Sinus Rinses: if once/day is good, is 4x/day even better?

I recently posted a 4-part series on the natural remedy, saline nasal rinses:

What is their benefit? What is the evidence that they work? How to do them? How to make them?

Here are a couple follow up points based on questions from readers:

Easy Does It

If once per day is good, isn’t 4 times per day 4 times  better?  NO, not really!  Saline nasal and sinus rinses reflect a fine balance between the benefits of rinsing all the bad stuff out (viruses, bacteria, mold, allergens, pollutants), and simply irritating the lining of the nose and sinuses.  Easy does it.  Be kind to your nose.

Keep Your Cilia Happy

Let’s face it – if you’re thinking of doing sinus rinses your nose and sinuses are ALREADY inflamed anyway.  Don’t push it.  Once per day is great for prevention and maintenance of healthy sinuses.  Kick that up to twice per day during an acute infection (virus, whatever).  Just don’t do saline rinses more than twice per day.  Studies show that your cilia won’t like it.

And you want those cilia to be happy.  You want to optimize muco-ciliary clearance.  (Say that 3 times fast.  Dare you.)  See Nasal and Sinus Anatomy post in April (maybe just the Cliff Notes) for more details about the role of cilia in maintaining healthy sinuses.  Also a future post will be devoted to cilia, what can go wrong with them, how to care for them.  Be kind to your cilia.


Consider additives:  for chronic rhino-sinusitis (CRS) or recurrent sinusitis, get your hands on some Manuka honey (check boogor doctor’s Amazon Store in the right column; disclaimer: Amazon affiliate).  More on Manuka honey next week in a post devoted to the medicinal qualities of honey.

For truly severe, debilitating CRS, some of my patients get custom-made solutions containing antibiotics.  This seems to work especially well for those with CRS and Staph infections (including MRSA), or those with fungal sinusitis.  I have my formulations provided by Sinus Dynamics (Disclosure:  NO financial or other relationship).  These require a physician’s prescription.

Home Grown

For those of you who make your own saline, this is the formula for hypertonic saline (for chronic sinusitis, or super stuffy nose) that I used prior to switching to one of the store-bought preparations:

  • 1 liter distilled water (distillation purifies and nearly sterilizes it)
  • 2-3 tsp salt (kosher canning or pickling salt)
  • 1 tsp baking soda (‘buffers’ it so it doesn’t burn as much)
  • For chronic sinusitis:  add 3-7 tablespoons Manuka Honey

NOT to be used on a daily basis for long-term – your cilia won’t like it.  It is great for short-term rinses for severe, acute sinusitis, when you need to reduce the swelling fast.

Don’t Kill It

Mix, microwave gently to dissolve.  Even better:  slowly heat over the stove to dissolve.  Allow to cool – do not use hot!

Don’t over-heat.  Heat just enough to dissolve ingredients.

Excessive heat kills the active enzymes and proteins in the Manuka Honey.

It Works

Final comment: saline irrigation of your nose and sinuses is THE single most effective means of reducing or eliminating your symptoms of allergic rhinitis or sinusitis, and even asthma.  It may be the ONLY thing that helps you control chronic sinusitis or CRS.

Yes, it may be unpleasant (I have friends who actually enjoy doing it, but they are my friends, so that tells you that their judgement is suspect).  It is especially unpleasant to do this for / with / to a little child, but it WILL help.

If everyone with rhinitis and sinusitis were doing saline rinses I might be out of business.  On second thought, nobody should be doing these, everyone stop now ~(;-))   For a convincing medical case with CT scan images, see previous post on 3-year-old boy hospitalized with severe sinusitis.

In case I wasn’t clear about this (I probably wasn’t): Saline Rinses work GREAT for allergic rhinitis, not just sinusitis.

If you are just checking into this site, also check the 4-part series on Saline Sinus Rinses that were posted April through May, 2010.  Those posts have resources listed that the super-curious may find interesting.

So, what do YOU use?

POLL (please leave comments):

If doing sinus rinses, do you use: (1) suction-bulb / syringe (like you suck a baby’s nose out with);  (2) a Neti pot;  or (3)  a plastic squeeze-bottle, like the ones in the store-bought kits.  I know, some of them have neti pots instead.

Thanks for visiting, and see you here again.  I appreciate your comments and questions.  Keep ‘em coming.  And please, “be excellent to one another.”

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Best of health and success to you and your families.

Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor :~D)


  1. Dear Dr. Russell,

    I have sinusitis or allergic rhinitis and its been with me for probably more than 6 month now. Should I start using the saline rinses including the Manuka Honey in the saline recipe? How often should I use it per day? How long should I keep using it?

    I am currently using a budesonide (Rhinocort Aqua) and taking antihistamine (Zyrtec), is it ok if I take the rinses while continuing to take the above medicines?

    Thank you for your support!

    • Russell A. Faust, PhD, MD says:

      Dear Yousef,
      First, you should visit a doc to check out your symptoms, confirm your diagnosis.
      If you decide to give saline nasal rinses a try, read through the 4-part series here on this blog for details – how to do them, how to make the saline (with or without Manuka honey). One of the advantages of saline nasal rinses is that they never interfere with your medicines. My only recommendation is that if you are using nasal steroid spray: do your daily saline rinse, blow your nose, then use your steroid spray as you normally would.
      To maintain optimal nasal and sinus health, saline nasal rinses once per day works great. If you have particularly bad symptoms, like an acute sinusitis, twice per day can help clear the infection. But more than that is not helpful due to the increased inflammation and irritation from frequent saline rinsing. So – never more than twice per day for saline nasal rinses.
      Thanks for visiting, and for contacting me. Please get back to us and let us know how things go.

      • Tina Innocenti says:

        My daughter is 7 and has terrible sinuses/sinusitis/asthma/allergies..
        We bought Naso about 8 months ago..Her Pediatrician had her on so many different Steroid nasal sprays.>They had such BAD and terrible side effects (they worked but the side effects were absolutely terrible)…She suffered a ton ..I stopped all steroid sprays(every one is different..but she could not handle them)..That’s how I found this site.
        I LOOOOVE this site..and LOVE NasoPure..I give her Naso every day..Once a day..she is sooooo good and feeling well..It’s amazing how it works so incredibly well..No medicine, no side effects..
        When her sinusitis acts up, we do it twice a day for a few days until it calms down..and sometimes take Zyrtec as well.
        We are SO happy to have found this site and NasoPure..It is so worth it…and natural..I am beyond happy.
        Hope everyone feels better.
        We only use the Naso….and sometimes Zyrtec..and Saline Nasal Spray (only when it’s really bad)..NasoPUre is the BOMB..and this site..

        • Russell A. Faust, PhD, MD says:

          Hi Tina,
          Thank you for your kind comments. I agree, Nasopure is a great product, and their website is a great resource.
          Glad to hear that things are working out well for your daughter.
          Please stay in touch, and tell your friends about us!

          • Tina Innocenti says:

            You are very welcome..I love this website..Very helpful..and I tell everyone about it and NasoPure..

      • Hi I have been doing this rinse as per your instructions and wanted to know why after I am done am I more congested than before ? I’m using one cup of the solution with Neti pot through each nostril. Waiting a minute then blowing. A lot of clear and a tiny bit of yellow green snot comes out tiny as in trace amounts. Then after I just feel stuffed up for about an hour. Is that normal?

        • Russell A. Faust, PhD, MD says:

          Hi Liz:
          Increased stuffiness can be from either (1) incorrect saline formula, or incorrect concentration – specifically, if you mis-calculate and use too much water for the salt packet, tissues lining the nose will take up fluid, resulting in temporary swelling (possible solution: try decreasing amount of water per salt recipe); (2) irritation of nasal lining, causing temporary swelling (possible solution: try a different saline formulation – if making saline from recipe at home, consider buying packets of saline from Nasopure or other saline-rinse vendor). If you can’t find a solution, you may simply need to stop doing the rinses.
          Thank you for visiting, reading, and sharing!

  2. Hi, have you heard of Sinupret? Does it work to clear sinus infection?

    Thanks, Lilla

    • Russell A. Faust, PhD, MD says:

      Hi Lilla,
      I don’t know what is in it, but I have heard mostly positive things about Sinupret. Some patients of mine have used it with good results. On Amazon, 27 out of 32 reviews were very positive (4 or 5 stars). That is pretty strong testimonial. If you end up using this for your little Naia, please let us all know the results! Thanks for much for visiting, and for contributing.

    • Great actrile but it didn’t have everything-I didn’t find the kitchen sink!

  3. Wonderful website! Thank you for making it, I learned a lot here!

    • Russell A. Faust, PhD, MD says:

      Hi DG,
      Thank you for your kind comments.
      Please let me know what topics are important to you, and I will seek out experts to provide great, accurate information for you!

  4. Dear Dr. Russell,

    I am writing here with the hope of getting a suitable solution for my 4years and 3months old son who has been suffering from constant coughing which occurs mostly during evenings and early morning hours. For the last two years his cough use to aggravate so much that he had fast breathing and bouts so we consulted the doctor who advised him some steroids- Omnacortil, Levolin & Azee. Also nebulisation with Asthalin & Budecort. At first I was very scared to give him these strong medicines but looking at his conditions had to give up. A little background -when he was 3 months old , he had skin allergy diagnosed with Atopic eczema for which oinments were applied but now at this age is very minimal (only limited to mild redness above eyes sometimes) . However, now this coughing takes all his energy away and it has become an everyday problem. He coughs for almost an hour sometimes continuously due to which gets tired and gets stomach ache.
    I have lately started homoepathic treatment and ocassionally have to nebulise him with Asthalin when the cough aggravates.
    I read about the nasal washing saline recommended here on your site and wanted to know that if it would help in my son’s case?
    Is his coughing really related to Asthma in any way and is it curable at his young age ?

    A very concerned mother awaiting your response.
    Thank you

    • Russell A. Faust, PhD, MD says:

      Hi Swati,
      Thanks so much for visiting and sharing.
      I cannot offer medical advice.
      I will answer you offline with some general suggestions.

    • Tina Innocenti says:

      I hope your son gets better..Both of my girls has “seasonal asthma”..When the weather changes or when they get a cold, they cough constantly. My oldest was diagnosed when she was 18 months old..she is 11 now and still has it..They are “supposed” to outgrow it.
      She has a Nebulizer (breathing treatment machine), an albuterol inhaler (Proventil) also Flovent (which is a steroid inhaler)..The Flovent is supposed to be taken everyday to keep her from coughing and controlling it..(This is just MY story w/ my girls..not medical advice).
      Just wanted to share that the constant coughing could be due to asthma or a form of seasonal asthma. The NasoPure has REALLY helped. We use it as soon as they sneeze or show signs of a cold or asthma attacks coming on.
      They do not have asthma all year round (thank God)..but when they do, The oldest’s gets really bad..Sometimes she even has to take oral Prednisone steroid as well to control her cough..So sad..She coughs so much and is so used to it at night that she doesn’t even wake up..It scares me and I have to wake her up for a breathing treatment or inhaler.
      Also, he may have allergies..I took my girls for allergy testing as well.
      Another good thing for his room (just my advice)..Is to make sure there is NO dust in there..don’t use chemicals to clean it( I make my own w/ household things so there are no chemicals in there)..I keep their rooms dust free and use an Air Purifier in there..make sure to keep the filters clean and change when needed.
      I would DEF> take him to a Pediatrician and ask about Seasonal Asthma or Asthma in general..And the NAsoPure for US..has worked AMAZING…
      Hope this helped a little..again, just my story, not advice..Hope he is doing well…
      DOes he cough a lot when he is running/jumping or exerting himself? That is a major sign of asthma..I never knew there was Asthma that was not just “Not being able to breathe/wheezing”..there is Asthma where people cough non stop, which is what my girls have ..and when they get a cold, oh My…
      Naso is wonderful..

      • Tina Innocenti says:

        Also…we do steam showers and they help a ton.. When they are out of the bathroom..I turn on the shower as hot as it goes, close the door..let the room steam up for about 5 mins…Take the kiddos in there and read them a book or play a game so that they are breathing in the steam..It helps for us?? Obviously, you don’t put the kiddos in the shower w/ hot water..LEave the shower door/curtain closed and let the room steam up..
        I found that playing or reading to them distracts them from the hot and steaminess..We do this in the middle of the night sometimes w/ coughing fits..Good luck and keep us updated on your son.

      • Tina Innocenti says:

        Oh geez..sorry for the million reply’ use the allergen covers that go over the mattresses and pillowcases…I try everything..That won’t cure his coughing, but it keeps dust,etc from getting in his bed.

      • Russell A. Faust, PhD, MD says:

        Hi Tina,
        Thank you for sharing!
        I agree with all your comments.
        The only other impression that I have developed over the years is that “cough-equivalent” asthma in children that is mostly at night is almost always the result of reflux!
        Thanks again for your contribution here :))

        • Tina Innocenti says:

          Dr. Faust..I agree as well…My daughters get it all day/night when they get their seasonal asthma attacks..Not just at night..but at night, sometimes it’s worst..
          Hope everyone feels better and the kids..
          Love this site.!!

      • HI Tina,
        As for asthma,please give your children ample drinking water and some sea salt(unrefined salt) for 15 days and see the result.Its dehydration that’s causing the Asthma.Please hydrate your children and you yourself also possibly. A minimum of 2.5 lts pure clean water for a grown up is recommended and some extra half teaspoon sea salt.This is recommended by Dr BATMANGHELIDJ.Plaese go to you

        • Russell A. Faust, PhD, MD says:

          Thank you for that, Tanmoy!
          Agreed: don’t treat simple (and common) dehydration with medications!
          Dehydration is a serious problem for children and adults with any respiratory ailment: asthma; rhinitis; sinusitis; bronchitis…

  5. Hi Dr Faust,

    Thanks so much for all the helpful information on your site. I had FESS, and septoplasty and turbinate reduction surgery in October due to a mass (benign) in sphenoid sinus. (Have also had sinus problems for years.) My surgeon recommended saline sinus rinses which I had also been doing regularly for several years before seeing him, but I’ve had a slow recovery from the surgery. I added manuka honey to my rinses after finding your site and I feel it’s been helping. My Dr is kind of unsure whether it was safe so I was hoping you could point me to the scientific studies on it so I could forward the information on to him.


  6. Susan Sowiak says:

    Hi there,
    I’m going to give your honey, saline and baking soda mixture a try, does the unused portion need to be refrigerated between treatments?

    • Russell A. Faust, PhD, MD says:

      Hi Susan,

      Yes, please refrigerate any un-used saline rinse that you make up. I simply use one of the commercial packets ( in the Nasopure squeeze-bottle (BPA-free), and I use it all at once, so I don’t have left-over. But when I made my own from a recipe, I would keep it in the ‘fridge. If you leave it out, it will grow fuzzy mold – something that you DON’T want to flush into your sinuses!!
      Thanks for visiting, and for sharing. Please visit again and let us know how it’s going!

  7. Tellyrow says:

    Dr. Faust,

    Thank you for this informative blog. My son has been using the Neilmed sinus rinse system with just saline since he was 3. He’s now 7. Although it has helped tremendously, he still suffers from the chronic runny nose and lots of mucus production that gets stuck in his throat and causes him to cough without being able to expel anything out. His doctor just prescribed flovent for him today. I’m wondering if the rinses with manuka honey will be helpful for him. He currently rinses with 1/2 cup of saline, twice a day. How much honey would you recommend if we were to use it on a daily basis? Thank you.

