Bronchiectasis Complications: How Your Lungs Affect Your Whole Body

If you have non-cystic fibrosis bronchiectasis, you’re likely an expert on the “lung side” of the disease — the stubborn mucus, the nagging cough, and the constant threat of a flare-up. But by causing low oxygen levels and chronic inflammation, bronchiectasis can affect your heart, bones, and even your mind and mood.

Learn about the various complications of bronchiectasis and how to work with your doctor to best manage them.

Advanced bronchiectasis can lead to muscle loss or muscle wasting (sarcopenia), says Panagis Galiatsatos, MD, national spokesperson for the American Lung Association and assistant professor at the Johns Hopkins School of Medicine in Baltimore. “Because the lungs require so much attention to do what they do, they steal all these nutrients from surrounding muscles, so there’s muscle wasting,” he says.

Since daily exercise is often challenging with bronchiectasis, you may also be less active. “As a result, your body can get deconditioned [and lose muscle],” says Amit “Bobby” Mahajan, MD, national medical spokesperson for the American Lung Association and system chief of interventional pulmonology at Inova Health System in Virginia. “We really try to get to the point where people are doing good airway clearance and get pulmonary rehab to keep their muscles strong and have energy,” he says.

“A lot of patients get steroids over and over again, and that can lead to bone density loss,” says Dr. Galiatsatos.

Talk to your doctor about whether you need to be screened for osteoporosis, depending on your age and use of glucocorticoids.

It’s completely normal to feel on edge when you have a condition that “could rob you of your breathing at any point in time,” says Galiatsatos. “But if the anxiety continues to progress where it’s keeping you from really doing well, then we could talk about bringing in mental health specialists.”

Because of chronic fatigue and breathlessness, many people with bronchiectasis also isolate themselves, which can increase feelings of depression. Dr. Mahajan says some “close themselves off from society” because they’re afraid of catching an infection, coughing in public, or simply not being able to keep up with others.

Unintentional weight loss can occur because bronchiectasis keeps the body in an “unrelenting inflammatory state,” says Mahajan. He compares it to how you feel when you have a fever or an upper respiratory infection with lots of inflammation. “You tend to just not be hungry. You don't feel like eating,” he says. “That’s a constant for some people with bronchiectasis, and as a result, they tend to lose weight.”

Additionally, the constant presence of mucus doesn't just make breathing hard. It can lead to nausea and a further lack of interest in food, says Mahajan.

If you find the numbers on the scale dropping without trying, don't ignore it. “You’ll fall into a spiral of less activity, less energy, and continue down that spiral because you’re not eating,” says Mahajan. Talk to your doctor about how to boost your calorie and protein intake to give your body the fuel it needs to stay strong enough to stay active and clear infections.

Many people with bronchiectasis describe experiencing a persistent “cloudiness” — trouble focusing, forgetting words, or feeling mentally slow. While poor sleep and fatigue can play a role, chronic inflammation, low oxygen levels (hypoxemia), reduced lung function, and depression may also affect brain health.

• Chronic inflammation and low oxygen levels from bronchiectasis can lead to serious heart issues, including pulmonary hypertension, right-sided heart failure, and an increased risk of stroke and coronary heart disease.
• People with bronchiectasis often face muscle wasting (sarcopenia) as the body diverts nutrients to the lungs, while long-term use of certain steroids can significantly increase one’s risk of bone loss and osteoporosis.
• A high percentage of patients experience anxiety and depression due to the constant threat of breathlessness, chronic fatigue, and social isolation, which can create a cycle that worsens disease severity.
• The disease can also cause unintentional weight loss due to nausea and loss of appetite, as well as “brain fog” and a higher long-term risk of cognitive decline and dementia.