magazine presents

Sinus Health

Breathe Easy the Natural Way fight Allergies, Colds, Sinusitis, and Sinus Headaches

Surprising

Fixessal

f o r Na Congestion

$4.95

magazine presents

sinus health by

kim erickson

sinus health CONTENTS Introduction: Sinus SOS ................................................. 4 Chapter One: All About Your Sinuses ................... 7 Chapter Two: Sinus Problems .................................... 10 Chapter Three: A Sweet Solution ............................ 17 Chapter Four: Breathe Easy ........................................ 23 Selected References .......................................................... 31 Copyright © 2010 by Kim Erickson, and Active Interest Media, Inc. All rights reserved. No part of this booklet may be reproduced, stored in an electronic retrieval system, or transcribed in any form or by any means, electronic or mechanical, including photocopying and recording, without the prior written permission of the publisher, except for the inclusion of quotations in a review. Published by: Active Interest Media, Inc. 300 N. Continental Blvd., Suite 650 El Segundo, CA 90245 This booklet is part of the Better Nutrition Healthy Living Guide series. For more information, visit www.betternutrition.com. Better Nutrition magazine is available at fine natural health stores throughout the United States. Design by Aline Design: Bellingham, Wash. The information in this booklet is for educational purposes only and is not recommended as a means of diagnosing or treating an illness. All health matters should be supervised by a qualified healthcare professional. The publisher and the author(s) are not responsible for individuals who choose to self-diagnose and/or self-treat.

Introduction

Sinus SOS

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reathe. It’s something we all do every minute of every day without giving it a second thought. That is, until our sinuses act up. Whether they are blocked, stuffed, or draining, sinuses can be a source of pain and inflammation. For some people, sinuses can create chronic misery, especially during cold or allergy seasons. More than 70 million Americans suffer from sinus problems. If you are one of them, you are all too familiar with the symptoms—postnasal drip, stuffiness, obstructed breathing, headache, coughing, sore throat, swollen glands, hoarseness, a decreased sense of taste and smell, facial pain, ear pressure, dizziness, and even hearing loss. Your sinuses are hollow cavities in the skull that sit directly behind your face. There are typically four pairs of these cavities. One of each pair is located on either side of your face—a pair behind your forehead; one between the eyes; another directly under the eyes and behind the cheekbones; and the last pair is located behind the eyes, under the brain. But while your sinuses take up a fair amount of space in your head, scientists aren’t exactly sure what they do. Some in the medical community believe that sinuses affect the way our voice resonates, which changes the characteristics of the spoken voice. Others think that the sinuses act as air-­conditioners, filtering, heating, and humidifying the air that comes through the nose. Still others speculate that sinuses act like “crumple zones” during facial trauma, helping to protect the cranial cavity and brain. And some scientists think that the sinuses are simply there to lighten the weight of the skull. Whatever their purpose, healthy sinuses function thanks to mucus, a thin, sticky fluid made up of water, proteins, salts, and enzymes that create a barrier against bacteria, viruses, and allergens. Mucus adds moisture to the air taken in through the nose. It also lubricates the membranes in the nose. Each set of sinuses is lined by mucous membranes that are covered by a thin blanket of mucus. When you inhale, the mucus traps dirt, chemicals, irritants, dust, allergens, fungi, molds, bacteria, and viruses so they can be expelled from the body before they can do any damage. It is estimated that this mucus blanket is regenerated in the nose every 10 to 20 minutes and in the sinuses every 10 to 15 minutes.

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The nose and sinuses normally secrete about two liters of mucus a day. But if you suffer from allergies or an infection, the body increases mucus production. When we experience an excess of thin and watery mucus (like a runny nose) or when mucus becomes thick and dry (nasal congestion), we often find ourselves reaching for antihistamines or decongestants to try to relieve the pain and discomfort. But that approach can actually undermine the body’s natural healing system and create even more problems. Antihistamines block symptoms like itchy, watery eyes; sneezing; or a runny nose caused by histamines. Histamines are chemicals produced by the body during an allergic reaction. When an allergen is present, histamines bind to receptor cells in nasal tissue, nerve endings, and nearby blood vessels. When this occurs, blood vessels begin to enlarge and leak fluid as the production of mucus increases. Not only does this help the body clear the offending allergens, it also triggers the symptoms of an allergic reaction. While antihistamines can temporarily ease symptoms, using them can actually worsen the problem by interfering with the clearing of secretions. If mucus stagnates, it can lead to a full-blown sinus infection. What’s more, antihistamines can cause drowsiness and dry mouth. Decongestants are often used to relieve congestion and sinus pressure by shrinking blood vessels, reducing inflammation in the nasal passages, and opening mucous membranes. They improve airflow, reduce the need to breathe through the mouth, decrease pressure in the sinuses and head, and lessen discomfort. But while decongestants ease breathing, these drugs are not without side effects. Decongestants stimulate the nervous system and can cause nervousness, irritability, insomnia, and dizziness. They can also increase blood pressure and heart rate. Both decongestants and antihistamines can interact with other medications, especially monoamine oxidase (MAO) inhibitors. It’s important to check with your healthcare provider before taking either decongestants or antihistamines if you suffer from high blood pressure, heart disease, glaucoma, or benign prostatic hyperplasia (BPH). While these over-thecounter drugs offer temporary relief, long-term use interferes with the natural systems in the body that deal with allergens and foreign invaders. Fortunately, there are safe and natural ways to manage sinus problems without resorting to drugs that don’t address the underlying cause.

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Chapter One

All About Your Sinuses

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o understand how your sinuses work, you need to start with the nose. Your nose is made up of several bones and soft tissue. When you take a breath, your nose filters, warms, and humidifies the air you inhale. A thin layer of tissue, called the mucosal membrane, that is covered with tiny hairs known as cilia helps to accomplish this. A small amount of mucus sits atop the cilia and traps the dust, pollen, and bacteria we breathe in. Eventually, the mucus blanket moves to the back of the throat where it is unconsciously swallowed. This entire process is closely regulated by several body systems.