    • Russell A. Faust, PhD, MD says:

      Dear T,
      Sorry to hear about your son’s struggles. It sounds like you’re doing all the right things. For kids with chronic rhinitis and chronic cough, I am suspicious of reflux (GER/GERD) as a contributing factor. Take a look at the articles on this site for that topic. Regarding the precise amount of Manuka honey to use, it ends up being about a tablespoon for an 8-oz bottle of saline. Manuka honey may help reduce inflammation, studies have found that Manuka contains both a strong anti-microbial, and strong anti-inflammatory agents … worth a try.
      Please let us know how it goes, and thanks for visiting.

      • Tellyrow says:

        Dr. Faust.

        Thank you so much for your comments and suggestions.

        We tried only 1/4 tsp of manuka honey per 8oz of saline to start (thinking that we’ll work our way up to the 1 tbsp – manuka honey sure is expensive!) and it seems like it’s making a difference already. His nose is definitely less drippy. Can 1/4 tsp of manuka honey really make a difference?

        As the day went on, he said his nose was getting dry, so we tried the XLEAR nasal spray on him as well and he says his nose feels good.

        We’ve also been back to the doctor and she listened to his lungs and said they sounded fine and that we could discontinue the Flovent.

        We also have my son on a product called Respiractin – Dr. Faust, are you familiar with this product and do you have any comments on it?

        I will also look into the GER/GERD link. I had absolutely no idea that it could be linked to rhinitis. Wouldn’t my son be complaining of acid reflux symptoms if he had this? Would the timing of when he eats or drinks make a difference as well? For instance, we allow him to drink some rice milk right before bed (before we brush his teeth!). Could eating/drinking right before bed be the culprit for his rhinitis since he’d be in the lying down position while in bed?

        Thank you again!

        • Russell A. Faust, PhD, MD says:

          Great! So glad to hear that these remedies are helping your son. I do not have experience with Respiractin, but let’s see if any of the other readers here can comment on it.
          The unique thing about reflux in children is that they rarely complain of “heartburn”. They may complain of a “tummy ache,” but more often they will simply have a cough that is worse at night, with throat-clearing for the first hour or so in the morning. The other common manifestations are recurrent ear infections, chronic rhinitis, and recurrent sinus infections. If you search the term “reflux” on this boogordoctor blog site you will find a few articles that may be useful.
          The fact is, ANYthing that you eat within 2 hours before bedtime will increase the risk of reflux. Of course, it’s pretty difficult to NOT feed a kid for hours before bedtime. But to answer your question, my answer is always yes – reflux is a common contributor to chronic rhinitis.
          Thanks again for sharing, and please keep us updated.

          • Tellyrow says:

            Hi Dr. Faust,

            The GER/GERD link is so interesting! My son does do the throat clearing for the first hour or so in the morning. Lately, he hasn’t been coughing too much, but occasionally it’s there.

            We’re still doing the manuka in his nasal saline rinses and the XLEAR xylitol nasal spray and so far, it seems to be pretty good. He’s definitely not as drippy!

            I have a few questions about the manuka that I’m hoping you can answer for me. If it has such powerful anti-bacterial properties, can it kill the beneficial bacteria in the intestinal tract if the manuka is consumed?

            I also found that shortly after I gave my son manuka orally, he would need to clear his throat quite a bit. I didn’t know quite what to make of this, but wanted to see if you observed anyone else that this has happened to as well.

            Have you any experience with oral manuka honey helping with GER/GERD?

            I’ve been focusing more on the possibility of GER as a factor for his non-allergic rhinitis. I would imagine that GER is likely a manifestation of a weakened digestive tract. I truly believe that many of our so-called diseases and conditions nowadays are often or partly due to nutritional deficiencies caused by our modern day diet. For instance, a carrot of today probably doesn’t have the same nutritional punch of a carrot from 20 years ago due to the loss of mineral content in our soils today. Anyways, I’ve been trying to assess the nutritional “holes” in my son’s diet and wondering if I can fill those “holes” and possibly have a positive effect on strengthening his digestive tract and possibly his other systems as well.

            The first “holes” I’m working on are his vitamins A and D. If I’m not mistaken, vitamin A is important for mucosal membrane health and I’ve read that vitamin D is important for gastrointestinal health (of course, these vitamins are important in other aspects as well, but I took particular notice of these). I’ve also read that vitamin D deficiency may have a role in asthma as well. In any case, much of my son’s vitamin A & D is currently coming from synthetic versions in his enriched rice milk. Yes, he consumes vegetables with natural beta carotene, but it needs to be converted to A in his body and maybe that process isn’t efficient because of a weakened digestive tract?? We also live in the Pacific Northwest where it basically rains for 9-10 months of the year, so we don’t get alot of sunlight for natural vitamin D production. His vitamin D from his rice milk is also the D2 version, which apparently isn’t the ideal version to take (according to the vitamin D council, we should take D3). So, to make a long story short, I’ve begun to give my son cod liver oil. It’s a fermented cod liver oil from Green Pastures (I have no affiliation with them!) and it’s natural vitamins A and D are intact (unlike most cod liver oils on the market). Plus it contains a whole host of other goodies that science hasn’t begun to figure out how they all work synergistically. In a way, it’s all about going back to what Grandma did, isn’t it?

            I’ve also been looking at digestive enzymes for my son, which I’m hoping will also aid digestion to help with any GER. I finally found a chewable one that doesn’t contain his allergens – I’m just waiting for it to arrive by mail.

            I’ve checked out your GER/GERD articles. In your experience, what supplements or herbs have you had the most success with in children? In the back of my mind, I’m thinking of trying aloe vera and perhaps L-glutamine since both of these are beneficial for healing the digestive tract. However, I won’t be adding this to our repertoire yet until I’ve given the cod liver oil and the digestive enzymes a good try.

            As for probiotics, I think we’re good there. He’s been getting probiotics for at least 5-6 years of his 7 year old life!

            Thank you again! I absolutely love your blog and all the information it provides from you and others who share on it!

          • Russell A. Faust, PhD, MD says:

            Hi again!
            Honey does not seem to affect GI bacteria, perhaps because many of the anti-microbial properties are destroyed by the time that honey makes it to the part of the GI tract with all the useful bacteria. That is, by the time that honey gets through the stomach acid, then through the alkalai and “soap-like” effect of bile, it no longer has the oomph to do any damage to our beneficial gut bacteria. That’s okay by me. Most of the beneficial anti-microbial properties of honey are achieved when it is used topically – on a wound, or in a rinse – where it directly touches the affected area. There are currently several biotech startups that make honey products for chronic wounds, things like diabetic ulcers, etc. When used directly, those anti-microbial and anti-inflammatory effects are powerful.

            Like your son, I feel a need to clear my throat after swallowing honey. Manuka has an even stronger affect. I’m not sure why, but I think it is the high osmolarity of the honey stimulating some sensory receptors near the larynx. I have not noticed any benefit of Manuka for GER/D, but I have read reports (found on internet searches) of Manuka being used as an anti-inflammatory for reflux esophagitis.

            I recently reviewed some of the supplements / herbs that are used for GERD here:

            In my clinical practice, the one that parents have told me seems to be the most effective in their children is the DGL form of licorice.

            With probiotics, please not the importance of the effect of stomach acid on them: stomach acid kills up to 90% of probiotics before they make it to the lower GI tract where they do their good. That’s a lot of wasted probiotics, not to mention wasted money! As you know, a good probiotic is not cheap. For a couple years now, we have been using Probiotic Pearls from Integrative Therapeutics, with great results.

            Finally, thanks as always for visiting, sharing your knowledge and experiences, so that we can all learn from each other.
            Be well,

  8. Hi TellyRow, the Manuka worked wonders for my daughter but her issue was not chronic. I am a nutritionist and since your sons is chronic it seems like either an allergy (dairy or wheat)? Candida, too much sugar intake? Would suggest getting him tested. And in the meantime really boost up his immune system through organic whole foods. Elderberry syrup from Gaia is an excellent natural immune booster! Wish your son healing:)

    • Tellyrow says:


      Yes, I also thought that my son’s perpetual runny nose was due to an allergy since my son has numerous food allergies already. However, through testing, no other foods came up positive (which was a relief since we avoid so many foods already). He also has some environmental allergies to some tree pollens and animal dander as well. We have no pets & our home was new – so we know that there were never any pets in it. We bought an air purifier (IQ Air) for his room, dust mite covers on his bedding plus weekly hot water washing, vacuuming with a completely sealed HEPA vacuum and still…the runny nose. Finally, his allergist told us that he had non-allergic rhinitis and recommended that we use a steroid nasal spray. We never did use the spray, but opted for the daily nasal saline rinses 2X a day instead.

      I suppose Candida could be a possibility. We do eat rather healthy and since he has so many food allergies, practically all of his food is made from scratch with organic whole ingredients, if possible. I also try to source my veggies from local farms when I can so that they are seasonal and hopefully nutrient packed.

      Another thing I’d like to look into more is a histamine reduced diet. I’m not keen to really go there though, since we already avoid so many foods as is. But if it will help….sigh!

      lilla, can you please provide more details on how you used the manuka honey for your daughter?

      I was also looking at immune boosters for my son the other day at the store. Elderberry would be a good one as he already likes it – it’s in a product that we use for colds. Any experience with astragulus?

      Thanks so much for sharing your thoughts and comments! I really appreciate it!

      • Russell A. Faust, PhD, MD says:

        Great comments and advice! I especially like the reduced-histamine-diet approach, although – more accurately – I should say that I like the IDEA of the reduced-histamine-diet. All of the foods that I love (cheese, tomato – pizza!) are high in histamine, so the reality of the diet can be a challenge. Dr. Janice Joneja is one of the ‘gurus’ in this area. Thanks for connecting and sharing everyone!

  9. Hi Tellyrow, wow it seems like you are on top of everything! I have to say, your son is Super lucky to have a mother like you who cares so much:)

    I also like the histamine reduction approach but not on a strict basis. Bee Propolis is great for histamine reduction and is excellent for immunity and so much more. Look into it:) HerbPharm makes it in tincture, its amazing! Start with 2 drops in a little water and increase every couple of days to a child dosage which you can look up online. Bee Pollen is also excellent for allergies. You can get Local pollen from the farmers market. Very helpful for allergies! Start with a granule and increase every two days.

    You can also have him take a teaspoon of the manuka orally, its an amazing food! I think I did a teaspoon in my rinse for my daughter.

    Astragalus is good for short periods of time, not long term.

    If you make smoothies, you can add virgin organic coconut oil to his smoothies. Look up benefits if you do not know;)

    I can go on and on……

    Let me know if you have any other questions:-)

    • Russell A. Faust, PhD, MD says:

      Whoa, Lilla!
      Thanks for the contribution. I LOVE it when someone with experience and an opinion contributes to our little community of ‘boogorheads’!!
      I agree with the local pollen (and even local honey) tip, based on the notion that LOCAL will contain antigens that you respond to. I also agree with oral intake of Manuka – it is amazing stuff. Aren’t you just baffled that such strong and effective remedies – some that have existed for thousands of years – can be so actively ignored by the ‘healthcare’ world?
      I agree with you: Tellyrow’s son is fortunate to have a caring, vigilant mom; same for your son! It is so great to read comments from parents who are trying to raise healthy, thriving children.
      Thanks so much for visiting and sharing!

      • Tellyrow says:

        Awww…thank you Lilla and Dr. Faust for your kind comments! I can say the same about the both of you!

        Lilla, I didn’t realize that propolis had histamine reducing properties! When my son was less than a year old and covered head to toe in eczema, I tried propolis cream for it’s anti-bacterial properties. It didn’t do much for him at the time, but I’ll need to look into it for it’s histamine reducing activity. Do you think it’s better than quercetin?

        Ha ha!! We’re avid users of coconut oil too for a few years now! Nice to communicate with someone who also feels the same about it! Whenever I mention it to family and friends, they keep telling me that I’m going to have a heart attack from all the saturated fat. Sigh! They don’t want to listen to me and they won’t bother educating themselves either. Oh well…

        Thanks again!

        • shellysscorner says:

          Hi Tellyrow (& Dr. Faust)!!!
          WOW!!! I truly don’t even know where to start!
          1st and really foremost, Tellyrow, I truly, honestly, am in awe of you! Can I come let you be my mom too? (‘Course, being that I’m about to turn 50, in about 3 weeks might make it a tad bit awkward!) (But HEY! Can’t blame a gal for trying!) Seriously, if more moms, not even all moms, or most moms,…just more moms, were like you, not only would we have a healthier society physically, but I believe it would be healthier mentally and emotionally! The benefits of having at least one parent as invested as you obviously are in your son, are simply untold! I cannot imagine the time and energy that it takes, … just so impressive. I could go on for quite a bit, but I’ll refrain.

          2ndly, Dr. Faust, for starters, sorry about the second billing there, you’re pretty impressive in your own right here, but… wow! What a mom! I do want to say that I have just “stumbled” onto your site for the for the first time. So far, I’ve only had the chance to look at this particular article on sinus rinsing. I found you after doing a Google search for “MRSA in the nasal lining”. I’m very anxious to be able to sift through and peruse the rest of your blog. I figured any doc who was confident enough to use the name “boogerdoctor” for his website was worth at least a glance!

          Okay, 3rdly, the other reason that I’m commenting was because Tellyrow’s son’s “case” is very intriguing to me. I can’t IMAGINE that I could POSSIBLY tell you ANYTHING, Tellyrow, that you either already don’t know, or at least haven’t heard about, but yeah, hear goes! While reading the comments I really had two main thoughts specific to Tellyrow’s comments and efforts, beyond what I already stated above. Firstly, on propolis. My mom and her husband raise bees. Because I have a MRSA infection inside my nose (hospital acquired), my mom thought that putting propolis on the inside of my nose might help. Yeah, not so much. It was a great idea in theory, but because it comes from bees, specifically their honey, as it dries it tended to dry hard rather than stay moist. Sounds crazy, but not when you find out that I’m on oxygen around the clock. So ANYTHING that I put in my nose has heavy air flow across it 24/7. I use 6 liters at rest/putzin’ around the house and 8-10 liters on exertion, like when I leave the house to go to the store or take the dog out potty, etc. So since the O² tends to dry out the nasal lining in and of itself, anything that makes it worse is just a bad plan! So, here I have this tiny little bottle of one of the purest forms of natures antibiotic…what to do with it? You mentioned having used it in a cream preparation on your son’s skin condition and not being particularly impressed with the results. I sometimes get very frustrated when the pharmaceutical industry takes something found in nature, that I believe was meant to be used “AS IS”, then “waters it down” to “minimal effectiveness” and then sells like it like it’s the cure-all just for a buck, knowing full well that they’re profiting on something that isn’t going to do much because they’ve “diluted” it down so much. Now, I don’t know that that’s what happened here, but I know that when propolis is used at “full strength” “right out of the beehive” the results can be spectacular! When I say right out of the hive, there is a process that has to be done to basically “purify” the final product. For instance, like I said, for several reasons it didn’t work in my nose but, I had a severe toothache one day…(my teeth are in HORRIBLE condition due to years of unavoidable medications) I have a chronic pain condition for which I am prescribed a “fixed dose” of a narcotic medication. The tooth was hurting right through the narcotic, which is highly unusal for me. I tried to NO AVAIL taking some Tylenol and some ibuprofen in addition to my prescribed meds (separately of course, not all at the same time!) Then I remembered that I had the propolis! I took a cotton make-up pad, cut it down, soaked it pretty good with the propolis, rolled it up (trying to imitate one of this cotton rolls you get in the dentist office between your cheek and gum to absorb liquids), put it in between my lip and the gum in front of the offending tooth. I left it there for about 20 minutes before I finally took it out. At first, I didn’t think it had helped. But about 20 minutes later I realized the tooth was no longer hurting. I went to look in the mirror, and sure enough, ALL the redness and swelling was GONE! That was about 6-8 months ago. It hasn’t bothered me since. Now, that being said, I would NEVER suggest to ANYONE that they put something on or in them, let alone a child, at full strength like that without checking with somebody that knows a whole lot more than I do about what ever the item at hand is. Perhaps Dr. Faust could offer some input about it. I would be genuinely interested in your thoughts.

