Why does my nose get stuffy when I drink beer?

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‘Allergic’ to Alcohol? There May Be a Way to Treat Your Symptoms

It’s a trifecta of chronic diseases, with three conditions rolled into one — asthma, sinus infections and recurring nasal polyps, and a negative reaction to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs).

Known as aspirin-exacerbated respiratory disease (AERD), or Samter’s Triad, this condition also has a fourth component that further affects a person’s quality of life — an allergy-like response to drinking alcohol.

When many people with AERD drink alcohol, they develop nasal congestion, a runny nose, wheezing, or shortness of breath. These usually start within an hour of having a drink.

But there’s good news. A new study found that a common treatment for AERD can reduce many of these symptoms, and may allow people to have the occasional drink again.

Loss of smell and alcohol intolerance

Dr. John Bosso, a co-author on the new study, said that about 75 to 80 percent of patients who have AERD are intolerant to alcohol.

On top of this, the condition may also impair their sense of smell and taste due to nasal symptoms. This can severely impact their quality of life.

“Sense of smell is probably number one for these patients, in terms of the thing they want back the most. I think it sometimes even causes them to be somewhat depressed and upset about the disease,” said Bosso, director of Penn Medicine’s Otorhinolaryngology Allergy Clinic and medical director of the Penn AERD Center in Philadelphia.

Lack of smell can rob people of many of life’s pleasures, such as enjoying their food. Alcohol intolerance is not far behind.

“Next to sense of smell, the inability to drink alcohol is definitely one of the things people get bummed about — that they can’t have a glass of wine or beer once in a while,” said Bosso.

According to the American Academy of Allergy, Asthma & Immunology (AAAAI), most people with AERD need to take daily medications to control their symptoms. These include inhaled corticosteroids for asthma, intranasal steroids for nasal symptoms, and steroids injected directly into the polyps.

People may also need endoscopic sinus surgery to remove nasal polyps. These benign growths in the sinus cavities often return after surgery, though.

The reason that AERD also has symptoms after drinking is due to chemicals in the alcohol that block an enzyme called cyclooxygenase, which makes people with AERD develop sinus and asthma symptoms.

“In addition to aspirin, a group of naturally occurring substances found in plants known as polyphenols can also block cyclo-oxygenase,” the AAAAI writes. “Polyphenols are frequently found in red wine, where they come from the grape skin, and in beer, where they come from the barley and hops added to the brew.”

A common treatment for AERD — known as aspirin desensitization — can reduce many of the symptoms of AERD, including the regrowth of polyps.

In this treatment, a doctor gives a patient gradually increasing doses of aspirin to help the person become less sensitive to NSAIDs. Patients need to continue taking aspirin daily in order to maintain their desensitization.

The reaction to NSAIDs in people with AERD isn’t a true allergy because it doesn’t involve the production of antibodies.

The Penn AERD Center uses a multidisciplinary approach to this condition — aspirin desensitization to reduce the growth of future polyps, and surgery to remove existing polyps.

Treatment reduces alcohol symptoms

Aspirin desensitization has other benefits. One of these is the return of peoples’ sense of smell and taste. And, it turns out, the ability to drink alcohol without unpleasant symptoms.

Doctors, including Bosso, had heard stories before from people with AERD that they could drink alcohol again after aspirin desensitization.

In this published case study, a 56-year-old man reported significant runny nose and facial flushing while drinking, but after undergoing aspirin desensitization he was able to drink without issue.

“Significantly, he self-challenged to wine, grain liquor, and beer without any symptoms and continues to tolerate these beverages without issue,” the authors wrote.

But that was a single case study and until now, no one had done a thorough study of this additional benefit.

But in this recent study published July 10th in the International Forum of Allergy and Rhinology, Bosso and his colleagues asked 37 people undergoing aspirin desensitization a series of questions about their intolerance to alcohol after surgery.

They asked questions before and after treatment, including what kind of reaction people had, and how long after they drank alcohol the reaction occurred.

“About 86 percent of patients showed significant improvement in their ability to tolerate alcohol — for about 70 percent it was pretty dramatic,” said Bosso. “I think it’s made their lives a little bit more ‘normal.’”

These improvements also fit with improvements seen in other symptoms.

“People who really say that they’re able to drink alcohol seem to have very good control of their disease now,” said Bosso, including regaining their sense of smell, less congestion, and having fewer sinus infections and asthma flare-ups.

There are, of course, both benefits and drawbacks to surgery and aspirin desensitization, and not everyone’s symptoms improve.

But given the new study results, Bosso said he now feels more confident about including “being able to enjoy a drink of alcohol again” as one of the potential benefits when he talks to patients about treatment for AERD.

“I don’t think is the selling point for why people should undergo treatment exclusively,” said Bosso. “But it’s one extra thing to add to the ‘pro’ column.”

Does alcohol consumption have anything to do with nasal congestion?

The consumption of alcohol has been linked to nasal congestion in some people. This is due to the way some people digest the alcohol.

Everything we consume is broken down by enzymes in our bodies. While some foods are broken down in the intestines, others are digested in the stomach. Alcohol does not need to pass through the digestive tract in order to be digested; rather, it is absorbed directly into the blood stream. Alcohol is a toxic substance. The body produces a special enzyme in the liver, known as Aldehyde Dehydrogenase (ALDH) enzymes, to break down and oxidize the alcohol in a process that turns the alcoholic substances into acetic acid (vinegar), from which some energy can be obtained.

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Some people have malfunctioning ALDH genes. As a result, their bodies produce inactive ALDH enzymes that are unable to properly break down the alcohol into acetic vinegar. This incomplete processing of the alcohol can cause the body to react by producing symptoms that reflect an allergy to the alcohol. People with this gene deficiency suffer two-fold from allergic symptoms to alcohol. First, the body produces histamines in response to the presence of the alcohol that the body is unable to digest. Second, because ALDH is also the enzyme that is supposed to metabolise histamine, people with alcohol allergies suffer from excessive amounts of undigested histamine in their systems, leading to allergy-like symptoms such as nasal congestion and mild flushing immediately upon consuming even minute amounts of alcohol.

