Sinus Ninja understands. You're not the kind of person who rushes into taking medications. You like considering options, and will choose the most natural, least toxic remedy whenever possible. This article compares how medical doctors (MD's) and naturopathic doctors (ND's) look at sinus problems.
On the surface, choosing a sinus or allergy medicine like Sudafed®, Afrin®, or Benadryl® is simple and straightforward.
Most of us start by walking into our Seattle neighborhood pharmacy. Which pill or potion should we try? Some of us read every label. Some call the pharmacist over for advice. And some know exactly what sinus or allergy medicine they want after seeing an ad on TV. So after browsing, brain picking, and media surfing, we make our purchase. Maybe, our trip to the pharmacy wasn’t to get off-the-shelf relief. It could be that we’ve tried or don’t trust the safety of self-prescribed remedies. No, today we’re here to get a “real” medication that was authorized by our doctor – likely an antibiotic, steroid, or both. In this article, we’ll take a close look at the main types of sinus and allergy medications and offer an alternative that may have you thinking twice about popping your next pill.
As a Registered Nurse, I'm impressed by the results. In my case, drugs weren't needed.
As a Registered Nurse, I'm impressed by the results. In my case, drugs weren't needed.
Before jumping into drug treatments for sinusitis, congestion, and nasal allergies, let’s take a step back and decide when (or if) we need them.
Every doctor is concerned with three basic things: symptoms, cause, and what to do. Whether you see a medical doctor (MD) or a naturopathic doctor (ND), they will hear your story, diagnose the cause, and prescribe a course of action. Let’s begin with how MD’s and ND’s view sinus disease. Keep in mind, ND’s in the State of Washington are licensed to prescribe any of the medications referenced at the end of this article1. Your clinician at Sinus Ninja may decide use these agents in conjunction with Sinus Ninja Treatments™ so that all interventions will work in concert to speed recovery. Rest assured that the non-drug, all-natural Sinus Ninja Treatment™ works well for the vast majority of sinus sufferers. And after reading this article, you can decide for yourself which of the interventions described here feels right for you.
Nose congestion, odd colored discharge, facial and forehead pain, feelings of pressure in the cheeks or between the eyes, low grade fever, and general fatigue are symptoms of sinusitis.
The conventional thinking is, your body is making some kind of error which must be corrected. Within a few minutes of hearing your story, your MD is reaching for a prescription pad and advising a course of antibiotics and/or steroids. Seems like a simple case. But hold on. You probably didn’t realize that your doctor has jumped right to diagnosis and treatment on the basis of one critical assumption: Your body is making a mistake.
It makes sense to name bacteria as the cause and offer therapy to remove them. Still, disease-causing microorganisms are everywhere. If bacteria were the only cause of sinus problems then everyone who breathes would have chronic sinusitis. What’s more, if sinus medications were the fix, Sinus Ninja wouldn’t be meeting folks everyday who are on their second, third, and fourth courses of antibiotic and/or steroid therapy.
When MD’s go to school, they learn all the ways the body can make errors. Then, they go about learning how to fix them.
Drug therapy is one way, surgery is another. Of all human illnesses however, only a small number are actually caused by the body’s error. One such example is an error in the genetic code. Accidents of birth such as Down’s syndrome are decidedly out of your doctor’s control to correct. Another error is an organ or tissue hyper-response to an accident or trauma (runaway inflammation). Drug and surgical intervention is well suited in these cases since the root cause is beyond the body’s ability to correct. The majority of chronic, non-emergent illnesses however are caused by an abnormal set of conditions. The Sinus Ninja Treatment™ seeks to correct these abnormal conditions in the nose and sinuses leading to lasting health and wellness.
Let’s suppose for a moment that your body is reacting normally to a given set of conditions.
In the case of chronic sinusitis, these conditions are overgrowth and entrapment of bacteria in the air-filled spaces of the face and skull bones. Pathogens like viruses and bacteria cause the release of a number of chemical substances, which are experienced as the classic signs of sinus inflammation: pain and pressure. Such inflammation is a normal response. What isn’t normal are the conditions that cause nose and sinus pathogens to reproduce and colonize so aggressively in the first place.
The best physicians of the past and present will tell you: No therapy is curative. Normal health evolves from the body itself when given the right conditions. If you’re fortunate to be one of the few for whom antibiotics have “worked,” congratulations. That is, until your next episode of sinusitis. If you and your doctor are not working to adjust the root causes, your chronic and recurrent sinus problems will continue. The same is true for sinus surgery. While functional endoscopic sinus surgery (FESS) and less invasive procedures like balloon sinuplasty seek to restore sinus ventilation they do little to address the set of abnormal conditions that caused your sinus problems to begin with. The evidence? Sinus Ninja often sees folks looking for help after years of sinus problems despite multiple sinus surgeries and procedures.
