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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
B
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
T
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.
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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
W
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.
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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.
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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
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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
S
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.
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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
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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
O
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
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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
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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
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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
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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.
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