It’s that time of year, when the sniffles, coughs and bugs come home from school and work. We have busy lives and these respiratory viruses can linger. We all know that using antibiotics for viruses are not helpful and can actually harm the gut microbiome, so today we are going to dive deep into these infections and what we can do about them.
A lot of us have had common symptoms of upper respiratory infections (URIs) in our life. These symptoms can include; cough, runny nose, headache, mucous drainage, sinus inflammation, fatigue, fevers and throat irritation. Many Americans have also suffered with sinus infections, and show symptoms such as nasal congestion, facial pressure, facial pain, fever and white/yellow/green mucus discharge.
How can we tell the difference between viral and bacterial sinus infections? Well, we really can’t! Mucous discharge can be all sorts of ‘funky’ colors with both viral and bacterial infections and all other symptoms can also be seen in both as well. Typically children have viral infections and we rarely see them as bacterial infections unless the child is susceptible to a chronic disease or illness. As we age and are exposed to more pathogens, we have a variety of viral, bacterial and fungal microbes harboring in our sinuses.
Acute sinusitis typical lasts less than 10-14 days. It is usually allergic or viral in nature. This type of infection can set a person up for bacterial or fungal infections, especially if the person is already predisposed to chronic sinusitis.
Chronic/recurrent sinusitis has a typical inflammatory cycle consisting of all the above mentioned pathogens. Imaging the sinuses can be helpful in these cases to show if there are old injuries occluding drainage. It can also show balls of fungi or cysts present. Mold exposures or chronic allergies (food or environmental) can keep sinuses chronically inflamed and sometimes fungi can cause an “auto-allergy” type syndrome where the fungus stimulates an allergic response and continuously repeats the cycle of chronic infections.
Looking at mycotoxins (there are urine tests available that do this), blood IgE allergen tests and simple imaging, can help determine the root cause of chronic sinusitis. Many times, babies, children and adults with sinus infections, ear infections or URIs have an underlying dairy intolerance and once removed from the diet (I advise a minimum of 4 weeks), they show marked improvement in the above symptoms. A lot of times making this change can prevent ear tubes in babies. Most people don’t realize that dairy causes thick mucus, which leads to the multitude of upper respiratory symptoms mentioned above.
Always see your primary care provider or ENT specialist if you are having recurrent sinus symptoms. If you have high fevers and other acute symptoms, it is always safest to get it checked out.
What I’ve seen help the most for chronic infections are:
- Vitamin C: (3-5,000mg daily during acute illness, decrease dose if having bloating or diarrhea)
- Vitamin E :(400IU daily), studies show this helps decrease URIs among men. It can help give antioxidant support. Avoid if you are a smoker.
- Zinc: (25-30mg daily)
- Vitamin A: (10,000IU daily)
- Probiotics: 1-2 caps daily. Avoid probiotics with histamine.
- Curcumin/Turmeric: (900mg 1-2x/day). Curcumin is an anti-inflammatory and can help decrease airway inflammation.
For acute infections: *Always ask provider before starting any herbal treatments to make sure they won’t interact with current medications.
- Berberine: Works broad-spectrum to kill variety of pathogens (virus, bacteria, fungus). Typically 1000mg three times a day x7-10 days.
- Allicin (Garlic): Great at helping with fungal infections. 1000mg three times daily with meals (can cause GI upset) x7-10 days.
- Oregano: Favorite kind is Mexican Oregano and can do 1 cap three times daily with food to start and then increase up to 2-3 caps three times daily for 7-10 days.
- Glutathione: This is an antioxidant that has been helping my patients very successfully with all URIs, including sinusitis. This is given via inhaled nebulizer treatments. Doing this treatment once every 24-48 hours one to five times has shown marked improvement in overall symptoms with acute infections.
Nasal Sprays that can help with Sinus Relief:
- Multi-Targeted Spray your provider can potentially order when not quite sure what is going on: 0.1% Amphotericin B + 0.2% Fluconazole + 0.2% Mupirocin + 0.03% Triamcinolone 30cc vial. 1 spray in each nare four times a day for a few weeks or sooner if acute symptoms are gone.
- If the chronic sinusitis appears to be more fungal related:
- Ketoconazole 1% compounded, preservative free. 2 sprays in each nare twice daily x2 weeks
- Amphotericin B 0.1% same directions as Ketoconazole
- Lastly, for someone with multiple infections BEG Spray can be effective: Bactroban 0.2% + EDTA 1% + Gentamicin 0.5%
- If your provider won’t order any of the above, you can do some over the counter sprays:
- Argentyn 23 Nasal Spray 2 sprays each nare 2-4x/day (anti-infective + Biofilm disruptor)
- Capsaicin 2 sprays per nare 2-4x/day (sinus buster *can mildly burn)
- NAC nasal spray 2 sprays per nare daily (Biofilm disruptor)
- Vive IV Therapy also offers nebulized solutions to help with sinusitis, ear infections, acute asthma and more.
Underlying Sneaky Causes to Consider in Resistant Cases:
- Heavy Metals
- Immune Supression
Sinus infections and URIs can impact the health and wellbeing of the person struggling. Just know that if you or someone you love suffers with these chronic or constant recurrent conditions, there is some light at the end of the tunnel (or dark, hollow sinus cavity -> nerdy joke). Keep finding solutions for your symptoms, there are answers out there.
Until next time,
Stephanie Grutz, ARNP, FNP-C