Any drug you may be taking for sinusitis is doing one of two things: battling bugs or squashing symptoms.
What is it not doing? Removing the biofilms and sticky mucous blockages in your nose that’s causing your sinus problems to begin with. Some clients are surprised to learn about the 2008 Lancet article that found 94% of us will not get better with antibiotics2. Others are all too aware of the intestinal side effects like gas, bloating, and diarrhea. Many more are seeking an alternative to feeling “wired and tired” on sinus and allergy medications intended to offer a better quality of life. In conclusion, let’s summarize the main classes of sinus and allergy medications3. And, we’ll give each a “smile,” “grimace,” or “caution” emoji based on the risk-to-benefit ratio of the drug being considered. That is, a smile means more benefit and less risk and a caution sign means this drug is to be used only with careful thought. A grimace is somewhere in-between. And of course, if you’re pregnant or lactating, drugs in general are to be used with caution and under your physician’s supervision. In cases of pregnancy and lactation, the drug-free Sinus Ninja Treatment™ is a safe and effective alternative.
Common examples: Amoxicillin, Augmentin®, Zithromax (Z-Pak)®, Levaquin®, Cipro®
Prescription required? Yes
What they do: Reduce the number of bacteria so the immune system can fight off those remaining.
What they miss: Biofilm colonies are often antibiotic resistant, not effective against viral or fungal sinusitis.
Key adverse effects: Gas, bloating, diarrhea (due to die off of beneficial gut flora). A class of antibiotics called fluoroquinolones including Levaquin® and Cipro® are known to cause painful tendon ruptures and nerve damage. Sinus Ninja does not prescribe these and they are to be considered only when the benefit outweighs the known risks.
Do we prescribe them? Not routinely. Reserved for especially resistant cases. Used in conjunction with Sinus Ninja Treatments™.
Common examples: Benadryl®, Zyrtec®, Claritin®
Prescription required? No
What they do: Block histamine receptors which reduces seasonal allergy symptoms.
What they miss: All cause some drowsiness and are sedating, Zyrtec® and Claritin® less so. Benadryl® contains diphenhydramine - the same drug marketed as Nytol®, a sleep aid.
Key adverse effects: Drug resistance makes them less effective over time. Folks often “rotate” through various formulations until none are effective. It’s also known that antihistamines can cause severe nasal dryness, mucus thickening, and crusting of the ostiomeatal complex, potentially blocking outflow from the frontal and maxillary sinuses. This is exactly what we don't want when we have an active sinus infection.
Do we advise them? On a limited basis, for relief of severe seasonal allergy symptoms. Because they are so drying, we never recommend them during an active sinus infection. Used in conjunction with Sinus Ninja Treatments™.
Common examples: Azelastine (Astelin®, Astepro®)
Prescription required? Yes
What they do: Locally inhibit the action of histamine which reduces seasonal allergy symptoms. Also has anti-inflammatory and mast-cell stabilizing effects (stops histamine release).
What they miss: Potentially causes mucus thickening and crusting of the ostiomeatal complex.
Key adverse effects: Bitter taste, headache, nasal burning, nosebleed, drowsiness.
Do we prescribe them? On a limited basis, for relief of severe seasonal allergy symptoms. Because they can be so drying, we never prescribe them during an active sinus infection. Used in conjunction with Sinus Ninja Treatments™.
Common examples: Prednisone, methylprednisolone
Prescription required? Yes
What they do: Suppress inflammation and reduce the activity of the immune system.
What they miss: Long term use is not advised. 21-day prednisone taper can be effective in the short term, allowing the nose and sinuses to normalize. Because of its harmful adverse effects corticosteroid use is not a useful strategy for lifelong nose and sinus health.
Key adverse effects: Short term effects include glaucoma, fluid retention, high blood pressure, mood swings, and weight gain. Long term effects include cataracts, high blood sugar, easy bruising, and bone thinning leading to fractures.
Do we prescribe them? On a short-term limited basis, for relief of severe and long standing sinus pain and pressure. Used in conjunction with Sinus Ninja Treatments™.
Common examples: Fluticasone (Flonase®), budesonide (Pulmicort®), Rhinocort®, Nasacort®, Veramyst®, Nasonex®, Omnaris®, beclometasone (Beconase®)
Prescription required? Flonase®, Nasacort®, and Rhinocort® are available without a prescription.
What they do: Locally suppress the immune response decreasing inflammation in the nose and sinuses.
What they miss: Intranasal steroid sprays are the most common prescription for nose and sinus inflammation. Because they act locally, there is less (but not absent) risk for systemic absorption. Omnaris® is a relatively new spray that takes advantage of pro-drug conversion to reduce absorption. Its use during pregnancy is controversial.
