By Andrew Gaeddert
I’m going to start with a quote from Ye Tian Shi from the year 1746. “The lung is one of the delicate organs, which is extremely sensitive to the influences of evil qi. The lung has an innate aversion to cold, to heat, dryness, dampness and most of all to fire and wind.”2
It’s important to keep in mind the relationship between the lung and the sinus and nose. The main lung imbalances involved in sinus problems include lung qi deficiency, lung dryness and yin deficiency, lung heat, lung cold; and all of these can be complicated with an excess amount of water and phlegm.
These are conditions where the lung is challenged, then sinus problems result. We’ll go over some lung protocols as well as prevention strategies and how to deal specifically with sinus infection, which can be either acute or chronic.
Let’s just go over a quick medical review. Now approximately 31 million, that’s almost one out of ten Americans, is diagnosed with a sinus infection each year; 21% of the antibiotic prescriptions in the United States are for sinusitis.
Even though 21% of the antibiotics are for sinus infections, around 2% of the sinus infections are actually caused by bacteria. About 25% of the sinusitis patients who get prescribed antibiotics have side effects such as gastrointestinal problems, skin rashes or headaches.3
Sinus infections almost always start as a viral infection and in some cases turn into a bacterial infection. In other cases, sinus infections start out as sort of a mild bacterial infection. Over time it typically goes away on its own.
Groups like the American Academy of Rhinology, Head and Neck Surgery are recommending that surgeons and doctors wait ten days before even considering an antibiotic. This also includes not only acute infections but also chronic sinus infections, chronic sinusitis and sinus blockage.
At the Mayo Clinic, they found when they actually cultured the sinus cavity of individuals with sinusitis/chronic sinus infections, 96%, had chronic fungal infection, not a bacterial infection.4
Typical biomedical treatment includes decongestant sprays. These are really only indicated for about three days at the most, because a decongestant spray can cause a rebound reaction. In other words, a person takes a decongestant and then gets rebound sinus blockage if they don’t use the decongestant. I would be very careful with your clients using decongestant nasal sprays because they are really only indicated for short-term use.
Medical doctors also recommend topical steroids and one of the problems that’s prevalent in chronic sinus infections is stagnation. And of course the topical steroids, and topical decongestants tend to, over time, just make the stagnation worse. Over the counter pain medicines such as Advil and Tylenol are recommended. There’s really no evidence that they actually improve the health at all or improve the sinus infection. One of the few Western medical options that really does work for acute and chronic sinus infections is saline irrigation.
You’re all probably familiar with a Neti Pot but there are also preparations that are available in health stores and drug stores that are just saline, or some of them combine saline with baking soda.
Sinus saline irrigation is very important. Add a little bit of salt to room temperature or slightly warm water. You can also combine equal parts of baking soda and table salt.
Generally this doesn’t cause a rebound reaction. It can be very healing to get some of the debris out of the nose. I recommend sinus irrigation twice a day.
Steaming is also very useful, where a person puts a couple drops of eucalyptus oil, thyme oil, or orange peel oil in boiling water, covering their head with a towel, while alternate nostril breathing. Make sure to remove the boiling pot from the stove before you start inhaling.
Let’s go a little bit deeper into some of the factors in terms of sinus infections. Like many conditions in Chinese medicine, they revolve around combinations of excess and deficiency.
Now remember, the lung is also in charge of bringing down waste and other materials. So the lung is involved in the descending action. Many sinus problems result from having weak lungs and then having some damage to the lung.
Another factor that’s very important is weather and location. For instance our patients that come from Colorado, where there are high altitudes, often have more dry sinuses than the people who are in San Francisco.
The San Francisco clients we see often times live in areas like Haight-Ashbury which has very damp weather. Much of the housing in Haight-Ashbury area is old Victorian houses, which have excessive amounts of ventilation and may contain mold contamination.
One of my clients had a really bad sinus infection for many years. If he would just stop smoking marijuana and would just stop drinking wine and move to a dry climate like Arizona, he probably wouldn’t have sinus infections. But because he lives in a drafty, moldy old house in San Francisco, smokes marijuana and drinks alcohol, particularly red wine, he has to constantly do things that help his sinuses or that stop his sinus blockage.
