canklecat

Short version: bromelain and niacin. Bromelain is an enzyme derived from pineapples. Niacin is Vitamin B3. I take 500mg of each, usually once a day, in the non-timed release versions for quicker effect.

This year in Texas, winter and allergy season have been the same thing. We've had allergy alerts throughout most of what so far has been a spring/autumn-like winter, mostly due to high winds blowing in cedar and other pollens, and mold/mildew/fungus. I always have sinus allergies and congestion but almost everyone I know has too this winter, so it's really bad.

It's so bad I've avoided most group rides, especially faster groups. I'd have to stay at the back constantly blowing snot rockets and hawking up endless gobs of goo. Worse, a few weeks ago I was blowing and hacking up blood clots. No infection, just blood from inflamed sinuses. The urgent care clinic tried Prednisone and antibiotics in December but it wasn't helping much. When I returned a month later they said there was nothing more they could do and it would be more risky to continue the Prednisone and unnecessary antibiotics when I didn't have an infection. They just suggested avoiding the outdoors. That would pretty much mean moving away from Texas. I've never had bloody noses before, even as an amateur boxer, so this was new to me. Pretty disgusting, so I avoided group rides.

In the past I've usually taken real pseudo-ephedrine or ephedrine for congestion and asthma on the worst days. Phenylephrine doesn't work for me. But for the past several months I've taken it almost every day and it was contributing to marginally high blood pressure and heart rate -- around 140/90 and 90 bpm rather than my usual 120/70 and 70 bpm or lower. Not good.

Flonase helps a little with sinus allergies, and I have albuterol and some other powdered inhalant for asthma, but they weren't helping with the sinus congestion and headaches in the upper sinus, the forehead between the eyes.

So I've been poring over the more credible health sites, cross-referencing NIH/NCBI studies, to find alternatives. I'm not a big fan of any form of woo, "natural" or alternative medicines, homeopathic remedies, voodoo or bad advice, no matter how well intended. I get eye-roll headaches from reading suggestions to chew willow bark for the salicylates when perfectly good, cheap aspirin from the dollar store does the same thing better. There's nothing "unnatural" about isolating the effective portion of something and omitting the superfluous stuff. We do it when we trim trees to build framed homes rather than log cabins everywhere. We make cotton fabrics rather than wrapping ourselves in whole cotton plants.

But I'm open minded and willing to try anything that might help and not cause worse problems. For example to cope with chronic pain last year from injuries (I was hit by a car in May while I was riding my bike) I wanted to minimize use of opiates. I tried CBD (didn't work for me) and kratom (works very well for me, with fewer side effects than prescription pain meds). And I've tried many topical analgesics as an alternative to oral meds for pain. Some work very well (Stopain roll-on, Ted's Pain Cream) while most do absolutely nothing for pain -- although topical salicylates can relieve psoriasis, acne and other skin problems.

A local store was blowing out some stuff I'd normally never buy at full price, but for a couple of bucks I thought I'd try it: Somnapure PM. There are a few varieties. Some contain bromelain, melatonin and valerian root for sleep, maybe hops, GABA and other stuff. I was mostly interested in the bromelain since the stores didn't have just the bromelain supplement. It seemed to reduce the sinus congestion headaches that woke me almost every night between 3-6 am.

I ordered a bottle of just the bromelain via Amazon. Much cheaper than the full price for Somnapure. Ditto, buying individual bottles of melatonin, valerian root, etc., for sleep. But I didn't want the sleep aid components. A bottle of 120 500mg tablets costs around $5-$10 depending on brand and vendor.

The bromelain seems effective on my chronic sinus inflammation. Some folks report it's also effective for their chronic pain. I can't say it's done that for me. But it appears to be effective for my sinus inflammation. After I ran out of the Somnapure PM with bromelain it was another week or so before I ordered the supplement. During that time my bloody sinus congestion worsened. Within two days of taking the bromelain again the bloody drainage and clots cleared up. Again, it's not an infection and the clinic didn't think it was bad enough to prescribe any meds. But it was annoying as hell to me, especially during bike rides or trying to sleep.

Niacin was an old familiar friend/enemy/frenemy. My grandparents were really into vitamins, supplements, holistic lifestyles, etc., during the early 1970s. They probably didn't realize it but in retirement they had morphed from typical middle class conservative working stiffs into latter day hippies. They subscribed to Mother Earth News, bought everything published by Rodale Press, and swallowed mounds of vitamins and supplements. My granddad called niacin his "stinging pills", as they made his face flush with the sensation of stinging nettles.

When I took niacin routinely the capillary flushing and stinging subsided, especially when taken with food or on a full stomach. But it loosened mucus congestion within 5-30 minutes.

Anyway, short version, if you have similar sinus congestion problems and want to minimize use of prescription and OTC meds that have potentially serious side effects, try bromelain and niacin.

References (NIH/NCBI site):
Properties and Therapeutic Application of Bromelain: A Review

Potential role of bromelain in clinical and therapeutic applications

The mechanism and mitigation of niacin-induced flushing

Note that large doses of niacin over time may be associated with liver damage.