Key adverse effects: Side effects are reduced as compared with oral corticosteroids. Significant absorption is possible however and long term use must be cautiously monitored.
Do we prescribe them? On a limited basis. Used in conjunction with Sinus Ninja Treatments™.
Common examples: Sudafed®, Actifed®, Advil Cold and Sinus®
Prescription required? No. But as of 2010 Washington state law requires retailers to limit access to products containing methamphetamine precursors. They are also required to record the name and address of the purchaser, the date and time of the sale, the name and the initials of the person conducting the transaction, the name of the product sold, and the total quantity in grams sold.
What they do: Constrict blood vessels in the nose and sinuses leading to reduced congestion
What they miss: Use in pregnancy is controversial, moderate abuse and addiction potential
Key adverse effects: Insomnia, dizziness, heart palpitations, increased blood pressure
Do we advise using them? Not routinely. Can be useful for helping clients sleep when the nose is severely congested. A better all-natural decongestant is hypertonic saline4, which we recommend in conjunction with Sinus Ninja Treatments™.
Common examples: Afrin®, Neo-Synephrine®
Prescription required? No
What they do: Dramatically constrict blood vessels in the nose and sinuses leading to reduced congestion.
What they miss: Significant abuse and addiction potential due to drug receptor up-regulation.
Key adverse effects: Use longer than 3 days commonly results in rebound congestion (worse than before use). This can lead to a condition called rhinitis medicamentosa.
Do we advise using them? Never. A better all-natural decongestant is hypertonic saline4, which we recommend in conjunction with Sinus Ninja Treatments™.
Common examples: Montelukast (Singulair®)
Prescription required? Yes
What they do: Inhibit the action of pro-inflammatory mediators called leukotrienes made in the nose and sinuses.
What they miss: May not be as effective as intranasal steroid sprays.
Key adverse effects: Headache, earache, sore throat, and slight increase in respiratory infections.
Do we advise using them? On a limited basis, for relief of nasal polyps. Used in conjunction with Sinus Ninja Treatments™.
Common examples: Cromolyn sodium (Nasal Crom®)
Prescription required? No
What they do: Prevent the release of mediators that would normally attract inflammatory cells to the nose and sinuses.
What they miss: Can take up to four weeks to be effective.
Key adverse effects: Lightheadedness, sneezing, nasal irritation.
Do we advise using them? Rarely, since a naturally occurring bioflavonoid formula we recommend called Quercenase®5 has been shown to work better than cromolyn sodium. Used in conjunction with Sinus Ninja Treatments™.
Common examples: Guaifenesin (Mucinex®)
Prescription required? No
What they do: Increase the volume and reduce the viscosity of secretions (mucous) in the upper and lower respiratory passageways.
What they miss: Careful attention must be paid to drinking adequate water while taking this medication. Otherwise, it will not be optimally effective. Unless there's a medical reason not to, an extra 2-3 glasses of water should be consumed daily while taking this medication.
Key adverse effects: In general, very few side effects have been reported. In fact, there are a few reported health benefits which include uric acid excretion (benefits gout), keeping the vocal cords coated with secondary mucous (benefit to speakers and singers), and acting as a skeletal muscle relaxant.
Do we advise using them? Yes. Used in conjunction with Sinus Ninja Treatments™.
Common examples: Ipratropium bromide (Atrovent®)
Prescription required? Yes
What they do: When applied locally as a nasal spray, Atrovent® inhibits secretions from the serous and seromucous glands lining the nose.
What they miss: Atrovent® does not relieve nasal congestion due to the common cold or seasonal allergy. The safety and effectiveness of the use of Atrovent® Nasal Spray 0.06% beyond four days in patients with the common cold or beyond three weeks in patients with seasonal allergic rhinitis has not been established.
Key adverse effects: Immediate hypersensitivity reactions may occur after administration of ipratropium bromide, as demonstrated by rare cases of urticaria, angioedema, rash, bronchospasm, anaphylaxis, and swelling of the throat.
Do we advise using them? On a very limited basis, for relief of severe mucous hyperproduction or seasonal allergy symptoms. A better all-natural nasal discharge remedy is hypertonic saline4, which we recommend in conjunction with Sinus Ninja Treatments™.
As a Registered Nurse, I’m impressed by the results. In my case, drugs weren’t needed.
Like many interventions in medicine, the alternative treatment referenced on this site is an empirical one. That is, we “try it” to see if it works. No promise of result is implied or intended. This site is not intended to provide medical advice or to be a substitute for proper diagnosis and treatment by a qualified health care provider. If you have concerns about your condition, seek medical help right away.
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