Also indexed as: Sinus Infection
Breathing is less of a chore when air can flow freely through
your nasal passages. According to research or other evidence, the following self-care steps
may help relieve the pressure and congestion caused by sinusitis:
- Rule out allergies
- Make an appointment with an allergist, who can help determine if
your sinusitis is allergy-related
- Discover the benefits of bromelain
- Try taking 3,000 MCU of this enzyme, derived from pineapple, three
times a day for relief from acute sinusitis
- Try nasal irrigation
- Prepare a warm, salt-water solution in a special ceramic pot known
as a “neti lota” pot and pour it through your nose to relieve your sinuses
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full sinusitis article for more
in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
Sinusitis is an 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.
Hay fever, other environmental triggers, food
allergens, and dental infections can also
lead to sinusitis.
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What are the symptoms?
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.
Over the counter analgesics, such as
aspirin (Genuine Bayer®, Ecotrin®, Bufferin®), ibuprofen (Motrin IB®, Advil®), naproxen (Aleve®), and acetaminophen (Tylenol®), reduce pain due to
sinus pressure. Topical nasal decongestants such as oxymetazoline (Afrin®) and
phenylephrine (NeoSynephrine®) may provide relief from nasal congestion, but they should
only be used for a few days. The oral decongestant pseudoephedrine (Sudafed®) may also help relieve
nasal congestion and sinus pressure.
Guaifenesin (Robitussin®, Mucinex®) is an expectorant used to remove mucous in
the sinuses, lungs, and ears.
Prescription drug therapy for sinus
infections usually includes antibiotics,
such as amoxicillin/clavulanate (Augmentin®), loracarbef (Lorabid®), azithromycin (Zmax®), cefprozil (Cefzil®), and levofloxacin (Levaquin®). Corticosteroid nasal sprays, such as flunisolide
(Nasarel®), fluticasone (Flonase®), budesonide (Rhinocort Aqua®), or
triamcinolone (Nasacort AQ®), may also be used to reduce inflammation.
Surgery may be used to unblock the sinuses and drain thick secretions if drug therapy is
not effective, or if there are structural abnormalities.
Dietary 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 People with sinusitis may benefit by working with a doctor
to evaluate what, if any, effect the elimination of food and other allergens might have on
reducing their symptoms.
Vitamins that may be helpful
Bromelain, an enzyme derived from pineapple, has been reported to relieve symptoms of
acute sinusitis. In a double-blind trial, 87% of patients who took bromelain reported good to
excellent results compared with 68% of those taking placebo.4 Other double-blind
research has shown that bromelain reduces symptoms of sinusitis.5 6
Research with bromelain for sinusitis generally uses the enteric-coated form. Enteric-coating
prevents the stomach juices from partially destroying the bromelain. Most commercially
available bromelain products today are not enteric-coated, and it is not known how the potency
of these different products compares.
Studies conducted in the past have used bromelain compounds with therapeutic strengths
measured in units called Rorer units (RU). Potency of contemporary bromelain compounds are
quantified in either MCUs (milk clotting units) or GDUs (gelatin dissolving units); one GDU
equals 1.5 MCU. One gram of bromelain standardized to 2,000 MCU would be approximately equal
to 1 gram with 1,200 GDU of activity, or 8 grams with 100,000 RU of activity. Physicians
sometimes recommend 3,000 MCU taken three times per day for several days, followed up by 2,000
MCU per day.7 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
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.8 Another study found that 2,000 mg of vitamin C helped protect people
exposed to a histamine challenge test.9 Not every study reported reductions in
histamine.10 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.11
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
The main ingredient of eucalyptus oil,
cineole, has been studied as a treatment for sinusitis. In a double-blind study of people with
acute sinusitis that did not require treatment with antibiotics, those given cineole orally in
the amount of 200 mg 3 times per day recovered significantly faster than those given a
placebo.12 Eucalyptus oil is also often used in a steam inhalation to help clear
nasal and sinus congestion. Eucalyptus oil is said to function in a fashion similar to menthol by acting on receptors in the nasal
mucous membranes, leading to a reduction in the symptoms of nasal stuffiness.13
One of the most popular supportive treatments for both acute and chronic sinusitis in
Germany is an herbal combination containing
gentian root, primrose flowers, sorrel herb, elder flowers, and European vervain.14 The combination has been found
to be useful in helping to promote mucus drainage (“mucolytic” action) from the
sinuses.15 The combination is typically used together with antibiotics for treating acute sinusitis.