Structurally, the nose is separated into two passageways (left and right nostrils) by a structure called the septum. Protruding into each nostril are bony projections called turbinates, which help to increase the surface area inside the nose. There are three turbinates on each side of the nose (inferior or lower turbinates, middle turbinates, and superior or upper turbinates) that control air flow via a repetitive pattern of swelling and constricting every two to three hours. The turbinates swell on one side of the nose while the other side shrinks.

Because of the interconnected nature of this system, anything that causes a swelling in the nose can also affect the sinuses. s i n u s

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Once air passes over the turbinates, it travels through the sinuses, which are covered by membranes that respond to the ever-changing environment. They clean and prepare the air so it is free of most contaminants when it reaches the lungs. Most adults have four pairs of sinuses: Maxillary sinuses, located behind the cheeks. Ethmoid sinuses, located between the eyes behind the bridge of the nose.

Frontal sinuses, located behind the forehead over the brow. These develop around the age of 7. Sphenoid sinuses, located behind the ethmoids and the eyes. They are deep in the face and form during adolescence. Maxillary Sinuses. When most people talk about sinus pain, they are referring to discomfort stemming from the maxillary sinuses. The largest of all the sinuses, the maxillary sinuses are shaped like a pyramid and drain into the nose through a hole located about halfway up the side of the sinus wall. If the maxillary sinuses become blocked, they fill up with fluid that often causes infection (sinusitis). This can cause toothache or a dull aching pain under the cheeks. Ethmoid Sinuses. The ethmoid sinuses are key to sinus health. Shaped like a beehive, they are filled with seven or more interconnected bubbles made of very thin-walled bone. These bubbles are lined with mucous membrane and each bubble has its own opening to drain into the nasal cavity. Mucus produced by any of the four types of sinuses eventually drains through the ethmoid sinuses and into the back of the nose.

frontal sinuses ethmoid sinuses

Frontal Sinuses. These sinuses—which vary in size and shape from person to person—are empty air sacks that act like shock absorbers, protecting your brain from frontal trauma. They also aid in filtering the air that eventually goes to the lungs. The frontal sinuses drain into the nose through the ethmoid sinuses. If there is an obstruction or blockage of the ethmoid sinuses, this usually causes inflammation of frontal sinuses, which can, in turn, impair mucus drainage.

sphenoid sinuses maxillary sinuses

Sphenoid Sinuses. Buried deep inside the head under the brain, the sphenoid sinuses are small cavities, each approximately the size of a large grape. The left and right sphenoid sit next to each other and are separated by a thin plate of bone (septum). Sphenoid sinuses drain the mucus into the very back part of the nose through a special opening called ostium. There are critical structures, such as the nerves for vision and major blood vessels that carry blood to and from the brain, that lie in close proximity to the sphenoid sinuses. Under normal circumstances, this system of sinus cavities and nasal passages supports good respiratory health. But, because of the interconnected nature of this system, anything that causes a swelling in the nose—an infection, an allergic reaction, or another type of immune reaction—can also affect the sinuses. The following chapter will examine all of the problems that can plague your sinuses when they are overcome by bacteria, allergens, or other foreign elements.

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Chapter Two

Sinus Problems

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Common Allergens and Irritants Unsure about what is causing your sneezing, watery eyes, runny nose, or itchy skin? Here are the most common respiratory allergens and irritants: • Animal dander

hether it’s a pesky tickle in the back of your throat or full-blown congestion that makes your sinuses feel heavy, sinus problems are nothing to sneeze at. Thirty-six million Americans have chronic sinus troubles. Millions more suffer from rhinitis (a fancy name for stuffy nose). As a result, Americans spend more than $5 billion on sinus products annually. And yet, these products offer no more than temporary relief. More than 73 million days of work and school are missed each year due to sinus problems. The most common sinus problems are listed below.

• Chemical fumes

Allergies

• Household cleaners

An allergy is an exaggerated immune response to a common substance like dust, mold, pet dander, fragrance, or cleaning chemicals. The immune system, which normally protects the body against foreign substances, becomes overly sensitive. When it recognizes an allergen, the body produces a specific type of antibody called IgE. The allergens bind to the IgE, which is attached to mast cells (a specific type of blood cell in the airways). This causes the mast cells to release a variety of chemicals, especially histamine, the main chemical that causes symptoms like burning, tearing, or itchy eyes; coughing; headache; hives; itching of the nose, mouth, throat, or skin; runny nose; skin rash; wheezing; and other symptoms, which can vary from person to person.

• Cigarette smoke • Cockroaches • Dust • Dust mites • Fragrance • Mold spores • Paint fumes • Pollen from trees and grasses • Pollution • Ragweed • Rye grass • Strongly scented flowers

As miserable as allergies can be, the bigger problem is that they can trigger an asthma attack in those who suffer with the condition. If you suffer from allergies and asthma, a reaction to any offending allergy-causing substance can worsen asthma symptoms. Hay fever almost always runs in families. People with asthma or eczema (allergic dermatitis) are more likely to develop hay fever—and about one-third of those with hay fever also suffer from mild allergic asthma.

As many as one in five Americans suffer from allergies that affect the sinuses. Many of them have what’s known as “hay fever,” an allergic response to pollen and other environmental substances. Also known as allergic rhinitis, there are two types of hay fever: seasonal, which occurs during specific times of the year, and perennial, which can affect you all year round. Typically, if you suffer from hay fever in the spring, you’re likely allergic to tree pollens. Grass and weed pollens are common triggers in the summer. Autumn can bring on ragweed allergies. Fungus spores cause problems from late March through November.