          My second thought, (a shorter monologue, I promise!) was regarding nutritionist Adelle Davis. Tellyrow, I was wondering if you were at all familiar with her. I know she has been somewhat controversial and many have considered her to be a nutritional lunatic! All of which I find to be sad and disheartening. Personally, I don’t grasp a thorough enough understanding of nutrition to be able to judge one way or another. I just know my mom believed in her A LOT when I was a kid…and made a believer out of me when I was a freshman in high-school. The short story is I got EXTREMELY sick. They finally figured out that I had mono. This was back in the fall of 1977 or ’78… Doctors told mom that best case scenario I would only miss 6-8 weeks of school, but realistically, it would probably be more; a good bit more. In one of Adelle Davis’s books, “Let’s Eat Right To Keep Fit”, there is a recipe called Pep-up! At the time, it was the vilest tasting stuff that could have been known to man, both before or since! I know mom ended up adding some strawberry yogurt, extra OJ, and extra bananas to try to make it more palatable. I don’t remember what else she added, and safely neither does she. Anyway, I drank that stuff for weeks! After, the first 3 or 4 days, I didn’t even have to look at the clock to know when it was time to drink it, because my body literally caused me to crave it! Oh, and the best part, I only missed just under ONE WEEK OF SCHOOL!!! It was so amazing! Seriously, we were looking at possibly getting me a tutor because we were afraid I was going to miss so much school that I would be in danger of not graduating on time, but it all worked out fine. I don’t know that Pep-up would be the solution for your son, but having recently retrieved a copy of the book from my mom,(yup, she had more than one copy ;-) and she just seems to do a great job of breaking things down and talks about foods to avoid that are counter productive to absorbing certain nutrients when eaten at the same time. It just might be worth picking up a copy.

          I sincerely apologize for the length, but there wasn’t much way to shorten it up and still get it all in there. So there’s my two bucks worth, and YEAH!, two cheats for saline sinus rinses! Yeah, okay, I need to get a life…I get it! ;-)

          Oh, the other thing was, I’m not familiar with the brand of air purifier you mentioned, but when doing research about the different types, I found that the ones touted as “ionic” purifiers actually made the air quailty worse than not using one. Wish I could give you the references for that, but its been awhile
          I’d like to hope things have been improved since then. Just be sure to do research on those products, independent of the industry type research. Lastly, as to your friends, remember, you can lead a horse to water, but you can’t make him drink!

          Best wishes to all and MANY THANKS Dr. Faust!

          • Russell A. Faust, PhD, MD says:

            Hi Shelly,
            I agree completely with your praise for ‘Tellyrow’.
            It is readers like the both of you that make our little community of “boogorheads” worth contributing to! Thank you both for reading, but mostly for sharing. I appreciate it!
            Re air purifiers: I have similar criticisms on the “ionic” purifiers. I have heard / read positive things about the “Alen A350” from AlenCorp; available at Amazon. (Transparency: I have NO financial or other arrangements with AlenCorp).
            And, I don’t mind taking ‘second billing’ to folks who have information that I don’t. The way I see it: if I can surround myself with people who are smarter than me, it makes me look good :)
            Stay informed. Stay healthy.

  10. Tina Innocenti says:

    Hi Dr. Faust, First of all, I wanted to say that I just found your site late last night..I LOVE it and there is so much good information and support on here..Very glad to have found it.
    My daughter will be 7 next month..She has severe allergies, Rhinitis, Sinuses,etc..We took her and her older sister (who has asthma) for Allergy testing yesterday..Neither was allergic to anything, So I am guessing that my youngest has “non-allergic Rhinitis?”
    I am just fed up with all of the medications being prescribed..We love their Pediatrician and he knows how anal I am about taking meds, unless absolutely neccesary.
    She cannot breathe good at night, her nose is swollen inside and she holds her breath and wakes up because she is so stuffy. (She still has her adenoids, which I thought may be the problem, but when she took the Singulair,she did not do this,she slept perfectly with no distractions).
    He put her on Flonase last month..I gave it to her ONCE..NEVER again would I give her that again..She had heart palpitations and said her heart was beating really fast, she was terrified, anxiety, couldn’t sleep..So many things from once taking it..I threw it out.
    So, he prescribed her Singulair 5mg once a day..After day 2 of taking it, it worked AMAZING…but after a week of taking it,I noticed a change in her behavior..She was acting out, she was angry,sad and just plain bad and she is NOT like that..she was mean..She kept having this weird Neck “tick” and kept moving her neck/twitching it..And I asked her why, and she said, she couldn’t help it”..She got a lot of stomache aches and urinated a ton..Too many side effects..So before I refilled it, I looked it up and found SO many people w/ the same side effects..I stopped giving it to her and the withdrawal from it wasn’t fun..
    Now it’s out of her system (for almost 2 weeks)..She is miserable again..I give her Zyrtec, but it doesn’t really help.
    I need HELP for my poor baby to be able to breathe at night and sleep.
    I am going to buy the Nasopure today..I am DEF. giving that a shot.
    Also, should I not be giving her a lot of dairy products? Does that increase the mucus? How does that have anything to do w/ the nose being so swollen?
    Thank you so much for your time and I cannot wait to hear back..I want my baby to be ok..It breaks my heart everynight to see her struggle and not sleep well..(She slept so good w/ Singulair, but its so NOT worth the terrible side effects).
    Please help..Thank you so much.

    • Russell A. Faust, PhD, MD says:

      Wow, Tina,
      I am so glad we connected here! Thank you for your kind comments about my site.
      So sorry to hear about the side effects from Singulair; those are rare, but real.
      The nasal steroid sprays provide small improvements for most children. The “designer” (second generation) anti-histamines often provide minimal benefit, especially for non-allergic rhinitis. The frustrating thing is, most young children and infants will test “negative” for allergies, even when they seem to be experiencing allergic rhinitis.
      Milk can cause inflammation and thicker secretions; wheat can also be a problem. If I had to choose which one to eliminate, it would be dairy (wheat is in EVERYthing!).
      Bottom line? You can’t do better than nasal saline rinses. Be sure to check out the site for their videos. That will reassure you that you’re doing the rinses properly.
      Thanks for visiting, and for sharing. Please stop by again to keep us updated.

  11. Tina Innocenti says:

    Thank you SOO much for getting back so fast. I have been researching this and I was thinking dairy and wheat as well..Do you have any sites you can direct me to so that I can find things that she will like and eat? She loves milk,cheese,yogurt,etc..and I buy wheat bread..yikes..I didn’t think that these things could aggrivate her like this, but I want to try the food changing as well.
    So if there are any sites for foods,brands,ideas for kids…please let me know..She does love Soy yogurt, but I don’t know if she would drink soy milk or if it’s even good for her? Should I be buying “Gluten-Free”? I have no clue..I just want her to eat..She loves fruits and veggies, and is not a big meat eater..but loves her yogurt,granola bars,milk,crackers..Oh my..
    Thanks again for getting back so quickly..I am amazed at this site and so thankful for finding it..
    Can’t wait to try the nasal saline..I showed her the video of the little kids using it this morning and she said “I can do that all by myself” I am praying and hoping she…
    Thanks again.

    • Russell A. Faust, PhD, MD says:

      Hi Tina,
      The best resource for dietary issues, food allergies, is Dr. Janice Joneja, at:
      Be sure to check out her FAQ section:
      She has helped me and our children tremendously, and her books are excellent! You can find them through the boogordoctor Amazon Store, on the right-hand column (affiliate link), or simply search for her on Amazon.
      Best, RF

    • Tellyrow says:

      Hi Tina,

      You mentioned that your daughter was allergy tested. May I ask if she was tested for just food or for food and environmental allergens?

      We avoid dairy and soy and lots of other things too because of my son’s allergies. You mentioned that your daughter likes milk, cheese and yogurt.

      If you do decide to try the alternative milks such as soy, rice, almond, coconut, hemp, potato etc, please be aware that they won’t have the same nutritional value as cow’s milk. For instance, my son drinks rice milk, but it really has just about no protein in it, so he gets his protein from other food sources. Soy milk probably comes the closest to cow’s milk in nutritional value protein wise, but I’m not a fan of processed soy products because of the phytoestrogens. In terms of flavor, I find soy milk to be kind of “beany” and hemp milk is kind of “earthy” tasting. I like the taste of almond milk, but my son can’t have nuts either. So Delicious makes a coconut beverage that is very neutral flavored, not too coconutty – I use the unsweetened version of this whenever a recipe calls for milk, whether it’s a soup or a cake and it turns out great – very similar to using cow’s milk in terms of taste and texture. A flax milk has recently made it’s way to the grocery shelves and I haven’t tried it myself, but I have heard that it’s quite neutral flavored as well.

      Cheese…sigh! This is a tough one. I’ve tried alternative cheeses and the best one I’ve come across is a product called Daiya. It’s dairy and soy free. It comes as shreds and I think it tastes best cooked and melted, but it can be eaten uncooked too. We use Daiya on our homemade pizza, grilled cheese sandwiches and it’s actually surprising tasty just fried up on it’s own. It comes in mozzerella style, cheddar style and there’s a new spiced one, but I can’t remember what it’s called right now. We haven’t tried the spiced one, but we use the mozzerella style one. We find the cheddar style one a bit too “fake” tasting.

      Yogurt…another sigh! If your daughter eats soy yogurt, then you’re ok here for going dairy-free. However, if you’d like to go soy free too, we use So Delicious coconut yogurt. It’s ok, but the consistency is a bit too “rubbery.” So, I just add a bit of water to it and then it’s more like “real” yogurt.

      Butter. If you use butter or margarine, Earth Balance makes dairy free spreads with soy or without soy. Another option is to use coconut oil.

      Chocolate. Dark chocolate is typically milk free. For chocolate chips, we use Enjoy Life Chocolate chips since they are both dairy and soy free. However, I believe there are other vegan, non-dairy chocolate chips on the market.

      I also can’t stress the importance of reading ingredient labels for milk in purchased products – also look for “whey” and “casein” as these are milk derived. Milk is often an ingredient in store bought cookies, crackers, snacks, breads etc. However, there are milk-free options out there. If you also look for vegan options, these will be milk free too.

      If you give your daughter medications or supplements, be sure to check these too. I was looking at some immune boosting tinctures for my son a few weeks ago and some of them had a form of whey in it. Homeopathics can sometimes be formulated with lactose too – which typically isn’t a problem if you’re just avoiding the milk protein, but we avoid these too just because my son is anaphylactic to dairy.

      One option we also considered was goat’s milk. We’ve heard of other children who were not able to tolerate cow’s milk, but were fine with goat’s milk. Unfortunately, our son was not one of them.

      If you have any other questions about going milk free, please feel free to ask. I’d be happy to help you out!

  12. Tina Innocenti says:

    Also, would Lactaid or Organic Valley Lactose Free Milk be ok?

    • Russell A. Faust, PhD, MD says:

      Hi Tina,
      Lactose-free milk is helpful IF the problem is lactose-intolerance (not having the enzyme that helps to digest lactose). However, many people who have milk “allergies” or intolerance are okay with the lactose, but they do not tolerate some of the milk proteins. To really figure it out, a methodical “elimination diet” approach may help. But that can be a major pain to go through, especially with a child! It can be challenging enough to get them to eat sometimes.
      Best success!

  13. Tina Innocenti says:

    Thank you so much Dr. Faust..I will def. be looking those up . Thanks for all of the help..

  14. Hi Dr. Faust. So I was reading recently that a lot of very well established clinics believe that CHRONIC Sinus issues is most likely a fungal connection. I totally thought of Tellyrow and her son because it might be fungus! And if it is, how would a child be checked for that? I would think that a naturopathic doctor can check for that? Tellyrow, I also heard that a book by Doug Kaufmann called The Fungus Link is supposed to be amazing and have a special diet in there to get rid of fungus. Try it and see if it helps your son. There is also a product called OREGARESP by North American Herb & Spice that is supposed to be Amazing and it is safe for all ages! I know personally that Oil of Oregano is a miracle worker so I am sure this blend that they came up with for allergies and sinuses, etc. works! Sorry Dr. Faust for the addition but after I was back and forth with Tellyrow I have had this in the back of my head on how to help……….Thanks for letting me share from my Nutritionist perspective:)

    • Russell A. Faust, PhD, MD says:

      Hi Lilla,
      No need to apologize – it’s comments like yours that add the real value of a blog site like this! I have read the papers and books on fungal sinusitis, but have rarely seen a case in a child.

      The sinus group at the Mayo Clinic has been studying the fungal origins or chronic sinusitis for a couple decades now. Dr. Jens Ponikau had started that research; he is now at the University of Buffalo. His theory of non-invasive fungal infections being responsible for chronic sinusitis has been controversial. Here is a good article on that topic:

      Thanks again for your contributions – I will add these to my growing list of remedies!

    • Tellyrow says:

      Hi Lilla,

      Thank you for thinking about us! I really appreciate it!

      Do you know if Doug Kaufmann’s fungus diet is similar to the Candida diet?

      The Oregaresp sounds interesting. Like you, we’re also oil of oregano users (my husband and I)!

      Thanks for the link, Dr. Faust!

      • Russell A. Faust, PhD, MD says:

        I’m sorry to say that I know very little about the ‘anti-fungal’ diets. And I have yet to try Oregaresp. I am using a preparation by Dr. Michael Murray ( called “Lung, Bronchial & Sinus Health”, that includes many of the herbal anti-inflammatory herbs that I have reviewed on this site. I have only been using it for less than a week … we’ll see …
        And thank YOU – it is readers like you who contribute that add the value to a site like this!

  15. Well, I bought the works AMAZING..Actually,my older daughter asked if she could use has asthma and allergies..She told me that she can breathe so clear..My younger daughter is doing great at night now, with NO meds..Just the love love it.
    They actually have a contest to see who can rinse the longest..So happy to have found this site and the great info..Thanks so much again..
    The NasoPure is amazing..and its nice that the kiddos can do it themselves :)

  16. I have been using a neti pot for my daughter’s sinus problems since she was 2 years old (she is 7.5 now). I like the Baraka salt mix. We sing “I’m a little tea pot” and it makes the going much easier. I’m going to try the manuka honey. I have used honey on open wounds before and love the medicinal benefits. Never knew about putting it in the neti.


    • Russell A. Faust, PhD, MD says:

      Hi Mia,
      Glad you found us!
      Please let us know how that works for you (your daughter).

  17. Dr. Faust,

    Thank you for a wonderfully informative site. Out of the blue, my 5 yr old has had persistent purulent discharge since the beginning of the year. No other medical condition prior to this. No asthma. Allergy tests are clear. Multi-week courses of abx and nasal steroids did not help. We’ll likely pursue an adenoidectomy.

