. In fact, it is not unreasonable. After all, many people cannot distinguish between ordinary oranges and Seville oranges (limes commonly used for making jam, which also contain high furanocoumarins). They also do not know whether the mixed juice they buy contains grapefruit. To save trouble, simply saying "don't eat citrus" can help patients avoid pitfalls. But if you can distinguish the categories clearly, you can eat one or two of the tangerines, tangerines, and sugar tangerines that you usually like to eat every day. There is no need to miss out on delicious food because of unnecessary taboos.

Many people ask me if they can eat spicy food, but I usually don’t just say “absolutely not”. There used to be a sophomore boy who was diagnosed with tuberculosis. He was born and raised in Hunan. He had eaten spicy food every day since he was a child. After he was diagnosed, his family could not even see a crushed chili pepper. He often lost his appetite when taking anti-tuberculosis drugs. He lost eight pounds in half a month. During the reexamination, the absorption rate of the lesions was nearly half slower than that of patients with the same condition. Later, I told him that if he really wanted to eat, he could eat something slightly spicy, as long as he didn’t have aggravated coughing or sore throat after eating. After he went back, he added two spoons of chopped pepper to every meal, and his appetite suddenly increased. He gained back five pounds in half a month, and the lesions were absorbed very quickly during the next review. Of course, if you can't stop coughing when you eat spicy food, or you are in the acute stage of coughing up blood or chest pain, you'd better be patient and put away irritating things like hot pot, spicy strips, and liquor first, otherwise you'll be the one to suffer when you cough and cause pleural pain.

There is another taboo that many people tend to overlook: pyrazinamide in anti-tuberculosis drugs has a very common side effect of increasing blood uric acid. If you drink Laohuojing soup that has been simmered for several hours, eat animal offal, seafood and beer while taking the drug, it is easy to induce gout. I met a 40-year-old Guangdong uncle before. During the period of taking medicine, his family made him pork bone soup and abalone soup every day to replenish his body. However, within three weeks of drinking it, gout broke out and his left foot was so swollen that he couldn’t wear shoes. The tuberculosis was almost gone, but he had to add uric acid-lowering medicine, which added a lot of burden. But don’t overdo it. Not all soups cannot be drunk. Vegetable soups and mushroom soups with the oil removed are completely acceptable. Peeled chicken, freshwater fish, eggs, and milk are all high-quality proteins. Instead, eat more. Eating two eggs and drinking a cup of pure milk every day is more effective than drinking ten bowls of heavy-fat tonic soups.

By the way, there is a rumor that has been circulating for many years. The saying on the Internet that "beef, mutton, and seafood are fat and cannot be eaten" is pure nonsense. As long as you are not allergic to these foods, not only can you eat them, but it is also recommended to eat more. I once had a patient who heard from a relative that he should eat a light diet when he had tuberculosis. He only ate white porridge with vegetables. He lost 12 pounds in two months. A CT scan showed that the lesions were not absorbed at all. Later, he adjusted his diet and ate beef twice a week, fish once, and two cups of milk a day. When he was checked again in three months, more than half of the lesions had been absorbed. You must know that tuberculosis is a wasting disease. The body's repair requires a lot of nutrients. If you don't eat this or that, how can you kill the tuberculosis bacteria if your immunity is not improved?

To be honest, I have encountered too many patients who regard taboos as more important than eating. In fact, it is really unnecessary. Just remember the core taboos and make the rest happy. Eating well, drinking well, sleeping well, is better than anything else.