What are the take home messages? It is that lifestyle factors are very important. If people have deficient lungs and a deficient constitution, they are particularly susceptible to smoke and alcohol. Smoking tobacco is very bad, as well as second hand smoke. There is some evidence that marijuana smoking may predispose a person to fungal infection.
In terms of Chinese medicine, emotions can cause an effect of sinusitis mainly by causing stagnation. Diet is definitely something to look at, people who eat too much dairy products in particular – as dairy is a direct mucus causing food. Beer and fish contain histamines. Red wine contains sulfites and other allergens.
Much of the damage causes stagnation in the body. One of the things that we want to do is get things moving. One of the special formulas that you may not be familiar with, that Health Concerns produces, is called Serramend.
Chinese and Japanese research over the last 20 to 30 years has revealed that the ingredient in Serramend can be very useful for treating chronic lung, ear, nose and throat disorders.
Another special ingredient that I like to talk about is cordyceps. Cordyceps is just a fascinating ingredient. Some of the medical uses are for fatigue, night sweats, impotence, hyperglycemia, hyperlipidemia, neurasthenia or weakness after severe illnesses, renal dysfunction and renal failure, arrhythmias and other heart diseases, liver diseases and last but not least, respiratory disease.
In terms of Chinese medicine the interesting thing about cordyceps is that it tonifies both yin and yang, and treats deficiency of the lung and kidneys. The wild cordyceps is derived from a symbiotic relationship between a fungus and a caterpillar.
The problem is that the wild cordyceps is wild crafted from very high altitudes and typically costs thousands of dollars a pound. In addition, there are some political concerns about the use of wild cordyceps.
We tend not to recommend the wild cordyceps. Health Concerns has a special type of cordyceps that is in both our formula Cordyceps PS, which is an extract of cordyceps; and CordySeng, which is perhaps more useful in the treatment and prevention of chronic lung infections. At any rate, what’s unique about our cordyceps is that it was developed from a culturing process that was developed from the Institute of Materia Medica at the Chinese Academy of Medical Health Sciences. It contains the same constituents as wild cordyceps.
CordySeng is the combination of cordyceps (dong chong xia cao) herb along with astragalus (huang qi), ganoderma (ling zhi) mushroom, and American ginseng (xi yang shen). These are all very powerful extracts and useful when we want to strengthen the lung’s health, which is again the main prevention strategy against developing sinus infections.
That’s some information about some specific herbs and formulas to think about, namely Serramend to increase circulation and loosen mucus secretion in the ear canal as the sinus passages and in the lungs, and the specific herb cordyceps found in Cordyceps PS and CordySeng.
Next I’d like to talk about some specific protocols for both acute as well as chronic sinus infections. In terms of Chinese medicine we usually differentiate by symptoms and the color of the discharge. We typically say if there’s colored discharge from the nose, there is heat. If the discharge is yellow, green, blue or even red, we say that there is heat in the local area. If somebody has sputum from their nose and it’s clear or white, we typically say there is no heat.
If the person just has sinus congestion, one of the formulas that we use is Nasal Caps 2. Nasal Caps 2 is formulated to have an ephedra effect without the ephedra.
Now if there is indication of heat, this would be if somebody has been diagnosed with a sinus infection, or has congestion or a runny nose and there’s actually yellow and/or green phlegm, then we typically use the formula Nasal Caps 2 with Coptis Purge Fire.
Coptis Purge Fire is our version of Long Dan Xie Gan Tang and is a specific formula for heat and damp heat. All the debris that tends to accumulate in the sinus, that typically is associated with dampness; damp heat, particularly if there is yellow or green phlegm.
If you feel that it is more of a chronic sinus infection complicated or caused by allergy then one of the formulas we use is Xanthium Relieve Surface. If there is copious phlegm, whether it’s acute or chronic, we use Clear Phlegm.
Clear Phlegm is based upon an ancient formula called Wen Dan Tang. Recently, I was at a Pacific Symposium meeting with many of the practitioners and we got some really good feedback about how our Clear Phlegm works much better than other versions of Wen Dan Tang.
We added special herbs to the traditional formula to make it more versatile for acute, chronic and insubstantial phlegm. So, when we have the copious discharge we certainly want to use Clear Phelgm.
What you want to keep in mind is Clear Phlegm is a drying formula. We really want to monitor the patient on that formula. Some of the questions we might ask after starting the formula; Are you a little bit thirstier? Are you noticing that your sinus passages are a little bit more dry than usual?