The Common Cold

People with perennial hay fever are usually allergic to one or more indoor allergens like dust mites, feathers, or animal dander, all of which can be found in pillows, bedding, heavy draperies, upholstery, and carpeting. Mold, another common allergen, is usually found in damp areas such as bathrooms and basements.

Most of us are familiar with this viral infection. Most adults suffer from two to four colds per year; children, especially preschoolers, can catch a cold six to 10 times annually. The common cold is a viral infection of your upper respiratory tract that affects your nose, sinuses, and throat. It’s usually harmless, and most people recover within a week to

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10  days. Symptoms include a runny nose, sore throat, cough, sneezing, and congestion. More than 200 viruses can cause a cold. The most common is rhinovirus, which is to blame for 10 to 40 percent of all colds. The lesser-known coronaviruses cause about 20 percent of colds, and the respiratory syncytial virus (RSV) causes 10 percent of colds. All of these viruses enter the body through your nose or mouth and are easily spread by touch. A cold begins when a cold virus attaches to the lining of your nose or throat. Your immune system sends white blood cells out to attack this germ. Unless you’ve encountered that exact strain of the virus before, the initial attack fails and your body sends in reinforcements. Your nose and throat become inflamed, and your sinuses begin to produce an excess of mucus in an effort to flush the virus from your body. With so much of your body’s energy directed at fighting the cold virus, you are left feeling exhausted and miserable. Unfortunately, there’s no cure for the common cold.

Sinus Headache A sinus headache can occur when the sinuses become blocked or congested. Air trapped within a blocked sinus cavity, along with mucus, can cause painful pressure on the sinus wall. Similarly, when air is prevented from entering a paranasal sinus by a swollen membrane at the opening, a vacuum can be created that also causes pain. This intense pain is usually felt behind the cheekbones, forehead, and/or bridge of the nose, and it usually gets worse with sudden head movement or strain. The pain is typically accompanied by other symptoms like nasal discharge, the feeling of fullness in the ears, and facial swelling. Unless your sinus headache is accompanied by an infection, treatment usually focuses solely on relieving the pain. Decongestants help relieve headache symptoms because they constrict blood vessels that cause headache pain. The problem is, these drugs can become habit-forming. If your headaches seem to be relieved by decongestants but you do not have a sinus infection, you could actually have a migraine or tension headache, each of which requires specific treatment.

Sinusitis Sinusitis occurs when the sinuses become inflamed because of a viral, bacterial, or fungal infection. This can cause a headache or pressure in the eyes, nose, cheek area, or on one side of the head. Along with making you feel like somebody just hit you in the face, a sinus infection can trigger pain in the jaw or neck, nasal congestion, a cough, and general malaise. 12

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Children, especially preschoolers, can catch a cold six to 10 times annually.

Because a sinus infection causes mucus to drain down the back of your throat, you can also suffer a sore throat. The condition can be either acute (sudden onset) or chronic (long term). Acute sinusitis usually lasts less than eight weeks or occurs no more than three times per year, with each episode lasting no longer than 10 days. Chronic or recurring sinusitis lasts longer than eight weeks or occurs more than four times per year, with symptoms usually lasting more than 20 days. Either form can severely impact your life, interfering with home, work, and social commitments. s i n u s

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Sinusitis often occurs after a viral infection in the upper respiratory tract, but allergens or pollutants can also trigger it. Viral infections damage the cells of the sinus lining, leading to inflammation. The lining thickens, obstructing the nasal passage. This blockage disrupts the natural process that removes bacteria normally present in the nasal passages. When this happens, the bacteria begin to multiply and invade the lining of the sinus.

Too often, doctors treat sinusitis with decongestants and antibiotics. However, this does nothing to support the body’s natural healing systems or fortify the immune response against future sinusitis flare-ups. Too often, doctors treat sinusitis with decongestants and antibiotics. However, this does nothing to support the body’s natural healing systems or fortify the immune response against future sinusitis flare-ups. The best way to prevent sinusitis is to avoid colds and other upper respiratory infections, as well as pollutants and irritants like cigarette smoke and airborne chemicals. Adopting the strategies in the following chapters will also help thwart sinusitis as well as protect against allergies, colds, and other upper respiratory problems.

Nasal Polyps Nasal polyps can affect people of any age, but they’re most common in adults over age 40 and are twice as likely to affect men. They are noncancerous, sac-like growths of inflammed tissue that form in the nose or sinuses, usually around the area where the sinuses open into the nasal cavity. Nasal polyps typically start near the ethmoid sinuses and grow into the open areas. Large polyps can block the sinuses or nasal airway. Not surprisingly, people with larger polyps often complain of a cold that continued on page 16 14

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Sinus Health and Middle-Ear Infections Middle-ear infections are among the most common childhood ailments. What many parents don’t realize is that these painful ear problems can originate in the sinuses. The maxillary and ethmoid sinuses are connected to the ears through the Eustachian tube. This connection makes it easy for an infection in the sinuses to spread to the ear. In fact, any congestion that occurs in the sinuses can move into the ears via a simple sneeze. When you sneeze, air from the sinus cavities is forced to escape through different portals, including the ears. As a sneeze occurs, the air is pressed through the Eustachian tube. This air can effectively push out the bacteria and infection as it is being forced out of the sinuses. Because of this, a sneeze, a cough, or simply blowing your nose can force bacteria into the ear canal and cause infection. Unfortunately, many pediatricians rely on antibiotics to stem an ear infection. Yet frequent or long-term antibiotic use can lead to resistance. According to some scientists, this resistance may lead to the development of superbugs that are unfazed by multiple drugs. But antibiotics aren’t a pediatrician’s only option. Many treat chronic ear infections with ear tubes in hopes of preventing hearing loss. Ear tubes are tiny metal or plastic cylinders surgically inserted into the eardrum to drain fluid and equalize the pressure between the middle ear and outer ear. While ear tubes do work in the short-term, they are not an ideal solution to ear infections. According to a long-term study by Canadian doctors at St. Paul’s Hospital in Vancouver, BC, when young children were randomly assigned to receive ear tubes or to be treated daily with antibiotics, those with ear tubes suffered greater damage to their eardrums and had, on average, poorer hearing six to 10 years after the tubes were removed. Although the tube design has changed and daily antibiotics are no longer recommended, this controlled clinical trial calls into question whether the benefits of ear tubes outweigh the risks. What’s a worried parent to do? Keeping the sinuses healthy may be the key to reducing the number of ear infections in children. And that can be as easy as routinely flushing out the nasal passages with a special saline solution to prevent bacteria, viruses, and allergens from taking up residence in your child’s sinuses and ears.

