Preventing and Treating Sinus Infections When Taking Biologics

Biologics are notorious for increasing your risk of infections, especially those of the upper respiratory tract. In other words, sinus infections. Cue headaches, a feeling like your head is filled with cement, post-nasal drip, nausea, debilitating fatigue, thick brain fog, plus that awful smell that no one else can smell. There is nothing like it to convince me that I will feel like it for the rest of my life.

But there are things you can do to prevent sinus infections or, if one shows up, reduce the impact. This rarely involves antibiotics. Medical science has discovered that sinus infections mostly resolve on their own — yes, even when you’re immunosuppressed. In the past two months, I’ve seen my GP several times, as well as an ENT specialist and neither handed me a prescription for antibiotics. However, I have picked up a number of tips on how to prevent and treat sinus infections that I want to share with you. We’ll get to those shortly. 

How sinus infections happen
But first, let’s talk about mucus! (I can sense how excited you all are about this) 

Nasal mucous is produced in the sinuses and drain out of the body either through the nose or down the back of your throat. When you’re brewing an infection (cold, say) or you have allergies, the tissue in your nose can get irritated, inflamed and swell.

Think of the nose as a hallway and the four sinuses as rooms with tiny doors. It doesn’t take much for those doors to be closed — a tiny bit of nasal irritation and swelling from allergies or an infection brewing and the doors slam shut. All of a sudden, the mucus produced in the sinuses has nowhere to go. Add a few bacteria and you have all the ingredients you need for a sinus infection.

The Biologics also increase the risk of sinus infection for a couple of reasons. One, they lower your resistance to bacteria, making it easier for infections to happen. Two — and this is purely in my own experience — they increase the amount of mucus you produce, and may trigger your histamine response, increasing your allergies. 

Preventing and treating sinus infections
In the early days of being on Biologics, I discovered three things that have helped me keep sinus infections away, as well as reduce the impact of when they do arrive. If you’ve read Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain, you know what it is. If you haven’t, here it is:

Drink plenty of pineapple juice (the good one, 100% juice, such as Dole). Drink plenty of water. Eat plenty of garlic (add it to your food). Water dilutes the gunk in your sinuses, making it easier to drain. Pineapple juice contains an anti-inflammatory enzyme that will help the swelling in your nasal tissues to abate so the (diluted) gunk can drain. Garlic is anti-bacterial, helping to prevent infection. I use this regimen on a daily basis and increase amounts of water, pineapple juice, and garlic when I feel an sinus infection coming on. 

Until the spring, it’s been working brilliantly. And then I got a hellish virus/viral infection/sinus infection. The benefits of that was that I’ve accumulated some additional tips from various health professionals.

Treat your allergies. Allergies increase mucus production and irritation in your nasal passages. Treatment can include avoiding being outside during dry and windy days when a lot of pollen is floating in the air or, if you are allergic to spores, after it’s rained. Over-the-counter antihistamines can be an important part of your anti-allergy arsenal. If you’re interested in alternative medicine, ask your naturopath whether Allergiplex would be right for you. According to the package, Allergiplex can be used as a preventative, as well as treatment.

Nasal irrigation. You’ve heard of neti pots, haven’t you? People use them to rinse out their sinuses, which can sound a little flaky. Or so I thought. An ENT staff gave me a sample of NeilMed’s Sinus Rinse Nasal Wash at a fairly desperate point in the last two months. It feels very strange and is a bit messy, but boy, does it help! This particular one is also easier to use for those of us with limited mobility (I put it on the counter, insert the nozzle in my nostril, and press down — it’s an adapted and messier method, but when your hands are crap, you do what you can). These kits are a bit expensive, but you can also use the squeeze bottle kit or the Neti Pot, if your joints will allow. Nasal irrigation can be used both as a preventive and as treatment.

Steroid nasal spray. If you’re having a particularly stubborn infection, using a prescription steroid nasal spray can help shrink the inflamed tissue in your nose. Talk to your doctor about this.

Knowing that there are tricks that can help you keep sinus infections at bay and beat them down when they do arrive can be such a help for those of us who are magnets for these types of health challenges. *

How do you cope with sinus infections?

 * I originally wrote “the little f***ers.” Because they are.


Kirsten said…
So it was you who was talking about sinus infections and brain fog. I was trying to remember who, but sinus infection. Actually, I'd forgotten anyone had mentioned it till the monster in my head started shrinking down. Stories.
Rick said…
I bitch and complain to Sheryl. No, it does not do any good. But it has not helped for over 40 years. Why run a risk of something different happening?
Unknown said…
Very Nice & Impressive blog.
Cathy said…
Great tips Lene. I’m going to start drinking more water and get pineapple juice. Actually this is a remedy I used when my kids were young but forgot about! Thanks.
Tod said…
Thank you for this info regarding preventing sinus problems, especially when taking biologic meds... here's a list of prevalent current thinking as of 3/19 -

1) The pineapple ingredient, Bromelain, may be better as a capsule rather than drinking the juice - 500 - 1000mg daily
2) Daily sinus saline rinse/flush such as Nettipot
3) Frequent hand washing
4) Nasal saline spray as needed to keep the nose moist
5) Certainly lots of hydration is always good
6) Some use Mucinex (guaifenesin)on a regular basis to keep secretions thinner
7) For a badly deviated septum or chronic non-draining sinus consider corrective surgery

As a patient myself on a biologic (Entivio) with past sinus problems (maybe or maybe not related to the medication), to me, these are the ideas that seem most reasonable to consider - best wishes to all of you.

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