Although allergies to alcohol are rare, one of the most common symptoms of an allergy to alcohol is nasal congestion, also known as allergic rhinitis; caused by the inflammatory effect of the histamine produced by the body in response to the presence of alcohol. The histamine causes the blood cells in the nasal region to dilate, resulting in mucus, nasal congestion, sneezing, and a runny nose. However, the severity of these symptoms may vary from person to person.

Causes of Stuffy Nose on Drinking Alcohol & Ways to Get Rid of it?

If you are wondering why the nose gets stuffy on drinking alcohol, you have reached the right place. Flushing of skin is common in case of alcohol intolerance and many times, even your nose gets stuffy. This often leads to sneezing as the body is unable to tolerate regular intake of alcohol. People who lack certain enzymes in their bodies often get troubled by these problems.

Causes of Stuffy Nose on Drinking Alcohol

You may get stuffy nose owing to the presence of some preservatives in alcohol. Many times, some allergic reactions can make you more sensitive towards alcohol intake.

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Normally, the food that you consume, gets broken down into the substances which are absorbed by the body for nutrition and the rest gets excreted. It is the enzymes and juices, that break food into digestible substances but when such enzymes are not present in the body, it becomes tough for heavy substances like alcohol to break down which can lead to many problems like allergies and inflammation.

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Stuffy nose problem is also termed as sinus congestion which often occurs due to presence of preservatives like sulfur dioxide. To understand what causes stuffy nose on drinking alcohol, it is necessary to understand certain facts.

Alcohol & Its Breaking Down in the Body

While talking about the breaking down of alcohol in body, there is an enzyme called as aldehyde dehydrogenase (ALDH). This enzyme is produced from a gene but when, this gene is absent in the body, there is a lack of enzymes which leads to breaking down of alcohol but in an incomplete way.

Incomplete absorption of alcohol by the body could be one reason why you get stuffy nose on drinking alcohol. This happens because body is not able to tolerate the alcohol which circulates in blood. Additionally, the preservatives used in alcohol too can be harsh on your stomach, increasing the chances of allergic reactions causing stuffy nose or sinus congestion.

Alcohol and Histamine

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Presence of ALDH is necessary as it makes the histamine more prone to digestion. Also, some quantity of histamine is present in blood which protects the digestive tract. When any harmful substance enters in the body, it attacks the immune system and presence of histamine ensures that your immunity is not troubled by the same. But what happens when too much of histamine is there in your blood?

Well, excess of histamine eventually makes you more prone to falling ill. When ALDH is absent from your body, too much of histamine will circulate in blood which leads to problems like inflammation. Your nasal chambers can fall prey to inflammation and itching leading to and problems related with stuffy nose or sinus congestion.

Your descent may also have to do with that because those belonging to Asian countries face more of such problems leading to nasal inflammation on drinking alcohol.

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Ways to Get Rid of Stuffy Nose on Drinking Alcohol

Now that you know the causes of stuffy nose on drinking alcohol, you need to be aware of the possible treatment options to get rid of the stuffy nose. Some allergies develop over time and when it comes to alcohol, few things are bound to occur. While talking about the consumption of alcohol, you need to watch out for the gradual development of the nasal infections. Initially, it may not bother much, but eventually the nasal mucus can get thicker, causing more problems.

Take appropriate measures to relieve nasal congestion or stuffy nose.

  • Fruit juices and water also help in thinning of mucus when drainage is promoted.
  • Warm fluids, soups too can help.
  • Steam inhalation and warm water gargles can help get rid of stuffy nose.

There are few symptoms which need not to be ignored, like, swelling of throat which simply does not allow you to breathe. When such a situation occurs, you need to seek immediate medical help to get healed in a due time. Watch out for other signs like fever, gastric upset or dizziness, in which case you need medical help. If stuffy nose is accompanied with bleeding form nose, consult your physician immediately.

Make sure you avoid alcohol intake with any other medications, as there can be interaction between the two. This too, can trigger allergic reactions causing stuffy nose when you drink alcohol. It can also cause more serious problems, requiring immediate medical help.

People suffering from other allergies, asthma, existing medical problems, Hodgkin’s lymphoma or are under treatment for certain medical conditions, are at greater risk of allergy and inflammation due to intake of alcohol.

For many people, more than 2 ounces of alcohol can lead to triggering allergies which is also termed as alcohol allergy. This can again make your nose get stuffy when you drink alcohol with some complaints, which may need medical treatment.

Updated:09/10/17

Everyone has allergies from time to time, but imagine your life if you had a stuffy or runny nose, headache, or sinus pressure every day? There is something natural that can not only reduce these symptoms, but make you feel more energized, boost your immune system, and can even improve your skin and hair health: eating foods that fight inflammation. Inflammation is the root cause of chronic sinus problems, as well as allergies and hay fever.

However, traditional Chinese medicine has long held the belief that the foods you eat and the lifestyle you lead can impact your health as much as any medical regimen.

A nutritious diet can not only decrease inflammation in your system, but also boost your immunity to bacteria that can lead to sinus infections. Also, there are foods that can unclog nasal passages and ease your breathing. Just as we would put the right kind of gas into a car to ensure it runs well, the food you put in your body can be tailored to your needs to help you feel your best.

Let’s start by identifying the foods to avoid if you’re suffering from inflammation:

  1. Processed Sugar, also labeled as fructose or sucrose, are packed into favorite desserts such as pastries and chocolate bars, as well as sodas and fruit juices.
  2. Foods high in saturated fat, such as pizza and cheese, as well as meat products, pasta dishes, full-fat dairy products and grain-based desserts can trigger adipose, or fat tissue, inflammation.
  3. MSG, or mono-sodium glutamate, is present in fast foods, canned/processed soup mixes, salad dressing, Asian foods and soy sauce, as well as deli meats.
  4. Excess Omega-6 Fatty acids, not to be confused with omega-3 fatty acids, are found in oils such as “corn, safflower, sunflower, grapeseed, soy, peanut, and vegetable; mayonnaise; and many salad dressings,” according to the Arthritis Foundation.
  5. Gluten and Casein can be found in foods like wheat, rye, barley, and dairy products.
  6. Refined Carbohydrates, such as instant mashed potatoes, and processed white flour products as well as cereals can be the culprits behind your inflammation.