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never quite goes away. They are also more apt to suffer from repeated bouts of sinusitis. What causes these nasal growths? No one knows. Some experts say that inflammation causes an accumulation of fluid in the cells of the nose and sinuses. Eventually, gravity pulls these heavy cells down, resulting in polyps. Scientists believe that possible triggers include bacterial or viral infection, allergy, or an immune response to a fungus. Whatever the cause, most people with nasal polyps experience a runny nose, sneezing, and postnasal drip. About 75 percent experience a decreased sense of smell. Many people also develop the symptoms of asthma such as wheezing; sinus infections; and sensitivity to fumes, odors, dusts, and chemicals. Less commonly, people with nasal polyps can have a severe allergy to aspirin and an adverse reaction to yellow dyes. While small polyps aren’t typcially harmful, they can make you more prone to sinusitis. Large polyps, however, can push the nasal bones apart and broaden the nasal bridge, which can adversely affect appearance and self-esteem. In this case, polyps may need to be surgically removed. This can make it easier to breathe through the nose. But surgery is no guarantee that nasal polyps won’t return. While all of these conditions have different causes, they have a similar solution—one that is all-natural and drug-free. The secret is xylitol, a unique natural sugar that bolsters the body’s own defenses against the foreign invaders that can plague the sinuses and upper respiratory tract.

Chapter Three

A Sweet Solution

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uggesting that sugar can relieve your sinus problems may seem like a stretch, but studies show that one specific type of sugar—xylitol—can do just that. Xylitol is a white crystalline sugar alcohol found naturally in many fruits and vegetables like berries, plums, lettuce, and mushrooms. In its granulated state, it looks like the sugar in your sugar bowl. But that’s where the similarity ends. Xylitol has 40 percent fewer calories than refined sugar. What really makes this natural sweetener so remarkable, however, is its unique bacteria-busting properties. The secret to xylitol’s health benefits lies in its chemical structure. Most dietary carbohydrates (sugars and polyols) are based on a 6-carbon monosaccharide unit like fructose (fruit sugar) and glucose (a.k.a., ­d-glucose, dextrose, blood sugar). Saccharide units can be linked together into disaccharides such as sucrose (common table sugar that is glucose and fructose bonded together) or polysaccharides that can have hundreds of saccharides connected (starch is comprised of long strings of 6-carbon glucose units). Instead of the six carbon atoms found in other sweeteners, xylitol contains only five. This unique 5-carbon sugar alcohol structure is very stable and does not link to other sugars. This means that bacteria and yeast can eat xylitol, but they can’t digest it—and if it’s not digested, these harmful substances can’t reproduce.

A History Lesson Xylitol has a long history dating back to the 1800s. Discovered simultaneously by German and French scientists, who created a xylitol syrup, the sweetener didn’t become commercially available until World War II, when it was extracted from birch trees in response to a sugar shortage in Finland. As it became increasingly popular, scientists discovered that xylitol was metabolized in the body without triggering an insulin response. By the early 1960s, xylitol was used throughout Europe and Japan as a diabeticfriendly alternative to sugar. It also found its way into intravenous (IV) solutions as an energy source for patients with impaired glucose tolerance and insulin resistance. Xylitol finally made its way to America, where it was approved by the U.S. Food and Drug Administration (FDA) in 1963 for special dietary purposes. 16

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The early 1970s brought the realization that xylitol could also prevent cavities and gum disease. Study after study showed the beneficial effects of xylitol chewing gum on children’s dental health. Today, it’s an approved food additive that’s also recognized as a safe way to help maintain dental health. But xylitol wasn’t finished disclosing its healthful secrets. While Scandinavian researchers were busy focusing on xylitol’s dental benefits, an American doctor named Lon Jones came across a study that showed that children who chewed xylitol gum not only saw improved dental health, they also suffered from 42 percent fewer middle-ear infections. As researchers dug deeper, they discovered that xylitol prevented bacteria from sticking to the cells in the nose.

A short time later, researchers at the University of Iowa began to look at xylitol’s impact on airways. It turns out that this sugar alcohol works via osmosis to pull fluid into the airway. It also helps moisturize and thin the mucus so that the cilia in the nasal passageway move more freely. The study also confirmed earlier findings that xylitol reduces the number of bacteria that adhere to the nasal passage. Compared to saline, the reduction in a specific bacteria known as nasal coagulase-negative Staphylococcus was six times greater in those sprayed with xylitol than those who used saline. Intrigued by these studies, Dr. Jones began wondering if adding xylitol to a saline nasal solution would help prevent sinus infections caused by bacteria as well as other upper respiratory problems. He tested his theory

A Conversation With Dr. Jones Lon Jones, MD, has been a family physician for more than 30 years. His all-natural xylitol nasal solution, sold under the brand name Xlear, has lead to relief for thousands of patients throughout the United States.

Q: What led you to explore xylitol’s sinus benefits? A: It all started with my granddaughter, Heather. At five months of age, she began experiencing a series of ear infections. It got so bad that her pediatrician suggested surgically placing tubes in her ears to resolve the problem. Fortunately, about that same time, I stumbled on a study that introduced me to xylitol’s ability to greatly reduce the incidence of ear infection. I was immediately intrigued.

