A Look at Chronic Sinusitis
By: Allan N. Spreen, MD, The Nutrition Physician
Our sinuses are supposed to be air-filled cavities in the skull that are lined with mucous membranes. Unfortunately, air often may not be the only stuff in there. Mucous (that may or may not be infected) can take over if enough irritation occurs. Pollen, smoke, dust, microbes, allergies, and fumes may be involved; the cavities get boggy and begin to drain, either poorly or perhaps even constantly. A cold may have clear discharge, usually without fever, and lasts only a few days. Sinusitis adds a few more things to the list, such as drainage that ceases to be clear, changing to yellow or greenish, redness, fever, bad breath, local pain or odor, and fullness of the sinus regions of the face.
What's worth knowing is that sinusitis may not mean an infection. The diagnosis means only inflammation, not infection, and antibiotics may therefore be ineffective (and then again they might). When symptoms get more involved than the three-day minor variety more likely of a cold it may be time to get to the doc and get checked out. If you end up fighting such hassles over and over for a few months or more, then it becomes a chronic sinusitis problem.
Antibiotics may not even be the answer for even acute sinusitis, much less the chronic variety (but let your doc decide). One medical school study reported on in "Health & Nutrition Breakthroughs" (Jan. 1998) discussed a comparison of antibiotics and placebo (where the subjects received decongestants and salt-water washes. The latter group did just as well. In fact, the researcher expressed the opinion that antibiotics might make matters worse by killing off "good guy" bacteria that help keep harmful varieties from taking over. It's also generally recognized that getting enough oral antibiotic into an infected sinus may require pretty high doses.
Whether you go the antibiotic route or not, there are some other things that might make things a bit easier. First, beware of using antihistamines to "dry up" nasal discharge. They may very well thicken mucous that the body is trying to get rid of (taking debris with it), and help to impact the sludge within the sinus. If you need medication seek decongestants only, without antihistamines. An example would be Sudafed instead of Actifed.
Also helpful in loosening the "junk" in the sinus is water, especially with salt in it. One quarter teaspoon of salt in a cup of warm water (adding ¼ tsp. of baking soda may help even more), and irrigating the nasal passages as far up as you can pour the stuff may be remarkably helpful. For those who find the procedure difficult (I would), saline nasal spray used liberally can be an easier way to get some of the same effect.
I'm a fan of a cool-mist vaporizer for most respiratory problems. I'm also a fan of one of the most remarkable agents of all time: hydrogen peroxide. Pour a few ounces of that in with the water when you use one.
For chronic sufferers you must (seems to me) search for food allergies. Dairy, wheat, corn, egg, and peanut top the list of suspects, but anything that you crave or eat every day are suspects in your case. It takes roughly seven days for an allergen to clear except for dairy, which can take 21 days.
Avoid sugar and refined flour products (which convert to sugar quickly). Sugar can depress white cell response to gobbling up microbial invaders. This is not the case for whole fruits, for example, which are nutrient-dense and contain what they need to handle the less concentrated sugars within.
I'm one of those vitamin C nuts (I'm a nut in general, but particularly a vitamin C one). Two-time Nobel Prize winner Linus Pauling, Ph.D., wrote that if you have a chronic runny nose you weren't taking enough vitamin C. I was taking 3,000 milligrams daily at the time and had had a 30-year chronic runny nose (though not chronic sinusitis...just the clear runny stuff). I then increased to 6,000 milligrams/day to no effect. In my case, the actual day that I went up to 9,000 milligrams/day my basically life-long runny nose stopped, period, for years (now that I understand my own situation better I can control my symptoms with less). I certainly recommend vitamin C for chronic sinusitis sufferers, starting with 1000 milligrams three times/day, though an experienced health care practitioner should monitor such efforts.
For mucous membranes, vitamin A can be particularly effective, though it takes time to work its way into mucous tissue (but hey, your problem is chronic, right?). I use 25,000-50,000 iu of natural fish oil A, but that's just me - some docs don't like such high doses, so you must check with yours first. I have not found beta-carotene to work nearly as well in such cases.
Echinacea can be helpful for sinus infections. Depending on the product you might try the recommended dose, but it should not be used as a preventive. I'd save it for an attempt to cut short an acute flare-up.
If antibiotics have been used in the past (and for chronic sinusitis sufferers this is almost a given), acidophilus supplements should be taken, at least for awhile. ¼ teaspoon of a powdered form (or capsule) before meals and bedtime for a couple of weeks following antibiotics (and after diarrhea or vomiting) is worth trying. This is a culture of the beneficial bacteria that you can logically expect to be present in lower than normal amounts after antibiotic use.
There are dozens of supplements that might help, but the last I'd consider in a list that isn't too huge (for me, anyway) would be alpha lipoic acid. This is the only antioxidant that appears to be both water- and fat-soluble. 100-200 milligrams/day are a starting place.
As you may know I always suggest putting a basic team on the field before trying to recruit specialist players. A good multi-vitamin/mineral supplement, stronger than the 100 percent RDA types, is recommended. There are many excellent brands (NOW, Solgar, and certainly many others). Look for one that supplies 25 milligrams or so of the numbered B-vitamins B-1, B-2 and B-6.
"Chronic" sinusitis, in my opinion, doesn't have to be "permanent" sinusitis. Don't give up. Keep searching for a solution that works for you and I believe you can find a way to put this hassle behind you.
Allan N. Spreen, MD
"The Nutrition Physician"
Dr. Spreen is a nutritionally-oriented medical doctor in practice for over a decade before concentrating on nutritional writing. He is known for his original "Nutrition Physician" on-line sites for both America Online and iVillage's 'The Women's Network', offering nutrition information directly to the public.
His authored works include Nutritionally Incorrect-Why the American Diet is Dangerous & How to Defend Yourself (Woodland); Smart Medicine for Healthier Living (Avery), co-authored with Janet Zand and James LaValle: and The Menopause Diet (Woodland).
A graduate of both the Georgia Institute of Technology and the University of Tennessee before obtaining his M.D. from East Tennessee State University, Dr. Spreen wears a second hat as a coach of competitive divers at the national and Olympic levels.