So, what foods can reduce and prevent inflammation?

  1. Fish such as wild salmon, cod, and sardines are high in omega 3 fatty acids.
  2. Tart cherries. Did you know these little guys can reduces inflammation ten times better than aspirin? They can also reduce your risk for heart disease.
  3. Turmeric spice, which is often used in Thai and Indian food, contains curcumin, which actively reduces inflammation.
  4. Avocados are high in omega 3 fatty acids and can reduce immune dysfunction.
  5. Beans, such as mung, pinto, and kidney, are also high in omega 3 fatty acids.
  6. Red bell peppers are rich in Vitamin C and acts as an antioxidant.
  7. Green vegetables such as broccoli, asparagus, leafy greens, and bean sprouts contain high levels of vitamin C and calcium, helping to counteract histamine, “the substance that can contribute to inflammation, runny nose, sneezing, and other related symptoms.”
  8. Citrus fruits such as oranges, grapefruit, and berries are also high in vitamin C.
  9. Other fruits such as tomatoes, apples and pears are rich in Quercetin, a natural antihistamine.
  10. Green tea and drinking more fluids can help to alleviate any headaches that can result from dehydration caused by constant sneezing and blowing your nose.
  11. Spices like ginger, basil, and cayenne pepper are helpful in thinning mucus and help to simulate the sinuses and aid in air circulation. Ginger, chili peppers and black pepper contain -Gingerol, a dietary polyphenol that has anti-inflammatory effects.

The common thread between all the foods on the list above is that each contains antioxidants and or omega 3s. A part of the world that naturally gravitates to a omega-3 rich diet is Greece. A Mediterranean diet is very high in antioxidants, and studies have shown that people in Greece have very few reported allergies. Think like the Greeks! Eat fresh salads with tomatoes, onions, olives, and plenty of fresh fish.

By incorporating these foods into your daily diet, you will not only be drastically improving your sinuses, you will be reducing inflammation all over your body. This will boost your overall health—improving heart health, joint pain, headaches, and even acne and skin conditions. Enjoy!

SOURCES

U.S. Health News

About Sinusitis

Body Ecology.com

Top 10 Foods to Reduce Inflammation

WebMD.com

The Best Diet for Allergies and Hay Fever

Rhino-Sinusitis and Dairy Allergy

Dairy allergies do not cause nasal symtoms in isolation

If your child has rhino-sinusitis (a persistent runny nose), you might have wondered if an allergy to milk or dairy products is responsible as this is often mentioned in the media and on some websites.
 Some people think that milk causes excess mucus, and that this in turn causes rhino-sinusitis. This may be because of the sensation of coating the throat experienced when drinking milk, but this occurs similarly with other viscous fluids and does not mean that more mucus is produced.

There is no proven relationship between drinking milk and excess mucus.

Milk allergy does affect around 5% of infants but when it does occur, the symptoms are more marked than those in the nose, and it does not cause nasal symptoms in isolation.

Symptoms of milk allergies

Milk allergy is most commonly indicated by gut symptoms (colic or diarrhoea) and by failure to thrive (lack of weight gain). Other symptoms could include vomiting, rashes (eczema or hives), runny or blocked nose, bronchitis or wheezing, cough, irritability, and acute middle ear infections or glue ear. Just a runny or blocked nose is very unlikely to be a sign of an allergy.

The onset of a milk allergy tends to start in early infancy (in the first few months). The reaction is immediate. It is caused by a reaction of substances in the milk (alpha-lactalbumin and beta lactoglobulin) with a substance in the blood called immunoglobulin E (IgE). You might find your baby can tolerate sterilised milk as the substances responsible evaporate at high temperatures.
If allergy is suspected a skin prick test or blood test can help to detect it.

Milk intolerance

Some children who do not have an allergy can have an intolerance to milk. This is different to an allergy. The symptoms include diarrhoea and vomiting, and possibly skin or respiratory problems. The onset is likely to be some hours or even days after taking the milk. You can determine whether someone has an intolerance by eliminating the suspected food, and then gradually reintroducing it, while monitoring symptoms.

Common foods that include milk

If your child has a food allergy or intolerance and you need to eliminate certain foods from their diet please seek the advice of a dietician. 50% of young children with an allergy to milk have other food allergies as well, so it is essential to get professional help with devising a suitable diet.

Causes of Rhino-Sinusitis

If your child has rhino-sinusitis it is far more likely that there are other reasons for it.

Disclaimer: The details in this section are for general information only. ENT UK can not assist in providing further information on the content below or booking appointments. Always check with your own doctor.

7 tips for keeping your sinuses clear from the Harvard Men’s Health Watch

Published: December, 2008

More than 20 million Americans will have at least one bout of sinusitis this year. Blockage of the channels that drain the sinuses is the main cause of this painful condition. Keeping these channels open can reduce your chances of developing the problem, while restoring drainage if they become blocked is the key to treatment, reports the December 2008 issue of Harvard Men’s Health Watch.

Many people with sinusitis recover quickly and completely without taking antibiotics simply by promoting drainage. Harvard Men’s Health Watch offers the following tips:

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Ugh!If you suffer from sinusitis, you’re no stranger to congestion, excess mucus, and uncomfortable pressure caused by a swelling of the sinus cavities. You’re all too familiar with stuffiness and throbbing pain in the cheeks, forehead, and around the eyes; exhaustion; and headaches. Dental problems in the teeth or jaw can also be an issue. And it’s common-sinusitis, acute and chronic, affects more than 37 million Americans.

Why so many sufferers? Part of the reason is the way the sinuses are constructed. These air-filled cavities behind the bones of the upper face contain cells that produce mucus to trap bacteria and pollutants. The surface of the sinuses is covered with cilia, tiny hairs that move back and forth and push mucus through the sinus openings into the nose. But when mucus backs up, the narrow passages become clogged and pressure builds up, leading to the headaches characteristic of sinus problems.

