Sinusitis, an upper respiratory condition, involves inflammation of the sinus passages. There are four pairs of sinuses in the human skull that help circulate moist air throughout the nasal passages. The common cold is the most prevalent predisposing factor to sinusitis. Acute sinusitis typically causes symptoms of nasal congestion and a thick yellow or green discharge. Other symptoms include tenderness and pain over the sinuses, frontal headaches, and sometimes chills, fever, and pressure in the area of the sinuses. Chronic sinusitis differs slightly, in that symptoms can be milder and may only include postnasal drip, bad breath, and an irritating dry cough. Hay fever, environmental triggers unrelated to hay fever, food allergens, and dental infections can also lead to sinusitis.

Dietary and lifestyle changes that may be helpful:

According to some studies, 25–70% of people with sinusitis have environmental allergies.[1] Although food allergies may also contribute to the problem, some researchers believe food allergies only rarely cause sinusitis.[2, 3] If other treatment approaches are unsuccessful, people with sinusitis may choose to work with a nutritionally oriented doctor to evaluate what, if any, effect elimination of food and other allergens might have on reducing their symptoms.

Nutritional supplements that may be helpful:

In a preliminary trial, supplementation with 250 mg of pantothenic acid two times a day was demonstrated to help most patients suffering from allergic rhinitis, a significant predisposing factor for sinusitis.[4] However, research has yet to investigate the effects of pantothenic acid supplementation with people who have sinusitis.

Histamine is associated with increased nasal and sinus congestion. In one study, vitamin C supplementation (1,000 mg three times per day) reduced histamine levels in people with either high histamine levels or low blood levels of vitamin C.[5] Another study found that 2,000 mg of vitamin C helped protect individuals exposed to a histamine challenge.[6] Not every study has reported reductions in histamine.[7] Although preliminary evidence supports the use of vitamin C when injected into the sinuses of people suffering with acute sinusitis, the effect of oral vitamin C on symptoms of sinusitis has yet to be formally studied.[8]

Bromelain, an enzyme derived from pineapple, has been reported to relieve symptoms of acute sinusitis. In a double blind study comparing the use of bromelain with placebo, 87% of those patients who took bromelain reported good to excellent results compared with 68% of the placebo group.[9] Other double blind research has shown that bromelain reduces symptoms of sinusitis.[10, 11]

Studies conducted in the past have used bromelain compounds with therapeutic strengths measured in Rorer units. Potency of contemporary bromelain compounds are quantified in either MCUs (milk clotting units) or GDUs (gelatin dissolving units); one GDU equals 1.5 MCU. A supplement containing 500 mg with a labeled potency of 2,000 MCU per gram (1,000 mg) would have 1,000 MCU of activity. Nutritionally oriented physicians sometimes use 3,000 MCU taken three times per day for several days, followed up by 2,000 MCU per day.[12] Much of the research conducted has used smaller amounts likely to be the equivalent (in modern units of activity) of approximately 500 MCU taken four times a day.

Are there any side effects or interactions?

Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful:

An isolated double blind study compared the use of freeze-dried stinging nettles with placebo. In that one-week trial, 300 mg of stinging nettles taken twice per day led to moderate effectiveness among 58% of those in the treatment group compared with only 37% in the placebo group.[13]

Eucalyptus oil is often used in a steam inhalation to help clear nasal and sinus congestion. Eucalyptus oil is said to function in a fashion similar to that of menthol by acting on receptors in the nasal mucosa, leading to a reduction in the symptoms of, for example, nasal stuffiness.[14]

Are there any side effects or interactions?

Refer to the individual herb for information about any side effects or interactions.

References:

  • Bullock C. Chronic infectious sinusitis linked to allergies. Med Trib 1995;Dec 7:1.
  • Derebery MJ. Otoplaryngic allergy. Otolaryngol Clin North Am 1993;26:593–611 [review].
  • Host A. Mechanisms in adverse reactions to food. Allergy 1995;50(20 suppl):60–63 [review].
  • Martin W. On treating allergic disorders! Townsend Letter for Doctors 1991;Aug/Sept:670–71 [letter].
  • Clemetson, CA. Histamine and ascorbic acid in human blood. J Nutr 1980;110:662–68.
  • Bucca C, Rolla G, Oliva A, Farina JC. Effect of vitamin C on histamine bronchial responsiveness of patients with allergic rhinitis. Ann Allergy 1990;65:311–14.
  • Bellioni P, et al. La provocazione istaminica in soggetti allergici. Il ruolo dell’acido ascorbico. Eur Rev Med Pharm Sci 1987;9:419–22.
  • Nikolaev MP, Longunov AI, Tsyrulnikova LG, Dzhalilov DS. Clinical and biochemical aspects in the treatment of acute maxillary sinusitis with antioxidants. Vestn Otorinolaringol 1994;Jan/Feb:22–26.
  • Ryan R. A double blind clinical evaluation of bromelains in the treatment of acute sinusitis. Headache 1967;7:13–17.
  • Taub SJ. The use of bromelains in sinusitis: a double-blind evaluation. EENT Monthly 1967;46(3):361–65.
  • Seltzer AP. Adjunctive use of bromelains in sinusitis: a controlled study. EENT Monthly 1967;46(10):1281–88.
  • Gaby AR. The story of bromelain! Nutr Healing 1995;May:3,4,11.
  • Mittman P. Randomized, double blind study of freeze dried Urtica dioica in the treatment of allergic rhinitis. Planta Med 1990;56:44–47.
  • Schulz V, Hansel R, Tyler VE. Rational Phytotherapy, 3rd ed. Berlin, Germany: Springer Verlag, 1998, 146–47.

The information contained in this article is for information and education purposes only and is not medical advice. Do not use this information as an alternative to obtaining medical advice from your physician or other professional healthcare provider. Always consult with your physician or other professional healthcare provider about any medical conditions you are experiencing. If you are experiencing a medical emergency, contact your local emergency services for help.

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