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Good Scientific Evidence
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Bromelain
]: Bromelain may be a useful addition to other therapies used for sinusitis (such as antibiotics) due to its ability to reduce inflammation/swelling. Studies report mixed results, although overall bromelain appears to be beneficial for reducing swelling and improving breathing. Better studies are needed before a strong recommendation can be made.
- Avoid if allergic to bromelain, pineapple, honeybee, venom, latex, birch pollen, carrots, celery, fennel, cypress pollen, grass pollen, papain, rye flour, wheat flour or other members of the Bromeliaceae
family. Use cautiously with history of bleeding disorders, stomach ulcers, heart disease, liver disease or kidney disease. Use cautiously before dental or surgical procedures or while driving or operating machinery. Avoid if pregnant or breastfeeding.
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Butterbur
]: Good Scientific Evidence suggests that butterbur may effectively prevent allergic rhinitis in susceptible individuals. Comparisons of butterbur to prescription drugs such as fexofenadine (Allegra ®) and cetirizine (Zyrtec ®) have reported similar efficacy. Additional studies are warranted before a firm conclusion can be made.
- Avoid if allergic or hypersensitive to Petasites hybridus or other plants from the Asteraceae/Compositae family (like ragweed, marigolds, daisies and chrysanthemums). Raw, unprocessed butterbur plant should not be eaten due to the risk of liver or kidney, damage or cancer. Avoid if pregnant or breastfeeding.
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Nasal irrigation
]: Good Scientific Evidence suggests that nasal irrigation can effectively treat allergic rhinitis. A well conducted randomized controlled trial fully reporting data would make the case for allergic rhinitis stronger. There is also good scientific evidence that nasal irrigation may effectively treat chronic sinusitis. A large, randomized, double–blinded study would lend strong support to the usage of nasal irrigation for the treatment of chronic sinusitis.
- Nasal irrigation is generally well tolerated. Use cautiously with history of frequent nosebleeds. If the irrigation liquid is hot, the nose may become irritated.
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Unclear or conflicting evidence
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Acupuncture
]: More studies of strong design are needed to determine whether or not acupuncture offers benefit in chronic sinusitis patients.
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Aromatherapy
]: Despite widespread use in over–the–counter agents and vapors, there is not enough scientific evidence to recommend the use of eucalyptus oil as a decongestant–expectorant (by mouth or inhaled form). The available studies are of poor quality, and have used combination therapies or 1,8–cineole (eucalyptol), which is a component of eucalyptus. Further studies are needed before a definitive conclusion can be made.
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Cat's claw
]: It has been suggested that cat's claw may help treat allergic respiratory diseases. However, there is limited scientific evidence. More well–designed trials are needed to determine whether cat's claw is a beneficial treatment.
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Choline
]: Oral tricholine citrate (TRI) effectively relieved allergic rhinitis symptoms in one study. However, further research is needed before a firm conclusion can be made.
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Ephedra
]: Preliminary research suggests that ephedrine nasal spray, a chemical in ephedra, may help treat symptoms of nasal allergies. Additional research is needed to confirm these results. Since ephedra taken by mouth can cause serious side effects, including heart attack, seizure and stroke, ephedrine nasal sprays should only be used in the nose.
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Honey
]: Currently there is insufficient human evidence to recommend honey for the treatment of rhinoconjunctivitis (inflammation of the nose and eyes in response to an allergen). One poor–quality trial reported no benefit of the use of honey for the treatment of rhinoconjunctivitis. Further research is necessary before a firm conclusion can be made.
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Probiotics
]: Only a small number of probiotics combinations have been studied in treatment of allergies, mostly with children, teenagers and young adults. Further research is necessary before a firm conclusion can be made. Additionally, experts recommend selecting high quality probiotics with third party tested levels of stated organisms.
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Stinging nettle
]: For many years, a freeze–dried preparation of Urtica dioica has been prescribed by physicians and sold over–the–counter for the treatment of allergic rhinitis. Clinical trials demonstrating statistical significance over placebo, and/or equivalence with other available treatments, are needed to support the use of nettle in the treatment of allergic rhinitis.
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Vitamin E
]: Although thought to aid in reducing the nasal symptoms of allergies, vitamin E intake may not be effective. However, current evidence is limited, and more studies are needed before a firm conclusion can be drawn.
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