    Then I found your site and want to try nasal rinsing. We’ve purchased an electric irrigator. We’ve started 2x daily sinus rinses.

    My question for you:
    – What does it mean for us to see lots of thick mucus cleared at each rinsing?
    – After 7 days, I thought the volume of mucus would decrease? It has stayed constant.
    – How long after starting rinsing before one might expect to see a decrease in mucus discharge?

    Thank you!

    • Russell A. Faust, PhD, MD says:

      Hi SFBay,
      Thank YOU for visiting, and for your kind comments.
      Please note that “negative allergy tests” don’t rule out the presence of allergic rhinitis. On the flip side of that coin, “positive” allergy tests don’t mean that you will have an allergic reaction. This area of medicine is one of the weakest in scientific understanding. I plan to provide more articles on allergy as my allergy training continues (I just completed training in Colorado from the AAOA).
      Regarding your questions:
      It is a good thing to clear that thick mucus when you rinse. Imagine what that stuff would be like if you were not rinsing it out. The fact that there is a build-up within 24 hours, and that it continues even after a week of rinsing, suggests that there is continuing inflammation of the nasal and sinus lining. May be allergic inflammation, may be dust mite allergy, may be food allergy, may be swimming in a chlorinated pool, may be exposure to smoke – the list is endless.
      If there is continued inflammation of the mucosa (lining), you may not see a reduction in the mucus that you are rinsing out. Note that, when inflammation has been chronic, it can take months to reverse that inflammation with rinsing. Also try to determine what the cause is, and eliminate that (easier said than done).
      Best success. Thanks for visiting, and please keep us updated.

  18. Thanks for your response. We will see whether we can identify the source of the inflammation through careful monitoring.

    As I see it – understanding, managing and curing CRS requires teasing out issues from a multi-dimensional space. I’m currently reading about isolating the cause of allergies, tackling biofilm and restoring normal cilial function.

    It appears that regular sinus rinses can help in each case. If we don’t see improvement in a few weeks, I’ll ask about getting a CT scan.

    Thank you again for your site.

  19. Doc,
    Great site. I’ve had two FESSes, a mini in ’06 and a full in ’11. Funny thing is I still get infection flare ups (chronic pan sinusitis) but I can now still breathe. However, the maxillaries remain troublesome. I use a neti to get to those then use a neilmed to flush what’s rmaining of the ethmoids etc. I’ve recently been termed a “refactory” patient and seem to have been brushed off as there is nothing further my ENT can do. In other words, the pain, the smell, and the infections are here to stay, live with it. Oh, wait, the perforated septum that was a result of my septoplasty can be fixed. While I hate the whistling (makes it tough to fall asleep), I’ll live with it for now. Anyhow, what I can’t find is how long (in days) does one do the manuka rinse? The same as an antibiotic therapy (10-14 days)? How many times a day? One or two? Thanks for your site and time.
    Bill G

    • Russell A. Faust, PhD, MD says:

      Hi Bill, and welcome.
      Sorry to hear about the surgeries and the residual perforation. Bummer! And annoying!
      Regarding the Manuka: there isn’t any great formula for success. I think that the results are multi-factorial, and will be affected by the specific species of micro-organisms that are responsible for your chronic sinusitis, what their particular sensitivities are toward Manuka – that is, whether Manuka can help kill those specific species, and how your immune system responds to your infection.
      Having said that, I think that you should consider treating a truly CHRONIC sinusitis for a long time – consider daily rinses that include Manuka honey for a month or more. There is no down-side, except the expense of the honey. For my own chronic sinusitis, I do single once-per-day saline nasal rinses. When I was treating my chronic infection, I added Manuka for a couple weeks. I also added a great Probiotic (Integrative Therapeutics) to my daily regimen at that time. Hard to say which helped more to cure my chronic infection – the Manuka or the Probiotic, but my continued use of daily Probiotic has kept me free of another acute sinusitis! Whoohoo!
      Thanks for visiting, and for sharing. Please keep us updated on how things go for you!

  20. Dear Dr.,

    Love the site, as does everyone and for good reason. It’s a huge breath of fresh (pollen-free!) air to finally have a dialogue that doesn’t involve constant prescriptions. Anyway, thanks.

    Now to the complaint: I have serious allergies- to just about everything except food and my worst, most intolerable symptom is the swelling shut of the nasal passages. During the day, I can deal with it, but at night… I can’t sleep, I get up exhausted, no energy etc. I have an 18 month old and here comes the quandary— I’m 7 weeks pregnant and really hesitant to take my previous meds. I was on Flonase and Singulair which helped me immensely, but I’m looking for some answers that don’t involve constant drug-use.

    I have a nasal irrigator and I guess my main question is: HOW LONG WILL IT TAKE TO BE ABLE TO BREATHE AGAIN?! And, will this help me, really? Like REALLY? Also, do you have any other suggestions for a pregnant woman struggling with breathing/inflammation? I’d do just about anything at this point for a little relief. Even light drugs (OTC etc. known to be safe and effective for pregnancy)

    Thanks in advance,


    • Russell A. Faust, PhD, MD says:

      Hi Genna,
      Thank you for your kind comments. I really appreciate that!
      My question is this: did you have “allergies” before your pregnancy? Many women develop nasal stuffiness and runny nose ONLY during pregnancy, believing it is allergies, when in fact it is often “Pregnancy Rhinitis.”
      In either case, you definitely CAN reduce your symptoms using a variety of tactics.
      I am putting the finishing touches on my eBook that explains how to manage Pregnancy Rhinitis. Be patient, it should be available soon.
      Thanks again for visiting, sharing, and for the compliment.
      Please tell us what has been working for you, and not working for you.

  21. Hi Dr. Faust- first of all thank you very much for putting this site together-it’s great.

    I have a question related to rinsing- I recently had a balloon sinuplasty on the maxillaries and frontals and turbinate reduction on the two inferior turbinates (microdebrider on submucosa tissue only). I have had some nasal dryness in the past, but upon discussion with my surgeon he believed a slight reduction of my hypertrophied turbs would still bring me some benefit over the swelling I’ve been getting.

    Bottom line, I did the surgery 10 days ago, and I’m definitely very dry. I’ve been rinsing about 3 times a day and using Ayr gel, but I’m starting to wonder if part of my problem is I am actually rinsing too much. Today I am going to try to knock it back to once a day and see if that helps.

    Second question- is it common to feel this dry after surgery? I’m really hoping this is just a recovery issue and not a long-term complication (these ’empty nose’ and ‘dry nose’ conditions horrify me!).
    -Mike G

    • Russell A. Faust, PhD, MD says:

      Hi Mike,
      Without having your complete med history and without having examined you myself, I simply cannot provide much useful advice.
      I will say that it is still quite early to begin judging the results of your surgery. Healing and changes will continue for some months, so try to be patient. It will take a long time for the “muco-ciliary” clearance system to bounce back following nasal / sinus surgery, again, often months. In my opinion, you CAN rinse too often, but 2-3 times per day should be okay, especially for the first month following surgery. That will help compensate for the cilia not working entirely normally, and will help minimize crusting and scar formation.
      It sounds like you are in good hands.
      Thanks for your kind comments, and for sharing. Do let us know how things turn out for you.
      Happy and Healthy New Year!

  22. Dr. Faust….did I do more harm then good….I have sinusitis and taking amoxicillan…hate the drainage taste in mouth and smell so I started using the irragation minus the honey…..I was irrigating 7 times a day…Im stopping to only 2 times a day….but will my sinusitis still go away with help of the antibiotic and irrigating 2 times a day…or will i need to start over….geez…y didnt I see this sooner :-( thank you Hope

    • Russell A. Faust, PhD, MD says:

      Hi Hope,
      Take a look at my article, 5-Step Program to Eliminate Chronic Sinusitis:, for more tips.
      If you have not done this already, my advice is to develop a strong relationship with a trustworthy ENT doc.
      Beyond that, you should be okay with 2-3 times per day for your nasal saline rinses. Consider adding Xylitol, Manuka honey, or for truly chronic sinusitis, consider a couple drops (really, only a couple DROPS) of baby shampoo to help eliminate the biofilm that is produced by the bacteria that cause chronic sinusitis.
      Best success, and thank you for sharing. Please keep us updated.

      • Dr. Faust….just to report my chronic sinusitis is nearly gone….didn’t c a big difference I a long time until I got my hands on manuka honey…wow…it works awesomly…..thank u so much…
        God bless,

        • Russell A. Faust, PhD, MD says:

          You are so welcome!
          Delighted to hear that you are well.
          Isn’t it amazing (and wonderful!) that something so natural and simple works so well, instead of just another course of antibiotics.

  23. Dr. Faust,

    My 7yr old has recurrent, horrible drainage down her throat! She tries to cough it out and clears her throat often. She sometimes chokes on the congestion! She does have asthma and allergies. Every doctor says her lungs are clear but they can’t give me an answer about the throat congestion. We used to use a sinus rinse which seemed to help but we can’t get it to work now. It just goes up her nostril and comes back out the same nostril. Nothing is getting through. Do you have any suggestions?

    • Russell A. Faust, PhD, MD says:

      Hi Michele,
      When nasal rinses no longer go up, through the nasal passage and out the other side, it suggests obstruction: either complete swelling of the nasal lining, or growth (hypertrophy) of the adenoid tissue (“adenoids”) in the back of the nose. It is pretty easy to see adenoid hypertrophy on a brief, simply “lateral neck xray.” Your pediatrician can order that. From your description, your daughter may have adenoid hypertrophy obstruction, or even chronic indolent adenoiditis. Natural remedies that I have seen provide some reduction in adenoids include regular nasal saline rinses (even it they don’t seem to be ‘going anywhere’), and a daily probiotic. The probiotic helps improve natural host immunity and displace pathogenic bacteria.
      Now, having suggested those things, this is one area where most children benefit from adenoidectomy. That’s right: surgery to remove the adenoids. The good news is that an adenoidectomy is not nearly as uncomfortable (painful) or risky (bleeding) as a tonsillectomy. And most children with asthma experience a great benefit by having that reservoir of bacteria (and virus) removed.
      Thank you for visiting and for sharing.
      Please to keep us updated on how your daughter does!

  24. Hi Doc

    I started suffering from symptoms of fatigue and low immune response in Nov 2011 after a bad throat infection requiring AB’s. I visited every specialist including an endocrinologist and was ultimately told it was psychosomatic and I needed stress therapy. The symptoms continued even though reducing the stress did help somewhat but I still knew instinctively that something was wrong. I couldn’t even go for a gentle run without it provoking symptoms of illness and that was a give away as to the physical vs. psychological nature of the problem. As a keen athlete no wonder i was starting to suffer from depression! I just couldn’t take my daily “medicine”.

    I was referred to an alternative practice that started with a thermal scan and the results were horrific. From the neck up I was a red and white (hottest) mess. I was chronically inflammed. Long story, short was that after almost one year of malaise I started with nasal irrigation and 6 weeks later the results were amazing and the inflamed areas were almost all clear. I have however a few questions to ask.

    1. Why did an earlier CT reveal a far lesser problem than the thermal image?

    2. I have found that even though I feel far better that environmental heat kills me – for example a shower or steam inhalation causes the nose to immediately block up and temperatures above 90 deg drag me into the doldrums – my nasal passages swell up and over a few days many of the symptoms return. Cold compresses on the face help yet I can find little literature that suggests cold extolling warm compresses. Is this usual?

    3. Could the fact that up till last week I have been unknowingly using a hypotonic mixture (less than 1/4 teaspoon per 250ml mixture) have contributed to the over swelling of the nasal passages? I read that isotonic or hypertonic was far better? I started a few days ago and it does seem to be better but temps are lower so it’s difficult to confirm.

    4. I was told to take NAC (N-Acetyl-Cysteine) to help thin the mucous as a long term treatment. Any experience in it’s effectiveness?


    P.S. I would love to mail you the images of the before and after scans that shows what a change even gentle theraphy can achieve.

    • Russell A. Faust, PhD, MD says:

      Hi Brian,

      Thanks so much for visiting, and for sharing your story. Sorry to hear about your struggles.

      I’m afraid that I don’t know much about the thermal scanning modality that you describe. Please send me some links so that I can be educated. Very interesting.

      Yes, hyPOtonic saline will definitely add to mucosal swelling. At the very least, try to use ISOtonic saline, if not hyPERtonic saline.

      If you try hypertonic saline, you may notice a burning sensation, especially if you have chronic inflammation of the nose and sinuses (rhinitis / rhino-sinusitis). I have a long experience with chronic rhinosinusitis (CRS). The I got around that problem – trying to make the solution hypertonic, but avoid the burning sensation caused by adding so much salt – was to make the solution hypertonic by adding something other than salt.

      The solute to add is sugar – in the form of HONEY.
      I simply make up an isotonic solution, and add a couple tablespoons of honey to the warm mixture. For best results, I use Manuka honey. Whereas all honey has natural antibiotic (anti-bacterial and anti-fungal) activity, Manuka has several agents that make it a particularly powerful antimicrobial.

      It sounds like you are doing all the right things, and I am also a fan of NAC, very effective.

      The other things that helped eliminate my own CRS were a daily probiotic to help return my microbiome to an appropriate balance, and adding Xylktol to my nasal saline rinses, and also using nasal spray that contains Xylitol on a regular basis. By “regular basis” I mean multiple times throughout the day – basically every time I wash my hands.

      You can find all of these through the boogordoctor’s Amazon Store affiliate link, on the right side of this blog.

      Thanks so much for sharing.
      Please keep me updated.

      • Thanks Doc, very useful indeed. I have added the Xylitol into my saline mixture and got hold of a Xlear nosespray. Let’s see how it goes for the next while. I have certainly felt clearer since moving to a hypertonic solution.

        Just a quick question. Manuka honey is pretty scarce in South Africa. Does Xylitol do a similar job (make more hypertonic) and can one use any natural honey for a similar effect?


        • Russell A. Faust, PhD, MD says:

          Hi Brian,
          Manuka is scarce everywhere. I buy mine on Amazon (see boogordoctor’s Amazon Store on right side).
          Take a look at this site for Manuka in South Africa:
          To answer your questions:
          1- ALL honey has anti-microbial activity. Manuka simply has the strongest anti-microbial activity, and a couple anti-microbial agents that are not found in other honeys.
          2- Yes, you can use honey or Xylitol to increase the osmolarity of the saline rinse. That is exactly what I did to eliminate my own chronic rhino-sinusitis: I made up ISOtonic saline, then added both Xylitol and Manuka honey. In addition to making it HYPERtonic, both the Xylitol and the Manuka help to kill the bacteria that cause biofilm. Win-win!
          Thanks again for visiting, and for sharing,

  25. Hi Doc

    As promised here are a few links on the thermal imaging I mentioned. In my case the images were indicative of CRS with gingivitis and otitis media on the left side to boot (caused no doubt by the CRS)? The strange thing was that the ENT sent me earlier for a CT scan and whilst there was indications of “mild mucosal thickening in the one sinus”
    he was a little dismissive of the problem. My main symptoms were dizziness, light headedness and general malaise.

    The great thing about this imaging is that it was done in the rooms as part of the consult and was a fraction of the schlep and cost of a CT scan. I am not saying that it is the answer to world hunger but for me I could’ve given myself a diagnosis based on the heat patterns I saw – it was blindingly obvious. I have the before and after images but would need to send them as attachments not via the blog.