Q: But those studies used a xylitol chewing gum. How did you make the leap from the gum to a spray administered via the nose? A: One thing that ear infection, allergies, and sinusitis have in common is that they all begin with bacteria that first enter the nose. By routinely washing the nose with a xylitol-based nasal spray, you can prevent harmful bacteria from setting up housekeeping and reproducing in the nose, sinuses, and middle ear. It just seemed to make sense.

Q: So your granddaughter was your first test subject? A: I suppose she was! At the time, I was practicing medicine at Hi-Plains Hospital in Hale Center, Texas. My hospital pharmacy

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mixed up a batch of saline solution containing xylitol and put it into a squeeze bottle. Every time Heather’s diaper was changed, she got a squirt of the spray. Amazingly, her ear infections disappeared after just a few weeks of using the saline-xylitol nasal spray. It was so successful, I began using it on some of my other patients, among them 10 children with chronic middle-ear infections. After 11 months, the frequency of their ear infections plummeted by 90 percent. Similar results were seen in my patients with chronic sinusitis, allergies, and even asthma.

Q: Should a saline spray containing xylitol be used only when we have a cold or sinus problems? A. Not at all. I believe that prevention is key. Keeping the nose clean with xylitol is important because that is where all respiratory problems begin. I recommend that all my patients use Xlear twice a day—once in the morning and again at night.

Q: How safe is xylitol? A: Xylitol is incredibly safe. It occurs in small amounts in fruit, berries, vegetables, and mushrooms. For example, raspberry, strawberry, yellow plum, and endive contain xylitol. Xylitol also occurs in human tissues. The World Health Organization (WHO) and the FDA have given xylitol their safest ratings for food additives. Because Xlear contains only xylitol, purified water, saline, and grapefruit-seed extract, it can be used daily by everyone, even babies.

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on his own granddaughter, who suffered from numerous ear infections. Her positive response to regular nasal washing prompted Dr. Jones to use his proprietary xylitol-saline nasal wash on his patients who suffered from ear and sinus infections, asthma, and allergies. The results were amazing. Simply washing the nose with this safe and natural nondrug solution resolved the respiratory ailments in many of his patients. Based on these findings, Dr. Jones created a high-potency xylitol nasal spray under the brand name Xlear. Not only did this unique nasal wash reduce bacteria, but used regularly it also hydrated the nasal passages and helped flush out airborne pollutants that could trigger asthma and allergies. In addition, Xlear could shrink swollen membranes to allow easy nasal breathing. Since then, studies done on the airway surface fluid in the bronchi show that xylitol is effective for about four hours after use. This means it can be used as often as every four to six hours for continuous protection.

Safe and Natural Not only does xylitol possess a wealth of healthy benefits, it is also extremely safe. A scientific committee of the U.N.’s World Health Organization and Food and Agriculture Organization (the Joint Expert Committee on Food Additives) announced that xylitol, at levels up to 90 grams per day, was a safe sweetener for foods. While its most common use is for dental health, it’s also safe for use as a nasal spray and wash. Studies show that even infants can safely benefit from xylitol. Xylitol acts locally and isn’t absorbed by the tissues in the nasal passages or sinuses. Instead, it is swallowed and makes its way through the digestive tract. About one-third of the xylitol that we take in is processed by the liver. The other two-thirds are broken down in the intestines into short-chain fatty acids such as butyrate, which can improve colon health. While most people don’t experience any side effects, people who are sensitive to xylitol might initially experience loose stools or slight abdominal cramping when too much xylitol is ingested, particularly on an empty stomach. But, because the body makes xylitol—as well as the enzymes to break it down—larger amounts can be tolerated within a few days or weeks as the body’s enzymatic activity adjusts to a higher intake.

An Ancient Technique for the Modern Nose Xylitol’s nasal and sinus benefits aren’t just delivered via a nasal spray. You can also irrigate your nose with a neti pot. This Ayurvedic remedy has been practiced for thousands of years throughout India. In fact, neti is one of the six purification techniques performed prior to practicing yoga. Here’s how it works: Fill the neti pot, insert it into one nostril, turn your head to the side, and pour salt water into your nose, allowing it to flow out of the other nostril. A gentle stream of lukewarm water gently cleanses the nasal passages, washing away pollens, mucus, viruses, and bacteria. The technique is not as uncomfortable or difficult as it might sound, and it can make a world of difference. Doctors find that using a neti pot reduces allergies and sinus infections. It can also lower the incidence of the common cold. According to researchers at Pennsylvania State University, nasal-irrigation treatment is effective in reducing the incidence of colds. During their study, 294 college students were assigned to one of three groups: one group performed daily nasal irrigation with saline, one took a daily placebo pill, and the third group was left untreated. The doctors found that the group who irrigated with saline using a neti pot experienced a significant reduction in colds compared with the placebo or untreated groups. For years, people have made their own saline solution for their neti pots. The problem with that approach is that it’s hard to control the amount of salt in the solution. Too much can irritate nasal passages. Too little won’t mimic the body’s own salinity. Plus, a simple saline solution doesn’t provide the benefits of xylitol. NetiXlear is an easy and effective pre-mixed solution that contains xylitol and Celtic sea salt, along with sodium bicarbonate as a buffering agent. This solution—delivered via neti pot—provides an intensive cleansing process that helps to thoroughly wash away built-up mucus and irritants in the upper respiratory tract.

A Sweet Warrior Not only does xylitol prevent the adhesion of bacteria to nasal tissue, it also changes the environment in the nose and sinuses. The University of Iowa study also found that xylitol nasal spray reduced salt concentrations 20

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in the airway surface liquid (ASL) that coats your nasal passages. ASL contains natural antimicrobial compounds that kill small numbers of the bacteria that are constantly deposited in the lungs. But if the ASL becomes too salty, it can undermine this microbe-killing capacity. However, the Iowa researchers discovered that a xylitol solution sprayed directly into the nose lowered ASL salt concentration in the cells in the airway. This, they speculated, effectively boosts the body’s natural ability to kill the everyday bacteria we encounter before it can do any damage.