Typically what we would do is reduce the dosage if the Clear Phlegm tends to cause dryness. Another clinical tidbit in terms of recommending Clear Phlegm is that it’s not a long-term strategy. It’s an acute strategy typically prescribed for no more than a couple of weeks, maybe at the most one or two months.
Strengthening the spleen and avoiding phlegm causing foods is the long term strategy for reducing mucus.
If the lungs are very dry, susceptible to yin deficiency, we want to consider Lily Bulb formula.
Now in terms of sinus infections that are caused by fungus, a combination that I often use in my own practice is either the Nasal Caps 2 or Xanthium Relieve Surface with Phellostatin formula.
This can be very good for chronic sinus infections that are complicated with fungus. As part of their protocol the client may be prescribed an anti- fungal drug and antifungal diet. They can certainly safely take Phellostatin at the same time that they are on an anti-fungal drug.
Typically antifungal drugs drop the fungal count very quickly. However, once off the drug, the fungal count can rebound.
What we’ve found in about 15 years of recommending Phellostatin is, it contains herbs that are proven to reduce fungal counts but, it also has harmonious herbs, which are used to help strengthen the immune function.
You are not only getting the anti- fungal herbs but also the special immune building herbs. If you used other methods to reduce fungus, really consider Phellostatin long-term because it is one of the few formulas that actually keeps fungus away.
How would we treat somebody that we suspect has a chronic fungal sinus infection? Well, this might be somebody who has gone to many doctors, many ear, nose and throat specialists, or they’re just not getting better and have other signs of chronic fungal infection.
In my new book, Healing Digestive Disorders 4th ed.,I go into some of the factors on how clients can determine whether they may have a fungal infection empirically. You can see if a person has a fungal infection by culturing the nose sputum.
If we feel it’s more allergic we would tend to use Xanthium Relieve Surface. If we feel that it’s more of a blockage situation, we’d use Nasal Caps 2. Typically, we would add Phellostatin in the case of fungal sinusitis.
A person typically would take two capsules of Nasal Caps 2 or two capsules of Xanthium Relieve Surface three times a day along with Phellostatin, two to three capsules, three times a day. Now some of the practitioners out there are very experienced herbalists and have maybe even tried Xanthium Relieve Surface and Nasal Caps 2, or similar approaches and there’s still a lot of stagnation in the ear, nose and throat.
In that case the formula Serramend would be very useful.
If you have clients that are susceptible to chronic sinus infections, the best formula to consider would be CordySeng. The other two are Astra C and Astra 8. Astra C is the Jade Screen formula. I’ve added zinc citrate, which is a very absorbable form of zinc. Zinc itself is very useful to help keep the immune system strong.
Astra C can also prevent allergic reactions. Many of you are familiar with our allergy protocol, which works very well for hay fever and that is to combine the Xanthium Relieve Surface with Astra C.
Typically the person takes Astra C during the non-allergic season to help improve their lung function as well as to help rid some dampness in the chest. Think of CordySeng when you want a very strong tonic for the lungs. Think of Astra C when you want help to build up the wei qi and there may be some susceptibility to dampness in the lungs as well.
The last formula I want to mention is Astra 8, which has a number of herbs that are very good for the lungs, including astragalus (huang qi). It has many adaptogenic herbs and helps the body resist illness particularly due to stress. Use Astra 8 as a long-term tonic, especially if the person is under a lot of emotional stress.
If we want to very strongly tonify the lungs and spleen, use CordySeng with Astra C. That gives you some ideas for preventive strategies.
I want to make a couple of closing remarks. Sinus infections can be very successfully treated with natural methods. You really want to ask yourself: Might this client have a chronic fungal infection?
Finally of course, matching the correct pattern with the correct herbal formula will produce the best results. The chief role of herbal formulas like CordySeng are to strengthen and promote lung health and this in turn helps keep the sinus and lung passages clear.
For part 2 of this series, click here.
NOTES
- Discussion initially recorded on 11/19/08. The MP3 can be downloaded or listened to: healthconcerns.com.
- Ye Tian Shi, Handbook of Clinical Case Histories, 1746
- wsj.com accessed on 08/12/08.
- Ponikau JU, et al. The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc 1999;74:877-884.