The inflammation or infection that causes sinus problems can be triggered by bacteria or viruses, cigarette smoke, environmental toxins, air pollution, mold, airborne allergies, food allergies, tooth infections, dental problems, overgrowth of Candida albicans (yeast infection), or excessive consumption of dairy. Sometimes, structural abnormalities in the sinuses, such as narrow nasal passages or the growth of a nasal polyp, can prevent normal drainage.

Typical treatments for sinusitis include Sudafed, antihistamines, antibiotics, or steroids. But their side effects-including rapid heart rate, racing pulse, jitteriness, and insomnia-make them less than appealing. Happily for sinusitis sufferers, there are many safe and effective remedies for sinus problems. Skip the prescriptions, and breathe easier with these natural treatments.

1. Hydrate & Humidify

Drinking lots of water helps thin sticky mucous secretions, making them drain more easily from the sinuses. It also keeps the mucous membranes moist. Plain, filtered water is best, but herbal teas can also help; ginger and peppermint help loosen and thin mucus, holy basil and licorice boost immunity, and marshmallow soothes irritated nasal passageways.

You may also need to humidify. Dry air irritates already-inflamed sinus membranes, slows passage of mucus, and can exacerbate infections. If your home is excessively dry, use a vaporizer or humidifier. But don’t overdo it; too much humidity encourages the growth of mold, a common culprit in chronic sinus problems. The best range is 35-45 percent humidity. Or use humid air locally: take a hot shower, fill a sink with hot water and inhale the steam, or breathe in the mist coming from vaporizers (not the steam from humidifiers; it’s too hot and can damage delicate sinus membranes).

2. Rinse & Repeat

The Neti pot has been used in the Ayurvedic tradition for thousands of years. Today, its popularity is growing in the West, and it can be found in natural products stores everywhere. Made of glass, ceramic, or plastic, the Neti pot resembles an Aladdin’s lamp. It is designed to be filled with a saline solution and used to wash away pollens, mucus, viruses, and bacteria from nasal passages. The spout of the Neti pot is held to one nostril while leaning over a sink or basin, letting the water drain out of the other nostril. Research shows this technique can help ease allergy and sinus infection symptoms, and may even lower the chances of catching the common cold. To make a saline solution for a Neti pot, dissolve ½ tsp. noniodized salt in 1 cup of warm distilled or previously boiled water.

Use once daily until symptoms subside.

3. Go (Blue) Green

Spirulina, a blue-green alga that can modulate immune function, is an effective treatment for allergic rhinitis-an inflammation of the nasal membranes that’s characterized by sneezing, nasal congestion, and nasal itching-that’s linked to sinusitis. In one study, spirulina significantly improved symptoms, including nasal discharge, sneezing, and congestion. It’s thought to protect against sinusitis via its antimicrobial actions. Look for it in powders, tablets, or capsules, and be sure to choose high-quality varieties that have been tested to be free of heavy metals.

4. Bid Adieu to Dairy

It has long been thought that dairy increases congestion and mucous production, and can exacerbate respiratory problems. Until recently, scientific studies failed to show a relationship between dairy and mucus production. More recent studies suggest that the type of milk may be the culprit. Certain breeds of cows produce milk that contains beta-CM-7, a protein that can stimulate mucus glands in the sinuses, respiratory tract, and digestive tract in certain susceptible people. If you’re plagued by sinus problems, try getting rid of dairy for a few weeks to see if symptoms improve.

5. Clean House

Besides mold, other sources of indoor air pollution are often to blame for sinus woes. Generally, anything with fumes or a very strong odor-cigarette smoke, hairspray, oven cleaners, and other cleaning products-can exacerbate (or even cause) sinus problems. Keep indoor air clean: get rid of chemical-based cleaning products, and switch to natural, unscented products. An air purifier can help, or try an ozone generator. Ozone has been shown to remove airborne toxins and kill mold.

6. Tame the Flame

Quercetin, an antioxidant found in apples, onions, citrus fruits, red wine, parsley, and tea, acts an antihistamine and can help reduce inflammation and modulate allergic reactions that lead to sinus problems.

Or try quercetin supplements, especially those that also contain bromelain, a naturally occurring enzyme that has anti-inflammatory benefits. In one study, bromelain was effective in reducing symptoms in people with chronic sinusitis.

Another enzyme to try for sinus issues is serrapeptase. This remedy is becoming increasingly popular for addressing different types of pain and inflammatory conditions, including sinusitis. The enzyme has been clinically shown to break down mucus and promote a normal inflammatory response in the body.

7. Avoid Mycotoxins

Mycotoxins, chemical compounds produced by certain fungi, can exacerbate many sinus problems, especially those related to molds. Because they occur in common foods, they’re an often-missed source of sinus woes. If you suffer from chronic sinusitis, consider avoiding foods that are likely to contain mycotoxins, including peanuts, corn, wheat, barley, sugar, alcohol, cottonseed oil, aged cheese, and mushrooms or other fungi.

8. Take Butterbur

The butterbur plant has been used for hundreds of years to treat headache, fever, and allergies. Many modern studies show that it can alleviate respiratory problems that lead to sinus issues.

You’ll find butterbur in tinctures and capsules; look for a formula that’s standardized for petasin and isopetasin, the active components. Because the plant contains pyrrolizidine alkaloids (PAs), chemicals that can damage the liver, also choose products that are certified and labeled “PA-free.”

9. Get Some Sun

It’s the best way to increase the body’s levels of vitamin D, which may alleviate sinus problems by enhancing immune function. More specifically, vitamin D suppresses inflammatory response, and helps the body prevent viruses and infections in the sinuses. Studies have also shown that people with chronic sinusitis have lower levels of vitamin D. About 10-15 minutes of direct sun three to four times a week is enough to help the body produce sufficient vitamin D. If you live in the northern United States, have darker skin, are over 70, or spend very little time in the sun, consider a vitamin D3 supplement.

10. Spray Away Sinus Woes

Most commonly used as a natural, lower-calorie sugar substitute, xylitol is a sugar alcohol that is found in many fruits and vegetables, including berries, plums, lettuce, and mushrooms. But there’s a whole lot more to this sweet ingredient-xylitol’s unique molecular structure enables it to effectively stop bacteria in their tracks. Here’s how: bacteria and yeast like to “eat” xylitol as they would sugar, but unlike sugar, they can’t digest it. Therefore, the bacteria essentially starve to death and do not reproduce.

