Supplements and Herbs - Sinus Infection

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 day.

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

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 betony.