    Hope this interests you as much it did me.

    • Russell A. Faust, PhD, MD says:

      Thanks, Brian,
      VERY cool!
      I will need to continue my education in this modality.
      Thanks again for sharing!

  26. I am so glad I stumbled onto your website! I have had issues with allergies and sinusitis since before I can remember, and it just seems to keep getting worse over time. Last spring I had multiple rounds of antibiotics and steroids, had a CT (first ever- I try to stay away from the rads unless absolutely necessary) which showed Haller cells, paradoxical turbinates, hypertrophied inferior turbinates (tiny amount of space there on a GOOD day), blah blah blah- bunch of structural stuff and still some residual gunk. After that round I had about 4 more bouts of sinusitis (that I managed without the antibiotics, with rinses) and finally enough was enough. I had a planned septo/turb, tonsillectomy (horrible stones) and stereotactic fess for 12/21/12 (yay- Merry Christmas!) but my insurance denied the fess “lack of medical necessity”- I had to be treated with antibiotics for every single episode. I was so irritated. So, decided with my ENT to go ahead with the remaining surgery to see if that would help at least open me up some. Surgery and recovery went great- until 12/31 when I had my first post-op sinus infection (I was due). Started on a z-pack. That night started a nightmare. I will spare the gory details- but I ended up with infectious colitis with GI bleed and spent the new year in the ED. Never been that sick in my life or in that much pain- and I’ve had two kids. Left me very debilitated. About two weeks later I ended up with pleurisy. And then last Thursday I thought I was having some allergy attack (I’m allergic to every tree, grass, weed in the region, on shots), took Benadryl and that didn’t touch it. Ended up with some viral type deal- headache, fevers, pain everywhere, “stuffy” but s/p turbs much less so- went on vacation to CO and am now at 10k ft where the air is so dry and thin- ugh!! Progressed into sinus infection, bronchitis, and to round out the trifecta, now laryngitis. I am so not a happy camper right now. I cannot take any antibiotics due to the colitis being so recent- told them if this got bad they could always intubate me, but I can’t go through another bout of colitis, particularly as debilitated as I am. Before the surgery I was running about four miles comfortably, now I get winded taking laundry upstairs, and that was before this latest trifecta started… And at sea level.

    So- I’m managing with 2x/day sinus rinses and an inhaler for the bronchitis (I also have asthma, but very rarely a problem- only if sick or bad allergy attack). The post-nasal sludge is obviously gross and causing a sore throat- almost to the point of post-tonsillectomy. My question is- can I increase the rinses or am I going to offend the cilia- God forbid I piss off one more thing in my body! Oh, and as an aside- my insurance approved my sinus surgery on appeal 1/2/13 &@!?! Going to take a bit before I can go that route now!

    Sorry for the long post- love your website! Glad to see there are options for kiddos too, since both mine seem to be following in my footsteps, the bulb syringe comes out but that’s none too popular. They’ve rarely been on antibiotics- for the whole fam we have a ten day sick rule before we go that route unless clearly bacterial (or in the post-op window as was my case). We can add morning rinses to the tooth brushing routine;)

    • Russell A. Faust, PhD, MD says:

      Hi Julie,
      Not a problem to share. Space is cheap :))
      Yes, you can rinse several times per day, but you do risk disturbing the cilia by doing more and more rinses. On the other hand, any chronic inflammation that you may have is already disturbing the cilia, so given the alternative, rinses are probably healthier than fewer. For truly chronic rhino-sinusitis (CRS), consider adding either Manuka honey or Xylitol (or both) to make the rinses HYPERtonic. This will help to reduce the swelling which, in turn, will increase the air flowing normally throughout the sinuses.
      In addition, both Manuka and Xylitol have strong anti-microbial activity. The honey also has the added benefit of being strongly anti-inflammatory.
      DO NOT use a bulb syringe. Get your hands on the BPA-free plastic squeeze-bottle (mine is from / no financial affiliation) – it’s much easier to use than the Neti pot.
      Let us know how things go for you!
      Thanks for visiting, for sharing, and for your kind comments.

  27. Hi Doc, I’m not sure how I missed your site on any of my many forays on the net looking for info on post-nasal drip, rhinitis, etc. Anyway, glad I found it – lots of great info. I have asthma and frequent congestion. Over the years I’ve been on Nasonex, Flonase, Nasonex, Avamis and most recently Omnaris. About a year and a half ago, I moved to a high humidity/mold area and have had post-nasal drip ever since. Flonase wasn’t working, so started Avamis and a sinus rinse, which were helpful but didn’t stop the PND. I finally figured out that dairy increases my PND, so no more dairy – but I still have PND, just not as bad. It was relatively controlled on Arius and no dairy, but ENT gave me Omnaris, which I started about 2 weeks ago and have PND for last week. I stopped the Omnaris a couple days ago but still have PND and its driving me mad. I’m using a sinus rinse again, even though it typically dries my nose out and gives me constant nosebleeds. also, oddly it makes my ears instantly itchy, which seems to be highly irregular. I can’t find a common thread on that anywhere. I have to put Benadryl cream in my ears.right.away or.I start poking at them and then they really hurt. Any suggestions on the itchines and PND? They.are driving me mad ;P
    Thank kindly!
    Kerry (please ignore everything after this line, I’m typing on my phone andthe curser kept repositioning -I’ve spent 30 mins trying to cut the rest of itks kindly! help would be appreciated! I.m so fed.up!nd hhave had PNd for the last week – even with the ARIUS At that dairy increases the PND for me – so no no no dair anymore; however still have PND, it’s juss s and a sinus rinse. They helped but didn’t eliminate the problem, so I started taking Arius. startedave post-nasal drip to the degree that I take Arius daily and still have symptoms at nigbt

    • Russell A. Faust, PhD, MD says:

      Hi Kerry,
      Two issues:

      (1) Things that have helped decrease my own pnd include anti-inflammatory supplements, specifically Quercetin, and Curcumin. The Quercetin is not easily absorbed, so most supplements include Bromolain to help absorption. Integrative Therapeutics makes Iso-Quercetin. I have been using that for a month now, but I can’t say that I detect any huge difference between that and the Quercetin with Bromolain (Orthomolecular Dehist). You can buy both the Quercetin ( and Curcumin ( on the boogordoctor Amazon Store. The cost is the same to you, but buying through that affiliate link helps keep this site going.

      (2) The itching: a small minority of people will have ear complaints or ear sensations associated with nasal rinses. Here is why: the ear is innervated by 5 sensory nerves. These same nerves also innervate the ear canal, the middle ear, the Eustachian tube, the back of the nose, and the back of the throat. So for you, when you rinse your nose, it stimulates the nerves that innervate your ear canal, giving you the itching sensation. Annoying, I’m sure. Probably still worth continuing the rinses, though.

      Thanks for your kind comments, and for sharing your experience here.

  28. Hi Dr. Faust,
    I have struggled with sinus infections and allergies (every season) my whole life and now that I’m pregnant (3 months along) my body just can’t seem to shake the infection like it usually can. This infection started with the usual colored mucous and some sensitivity in the nerves in my top teeth, followed by full blown fever and severe congestion. I have been doing the nasal rinses all along (I use a plastic squeeze-bottle), but finally had to take antibiotics (azithromycin). I finished the antibiotics about a week ago and was feeling better. However, about a day ago I noticed that faint sensitivity starting again in the nerves in my top teeth and some colored mucous again. I’m extremely frustrated because I think that the infection is back, or that it never went away. What can I do?
    Thank you for your help,

    • Russell A. Faust, PhD, MD says:

      Hi Joanna,
      Sounds frustrating.
      Time to see an ENT doc!
      You might consider visiting an Naturopath, also (ND). One of my own personal physicians is a ND.

  29. Jessica says:

    I love your web site and the helpful information you provide. Like others I have seen great improvement since I started nasal washing. I use both the Neil Med Sinus Rinse bottle when traveling but primarily use the SinuPulse pulsating rinse system which I find cleans better and reaches areas the nasal wash bottle does not. It also minimizes the pressure on my ears when I am severely congested. I have had a great results with Xylitol and GSE added to my saline rinses and may try the Manuka honey if I find myself battling another infection but since using the SinuPulse regularly I have been infection free. I read elsewhere that a teaspoon of Johnson’s Baby Shampoo added to the saline solution can be quite helpful for a sinus infection. Any thoughts on this?

    • Russell A. Faust, PhD, MD says:

      Hi Jessica,
      Thanks so much for your kind comments about my site!
      You mention GSE: for everyone else, I think you are referring to grape-seed extract. I thank you for mentioning that, as I have not written about this effective addition to nasal saline rinses.
      I want to caution you about baby shampoo: I have used it myself – and it was helpful in eliminating my own chronic rhinosunusitis – but I would reduce the amount used to just a few drops (perhaps a third of a teaspoon at most) for a bottle of saline rinse! Despite its ‘gentleness,’ it is extremely irritating to the nasal and sinus lining. In short: it BURNS! Go easy if you try adding baby shampoo to your rinses. The only other recommendation I have for you is to consider the Nasopure system for your rinse supplies ( They are a smanll, US-based, mom-and-pop company, and their rinse bottles are BPA-free. Be sure to check out their videos when you visit the website, and also the book by Dr. Hana: Clearing The Air One Nose At A Time. Good book. (for transparency: I have no financial relationship with Nasopure; I simply think they have great products and are a great company).
      Thanks again for your kind comments. Thanks for visiting, and for taking time to share.

  30. solar power iphone charger says:

    Thank you for the help! It’s been so very much appreciated!

  31. Hey there! How often and how should I clean my sinus rinse bottle after each sinus rinse? Is it okay to use tap water to do so??

    • Russell A. Faust, PhD, MD says:

      Hi Gabby,
      I use tap water, but NOTE: amoeba are plentiful in the tap water, especially in Southern (warm, humid) states! Those are a risk, as there were a couple deaths last year that were traced to amoeba in a home’s plumbing, and that tap water used for nasal rinses. Go to the right-hand column of this blog and search “amoeba” – the first article describes the risks of tap water, based on an interview with an amoeba expert (really, they exist :))
      I clean my rinse bottle occasionally with bleach, but more often simply place some tap water in it and boil it in the microwave. That sterilizes it!
      Thanks for visiting and sharing!

  32. And how exactly do I even clean my sinus rinse bottle??

    • Kim Starkey says:

      Baby shampoo everytime and peroxide weekly.

      • Russell A. Faust, PhD, MD says:

        Hi Kim,
        In my experience, both baby shampoo and peroxide are pretty harsh.
        Manuka honey is mild and gentle on the tissues, but is a strong antimicrobial.
        Do give it a try.

  33. John Sigmon says:

    Hi Dr. Faust,

    If I’m using Nasopure once a day to treat rhinitis, what is the optimal amount of solution to use per day? Is it OK to rinse with the full bottle (8 ounces) everyday or should I be using more/less?

    Thank you!!

  34. Morris Ryan says:

    I have been experience a bacteria colony infection for the past 2 years. The colony has affixed itself to the Choanae/nasopharynx area in the right nasal passages. I have been a fan of your site for a long time now, and have tried the Manuka Honey – but always only get temporary relief of symptoms. Have also been on antibiotics for the past 2 years, almost continuously to put down flare-ups of bacteria activity.
    ENT doctors have told me to try Betadine — I have, off-and-on for the past year and it helps holding down bacteria flare-ups. I use Betadine in my nasal rinses and gargle to remove/reduce pathogen build up on the soft palet/throat areas.
    Your thougts on Betadine?

    • Russell A. Faust, PhD, MD says:

      Hi Morris,
      Betadine is an iodine-based bacteriocidal agent. Unfotunately, it is also tissue-toxic, and is not very friendly to your ciliated respiratory epithelial cells. Do a search for “betadine tissue toxicity” or “betadine tissue injury” for more in-depth reviews. Have you considered making an appointment with a different ENT doc, just for another perspective?
      Thanks for sharing, and best success!

      • Morris Ryan says:

        Thank you for your reply and caution on Betadine — will give it up in the nasal canals and use only Manuka Honey for now.

        I have been seen by 3 different ENT clinics in the Seattle area during the past 2 years. The last clinic was at UW Seattle Medical where Dr. Weymuller, this past August, operated on my sinus and nasal passages to open them up. Was prescribed and using MUPIROCIN 5GM IN SAL NASAL. Last week the application of Mupirocin started causing my nasal membrane to swell up, causing a feeling of extreme congestion.

        Last post-op visit I was prescribed Azithromycin 250mg, 1 tablet every other day, in hopes it would put a stop to the up and down effect of infection and then temporary relief provided by antibiotics. (Persister cells coming active?)

        I really enjoy your web site and have directed my kids and grandkids to it. Thank you for the web site and your response.


        • Russell A. Faust, PhD, MD says:

          Hi Morris,
          Thank you for your kind comments about this site. Dr. Weymuller is one of the best in the world, so you are in good hands. Do give the Manuka a try. It has helped so many, including me.
          Thanks for visiting, and please keep me updated.
          Best success!

  35. I stumbled across your website and the information here is great!! I purchased the manuka honey over the weekend for my 5 year old son. He has had a few sinus infections and we’re trying to do things naturally. We started a nasal rinse (neilmed) last week and he’s doing okay. The water doesn’t seem to come out the opposite side, but we’re still trying because stuff is coming out of his nose when doing the rinse. I am wondering if we’re not putting enough pressure when squeezing because he sometimes jumps as he is getting used to this process.

    How much manuka honey would I add to a 4 oz rinse? I tried 1 tsp. the other day and when I did the rinse he cried that it burned. I am using the packets that came with the bottle (it’s the pediatric kit). Also, would doing nose drops with the manuka be more effective?

    Thank you!!!

    • Russell A. Faust, PhD, MD says:

      Hi Suzanne,
      First, please go to and watch the videos of rinses for kids. Awesome site, great resource. That site should answer most of your questions about rinses for children. Nasopure is the rinse system that I use personally (no financial relationship): I like the fact that Nasopure was started by a Pediatrician (Dr. Hana); is a small, mom-and-pop establishment of Dr. Hana, her husband, and a single employee; based in the US (Missouri); and high-quality.
      Next: For an 8-oz rinse bottle, I add about two large tablespoons of Manuka. It’s a bit of a challenge – I use the handle of a cheap metal spoon. It’s thin enough to slide into the mouth of the rinse bottle. I scoop up some Manuka, slide the handle into the rinse bottle, and swipe the honey off against the inside; repeat until I have added at least two tablespoons of honey.
      It’s okay if the rinse does not come out the other side; it’s enough that you rinse each side. The rinse will help reduce swelling, and should eventually open things up. I wouldn’t bother with adding Manuka to the nose drops – adding Manuka to a solution that sits around for awhile is an invitation to contamination.
      One caution: if you heat the rinse solution, be gentle: over-heating Manuka can destroy the enzymes and other benefits.
      Thanks for your kind comments, for sharing, and please keep me updated.
      Best success!

      • Thank you so much for your response!!!!! I greatly appreciate it! I did purchase the nasopure tiny bottle for my son. We tried it with the solution but he started to cry because he said it burned. I think that solution may be more hypertonic than the Neil med. We’ll keep trying! I added a tsp. of the manuka to his rinse but he said it burned. He’s taking the manuka orally and I’m going to try the drops but I’ll just make enough for one use at a time. We have a follow up at the ENT Monday. My son’s pediatrician feels he should have an adenoidectomy but I’m trying to see if we can get by first with some natural things. Thank you again and I hope with continued use we it will work!