Research has demonstrated that when used in nasal sprays, xylitol reduces bacteria in sinuses. Additionally, it works via osmosis to pull fluid into airways and helps moisturize and thin mucus. Studies show that a xylitol nasal spray (sold under the brand name Xlear) reduces bacteria, and helps to hydrate nasal passages, shrink swollen membranes, and flush out airborne pollutants that may trigger asthma and allergies.

Get Rid of Mold, Save Your Sinuses

Fungal infection is a leading cause of chronic sinus problems, though it’s rarely identified as the culprit. One important study from the Mayo Clinic suggested that fungi, not bacteria or viruses, cause almost all chronic sinus problems. The first line of defense: get rid of mold in the home. First, take steps to prevent it: be sure your indoor air isn’t too humid, ensure good ventilation in bathrooms and attics, stop leaks, keep crawlspaces dry, and route water away from your home’s foundation. Find details on dealing with household mold at EPA.gov.

If you suspect you have mold-related sinusitis, try an antifungal nasal spray and antifungal herbs such as garlic and oregano.

Dr. Rehl’s 10 TIPS For Sinus and Respiratory Health This Fall and Winter

The time of year is upon us when blistering heat and monsoon winds give way to peaceful sunny 75 degree days. With the change of seasons come a multitude of challenges for the nose, sinuses and lungs. Allergens, dust, air pollution, particulate matter in the air, changes in barometric pressure and respiratory viruses can all wreak havoc on our respiratory systems leading to nasal congestion, post nasal drainage, cough, wheezing, fatigue and eventually sinusitis and bronchitis.

The following 10 tips can help keep your nose, sinuses and lungs healthy this fall and winter.

1. Stay hydrated. Drink plenty of water to keep the mucous produced by your nasal, sinus and respiratory passages thin and flowing. This will prevent stagnant mucous from building up in your sinuses and lungs. When thick mucous is retained for long periods of time in the sinuses and lungs bacteria may flourish in that environment leading to sinus infection, bronchitis or pneumonia. Adequate hydration by drinking water helps to prevent thick mucous.

2. Rinse the nasal passages with saline solution. Washing the nasal mucous membranes with saline solution eliminates irritating particles, allergens and thick mucous from the nose and sinus drainage passage ways. Saline solution also stimulates the lining of the nose and sinuses to clean themselves better. Little microscopic hairs called cilia move more frequently when exposed to saline resulting in egress of mucous from the nose and sinuses. Many products are available over-the-counter to rinse the nose with saline including Neil Med® Sinus Rinse, Simply Saline® and Neti Pot™. Remember to use distilled water to mix the saline rather than tap water or bottled drinking water. 1, 2

3. Keep doors and windows closed on poor air quality days. As the temperatures drop in the Valley it is tempting to open our homes to the more temperate desert air. This can allow dust, air pollution and allergens to enter the home and our nose and lungs causing inflammation, swelling and increased mucous production.

4. Change home air filters regularly. Make sure your home HVAC filters are changed as directed to ensure they are actually removing the unwanted particles from the circulated air.

5. Shower in the evenings. Rinse unwanted dust, air pollution and allergens from your body and hair in the evenings. This will prevent inhalation of undesirable particles from soiled pillows and bedsheets. Lingering in a steamy shower will also help loosen mucous in the nasal passages and moisturize dry mucous membranes.

6. Get adequate vitamin D. Vitamin D deficiency has been linked to more frequent viral upper respiratory illnesses, allergic rhinitis, chronic sinusitis, nasal polyps and asthma. 3,4,5,6 Studies have also shown that vitamin D supplementation lead to decreased frequency of winter respiratory tract infections and asthma exacerbations. 7,8,9,10 Thirty to forty percent of Americans are vitamin D deficient. 11 We make vitamin D through the interaction of sunlight on our skin. Our indoor lifestyles and use of sunblock prevent adequate vitamin D production in the skin and many folks, even in southern states, have vitamin D deficiency. 12, 13 Most adults and children take in less than 400 international units (IU) of vitamin D daily. The Institute of Medicine recommends children and adults get no less than 600 IU of vitamin D daily. The Endocrine Society recommends that children receive 1000 IU of vitamin D daily and adults 2000 IU daily.14 Risk factors for vitamin D deficiency include darker pigmented skin, winter season, sun avoidance, obesity, increasing age and use of certain medications including oral steroids and anti-seizure medications. 15 If you believe you are at risk for vitamin D deficiency, see your healthcare provider. You may need over-the-counter supplementation of vitamin D or even prescription vitamin D replacement for very low levels.

7. Get the sleep you need. Lack of sleep increases your risk of getting sick after exposure to a virus. Most adults need 7-9 hours of sleep. Teenagers usually require between 8-10 hours of sleep while children require 9-11 hours. 16

8. Consider an over the counter nasal steroid spray. When your nose has been subjected to allergies or other airborne irritants and nasal congestion is not relieved and prevented with the above measures then consider using an over-the-counter nasal steroid spray as directed for 4-6 weeks. These remedies are effective and relatively safe when used properly. 17,18,19,20 Be sure to aim the spray nozzle towards the internal sidewall of the nose rather than at the internal middle wall (septum). Do not use the steroid spray until consulting with your physician if you have frequent nose bleeds, prior nasal surgery or glaucoma. Discontinue the spray after 6 weeks unless you are under the care of a doctor who has recommended longer use.

