Nothing can have you feeling down in the dumps quicker and more completely than a full blown sinus infection.  Although common in spring with the rise in airborne allergens, susceptible individuals can succumb to a sinus infection any time of the year.  In its chronic state, is not uncommon for sinus infections, despite multiple courses of antibiotic therapy, to occur in repeated succession.  What we can infer from this is that the innate immunity of the individual, as opposed to the infectious agent, is far more indicative of the chronic nature of sinus problems.  This inference harkens back to the old debate between scientist Louis Pasteur on one side and Claude Bernard on the other.

The scientific climate of the late 19th century saw the rise of germ theory in part with the help of Louis Pasteur who brought us pasteurization as a means to semi-sterilize food.  The dominant medical belief that was strengthened by Pasteur’s findings purported that disease was caused by pathogens, that if eliminated, would cure the infection and its resultant symptoms.  The legacy that follows includes all things sterile and antibacterial, including antibiotic resistant strains of certain microbes that have adapted to even our strongest drug therapies.  Pasteur’s critics at the time argued that virulence of the microbe was not nearly as important as the resistance of the body, or as they termed in that time, the biological terrain or the milieu intérieur (internal milieu) as coined by Bernard.

Behind the scenes of the rising medical industrial complex, holistic medicine stuck to its roots (both metaphorically and medicinally) by employing therapies that both lower populations of microbes while strengthening the body’s immune system.  Moreover, this strategy could also be employed preventatively to the extent that if the body were sufficiently bolstered, a healthy individual could withstand all but the most virulent infectious diseases.  This understanding matches the observations of generations of public health practitioners.  Save for severe epidemic diseases, there is always a portion of the population exposed to a germ that does not contract the expected illness.  Many of us know friends or family members who catch every cold that comes along and others who seem miraculously immune.

Chronic sinus infections can be viewed in a similar way.  Repeated courses of antibiotic therapy miss the mark if the person’s biological terrain is not treated.  To resolve a chronic infection, we must add two treatment strategies to any anti-microbial regimen.  The first is strengthening the immune system and the second is removing the conditions that favor the growth of germs, also known as a biofilm.

There are many factors which can hinder an individual’s innate immunity, two common ones being consuming lots of sugar and periods of unremitting stress (how unfortunate that the two often go together).  Lack of sleep, environmental and chemical toxins (including pharmaceutical drugs), depression – all these things result in a compromised immune system.  The ideal treatment would be to eliminate these obstacles to the proper functioning of your immune system, however for instances where certain stresses are unavoidable, there are many great immune stimulants that can be supplemented.  High potency Echinacea angustifolia root is among my favorite remedies to accomplish this.

A biofilm is a colony of microbes that band together and adhere to the lining of exposed tissue.  The formation of a biofilm along sinus passages must also be addressed to rectify chronic sinus infections.  Physical barriers in the form of congenital sinus malformations can predispose an individual to pathogen overgrowth but ENT surgeons miss the bigger picture when they assert these nooks and crannies as the cause for microbial buildup.  Although these pockets can house areas of microbes, they are seldom themselves the cause of their accumulation.  The way in which they grow is similar to algae slime in a creek bed where you can observe a thin layer growing on the rocks.  They stay undisturbed until you were to wade through the water, at which point the water becomes turbid with algae.

Stubborn biofilms are often the result of lifestyle factors that favor their growth.  One of the most common in the ear, nose, and throat area is the consumption of dairy, especially pasteurized dairy, in individuals who tend to accumulate phlegm from eating cheese or drinking milk.  Chronic inflammation due to toxic chemical exposure also triggers mucus production that serves to anchor microbes along sensitive tissue.  What specific dietary and/or environmental triggers may be playing a role for you could be different in another individual so proper evaluation and avoidance of mucus producing foods must be done on a case to case basis (although avoiding sugar and dairy will often produce improvements in most patients).   

The third leg of treatment then is the use of medicines to lower native populations of pathogenic microbes that are overwhelming the body.  Antibiotic therapy will do this, but at a cost.  The systemic effect of antibiotics damage our natural flora.  This predisposes us to a buildup of pathogenic yeasts which are unaffected by antibiotics that only target bacteria.  The irony of this is that many cases of chronic sinus infections are not bacterial, but fungal.  If your doctor prescribes antibiotics without confirming by culture the nature of the infection, it is possible that you could be receiving the wrong therapy that carries the risk of delaying proper treatment of the infection if a fungal overgrowth is at the root.  Clinical experience suggests that this is true of many recalcitrant sinus infections. 

In most cases, a strong dose of antibacterial herbs will do just as well a job as antibiotics if you catch it soon enough, but due to the preponderance of fungal problems, I often pair antifungal herbs alongside antibacterial ones.  In getting an evaluation from a holistic practitioner at the first sign of a problem, you can often nip a sinus infection in the bud before it becomes full-blown.  By virtue of using herbal remedies, therapy proceeds within your body’s design without compromising your body’s natural flora.  

We can never fully eliminate these bugs from our system, but we can keep them in check.  This is the job of our immune system and the native flora of our sinuses. 
By reinforcing our body’s defenses we are well equipped to handle most any assault whether from germs, allergens, or toxins.  This is the sentiment that has permeated holistic medicine since the time of Hippocrates and echoed by Bernard in opposition to Pasteur’s claims.  Looking back we are confronted with an interesting twist of fate at the end of the story as on Pasteur’s deathbed he came to finally admit “Claude Bernard was right…the microbe is nothing, the terrain is everything.”



  • When I went to my PCP with complaints of sinus congestion, the first thing he did was prescribe a course of antibiotics, without any testing or further investigation. Needless to say, I went and found another PCP who suggested that an ENT take a look first. Since reading your post, I feel better about that course of action now.

  • Some doctors these days don’t even look at examining you…
    rather they diagnose you according to your symptoms and this is not right
    because many symptoms could mean many different things. It cannot possibly be
    right to diagnose people without even doing blood or saliva works on them
    “Antibiotics for sinusitis infections can cause bad breath” How true
    is that?

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