        • Russell A. Faust, PhD, MD says:

          That’s odd. I’ve used both (used NeilMed for years, until all the articles exposing their unfair labor practices). Noticed that the Nasopure saline burned LESS when I switched to that. Add a little more water, and perhaps a little Manuka – the sweetness helps when you’re dealing with children. But it’s NEVER fun to rinse a child’s nose. Be sure to watch the videos on Nasopure, and include your son. It’s good for him to see other young children doing the rinses all by themselves. I agree with you regarding avoiding surgery, but an adenoidectomy is very low risk, and nearly painless (nothing like a full tonsillectomy), and has huge potential benefit by removing that reservoir of pathogenic bacteria and mold.
          Thanks for sharing, and do keep me updated.

  36. lucy ball says:

    i have pseudomonas for 6 months, is it ok for me use manuka honey with hypertonic saline rinse
    once a day. or would colloidal silver be better.
    please advice.
    thank you

    • Russell A. Faust, PhD, MD says:

      Hi Lucy,
      I don’t have much experience (like, any) with colloidal silver, but my friend, Dr. Robert Ivker, is an advocate. Be sure to check out his book, Sinus Survival (I bought mine from Amazon – see the boogordoctor Amazon Store on right column of this blog). Also note that Manuka has been tested, and has worked well against pseudomonas in the laboratory and in clinical trials.
      Thanks so much for visiting, and for sharing. Please keep me updated.

  37. Valerie Milo says:

    Hi Dr. Faust,
    I have had some correspondence with you before about my CRS. To recap, oh boy, I’ve pretty much tried everything, supplements, diets, etc. I’m overall a healthy person, eat well, rarely eat dairy or gluten, I exercise & do yoga… I’ve been on many antibiotics & steroids over the yrs, which only seem to help temporarily. Then the infection soon returns with bad inflammation & infection. I do saline rinsing regularly & have for years with the Grossan Sinupulse Irrigation Machine. I had balloon sinuplasty back in April & ENT was able to flush out some blockage from my forhead sinus. But overall no other obstructions she thinks are causing the CRS. I immediately felt relief after the sinuplasty & because the swelling was down I even looked like a different person! (That’s how bad the inflammation was/is). I realized after a few wks when I finished the meds (more antibiotics & steroids), it was mostly the meds that relieved the inflammation & sinus infections were back. I have been tested for allergies, & only tested positive for mold. Living in Houston where it’s hot & humid, I wonder if that is the culprit along with my body reacting to yeast buildup from the antibiotics. Allergist thinks it’s bacterial more than allergies. I now regularly take Yeast Cleanse by Solaray & felt some improvement for awhile…but with my kids always catching colds & passing them to me, it is so hard to tell what keeps causing this CRS. My ENT thinks it could be biofilm & also prescribed me the antiobiotics saline rinses 2x per day for a month. Helped but 2 wks after I finished sinus infection returned. I have used the manuka honey rinses you recommended & I think they helped a little for awhile but here is my question. If I have a stubborn biofilm problem, I’m guessing it’s deep in my sinus passages because I can usually breathe through my nose. However, you can hear in my voice I am congested. What is the best method of irrigation to get the manuka rinse as far back into my sinuses as possible? I also was adding the drop of baby shampoo. The Grossan uses 8oz. & I was putting 1 tbsp of manuka but I just read you put 2 so maybe I need to bump it up. I tried the eye dropper method & felt like it penetrated my sinuses more deeply but found it very uncomfortable, making me gag & almost throw up each time. Not something I felt motivated to keep doing. I’m most comfortable using the Grossan. When I’m irritating with the Grossan, I feel like I have to suck it up into my sinuses & continually blow it out as I’m rinsing, otherwise I don’t feel like I’m really getting in deep enough (I think because of the congestion). I have found little relief from steroid nasal sprays. I usually quit taking antihistimenes after a few days because I’m so darn tired I can’t keep up with my kids. Sudafed 12 hr gives me relief from severe sinus pain but gives me heart palpitations after a couple days. I try to stay drug-free because I am sensitive to medication. I prefer to go as “natural” as possible. My next step is also to go to naturapath dr. You recommend that before too but I’ve been so busy I haven’t gone yet! But will! So overall, my main questions are about how to get the manuka rinse to really penetrate my sinuses? And any other suggestions you may have! THANK YOU! I love your site and have learned so much from you and others who comment. I feel I am lucky it is me and not my children. They seem to just get the snots & get over it. I always ends up with this chronic sinus infection absolutely affects the quality of my life :-/

    • Russell A. Faust, PhD, MD says:

      Hi Valeri,
      I feel you pain: sounds miserable.
      It sounds like you have tried most of the “remedies.”
      There are so many possibilities for the cause of your challenges!
      My best advice is to find an “integrative holistic” physician who can assess you very thoroughly, systematically. In my own experience, my own favorite physician is a “naturopathic doctor” – an ND. She is one of the smartest and most capable physicians I have ever met. Regardless, I urge you to seek the medical opinion of someone who will evaluate and treat the “whole” you – someone holistic.
      Thank you so much for sharing, and I apologize for being unable to provide advice at a distance without examining you.
      Best success on your journey to health!

      • Valerie Milo says:

        Thank you Dr.Faust. I am currently seeing a holistic Dr. who is an MD, Chiropractor, & uses acupuncture & Chinese medicine. He’s got me on some herbs & does some pressure point work. I’m hopeful but at present still sick. I also found out something VERY INTERESTING that I had never heard before. I have Hashimoto Thyroidisis with very high thyroid antibodies. I happened to come across a forum where sufferers from this complained of chronic sinusitis because facial, sinus inflammation & weekends immune system can contribute. Wow! I had never heard that before! This (like many auto-immune disorders) can be corrected with diet so the holistic Dr is trying to find out what my body is having an autoimmune response to. I have cut out gluten & dairy because I read gluten is a huge factor & Hashimotos is often associated with Celiac. Anyway, I am lethargic but do not have any of the other symptoms such has hair loss or dry skin. Have you ever heard of CRS related to thyroid conditions? Also, I love you, but you didn’t answer my question :-) about which saline rinsing method penetrates the most deeply? I ask because I can usually breathe out if my nose but my congestion (& infection) is deep. I currently use the Grossan Sinupulse & feel very comfortable with that. The eye dropper method makes me gag severely! The squeeze bottle I thought might not penetrate as well as the Grossan…any thoughts? I’m currently doing Manuka rinses to try to rid myself of this persistent CRS.

        • Russell A. Faust, PhD, MD says:

          Hi Valerie,
          Thank you for your thoughtful note.
          I have not used Dr. Grossan’s Sinupluse, but I have heard very positive reviews from patients and others.
          My own personal choice for daily nasal rinses is the squeeze bottle from (no financial affiliation).
          In addition to Manuka – or as an alternative – I have used Xylitol (10%) in my nasal saline rinses. There are many benefits. Here is the blog post:; and here is the link to buy Xylitol from Amazon:
          Best success, and please let me know how things go for you.

  38. Hi,

    I recently had a bad cold with bronchitis and now almost 2 months later, I find I can’t smell or taste still. it’s cold anosmia. I have haller cells, mild chronic sinusitis, concha bullous, a retention cyst in the maxillary sinus and a mild deviated septum. both ENT’s I saw said this shouldn’t be the reason i can’t smell or taste. they have no answers for me. it is causing me a lot of anxiety and depression.
    I can’t seem to clear my nose. it’s not really stuffy but very dry and inflammed and it’s like the air isn’t getting up there even though I am not really congested. if I put something really strong really close up to my nose, I can catch a whiff but its dull. I can’t smell the air. I lose anything I do catch a whiff of after a few seconds.
    I have been using simply saline but I am blowing my nose way too often. will this cause more inflammation and would this be the reason I am not smelling or tasting. would any of the conditions I stated be the cause for my lack of senses. has anyone else lost their smell and taste? what did you do and what helped? Will it come back and when?

    • Russell A. Faust, PhD, MD says:

      Hi Nanci,
      There are several possible causes of “anosmia,” including damage to the neuro-sensory cells in the upper part of the nose, caused by cold virus; alternatively, people with chronic nasal inflammation (from allergies, environmental pollutants, and other causes – mainly from smoking cigarettes) can develop nasal polyps. Nasal polyps can cause anosmia by obstructing the nasal passages. Anosmia can also be cause by rare tumors – both benign and malignant. Regardless, you should see an expert for evaluation.

  39. Hi – after describing my symptoms to my doctor (over the phone) he recommended NeilMed. I am heavily congested in my right nostril but have been using this for 5 days now and I can’t be completely blocked as the solotion is coming out of my other nostril. I do feel slightly better, but I think that is because my left nostril is clearer and seems to be compensating so I can breathe more easily, but my right nostril still feels heavily congested. I dont want to have to go to see GP with this unless I really have to, as I’m not in any pain or don’t feel ill, so it feels quite trivial. Is there any indication how long I should use this product for before I will really notice a difference. I can’t seem to find this information anywhere. I want to make sure I give this a good chance before I give up and have to go back to see doctor. Any advice would be appreciated.

    • Russell A. Faust, PhD, MD says:

      Hi Karen,
      Thank you for visiting, and for sharing your experience here.
      Most people notice an improvement within a week of using daily nasal saline rinses. If you continue to experience congestion or partial obstruction – especially if that partial obstruction is only one side – you must be examined by a physician, preferably a specialist. Please see you physician, request a referral to an Ear, Nose & Throat specialist for a thorough exam.
      Best success.

      • Thank you for your quick response – is there a possibility that this could be something quite serious?

        • Russell A. Faust, PhD, MD says:

          The correct answer is yes, it can always be something serious. Since I cannot diagnose at a distance, please see your doctor.

  40. Florence Januzik says:

    Hi Dr. Faust,
    I’m on my third round of antibiotic for sinus infection because the pain keeps returning. I am adding the baby shampoo rinse and the manuka honey rinse to this round of treatment. I know you’ve said not to do those rinses long term, but how long is OK? the antibiotic course is 3 weeks. thanks for any advice,

    • Russell A. Faust, PhD, MD says:

      It’s okay to do saline rinses long-term. But the cilia aren’t happy if you include baby shampoo in all your rinses. Manuka honey is okay, not at all toxic. Studies have shown that doing the rinses more than two or three times per day does not allow the cilia enough time to recover normal function.

  41. Dr. Faust,

    I have chronic sinusitis, and although I previously did sinus rinses during sinus infection flare-ups, I have recently began regular daily sinus rinses. I have also added in Manuka honey, but less regularly. However, it seems that when I use the Manuka honey, my sinus infection is exacerbated within a day or two (this has now happened on three different occasions). Perhaps I am making a false association, but I would appreciate your thoughts on anything that I could be doing wrong for the Manuka honey to be worsening the situation, or whether it might just not work for me. I am allergic to ragweed, but not much else.

    • Russell A. Faust, PhD, MD says:

      Hi Marcy,

      Thanks for sharing that observation. You may NOT be mistaken: for you, adding Manuka may alter your normal “microbiome,” or balance of microorganisms enough to open you up to infection. Or you may have a mild allergic reaction to the Manuka honey so that it causes swelling. Whatever the cause, my advice is to stay away from it. And thank you for sharing that experience. I’m sure you’re not the only one, and it helps when others find out they’re not alone.

  42. Gregory Holmquist says:

    Had FESS in January 2015. One week after surgery had infections that would not stop. Drainage was fine…no pain….just endless green. Finally they looked up my nose and discovered that the Propel stent had not dissolved. Dr pulled out the stent and cultured and it grew pseudomonas. Two days later I was doing great…and kept clear for 3 weeks, until the start of green started showing up again, but only from the side where the stent had been (and had cultured out pseudomonas). Things went up and down for 3 weeks, until I got a massive sinus infection in the ethmoids and frontal of the left side. Culture grew out pseudomonas. On Cipro now for 10 days. Questions 1) do you think I am getting biofilms? (I have tried the manuka honey for a few times, and it has made me dizzy…weird?? and only put 1 tsp per 240ml…any comments on the dizziness from manuka? When I used the manuka about a week about two weeks ago, then I had the flare up sinus infection…cannot figure out why…unless the manuka is breaking up biofilms and spreading the pseudomonas? 2) What is your opinion on the use of weak sodium hypochlorite solution (0.05%) to eradicate sinus biofilms or just kill off the pseudomonas? 3) other ideas?

    Thanks for your inputs.

    • Russell A. Faust, PhD, MD says:

      Hi Gregory,

      No way for me to know if you’re developing biofilm infection or not. However, I can say that pseudomonas species are notorious for their ability to form biofilms, so it would not be surprising if your recurrent infections are resulting from pseudomonas biofilm.
      Regarding the Manuka honey: by an interesting coincidence, I just answered another comment about a negative response to Manuka honey. It’s not a cure-all for everyone … if you’re having problems that you relate to Manuka honey, stay away from it.
      For folks who experience chronic rhino-sinusitis, check out my article, 5-Step Program for CRS.
      If you decide to try the baby-shampoo trick, be cautious! A little goes a long way, and start with only a few DROPS in a bottle of saline rinse.
      Thanks for visiting, and please follow up to let me know what works for you!

  43. Should you use more than one packet of saline solution at a time for better benefit?

    • Russell A. Faust, PhD, MD says:

      No, one packet of salt solution is adequate. But, in order to achieve a SLIGHTLY “hyper-tonic” solution, use one packet of salt solution, and don’t fill the rinse bottle quite to the full-line. That will result in a saline solution that is slightly more concentrated (hyper-tonic), and help reduce swelling in the infected or inflamed tissues. Best not to use hyper-tonic saline for daily rinses for long term, however; studies have suggested that regular exposure to hyper-tonic saline are irritating to the respiratory cilia.

  44. I want to express my thanks for your generous free advice and knowledge sharing.
    I am a fan !!
    Following an SMR as a 16 yr old I had been using a nasal decongestant several times daily for 40 years !!!! I was very heavily reliant on them to breathe through my nose at all. A true physical reliance. After reading the info on your website I figured that I had RMed. I did as you suggested: ceased spray, used hypertonic saline washes x 3 per day & bought an OTC steroid nasal spray. I used these as per your recommendation for 4 weeks.
    I have never needed to use the decongestant spray again since. Its amazing. So freeing. No longer a slave to the nasal spray demon !!
    Thank you, thank you, thank you. You’ve changed my life.
    I am forever in your debt.

    • Russell A. Faust, PhD, MD says:

      Wow! You are tougher than most, Bee!! Most folks with that sort of decongestant history have a much more challenging time of quitting. SOOoooo happy for you. And thanks so much for your kind feedback. Share the love … tell your friends :))

  45. Is it safe to use saline rinse & nasal steroid spray while taking DGL licorice and probiotics? I just had my ENT check-up yesterday and was given those meds. I didn’t tell my doctor that I’m taking alternative supplements as she may stop me from taking them. I’m getting benefits from DGL licorice and probiotics. I hope it’s fine to take them all together. I am on my second rinse and spray now. Hoping for your reply.

    • Oh, I forgot to tell you I was diagnosed with GERD July last year and I’ve stopped taking medications and opted for the alternative ones (DGL licorice, probiotics and digestive enzymes). I’m feeling great so far, though, I still have reflux 2-3x a week.