9. Consider over-the-counter remedies to relieve sinusitis symptoms. Almost every grocery store or pharmacy has everything you need to find relief from uncomplicated mild acute sinusitis. Symptoms of acute sinusitis include cloudy or colored nasal discharge, nasal congestion, nasal blockage, and pain, pressure or fullness in the face, head or around the eyes which have been present for 4 weeks or less. Over-the-counter decongestant and mucous thinning combination tablets (ie. Mucinex-D ™) and over the counter decongestant spray (ie. Afrin ™-use for maximum of 3 days only) when combined with nasal saline irrigations during early and uncomplicated acute sinusitis can relieve symptoms and help resolve acute sinusitis. Check with your healthcare provider if you have high blood pressure, heart disease, irregular heartbeat, prostate enlargement, urinary retention, frequent bladder infections, anxiety, nervousness or insomnia before taking over-the-counter decongestants as these medications can potentially worsen those conditions. Also, it is very important to avoid using nasal decongestant spray for longer than 3 days. Beyond 3 days of use the decongestant nasal sprays may cause long lasting irritation in the nose and worsen nasal congestion. Most cases of acute sinusitis will resolve without antibiotics. If symptoms last more than 7 days after starting over-the-counter treatment then it is time to see your healthcare provider to determine the appropriate course of action. At that point antibiotics may be prescribed. Keep in mind oral antibiotics have potential harmful side effects including nausea, rash, stomach upset, diarrhea, allergic reaction, causing resistant germs and ridding our body of essential helpful bacteria in the digestive tract. 21

10. Continue to exercise if your symptoms are mild and you have the energy to do so. Avoid exercise if you have shortness of breath, significant cough or any other chest symptoms. However, if you have mild nasal and sinus symptoms (congestion, pressure) aerobic exercise can bring relief. Aerobic exercise results in the release of epinephrine (adrenaline) into your blood stream. This epinephrine release acts as a natural nasal decongestant by constricting blood vessels in the inflamed and swollen tissues in the nose and sinuses. After a few to several minutes of aerobic exercise the nasal passages usually feel clearer. Additionally the repetitive bouncing or vibrations the body experiences from aerobic activity like running and high intensity interval training transmits vibrations to the sinus cavities and lungs which some experts believe helps with clearance of thick mucous from those passages. Natural clearance of mucous from the sinuses by cilia (microscopic hairs which line the mucous membrane and sweep mucous out of the sinus cavity) increases during exercise. 22 Remember to stay well hydrated when you exercise and when you have nasal and sinus symptoms. It is recommended you double your normal water intake to prevent dehydration during exercise in the setting of mild upper respiratory symptoms. Please be respectful of others and avoid group fitness and gyms if you believe you have a contagious viral or bacterial illness. Once symptoms have resolved you may return to the gym. Remember there are plenty of exercise activities you can do on your own without heading to a fitness class or gym.

I hope the preceding 10 recommendations keep you feeling clear headed, vibrant and healthy this fall and winter. If your respiratory symptoms persist beyond 7 days despite the measures above, or if you have shortness of breath, consult with a qualified healthcare provider or physician.

Ryan M. Rehl, M.D.

Founder, Arizona Sinus Center
a Division of Valley ENT, P.C.

Immediate Past President Arizona Society of Otolaryngology-Head and Neck Surgery

  1. Rudmik L, Hoy M, Schlosser RJ, et al. Topical therapies in the management of chronic rhinosinusitis: an evidence-based review with recommendations. Int Forum Allergy Rhinol. 2012
  2. Harvey R, Hannan SA, Badia L, Scadding G. Nasal saline irrigations for the symptoms of chronic rhinosinusitis. Cochrane Database of Systematic Reviews 2007
  3. Belderbos M. Oral presentation. 7th International Respiratory Syncytial Virus Symposium. December 2010 (Netherlands)
  4. Ginde et al. Third National Health and Nutrition Examination Survey. Arch Intern Med 2009;169:384–390.
  5. Stokes P, Rimmer J. Am Journal of Rhinol Allergy 2016 30(1)
  6. Schlosser et al. Int Forum Allergy Rhinol. 2016;6:58-65
  7. Linday et al. Annals of Otology, Rhinology & Laryngology. 113(11):891-901, 2004 Nov.
  8. Urashima et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr 2010;91:1255–1260.
  9. Majak P, Olszowiec-Chlebna M, Smejda K, Stelmach I. Vitamin D supplementation in children may prevent asthma exacerbation triggered by acute respiratory infection. J Allergy Clin Immunol 2011;127:1294–1296
  10. Linday et al. International Journal of Pediatric Otorhinolaryngology 2004 68 (6).
  11. Holick et al. J. Clin. Endocrinol. Metab. 2012, 97, 1153–1158.
  12. J Clin Endocrinol Metab 2005; 90:1557– 62.
  13. Am J Clin Nutr 2008;87:608–13
  14. Holick, M.F., Wacker M. Vitamin D—Effects on Skeletal and Extraskeletal Health and the Need for Supplementation Nutrients 2013, 5, 111-148
  15. Holick, M.F. The vitamin D deficiency pandemic: A forgotten hormone important for health. Public Health Rev. 2010, 32, 267–283.
  16. www.mayoclinic.org
  17. Snidvongs K et al. Topical steroid for chronic rhinosinusitis without polyps. Cochrane Database Syst Rev. 2011;(8)
  18. Kalish L et al. Topical steroids for nasal polyps. Cochrane Database of Systematic Reviews 2012, (12)
  19. Joe SA et al. A systematic review of the use of intranasal steroids in the treatment of chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2008;139:340–347
  20. Meltzer et al. Added relief in the treatment of acute recurrent sinusitis with adjunctive mometasone furoate nasal spray. The Nasonex Sinusitis Group. J Allergy Clin Immunol 2000;106:630 –7.
  21. Clinical practice guideline: Adult sinusitis Otolaryngology–Head and Neck Surgery, Vol 137, No 3S, September 2007
  22. Cohen NA. Sinonasal mucociliary clearance in health and disease. Annals of Otology, Rhinology, & Laryngology – Supplement. 196:20-6, 2006 Sep.

For additional information on sinusitis:

Andrew Goldberg, MD, never tires of telling people about how he was outsmarted by a patient while working as a second-year otolaryngology resident at the University of Pittsburgh. Now the director of rhinology and sinus surgery at the University of California San Francisco Medical Center, Dr. Goldberg recalled how he assisted in the examination of a patient with a history of chronic otitis externa in one ear. Despite repeated trips to doctors for antibiotics, vinegar washes and drops, the patient’s ear trouble always came back.