Beyond Sinus Health Because of xylitol’s remarkable chemical structure, its health benefits extend well beyond the sinuses. Studies show that xylitol also:

•

helps prevent tooth decay and reduces plaque formation on teeth.

• • • • •

helps reduce gingival inflammation.

• •

has a low (7) rating on the glycemic index.

relieves dry mouth. might help prevent osteoporosis. prevents respiratory infection in those with cystic fibrosis. does not trigger an insulin reaction in the body, making it useful for diabetics and hypoglycemics. is safe for all ages.

Chapter Four

Breathe Easy

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f course, nasal irrigation isn’t a cure-all. Your overall health and the habits you keep are also critical to keeping your sinuses healthy. If you live on junk food, burn the candle at both ends, or smoke, you leave the door wide open for upper-respiratory troubles. But adopting the following habits can fortify your nose and your sinuses.

Eat Well to Breathe Well The ancient physician Hippocrates famously said, “Let food be your medicine.” That’s particularly true if you are trying to maintain sinus health. The nutrients in food can bolster your immune system, thwart oxidative damage, and tame the inflammation that plagues sinus sufferers. A diet of whole foods filled with high-quality lean protein, fruits, and vegetables supports upper-respiratory health. Foods rich in antioxidants are especially important. Beta-carotene and vitamins C and E are essential nutrients that play a critical role in the body’s defense system by neutralizing free radicals. Free radicals are molecules that are missing one electron. These unpaired atoms cause oxidative damage to the cells in the body, including those in the nose and sinuses. Free radicals are created as a byproduct of normal metabolism. But they are also triggered by environmental factors like smoking, pollution, and poisons, as well as refined, processed, and fried foods. Antioxidants attract free radicals and destroy them before they can damage cells. Loading up on these three dietary antioxidants is one of the best ways to fight free-radical damage and stimulate your immune system: Beta-carotene plays a key role in regulating the body’s immune system. This helps the sinuses fend off bacteria, viruses, and other invasive agents. It also promotes healthy mucous membranes. The best food sources include apricots, asparagus, broccoli, cantaloupe, carrots, kale, spinach, sweet potato, and watermelon. Vitamin C supports the production of glutathione, a potent antioxidant that promotes sinus, immune, and respiratory health. It’s a natural antihistamine that lessens inflammation in the nasal passages and sinuses. It is also a potent immunity booster and can play a significant role in both preventing infection and helping to fight it off when it does

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occur. Food rich in vitamin C includes broccoli, cauliflower, kiwi, oranges, papaya, peppers, strawberries, and tomatoes. Vitamin E is a powerful antioxidant that stimulates the body’s immune response, and helps it to fight off a wide array of infections, including those that target the sinuses. One of the vitamin’s important benefits for the sinuses is improved circulation to sinus tissue. Almonds, cod-liver oil, hazelnuts, lobster, peanut butter, safflower oil, salmon, sunflower seeds, and walnuts are all excellent sources of vitamin E.

Beta-carotene helps the sinuses fend off bacteria, viruses, and other invasive agents. Protein also matters. An essential building-block for our cells and organs, protein plays a role in the respiratory, circulatory, and immune systems. Without enough dietary protein, the body becomes prone to infection. But not just any type of protein will do. High-quality lean protein is best, including grass-fed beef, bison, organic chicken, wild-caught fish, beans and legumes, soy or whey protein, and tofu. How much do you need to support good health? For adults, the National Institutes of Health and the American Heart Association recommend 50 to 60 grams of protein per day, on average. A more precise way to calculate how many grams of protein you need is to multiply your weight in pounds by 0.36.

Is It a Food Allergy? Many people with recurrent sinus problems will tell you that certain foods trigger or exacerbate symptoms. These foods can cause anything from a minor postnasal drip to a raging sinus headache in those with sensitivities. Foods like milk, cheese, and other dairy products tend to cause inflammation, which results in increased mucus production. In the narrow passages of the sinuses, this thick and viscous mucus can impair drainage and even cause the tiny airways to clog, creating an ideal environment for the proliferation of bacteria. Eggs also have a high mucus-­ forming index. Other foods that can aggravate your sinuses include chocolate, wheat, fried and fatty foods, refined carbohydrates, beer, and 24

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anything containing food additives. Sugar is another culprit because it acts as a diuretic and encourages dehydration. This tends to thicken mucus secretions in the throat. Other foods can prompt an allergic reaction and subsequent histamine release. A food allergy can cause swollen lips, wheezing, stuffiness, and other symptoms of allergic rhinitis and asthma. If you suffer from other allergies, you are more likely to have food allergies. Not to be confused with a food sensitivity, a food allergy involves the immune system and can be quite dangerous, even deadly. The best way to detect either a food sensitivity or a food allergy is with an elimination diet. Best done under the supervision of your physician, an elimination diet involves removing specific foods from your diet that you and your doctor suspect could be causing your symptoms. During the diet, you will need to keep a food diary to record all of the foods you are eating. If you remove a certain food and the symptoms go away, this could point to an allergy. You will then gradually reintroduce other foods, one at a time. This process helps link allergy symptoms to specific foods.

The Soup Cure Grandma’s chicken soup really might cure sinus woes. Recent studies show that sipping hot soup can actually help clear congestion. A hot cup of tea can function as a mini sauna right under your nose. The steam and warm fluids in your nose and mouth and at the back of your throat help loosen hardened mucus. But it’s not just the steam that thins out mucus and help to clear it; research from the University of Nebraska Medical Center in Omaha shows that chicken soup has anti-inflammatory properties that ease a sore throat. Plus, the soup helps stop the movement of neutrophils—white blood cells that encourage the flow of mucus. Other studies show that chicken soup contains an amino acid called cysteine, which is similar in chemical content to a mucus-thinning drug called acetylcysteine. So the next time you have a stuffy nose, try a nice bowl of chicken soup.

