Understanding Sinus Infections
Do not go to your doctor first. You first need to take a big dose of vitamin P—that stands for patience.
The first thing I want you to know, and the thing that will make sense of what I am about to tell you, is that viruses cause 95 to 97% of sinus infections. Only about 3 to 5% are caused by bacteria. A fungus causes less than 1%, and typically, if you have a fungal sinus infection, you have a compromised immune system and should go to the doctor.
However, there are people with no autoimmune problems who are relatively healthy out in society and now have a sinus infection.
So, 95 to 97% of sinus infections are viral, which is very important to understand. The average sinus infection lasts 5 to 10 days. Many people, as soon as they start to feel a sinus infection coming on, either see their doctor or schedule a virtual doctor visit.
The Ineffectiveness of Antibiotics for Viral Sinusitis
Most doctors expect you to get a prescription at the end of the visit, and many people do. Would it surprise you to discover that 95 to 97% of the time, an antibiotic prescription will not help your sinus infection at all? It would not help it get better quicker or go away sooner.
Also, if you take the antibiotic, you will be exposed to all the potential side effects and bad outcomes from taking one, whether you need it or not. In this case, there is a 95 to 97% chance you do not need it. But you will still be susceptible to all the side effects.
So, any doctor who sees you within 1 to 5 days of developing a sinus infection and prescribes an antibiotic is inappropriate. Especially if a doctor sees you over a virtual visit and prescribes you an antibiotic within the first 5 days of you developing a sinus infection, that is not doing you any favors, even though you might feel like you got what you needed.
A bottle of prescription pills is magic, and that will fix you. It ain’t. 95 to 97% of the time, many doctors think that you expect a prescription for an antibiotic because they have been trained to think that by hundreds of patients. I’ve seen many patients who demanded a Z-Pak or Cipro or Levaquin, and I had to take an extra minute, which many doctors
Do not have, and educate them: this is not going to help you at all. This is viral. This is going to go away on its own. If you take the Z-Pak or the Cipro, you are just exposing yourself to potential side effects and complications. You will decimate not only your gut microbiome but your skin microbiome, mouth microbiome, and all your other microbiomes, all of which are important for no reason.
Doctor’s Prescriptions and Alternatives
So I want you to go, if you do go to the doctor, please preface your office visit with: look, if this is viral and an antibiotic is not going to help me, tell me that. The only thing your doctor could prescribe for you or give to you that might improve the symptoms of your sinus infection is either a sinus injection, which is usually some blend of short and longer-acting steroids, or a DEX pack, Medrol dose pack, or prednisone pack medication. These will not make your sinus infection go away quicker. They will only decrease the severity of the symptoms, also again exposing you to the potential side effects and complications that come from taking steroids.
You can do a few things at home that will probably decrease the severity of your symptoms, and we will talk about that in just a minute.
Over-the-Counter Remedies and Their Limitations
Next, I want to talk about all the over-the-counter things because many people do not want to go to the doctor, so they go to the pharmacy and look up and down. One or two aisles are about nothing except sinus infection symptoms. If you are looking at the antihistamines, the decongestants, the nasal sprays, basically all the decongestants and antihistamines, they might help your symptoms slightly. However, for the majority of people, you wind up with antihistamine side effects or decongestant side effects that are worse than your actual sinus infection symptoms.
What can you get at the pharmacy that might help? Saline nasal spray might decrease the severity a little bit. A Neti pot if you are amenable to that. I do not like the idea of pouring water into my nasal passages. Some people like it and swear by it. Then, taking an anti-inflammatory like Aleve, Motrin, or naproxen for a few days to knock the edge off the pain and the pressure might give you some symptom relief.
But in no way is anything in the sinus aisle at the pharmacy going to make your sinus infection go away quicker or make it get better quicker. That is just not going to happen. That is impossible. Sinus infections are viral 95 to 97% of the time, meaning they must run their course.
Supplements and Social Media Remedies
What about zinc? What about vitamin C? Taking a supplement might help your immune system fight off the virus quicker if you are deficient in zinc or vitamin C. If you are not deficient, which most people are not, they will not help you. You will spend five or ten bucks on something that makes you feel like you are doing something, but it would not make it go away any quicker.
Now let’s talk about all the social media videos, some of which have millions of views; drink one cup of this, and your sinus infection goes away; touch your forehead, pinch your earlobe, thumb, and bottom of your foot. There is no evidence that these things will cure or make your sinus infection disappear quickly. Now, they are excellent busy work, so you can do these things if you’d like some busy work while you wait 5 to 10 days for your viral sinus infection to go away.
I do not think any of them will hurt unless they are very high in sugar; then, they might spike your blood sugar, which could worsen your immune system function. Otherwise, you can try all these little crafty, nifty tricks you saw on an internet video from a chiropractor or a naturopath, but they would not help.
Home Care and Symptom Relief
So, what can you do at home to treat your sinus infection?
Many people find that viral infections go away quicker if they fast while in the midst of one. So, if you are not hungry and do not feel like eating, listen to your body and do not eat. Just sip on some bone broth or warm liquid with some electrolytes, hopefully sugar-free, and give your body time to do what it needs.
An anti-inflammatory, like ibuprofen or toxin, will knock the edge off your symptoms, especially if you have a little fever and need to function. You have got to work. If you are working from home, you can take that for a few days only, in which case the benefits probably outweigh the potential complications.
Elevating the head of your bed while you are asleep may help you get more restful sleep and breathe better.
But there is no research on most things you see online. There is no science supporting that drinking a cup of this or touching your forehead here will help anything. 99% of the things in the sinus aisle at the pharmacy are completely and utterly worthless and often leave you with more symptoms than if you just left the sinus infection alone.
95 to 97% of the time, you do not need the antibiotic from your doctor, so don’t waste the copay, do not waste the time for the visit, and do not take the chance of the side effects or complications from taking an antibiotic that you do not even need.
Recognizing Bacterial Sinusitis and the Doctor’s Diagnostic Limitations
Now, what if you have a bacterial infection? Because 3 to 5% of the time, it is bacterial. How will you know? Well, this is how you will know: starting about the fifth or seventh day if it gets progressively worse. What you would expect is about the seventh day, you are going to wake up and say, “It is no worse, maybe a little better, but I still feel like crap.”
That is a viral sinus infection. But suppose you wake up on the seventh day, and you are like, “Oh my God, it is way worse,” and it proceeds to get worse and worse. In that case, your fever starts to go up more and more after the seventh day. Then, it may be time to schedule an appointment with your doctor because the odds of this being a bacterial infection increase.
When you see your doctor, especially if you go in the first five days of your sinus infection, how does your doctor know if it is bacterial? Well, the average doctor will take a history and ask you some questions, and they might poke around on you a little bit, look in your mouth, look at your throat. None of that will tell your doctor if this is bacterial versus viral.
There are some tests that your doctor can do, but they involve sticking something far up your nose, either an endoscope or a swab, and actually taking a culture from the sinus or the opening where the sinus drains into your nasal cavities, running an endoscope into your sinuses and taking a culture, or doing a CAT scan or an MRI of your sinuses. Even an X-ray of your sinuses, unless you have an advanced case of sinusitis, will not give the doctor any relevant information.