Explore This Issue

December 2012

Not this time. The doctors assumed that their treatments had finally done the trick, only to be told by the patient that he had likely cured himself by taking earwax from his good ear and sticking it in his bad ear. “I had no idea what that meant. I’m sure that we assumed, at the time, that what he was telling us was nonsense, that he was a little nutty,” Dr. Goldberg said. “We never thought anything more about it.”

The home remedy, however, now seems prescient in light of accumulating research suggesting that microbiomes, or distinct bacterial communities that coexist with us throughout our bodies, may play key roles in maintaining human health. When he began conducting his own microbiome research about five years ago, Dr. Goldberg realized that his former patient may have taken an intact, healthy microbiome and used it to re-inoculate the disrupted bacterial community in his bad ear.

The Microbial Ecosystem

A new study by Dr. Goldberg and colleagues likewise concludes that the health of our sinus cavities, once thought to be largely sterile, may be highly dependent on the composition of their microbial residents (Sci Transl Med. 2012;4(151):151ra124).

The study, published September 2012 in Science Translational Medicine, found an intriguing shift in the types of microbes inhabiting the sinuses of seven patients with chronic rhinosinusitis (CRS) when compared with healthy counterparts. Beyond a significant decrease in the diversity of microorganisms among the patients, the researchers found a noticeable drop in a group of bacteria known as Lactobacilli, long associated with maintaining health in the gut. Concurrently, the researchers saw an increase in a little-known potential pathogen called Corynebacterium tuberculostearicum.

Lactobacilli could lower the surrounding pH through their production of lactic acid.

“Central to the concept that we’re putting forward is that there is a protective mechanism in a normal sinus that comes about as a result of the microbiome,” Dr. Goldberg said. Exactly how microbes such as Lactobacilli may keep pathogens at bay isn’t known. But study co-author Susan Lynch, PhD, associate professor of medicine and director of the Colitis and Crohn’s Disease Microbiome Research Core at the University of California San Francisco, noted that Lactobacilli could lower the surrounding pH through their production of lactic acid. The ensuing environmental change may influence which microbes can coexist in the sinuses and perhaps exclude some troublemakers.

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The Healthy Sinus: Fact vs. Fiction

Vitamins
Diet
Lifestyle
Essential Quick Tips

Healthy foods can help your sinuses

Healthy Sinuses: The Key to a Healthy Life

Sinus problems can affect people in different ways. Most people are lucky to have no sinus symptoms while others may have one or multiple infections per year. Still others battle the painful symptoms on a daily basis. The incidence of recurrent acute sinusitis and chronic sinusitis are on the rise as pollution and other irritants increase both outdoors and at home.

Dr. Bennett feels strongly that explaining the characteristics of healthy sinuses, dispelling frequent myths about sinusitis, and suggesting tips to prevent infections, will help you to improve your quality of life!

The Meaning & Importance of “Healthy Sinuses”

Most of us are already aware of what unhealthy sinuses feel like. Unhealthy sinuses are linked to nasal pressure, green or yellow mucus, difficulty smelling or tasting and fatigue, but how do we know if our sinuses are healthy? Healthy sinuses mean more than simply not having these symptoms.

Understanding what the sinuses are and how they function is key to maintaining their health. Imagine that the area behind your cheeks, nose and forehead is a large cavern. Now imagine that that within that cavern, there are a series of 8 to 16 smaller caves – these are your sinuses.

Sinuses are thought to help lighten the head and cushion them in case of trauma to the front of the face. Sinuses and the inside of the nose also act as filters, sifting out harmful germs, bacteria and viruses from the air we breathe. Our sinuses are lined with a delicate nasal membrane that is made up of tiny cilia. Think of cilia as similar to the brushes at a car wash. They are tiny hairs that brush the dirty particles from our nose the back of the throat where they can be swallowed. Cilia aid in the filtration system by preventing bacteria from stagnating in our sinuses. Without the cilia, bacteria would enter our sinuses, causing inflammation and thereby affecting the body’s ability to stop infection.

Healthy sinuses are also linked to speech. Think back to the last time you had a sinus infection – you probably remember that it was difficult to pronounce common “nasal” sounds. These alterations in your voice are common. If you notice that when you speak, it sounds like you are pinching your nose, then your sinuses are probably not up to par, and you could be on the verge of a sinus infection.

Clear mucus is a characteristic of healthy sinuses. Clear mucus means clean sinuses and the absence of infection. Many people incorrectly assume that mucus, in any form, is not a good sign. Mucus is important because it creates a proper level of moisture in the nasal membrane. We make about a liter of mucus every day in our noses. Mucus also helps the hairs inside the mucus membrane (cilia) to move freely and to filter out bacteria.

When the sinuses fail to filter out bacteria and these harmful particles enter the nasal membrane, your body’s response is to produce inflammation and excess mucus to drain the bacteria from your nasal cavity. This leads to blockages in the nose, since your body is producing mucus faster than it can drain from your body. Blockages can increase inflammation of the nasal cavity in a cycle that can cause sinus infection symptoms.

For information about how to keep your sinuses healthy, read the diet and lifestyle tips below.

FACT: Diet Choices Affect Sinus Health

Sinus health is inextricably linked to nutrition. We all know that proper nutrition involves eating certain foods, but understanding the types of foods you should avoid is just as important. Dr. Bennett encourages patients to keep an eye on the amount of refined sugar consumed. Products that contain high fructose corn syrup are linked to bacteria growth that can cause illness, including sinus infections.

To help the body detoxify, an elimination diet can be a helpful tool. An elimination diet is a 2-3 week program of restricting one’s diet to mostly fruits, vegetables and protein, and keeping dairy and gluten on the grocery store shelf. Of course you should talk to your doctor to make sure this is appropriate for you.

Stay away from dairy

The goal of the diet is to find out if your body is allergic or sensitive to a certain type of food or food group. A food allergy or sensitivity can lower your immune system and force your body to produce a surplus of mucus (meaning an increased risk of sinus infection.) An overwhelming percentage of people site diary products as the offenders, so if you suspect food sensitivity plays a part in your frequent sinus infections, trying removing dairy from your diet.