Sinus Supplements Eating a healthy, balanced diet can go a long way toward enhancing sinus and respiratory health. But to optimize sinus health, consider taking supplements that fight infection, reduce congestion, and support healthy mucous membranes—especially if you suffer frequent sinus problems. Topping the list is bromelain, an extract derived from pineapple stems. In one head-to-head comparison of bromelain and conventional treatments, German researchers from the University of Leipzig divided 116 patients with acute sinusitis into three groups: The first group was given bromelain; the second was treated with a combination of bromelain, a decongestant, and an antibiotic; and the third group received conventional drugs. After reviewing all of the data, the researchers found that the bromelain not only relieved symptoms faster, it cut the duration of sinus infections by almost two days. And none of the bromelain-only patients experienced adverse side effects. Bromelain has also been credited with breaking down fibrin and supporting proper draining of tissues. Research indicates that an effective dose of bromelain is 250 to 750 mg, taken two or three times a day, between or before meals. Another effective supplement is quercetin, a bioflavonoid found in many fruits and vegetables. Quercetin is an excellent antioxidant that enhances the effectiveness of vitamin C and helps strengthen the walls of the intricate blood vessels in the nasal passages. Its antibacterial and 26

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For sinus congestion, try a whiff of eucalyptus oil. Not only does it affect receptors in the nasal mucous membranes and lead to less stuffiness, eucalyptus helps kill bacteria that can cause a sinus infection. anti-inflammatory properties are similar to those of an antihistamine in relieving pain and halting allergies. A dose of 500 mg twice a day is effective. Anyone suffering from sinus problems knows that inflammation is the root of much of the discomfort. Essential fatty acids, specifically omega3s, are vital to sinus health because they enhance immunity and reduce the swelling and pain associated with an allergic response. Studies show that essential fatty acids aid in the production of prostaglandins. This not only counters inflammation; it might also discourage the formation of nasal polyps. Two types of omega-3 fatty acids can be found in fatty fish like anchovies, herring, mackerel, salmon, sardines, and tuna. These are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Another type of omega-3 fatty acid, alpha-linolenic acid (ALA), can be found in plant foods like flaxseed and walnuts. However, most of us don’t include these healthy fats in our daily diets. An excellent way to ensure that you are getting all the omega-3s you need is with a purified high-potency fishoil supplement. A daily dose of at least 1,000 mg of fish oil can be quite helpful in reducing symptoms. Vegetarians can get their omega-3s by taking 1,000 mg of supplemental flaxseed oil daily. Be aware that it can take several months to see results.

Nature’s Remedies While simple lifestyle changes can reduce your chances of developing sinus problems, they might not completely eliminate them. For those 28

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times when you need fast relief from sinus symptoms, nature provides some safe and effective antihistamines and decongestants. For sinus congestion, try a whiff of eucalyptus oil. Not only does it affect receptors in the nasal mucous membranes and lead to less stuffiness, a recent issue of Alternative Medicine Review reported that eucalyptus helps kill bacteria that can cause a sinus infection. What’s more, cineole—an active ingredient in eucalyptus oil—can stimulate the immune system and decrease inflammation to help relieve sinus symptoms. You can simply apply a few drops of the essential oil to a tissue or add it to a humidifier to help clear nasal and sinus congestion. For sneezing and itchy, watery eyes, stinging nettle or butterbur are helpful. Both of these herbal antihistamines have proven effective in numerous studies. Stinging nettles is good for acute symptoms like itchy, watery eyes; sneezing; and respiratory symptoms. This prickly plant offers fast relief—often within 15 minutes. The key is the herb’s anti-inflammatory effect. In one open trial of 69 patients with seasonal allergies, 58 percent reported that taking 600 mg of freeze-dried nettle leaf daily relieved their symptoms. Almost half of the participants said it was more effective than over-the-counter allergy drugs. And, unlike over-the-counter allergy medicines, stinging nettle won’t cause drowsiness. A Swiss study found that butterbur is as effective as Zyrtec for longterm sufferers. But butterbur might also help those who only suffer occasional allergies, according to one clinical trial of 186 allergy sufferers who reported that butterbur worked well on people with intermittent allergies. For best results, most herbalists recommend taking 50 to 100 mg twice a day with meals. Not only will these all-natural strategies keep your seasonal sinus problems in check, they will support your body’s natural defenses against the foreign invaders that make you miserable—all without creating dependency on synthetic drugs.

Final Thoughts Sinus problems can feel unbearable. Allergies, sinus headaches, and sinusitis can make life dismal, but the recommendations outlined in this booklet can help immeasurably. If you suffer from sinus problems, clearing the air is critical. Avoid environmental allergens as much as possible, including pet dander, pollution, synthetic fragrance, and especially tobacco smoke. Smoking damages the airways and alveoli (small air sacs) in the lungs and can lead to emphysema, bronchitis, and chronic airway obstruction, as well as lung 30

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and nasal sinus cavity cancer and other life-threatening conditions. Secondhand smoke also carries severe health risks and can trigger asthma, middle-ear infections, sinusitis, and allergies. A healthy diet and targeted supplementation that discourages the overproduction of mucus, will also help bolster sinus health. But the most important step you can take is to regularly flush your nasal passages. Daily use of a xylitol-based nasal spray can reduce allergies and enhance your body’s natural defenses against the foreign invaders that lead to colds and sinus infections. A simple spray in each nostril twice a day is all it takes to diminish your sinus problems. And that should leave you breathing easy.