    • Russell A. Faust, PhD, MD says:

      The beauty of those “alternative” remedies is that they are completely safe. The “DGL” part of the licorice is the process whereby a compound is removed that caused severe lowering of blood pressure. And probiotics merely re-balance the GI microbiome – the normal bugs in the GI tract.
      Thanks for the update on your reflux. Based on my personal experience, most people can eliminate – or at least reduce – their reflux by just adjusting some behaviors (like not eating a “bed-time snack”) and using alternative remedies like DGL.
      Thanks so much for visiting and sharing! Please do keep me updated.

  46. Hello,

    As for maintenance for nasal saline spray you do once a day but do you spray 1 or 2 time in each nostril.

    • Russell A. Faust, PhD, MD says:

      Hi Anne:
      Saline used as a nasal spray – even with Xylitol added to it – is benign. So it’s okay to use it every hour if you like (although that’s a bit excessive :))
      Several times per day works well to help keep the lining moist, help keep pollutants and allergens and microorganisms rinsed out, and to help the cilia do their job.
      Thanks for visiting and for taking the time to write!

  47. Kim Parks says:

    I had a septoasty 1 1/2 years ago and my surgeon said to flush my sinuses and use a nasal spray twice a day for the rest of my life. If I keep up with it I’m fine. I do start to get congested if I don’t flush for 2 or 3 days. Now I’ve got a bit of a cold. Since I don’t have chronic sinus issues anymore I wondered if flushing twice a day is a good idea or not until I feel better. Suggestions?

  48. Dr. Faust, Thank you for the information you share on this website! I found your website in December after my newly turned 5 year old son (12/18/10) had a CT Scan done of his sinuses for diagnostic reasons after 3 months of respiratory sickness. October-December he’d been on 2 rounds of steroids, 3 rounds of antibiotics, 2-3x daily nebulizer with Albuterol and Pulmicort and had the scope down his nose. Nothing helped. CT scan revealed extensive paranasal disease, inflammation and blockage. No one had any suggestions. (In February 2015 he was in the ER with stridor at rest with croup, and had 3 more bouts of croup before becoming sick in October. Each time he was treated with oral steroids. He was diagnosed with global muscle myopathy at age 2. Respiratory wasn’t an issue until this year. He tested negative for CF this past spring).

    I found your case study on the 3 yr old, ordered Nasopure and began. A couple of weeks later he was doing much better. We enjoyed mid January/early February on maintenance mode. 2 wks ago he became congested again. A week ago it got worse and today he’s miserable with congestion and rattly chest. We use Nasopure faithfully 2x a day – he’s a trooper!

    We have an already scheduled Pulmonology appt tomorrow. A radiologist friend walked me thru his December CT scan images today and said his RT side cavities were almost fully blocked up to just below his eyes and his LF side about 50%. I want to push his pulmonologist for more answers on how to help him and see if his ENT can see him while we’re already there. Do you have any suggestions?

    • Russell A. Faust, PhD, MD says:

      Hi Candy,

      During your various visits to experts, someone, ether the Pulmonologist or the Otolaryngologist (ENT), or someone else, may mention “ciliary dyskinesia.” Given a youngster with frequent sinus infections and reactive airway (asthma) requiring treatment with antibiotics and steroids, some experts will focus on the possibility of “primary ciliary dyskinesia,” (PCD) meaning that when the respiratory cilia don’t function properly it results in greater respiratory infections. They may want to do “tests,” which usually means a general anesthetic for bronchoscopy and biopsy. They take a tiny (truly tiny) snip of respiratory lining from the bronchus, and test that for cilia that are abnormal: look at it under an electron-microscope, or place it in culture medium and look at it under a phase-contrast microscope to see how the cilia actually move. That’s all academically interesting, but none of that will actually change the way anyone treats your son’s episodes of reactive airway or infections. He will be treated the same way. Earlier in my own practice I would recommend the bronchoscopy and biopsy. After a couple decades of practice, I realized that the answer – “yes,” the child had PCD, or “no,” the child does not have PCD – did not change how we managed those kids.

      You’re doing a great job if you can get a 5-year-old to do saline nasal rinses!! Very impressive. I refer parents to the Nasopure website to watch the videos of kids doing them; children are often reassured to watch videos of other kids doing the rinses, seeing that it is not painful. But even so, NObody, not even me, likes doing nasal rinses.

      Note that CT scan results will vary dramatically, especially in children. According to statistics, kids aged 3-6 get 6 “colds” per year – some kind of viral upper respiratory illness. That means that they are ALWAYS either coming down with it, have it, or are getting over it. All the time. So a CT scan today may look terrible, but a CT scan two weeks from now un-impressive. Especially in children.

      My only recommendation for you is to minimize your boy’s symptoms, not to focus on the data (ct scan, lab tests, etc), but to focus on him, how he is doing. And again, if you can persuade your 5-yr-old to do saline nasal rinses, you’re an awesome parent! Thanks so much for visiting and for sharing. Best success.

  49. Hi.
    I’ve been using a neti pot once or twice a day for a couple of years. I love that I can breath better after using it.
    But I only use warm tap water, nothing else in it. So far I haven’t had any problems using just warm tap water.
    I don’t have sinusitis or anything, but, I actually snore badly, my ENT doctor says my nasal passages are narrow because of my turbinates so I’m going through a procedure with local anaesthetic to fix this. The doctor is using some kind of burning technique with a rod with I think he said radiofrequency.
    My questions:
    1. Is using just tap water for nasal irrigation okay?
    2. Is there any thing to think about, doing nasal irrigation, snoring problem and having the turbinates procedure?


    • Russell A. Faust, PhD, MD says:

      Hey Eric:

      Plain water in a neti pot, or even snorted up from a handful of water, is an old Ayurveda maneuver. If it works for you, great. But be aware of some potential issues: Municipal water – tap water – is increasingly infested with amoeba (ameba) the further South one goes in the USA. There have been cases of “brain-eating amoeba” meningitis resulting from use of Neti pot in the South, and the source of amoeba was traced to the plumbing. My recommendation is to use boiled tap water (let it stand covered to cool), or store-bought distilled water.

      The other issue is that water is very hypo-osmolar. That is, due to the difference in salt concentration between the water (no salt) and your tissues (isotonic salt concentration, or about 300 mOsm/L), fluid will flow toward the higher salt concentration. That means that the water will tend to move INTO the tissues lining you nose and sinuses. The result will be some transient swelling, causing congestion or stuffiness.

      At the very least, isotonic saline is preferable for nasal rinses with Neti pot or squeeze bottle. When you have severe congestion, say from a ‘cold,’ then using hyper-tonic saline for rinses can cause fluid to flow in the opposite direction: from the swollen tissues toward the higher salt concentration. That is, pulling fluid from the swollen tissues into the rinse solution. That can help reduce swelling and sense of congestion. Including reducing swelling of turbinates.

      I hope that helps. Best success.

  50. Thanks Russell,

    I’ve actually been using tap water for neti while living in Indonesia and now Mexico City for some years. Yikes! But so far so good. I hear if you make your own solution it needs to be used within 24 hours. Is that right? What I’d like to do is make up a big batch and keep in in a bottle in the bathroom and use as necessary so I don’t have to make it fresh every day.
    What do you think?


    • Russell A. Faust, PhD, MD says:

      “Yikes” is right! Huge risk of amoeba meningitis.
      Keep your “big stash” of saline in the ‘frig.
      Then aliquot-out (proportion some out) to a smaller bottle for convenient use.
      Otherwise, you risk growing fungus in the saline – not the sort of thing you want to flush your sinuses with.

  51. Richard says:

    I am so happy to read your site. Brief History: Sinus cancer, tumor removed, 8 week proton radiation directly to sinuses all of which resulted in CHRONIC sinus infections for 6 months. Nothing helped until I started using sesame oil/rose geranium oil emollients, xylitol rinses, and eventually manuka honey rinses. My question is this: you mentioned that all honey contains botulinus spores, should I be concerned with using raw manuka honey in my sinsues because of this? I’ve heard of medical grade/sterile manuka, but I’m really new to this.

    • Russell A. Faust, PhD, MD says:

      Hi Richard:

      Excellent question!
      Answer: I honestly don’t know the answer.
      In general, the risk of being exposed to the Botulinum spores in raw honey is similar to the risk of being exposed to all of the other spores that exist everywhere in our environment, all the time. The risk depends on the strength of your immune system. If you are currently on chemotherapy, I would stay away from raw honey while you are immuno-suppressed.

      Congratulations on surviving your cancer, and wishing you continued health and success!
      Thanks for visiting and sharing.

      • Thomas Dixon says:

        I have and suffer from chronic sinusitis with sinus infections 1-2 times per year–for 15 or more years. I am 64 years old. I believe I would have infections even more often if not for my once-or-twice daily sinus rinses. Non iodized salt, baking soda, and 1 drop of baby shampoo is dissolved in 12 oz. of warm tap water, and, listen to this: I use a 60cc disposable syringe to gently flush my sinuses, first right to left, then left to right and repeat. What could I be doing wrong?

        • Russell A. Faust, PhD, MD says:


          I have also used a 60cc syringe to do my nasal/sinus rinses. I have also tried the Neti pot, and virtually every squeeze-bottle on the market. I have settled on the Nasopure system for ease of use, for convenience of using their pre-packaged saline packets, and because I support their business model of a small American, mom-and-pop (literally) company. And, because Dr. Hanna (owner) is such a great pediatrician and friend to children!

          Thanks for sharing!

  52. Richard says:

    Thank you in advance for your help!

  53. I cured my sinusitis with baby Johnson’s shampoo (no tears).I mixed warm water with himalayan salt and 3-4 drops shampoo.I rinse 3 times a day for 5 days,I should do it for 7 but I was cured after 5 days.The problem with sinus bacteria is they make biofilms and no any antibiotic will destroy bacteria because is protected.The baby shampoo contain surfactant and is the single one to breake the biofilms.When biofolms breaking the symptoms are like cold and flu.
    But,despite I’ve got rid of the sinusitis I have another problem ,I have an open wound behind my nose between nose and throat and pus with blood coming from that area every morning.Night time when I sleep this discharge going in my lungs and I cough every morning .Before tested positive for staph infection ,since I broke the biofilms the test was come back negative,but I am sure that open wound behind my nose is a staph infection.My question is, if I do a rinse with manuka honey will heal that wound. .

    • Russell A. Faust, PhD, MD says:

      Hi Vera:

      First, you may not necessarily have “an open wound” back there: even a surface infection in the posterior nasal passages, sinuses, or throat, can cause the symptoms that you describe.

      Next: Several clinical research studies have demonstrated that Manuka honey DOES help heal wounds. In fact, several companies now use Manuka honey in wound-care products, including wound dressings and bandages. There are several advantages of adding Manuka honey to nasal / sinus saline rinses:
      – wound-healing
      – innate anti-microbial agents
      – increasing osmolarity of saline without adding more salt; provides ability to draw fluids out of swollen, inflamed tissues, without the increased ‘burning’ sensation from added salt.
      Thanks so much for visiting and for sharing. Please keep me updated, and best success!

  54. For maintenance once daily when is the best time to use saline solution in the morning or at night.

    Thank you for your time and this great website :)

    • Russell A. Faust, PhD, MD says:

      Hi Anne,

      Many people think that morning is best, if only to rinse out the secretions that have accumulated overnight during sleep. Others think that before bed helps them sleep. Try both to see what is best for you.

      Thank you for your kind comments, and for visiting.
      Best success.

      • Ok. Thanks so much. Your awesome :)
        I feel so much better today due to the fact yesterday I did the saline rinse :)
        I will look at your acid reflux – I think I have that also or gerd or leaky gut due to the fact I have no gallbladder. I started taking glutamine and that seems to be helping alot. DGL and Aloe did not agree with me …… gave me headaches and so on …… Seems I have a very sensitive stomach. I had blood work done in December all good so no health issues. Even had a breath test for asthma and I came out of that with flying colors I was like over the norm percentage lung capacity for my age …… Dont drink coffee just green tea a couple a day.
        Eat pretty healthy :) I will try and incorporate at a future date probiotics and digestive enzymes when my stomach heals from glutamine intake. I think enzymes could be good for me due to the fact I have no gallbladder at least with main meal of the day.

      • Sorry forgot to ask. After I use a saline nasal mist for my nose how long should i wait before blowing my nose. Thanks.

  55. Nicholas says:

    Dr Faust

    I stumbled upon this website about a week ago after seeing a naturopath in my area that perscribed me the same recipe but 1 tspn of salt and 1 tablespoon of manuka honey for my sinus rinse. It feels really good to read all your posts, we all appreciate your help. I really need your help please. About 2 snd a half years ago i had a tooth filled on my upper left side, for a year after the tooth was filled i was having random headaches, then finally i had what i thought was a cold green stuff coning from my nose and i wasnt feeling that great, then suddenly severe facial pain, i had to go to emergency. The doctors did an xray in my head, my left side was filled to the too with fluid, they perscribed me pain killers -tylenol 3 and an antibiotic, within a week the pain was gone but i was left with a sinus infection on my left side only. My doctor, sent me to a specialist. It took 2 months to get to see this specislist, he stuck a camera up my nose, then made an apt for me to have a ct scan done, he also gave me a percription for nasal steroids, decongestiants and a saline rinse. I wouldnt take any of them and i did not feel comfortable with a ct scan so i did not go to the apt. A few days after i missed the ct scan, the secretary from the specialists office keft me a mesage in my phone stating that since i did not go to the ct scan they would not help me. I have been stuck with a sinus infection on my left side only for over a year now, since february 1 of 2015. The sinus rinse that this naturopath seems to be helping, im not sure how much, its only been just over a week. I have a baby coming due in 5 weeks. Im not sure what kind of danger im in having this infection for so long but most important i want to be the best father i can be for my son that is about to be born. If you could please help me, i would greatly appreciate it. Thank you so much, i really need help

    • Nicholas says:

      I had the tooth pulled that i assume caused the problem about two months after the sinus infection started

      • Nicholas says:

        I use the saline rinse the naturopath gave me once per day, she has also prescribed me to take 4 caps of allicin per day and hmf intensive probiotics 2 capsule per day and she also told me to put 1 drop of oil of oregano in the saline rinse recipe she gave me. Before i saw this naturopath for a year my saline rinse was grapefruit seed extract and salt, sometimes i did a nasal rinse with collidal silver. I also took fish oil and tumeric pills for anti inflammatory, i still take the tumeric hut no fish oil

        • Nicholas says:

          The naturopaths saline rinse also has 8-10 drops of baby shampoo in it to break down the bio film

          • Nicholas says:

            The naturopath iam now seeing seems great, i can feel the positive energy coming from her when we meet, the nasal rinse def clears my inflamation when my sinuses feel inflamed and have pressure pains around my eye, my questions for you Dr Faust would be: In 1 litre of water: 1 teaspoon of pink hym salt, 1 teaspoon of baking soda, 1 tablespoon of manuka honey and 10 drops of baby shampoo and 1 drop of oil of oregano, plus the 2 capsules of allicin twice per day and the 2 capsule of hmf intensive probiotics once per day. Should i add more manuka honey? Do you think this will cure my chronic sinusitis? Do you have any other suggestions? Should i do this nasal rinse more then once per day? Am I in any danger from having this infection for so long? Do you think i need a surgery? Thank you so much for your time and information

          • Russell A. Faust, PhD, MD says:

            Hi Nicholas:
            The best options for chronic rhino-sinusitis that I have are in articles on this site. Unfortunately, I cannot offer medical advice. My best advice is for you to find an expert whom you trust and can work with.
            Best success.