FACT: Lifestyle Affects Sinus Health

Caring for your sinuses can sometimes be as simple as following common, everyday tips for a healthy lifestyle. It’s no myth that staying hydrated by drinking 8 glasses of water a day, keeping a good sleep pattern, avoiding alcohol and tobacco, and exercising 3-4 times weekly is the secret to healthy sinuses, and a healthy body, too.

FACT: One-A-Day Vitamins Affect Sinus Health

Studies show that supplements contribute to healthy sinuses. Think about it this way: if you are providing your body with essential nutrients, then you are equipping it with the strength it needs to fight against sinus inflammation. Dr. Bennett recommends taking supplements that fortify the adrenal gland – which is liked to the immune system.

Look for these vitamins when shopping at your local general nutrition shop:

  • Turmeric – Try this herbal supplement to fight congestion and inflammation.
  • Quercetin – This vitamin has anti-inflammatory properties to help with the onset of sinusitis symptoms.
  • Vitamin C – Take 2,000-3,000 mg per day to strengthen your immune system.
  • Stinging nettles – This herbal supplement helps dry up excess mucus in the nose.
  • B complex – Take 2-3 capsules per day to strengthen your adrenal gland.
  • B-5 (pantothenic acid) – This antioxidant, when combined with B-complex produced antibodies that help fight bacteria in the body.
  • Panax ginseng – Although usually associated with helping memory problems, ginseng also helps with sinus pain and mucus drainage

Vitamin C can be helpful for your sinuses

Dr. Bennett’s 4 Essential Quick Tips to Jumpstart Healthy Sinuses

1. See an allergist.

Why?

Many people are unaware that their body is allergic to certain foods or environmental irritants like pollen, mold or pet dander. See an allergist, who can perform a non-evasive skin test to determine whether an allergy is contributing to your frequent sinus infections.

2. Cleanliness is protective.

Why?

If you aren’t in the habit of maintaining a good hygiene regimen, then you may be exposing yourself to germs that may increase the likelihood of a sinus infection

How?

Prevention is half the battle in reducing sinusitis symptoms. Wash your hands after close contact with bacteria. Dr. Bennett suggests keeping a small bottle of anti-bacterial lotion in your bag or briefcase throughout the day. Avoiding contact with bodily fluids and personal items of those around you is helpful. Take care not to share things like make-up, hairbrushes or toothbrushes. Before you touch your nose or eyes, make sure your hands are clean.

3. Flush your sinuses.

Why?

When you inhale bacteria, the mucus membrane in your nasal cavity can become inflamed as a response to the foreign agents now present in your nose. Inflammation closes up your nasal passages, preventing proper draining and trapping mucus inside your sinuses. It is important to help clear away the infection-causing agents before your symptoms worsen. It will help you breathe easier and allow the mucus in your nose to drain properly.

How?

See Dr. Bennett’s article entitled “Fighting Sinusitis: Transform Yourself From Neti Pot Novice to Sinus Expert” for more details.

4. Pamper your Cilia.

Why?

The cilia are the most important tools for fighting infection, so treat them with the love and respect they deserve by giving them what they crave most – warmth and moisture.

How?

Easy tips like inhaling deeply near a hot tea kettle, installing a humidifier or vaporizer in the bedroom, or simply breathing deeply with a warm wash cloth placed over your face are the best gifts for your cilia.

Q: Years ago, I used to wake up every morning with “face aches,” aka sinus pain. I went to many different doctors, all of whom prescribed antibiotics for a sinus infection. Then I became allergic to these drugs.

An article I read said that many sinus issues are caused by an allergy to the milk protein casein. As an experiment, I stopped drinking milk and never had face aches again. I use unsweetened almond milk for my morning oatmeal, and all is well.

A: The role of milk protein allergy in causing sinus inflammation is controversial. Allergies sometimes can cause nasal congestion as well as hives, rash or swelling. Some research has linked cow’s milk protein allergy to ear, nose and throat problems in young children (Otolaryngology-Head and Neck Surgery, August 2012). There has been little if any research on whether this also holds for adults. We don’t see any trouble in avoiding cow’s milk if you find it makes you feel better.

Antibiotics are often overprescribed for sinus congestion. A review of research in the New England Journal of Medicine (Sept. 8, 2016) concluded that antibiotics are rarely helpful for acute sinusitis.

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Q: After I started using ashwagandha for my own stress and lack of restful sleep, I recommended that friends try it. They not only are using it now but have come off their antidepressants at the same time!

It’s important to taper down gradually on any drugs for anxiety or insomnia. My husband was taking sertraline for anxiety. When he no longer needed it, his doctor told him to take the medication every other day for a week, then every third day for a week, every fourth day for a week and then eventually quit.

A: Ashwagandha is part of the Indian ayurvedic healing tradition that stretches back thousands of years. It has a wide range of uses. Ashwagandha can be helpful in easing anxiety and insomnia, and has anti-inflammatory activity.

Some people have reported digestive distress, including nausea and diarrhea. Other side effects include drowsiness or headache. One visitor to our website reported an alarming drop in blood pressure.

To learn more about the pros and cons of ashwagandha and many other nondrug approaches, you may wish to read our eGuide to Favorite Home Remedies. You will find this online resource in the Health Guide section of PeoplesPharmacy.com.

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Q: I got a huge splinter in the end of my big toe. I couldn’t get it out and neither could my physician assistant or her nurse.

On the recommendation of a friend who is also a nurse, I put duct tape around the toe. The next morning when I took the tape off, there was the hunk of wood stuck to the tape. I am seriously grateful for the tip and want to share it with your readers.

A: Using a needle or a tweezer to get a splinter out of your skin can be tricky. What’s more, it’s often painful. After a time or two, children become unwilling to submit to this kind of first aid.

In addition to duct tape, we have heard about using a salicylic acid plaster of the sort sold for warts. After a day or two, the splinter works its way to the surface, according to an article in the Journal of the American Academy of Dermatology (April 1989).

White glue is another splinter-removal tactic. The trick is to let the glue dry over the splinter. Then pull it off in the opposite direction the splinter took going in.

Contact the Graedons at peoplespharmacy.com.

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