Selected References Bachert C. Middleton’s Allergy: Principles and Practice. 7th ed. Philadelphia, Pa; Mosby Elsevier; 2008. Baumeister P. Reduction of oxidative DNA fragmentation by ascorbic acid, zinc and N-acetylcysteine in nasal mucosa tissue cultures. Anticancer Research. 29:4571-4574, 2009. Blazek-O’Neill B. Complementary and alternative medicine in allergy, otitis media, and asthma. Current Allergy and Asthma Reports. 5:313-318, 2005. Brown CL. Xylitol enhances bacterial killing in the rabbit maxillary sinus. Laryngoscope. 114:2021-2024, 2004. Grevers G. Challenges in reducing the burden of otitis media disease: an ENT perspective on improving management and prospects for prevention. International Journal of Pediatric Otorhinolaryngology. 74:572-577, 2010. Harvey R. Nasal saline irrigations for the symptoms of chronic rhinosinusitis. Cochrane Database System Review. 8;(3):CD006394, 2007. Heinz SA. Quercetin supplementation and upper respiratory tract infection: A randomized community clinical trial. Pharmacological Research. 62:237-242, 2010. Helms S. Natural treatment of chronic rhinosinusitis. Alternative Medicine Review. 11:196207, 2006. Jones L. No More Allergies, Asthma, or Sinus Infections. Freedom Press: Topanga, CA. 2010. Jones L. Personal Interview September 2, 2010. Kalanin J. Preventing recurrent otitis by addressing nasal hygiene with a spray of nasal xylitol. Unpublished White Paper. 2005. Kassel JC. Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database System Review. 3:CD006821, 2010. Klapan I. Arachidonic acid metabolites and sinonasal polyposis. I. Possible prognostic value. American Journal of Otolaryngology. 16:396-402, 1995. Kontiokari T. Effect of xylitol on growth of nasopharyngeal bacteria in vitro. Antimicrobial Agents and Chemotherapy. 39:1820–1823, 1995.

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Mäkinen KK. Xylitol: An Amazing Discovery for Health. Woodland Publishing, Orem, UT. 2007. MarketResearch.com. Over the Counter Drug Sales Helped by Down Economy. MarketResearch.com. http://www.marketwire.com/press-release/Over-the-Counter-DrugSales-Helped-by-Down-Economy-1007100.htm. [September 2010]. Michel O. Nasal irrigation in case of rhinosinusitis. Laryngorhinootologie. 2006,85:448-458. Navarro J. The Nasal Cavity and Paranasal Sinuses. Springer, Berlin. 2001. Peldyak J. Dental Health: Create a Dazzling Smile. Active Interest Media: El Segundo, CA. 2010. Porter G. Paranasal Sinus Anatomy and Function. The University of Texas Medical Branch at Galveston. 2002. Pynnonen MA. Nasal Saline for Chronic Sinonasal Symptoms: A Randomized Controlled Trial. Archives of Otolaryngology: Head and Neck Surgery. 133:1115-1120, 2007. Rabago D. Saline nasal irrigation for upper respiratory conditions. American Family Physician. 80:1117-1119, 2009. Rennard BO. Chicken soup inhibits neutrophil chemotaxis in vitro. 2000. Chest. 136:e29, 2009. Roschek B Jr. Nettle extract (Urtica dioica) affects key receptors and enzymes associated with allergic rhinitis. Phytotherapy Research. 23:920-926, 2009. Rovers MM. The effect of ventilation tubes on language development in infants with otitis media with effusion: A randomized trial. Pediatrics. 106:E42, 2000. Sajjan U. A novel model to study bacterial adherence to the transplanted airway: inhibition of Burkholderia cepacia adherence to human airway by dextran and xylitol. Journal of Heart and Lung Transplantation. 23:1382-1391, 2004. Sadlon AE. Immune-modifying and antimicrobial effects of Eucalyptus oil and simple inhalation devices. Alternative Medicine Review. 15:33-47, 2010. Schapowal A. Treating intermittent allergic rhinitis: a prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze 339. Phytotherapy Research. 19:530-537, 2005. Stenstrom R. Hearing thresholds and tympanic membrane sequelae in children managed medically or surgically for otitis media with effusion. Archives of Pediatric & Adolescent Medicine. 159:1151-1156, 2005. Tapiainen T. Effect of xylitol on growth of Streptococcus pneumoniae in the presence of fructose and sorbitol. Antimicrobial Agents and Chemotherapy. 45:166–169, 2001. Uhari M. A novel use of xylitol sugar in preventing acute otitis media. Pediatrics. 102:879884, 1998. Uhari M. Xylitol in preventing acute otitis media. Vaccine. 19:S144-147, 2000. Zabner J. The osmolyte xylitol reduces the salt concentration of airway surface liquid and may enhance bacterial killing. PNAS. 97:11614-11619, 2000.

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magazine presents

Sinus Health The Sweet Solution for

M

Sinus Ailments

illions of Americans suffer from chronic sinus troubles like congestion, allergies, and sinus headaches. For many, decongestants and antihistamines are a part

of daily life. In fact, as a nation, we spend more than $5 billion annually on sinus products. Unfortunately, these drugs provide only temporary relief, and they come with a host of unwelcome side effects. It’s time to clear the air and take a more comprehensive approach to healthy sinuses. This booklet provides an easy-tofollow diet, lifestyle, and supplement plan that will help you avoid colds, allergies, ear infections, and sinus headaches. Take charge now, and breathe easy for good!

About the Author of this Booklet A respected health writer, Kim Erickson has been involved with the natural and integrative health industry for more than 16 years. The author of several books and hundreds of articles, Kim is also a certified Nutrition and Wellness Coach and frequent speaker on various aspects of healthy living. She recently coauthored the book Living Lessons (Active Interest Media, 2010). For more information about Kim, visit www.kimericksoneditorial.com.

Number 35 betternutrition.com