Horseradish is another herb used
traditionally as a mucus-dissolver.16 One half to one teaspoon (3–5 grams) of
the freshly grated root can be eaten three times per day. Horseradish tincture is also
available. One quarter to one half teaspoon (2 to 3 ml) can be taken three times per day.
Wood betony (Stachys betonica) is
used in traditional European herbal medicine as an anti-inflammatory remedy for people with
sinusitis. Modern clinical trials have not been conducted to confirm this use of wood
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful
A warm salt-water solution poured through the nose may offer some relief from both allergic and infectious sinusitis. A ceramic pot, known as a
“neti lota” pot, makes this procedure easy. Alternatively, a small watering pot
with a tapered spout may be used. Fill the pot with warm water and add enough salt so the
solution tastes like tears. Stand over a sink, tilt your head far to one side so your ear is
parallel to the floor, and pour the solution into the upper nostril, allowing it to drain
through the lower nostril. Repeat on the other side. This procedure may be performed two or
three times a day.
Some practitioners may treat sinus problems using various manipulation techniques. A single
case study described treatment of chronic sinusitis and sinus headaches with spinal
manipulation, massage, and a technique called: “bilateral nasal specific” (BNS).
The BNS procedure involves inflating small balloons within the nasal passages, creating a
change of pressure and, theoretically, a realignment of nasal bones. Initial treatment of a
41-year-old woman with manipulation and massage for approximately one year had resulted in
only temporary, mild relief. Her headaches resolved immediately following each treatment that
included BNS, followed by increased amounts of postnasal discharge and an improved sense of
smell. At the end of two additional months of care, her headaches were reduced significantly
in intensity and frequency.17
1. Bullock C. Chronic infectious sinusitis linked to allergies. Med
Trib 1995;Dec 7:1.
2. Derebery MJ. Otoplaryngic allergy. Otolaryngol Clin North Am
3. Host A. Mechanisms in adverse reactions to food. Allergy
1995;50(20 suppl):60–3 [review].
4. Ryan R. A double blind clinical evaluation of bromelains in the
treatment of acute sinusitis. Headache 1967;7:13–7.
5. Taub SJ. The use of bromelains in sinusitis: a double-blind
evaluation. EENT Monthly 1967;46(3):361–5.
6. Seltzer AP. Adjunctive use of bromelains in sinusitis: a controlled
study. EENT Monthly 1967;46(10):1281–8.
7. Gaby AR. The story of bromelain! Nutr Healing 1995;May:3, 4,
8. Clemetson, CA. Histamine and ascorbic acid in human blood. J
9. Bucca C, Rolla G, Oliva A, Farina JC. Effect of vitamin C on histamine
bronchial responsiveness of patients with allergic rhinitis. Ann Allergy
10. Bellioni P, Artuso A, Di Luzio Paparatti U, Salvinelli F. Histaminic
provocation in allergy. The role of ascorbic acid. Riv Eur Sci Med Farmacol
1987;9:419–22 [in Italian].
11. Nikolaev MP, Longunov AI, Tsyrulnikova LG, Dzhalilov DS. Clinical and
biochemical aspects in the treatment of acute maxillary sinusitis with antioxidants. Vestn
12. Kehrl W, Sonnemann U, Dethlefsen U. Therapy for acute nonpurulent
rhinosinusitis with cineole: results of a double-blind, randomized, placebo-controlled trial.
13. Schulz V, Hansel R, Tyler VE. Rational Phytotherapy, 3rd ed.
Berlin: Springer Verlag, 1998, 146–7.
14. Schulz V, Hänsel R, Tyler VE. Rational Phytotherapy: A
Physician’s Guide to Herbal Medicine. Berlin: Springer-Verlag, 1998,
15. März RW, Ismail C, Popp MA. Action profile and efficacy of a
herbal combination preparation for the treatment of sinusitis. Wien Med Wschr
16. Mills S, Bone K. Principles and Practice of Phytotherapy.
London: Churchill Livingstone, 2000, 21.
17. Folweiler DS, Lynch OT. Nasal specific as part of a chiropractic
approach to chronic sinusitis and sinus headaches. J Manipulative Physiol Ther