    • Russell A. Faust, PhD, MD says:

      Hi Nicholas:

      My best advice? Find a physician who specializes in sinus ailments – one that you can communicate with and that you trust – and follow their advice. If you’re not comfortable with something they recommend (like a CT scan), ask questions, tell them your concerns, and listen to their reply. As flattered as I may be that you have asked my opinion, in my opinion the internet is not the place for great medical care. A sinus infection for a year is a serious problem, and one that the experts can help with. Unfortunately, there is no way for me to offer specific advice at a distance.

      Thank you for visiting, reading, and sharing.
      And congratulations on your new baby!! Best success.

  56. Nicholas says:

    The naturopath recomended the squeeze nasal bottle, i always used the neti pot before, id pour in my good clear side of nose and out the infected side, when i did use the squeeze bottle the natropath recommended i put it up my good clear side and squeezed everything seemed fine after the rinse but later that night it cause severe pressure around my eye on my good clear side, i thought I had spread the infection to my good side, i took a second to think and felt that it was just some of the nasal rinse was stuck up in my good side, so i decided to go back to the neti pot and when i did it cleared, and the pressure pain around my eye on my uninfected side stopped, thank god. So now im only using my netti pot for now on, that was to scary. She also recommended that i shake my head around while i rinse, but when i blew my nose after the rinse, i believe that shaking my head almost gave me an ear infection, so i dont do that anymore either.

  57. Hi how’s it going? You mention making up a custom solution for a sinus rinse, and one of the additives is Antibiotics. Quote “get custom-made solutions containing antibiotics. This seems to work especially well for those with CRS and Staph infections (including MRSA), or those with fungal sinusitis. I have my formulations provided by Sinus Dynamics (Disclosure: NO financial or other relationship). These require a physician’s prescription.” end quote.

    I’m in Australia, what are the antibiotics so when I go and see a GP I can ask him for a prescription for exactly what I need.


    • Russell A. Faust, PhD, MD says:

      Hi Russ:
      I think that “Sinus Dynamics” may have closed.
      For your own access, closer to home, search “compounding pharmacy for sinus irritations” or “… for sinus nebulizer” to find a cource for custom solutions.
      Thanks for visiting, and best success. And please report back and let me know what you find: I will post it here for others.

  58. Nicole L says:

    Is it ok to use regular honey? I have a locally sourced honey in one of those bear bottles. Would that be of any help or does it have to be the manuka honey??

    • Russell A. Faust, PhD, MD says:

      Hi Nicole,
      Great question!
      Even “regular” honey does have antimicrobial activity, just not quite as much as Manuka honey.
      Thanks for visiting, and thanks for the question.

  59. Hi I hope you can help. Following on from a cold I have been feeling dizzy for 3 months and have also had tooth pain, some numbness in face (both on the same side) and pressure in my head check but the dental and numbness is the worst part. I have seen my doctor twice now and have had 3 X antibiotics, tablets for the dizziness and a steroid spray. I should add that my nose doesn’t feel blocked or runny. I really don’t know what to do, the doctor seems to have run out of options. I have a few days where I feel better and then it starts again, I am mostly ok on waking and the pain increases throughout the day. Please help! I will try anything now.

    • Sorry should have added I have had top and bottom dental X Ray’s and nothing was found that could be causing the dental pain.

      • Russell A. Faust, PhD, MD says:

        Ask about an evaluation by a Neurologist. Consider “trigeminal neuralgia” as possible diagnosis.
        Thank you for sharing, and please keep me updated.

  60. I have just come across this website and subscribed to the newsletter – thank you so much. I live in Australia and suffer from allergic rhinitis. I’ve just finished antibiotics for a secondary sinus infection, did 10 days of anti-histamine and 6 weeks of a steroid nose-spray. My sinus problems often bring on a migraine which knocks me out for two days. In between I often have headaches. I have more “sinus” days in a month than not. I started a sinus flush for the first time yesterday (using the squeezy bottle with a saline solution) and I am really hoping this will make a difference. I read that you should only do it once, not four times a day, but how frequently / episodically should I do the sinus flush?

    • Russell A. Faust, PhD, MD says:

      Hi Anna:
      Welcome! Don’t expect much from the ‘newsletter,’ as I’m focused mostly on other projects for awhile now (Sacred Herbals, for example). But there should be some useful info here on this site for you.
      The issue with very frequent rinses is that too much can irritate the delicate respiratory cilia that line your nasal and sinus passages. If irritated, those cilia don’t do their job of clearing secretions (with bacteria, viruses, mold spores, and other environmental pollutants) from your nose and sinuses. So, a paradox: a little rinse is good; more may be better; too much and you make things worse. In my experience (twenty years of chronic sinusitis), 2-3 times per day when things are really bad, and once per day for healthy maintenance.
      Thanks so much for visiting and sharing. Please keep me updated, and best success.

  61. Dear Dr Faust,

    You might not recall it, but you did reply to my post sometime ago, regarding my son’s nasal rinse.

    He is now 2 years and 8 months old. He can get some of the water through his nostrils by doing the nasal rinse himself. But not a lot. We have been trying to teach him for over 5 months now.
    And at times of emergencies, when he has a lot of congestion, I have to squirt it through his nostrils.

    We do mostly manage well.

    Today I have a couple of questions, for which I hope you can give me some insight. I have to say that you are really Godsend to parents like me. Very few people would use their time freely for others like you do.

    My first question is
    Can I use Manuka honey for my son’s nasal rinse?
    He has nasal polyps and as far as I can see down his nostrils, they are quite narrow. We live in London and GPs, sadly, don’t have much time to help out these days. I haven’t had any success in convincing our GP to give my son an ent referral. She has prescribed him nasal steroid spray which I use when I can see he is really congested.

    My second question is
    I read a lot about tea tree oil and castor oil for nasal polyps.
    Have you heard of any anecdotal experiences? I am extremely cautious about the use of essential oils especially on a small child, and hence the question.
    But I have been wondering if adding a drop to his nasal rinse will help him at all?

    Currently he has a terrible bacterial infection. Coughing lots, wheezing (for which he is on the ventolin spray) and on antibiotics too.

    I pray that I can find ways to help my son!

    Thank you once again for your time and patience.

    • Russell A. Faust, PhD, MD says:

      Hi Laxmi:

      My apologies for my delayed reply.

      1: Honey is safe for children beyond infancy – that is, over the age of 12 months. You will find that corroborated by an online search of pediatric care sites.

      2: The only anecdotal information I have on essential oils for nasal application are cautionary: most essential oils, tea tree oil especially, are potentially caustic to skin and – especially – to mucus membranes. I had a patient who, out of desperation, added tea tree oil to his nasal rinse and reported severe burning sensation; he did not repeat.

      3: Does your boy have reflux? Does coughing wake him from sleep at night? Children with “reactive airways,” or inflammatory airways, will often respond to reflux with asthma and cough. Reflux also makes rhinitis and sinusitis much worse. In fact, there is strong clinical research supporting the notion that reflux causes chronic and recurrent sinusitis (and asthma/cough) in some children. You might try searching “reflux cough asthma,” “reflux sinusitis,” and “reflux causing asthma.”

      Thank you so much for visiting, and for sharing. Best success!

  62. Hi, i just wanted to know that i have sinus and it’s woth me for 2 weeks and i just started with Neti pot, how long does it take to cure Sinus with a Neti Pot….?

    • Russell A. Faust, PhD, MD says:

      Hi Vishant:
      You should experience improvement within 48 hours. Length of time to “cure” depends on the type of infection, status of your immune system, your anatomy, and many other factors.
      Best success!

  63. I have been using sinus rinses for several years and about 2 years ago after my sinus surgery my ENT recommended using the budesonide nebules in the saline rinse twice daily everyday as maintenance.

    After several recurrent sinus infections over the last few months I am wanting to try adding manuka honey into my rinses. Is it okay to add this into my budesonide rinse or should I be doing 2 seperate rinses twice a day?

    • Russell A. Faust, PhD, MD says:

      Hi Mike:

      I’m not a fan of long-term use of steroids, topical (as in rinses) or systemic (as taken orally). On the positive side, topical steroids help reduce focal inflammation, but on the negative side, topical steroids (systemic, too) suppress you natural immunity to fight off infections.

      I AM an advocate of using Manuka honey to reduce inflammation, to increase the osmolarity of nasal rinses (without increasing salt concentration), and also for the anti-microbial activity innate to Manuka honey.

      My recommendation is for you to seek another opinion regarding your long-term use of budesonide (it’s not possible for me to offer medical advice).
      Thanks so much for visiting, and for sharing. And please keep me updated. Best success.

  64. Marissa Boyer says:

    I recently had sinus surgery to correct a deviated septum and removal of a large cyst in my right sinus cavity. My doctor gave me instructions to aggressively use the nelimed sinus rinse. It definitely helps to wash all the junk out. My only thing is I’m not sure how “aggressive” I should be. How do I know if I’m doing it to much or using too much pressure? Why does my nose drip for an hour or more after I’m done? And lastly, why can’t I use cold water?

    • Russell A. Faust, PhD, MD says:

      Hi Marissa:
      First, “too aggressive” would be anything that hurts or is uncomfortable. Otherwise, rinsing will remove the crusting and scabs that can lead to infection or scarring. The dripping is from saline solution that gets into the sinuses during the rinsing: the natural cilia action will then sweep it out over the next hour or two. That’s a good sign – your cilia are working. You can use cold water, but cold water will ‘shock’ your cilia so they don’t work for hours. Then that dripping will last for hours, instead of one hour. I hope this helps.
      Thanks for visiting, sharing, and for your great questions!

  65. Hi, I am suffering with sinus infection almost 5 months now, my GP prescribed me antibiotics which didn’t help, then tried steroid nasal spray which didn’t help, now I am trying nasal rinse with salt and bicarbonate of soda 2x a day (can’t take manuka honey as I am vegan), still waking up night time and in the morning with lot of mucus at the back of my throat. It is really hard to get rid of it, feels like my throat is full with glue. Is it normal? Thanks

    • Russell A. Faust, PhD, MD says:

      There are many possible reasons for morning ‘yuk’ in the back of your throat. From your description of symptoms, it may be time for you to get an opinion from someone with greater expertise than your GP.

  66. James Gregory says:

    Hi Doctor Faust, i’ve bought the Neilmed system with the bottle, can’t wait to try it, I’ve had it a week now but I’ve got a blocked ear and the instructions say not to use if your ears blocked, it is getting better as I’m using some Otex with I think peroxide in it, I can hear crackling when my missus drops it in my ear.
    I’m not sure what I’ve got to be honest as my GP (I’m in the UK) just tells me what to do but never gives me a diagnosis.
    I’ve dropped the milk altogether but I could murder a cup of tea right now.

    • James Gregory says:

      Sorry Doctor, just remembered something. I was surprised to read whilst digging around on the internet that non allergic rhinitis could be exacerbated by exercise (or did I dream that?). If that is the case (which I find difficult to believe) would it be better to use my steroid before going to the gym do you think? I go everyday except Sunday and usually use the spray after getting home from the gym and after showering.

      • Russell A. Faust, PhD, MD says:

        Good question, James.
        So using your nasal steroid before gym probably best. Even better: use the morning of your gym days.

    • Russell A. Faust, PhD, MD says:

      You crazy Brits – milk in tea?!?

  67. Diane Compo says:

    I appreciate your website. I have polyps and have had them removed once when I was 34, then when I was 48 and now that I am 56 they are really bad again. In fact they are the worst they have ever been. I was hopping to go for the PolypVac procedure but my ENT says I don’t qualify. I really don’t want to have the surgery again. In fact its taking forever for my HMO to get approvals. I went to the ENT on my own. I am really confused because on one hand I want the surgery and on the other hand I know even the surgery is a temp. fix and the intervals between surgeries are getting shorter and shorter.
    I am hope my problems are related to Candidiasis and thus a fungal over growth encouraged by my allergies. I am reducing my sugar and fruit intake to the bare minimum. I am basically juicing green drinks with berries and avocados in addition to home made kefir. After that I plan on starting a water fast. What else is there? Md’s are clueless and alternative doctors have their problems too. Drugs are not the solution.
    I am open to suggestions. Thanks

    • Russell A. Faust, PhD, MD says:

      Thank you for your kind comment, Diane.

      With your experience, you know more than I do. I do know that research has found a genetic (hereditary) factor in both chronic rhinosinusitis and sino-nasal polyposis. There is also a clear relationship between the bacteria – both good and bad – that inhabit us: the “microbiome.”

      In fact, there is an ongoing clinical trial looking to eliminate chronic rhinosinusisis – but WITHOUT polyps – by changing the microbiome:

      You should consider searching for a similar clinical trial for those WITH polyps to see what is being done, and whether you might qualify for the trial. At least to see what the current state of knowledge is on treatment for polyposis.

      Sorry to hear about your polyp history, but appreciate you sharing. Please do keep me updated, and share anything you find out right here!
      Best success

  68. pippari srivasthava says:

    A week back I met with a nose surgery endoplasty and removed extra muscle.They advised to use neti to clean the nose. Yesterday I used this neti wash twice continuously one after another. On that day night it was bleeding for nearly 5hours and it was stopped. So can you please give me the reason why it was bleeded?

    • Russell A. Faust, PhD, MD says:

      Please ask your surgeon. I’m sorry, but it’s impossible for me to evaluate you over the internet. Your doctor is the best person to ask about your results and further care.

  69. I have previously taken for 18 months Manuka Honey UMF16 Orally, 2-3 teaspoons a day to help with my health issues. This product is amazing and has helped to heal my immune system of ME which I had being diagnosed with after 20 years of being fobbed off by GPs. I am not fully recovered however I am dramatically improved. One of my other health issues was a post nasal drip caused by a severe dust allergy, which was making an increase of mucus in my ear which has been there now for approx. 6 years and is causing tinnitus. I have been trying the neilmed saline solution packet mixes which are slowly clearing the mucus, however I am convinced I have adult glue ear. Before I came across this website I had tried putting a very small amount of manuka honey into the mix as I thought if it could heal my immune system then it could heal my ear canal. I have read in above comments that it is tablespoons full of honey required, this seems very extreme, wont the mix be very yellow and gloopy? Is it safe for me to direct the solution with so much honey in towards my ear canal rather than my frontal sinuses?

    • Russell A. Faust, PhD, MD says:

      Hi Tracey,
      Two tablespoons of Manuka in 500 ml of saline does have a slightly golden color, but is not particularly thick or goopy. When performing nasal saline rinses, you aren’t really able to “direct the solution” toward the ear canal. In fact, when you perform the rinses, the solution will flow through the nasopharynx – exactly where the Eustachian tubes (from the ears) open up … perfect! Be sure to take a look at my illustrations on this article:
      Thanks for visiting, and for sharing!

  70. Great info here! We just started with manuka honey for what our ENT described as pus on my 10 y/o son’s adenoids. He has dealt with constant, harsh throat clearing for over 2 years, among other symptoms. Any thoughts on how effective this may be, or something else, for clearing up the adenoids? This has been a long journey to finally discover what may be part of the trouble.
    Thank you

    • Russell A. Faust, PhD, MD says:

      Hi Shelly,
      I honestly don’t know what to expect for Manuka to treat the chronic biofilm associated with adenoids – GREAT idea, though. And please keep me updated on how things go for your son!

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