Guaifenesin & sinusitis

Townsend Letter for Doctors and Patients, Nov, 2005 by Jule Klotter

Guaifenesin, an expectorant found in OTC cold medications like Robitussin, may be helpful for people with chronic sinusitis. An article by Wellington S. Tichenor, MD, refers to the Mayo Clinic findings that Major Basic Protein (MBP) found in the nasal mucus of people with chronic sinusitis injures the sinus lining, making the epithelium susceptible to bacterial infection. Major Basic Protein comes from activated eosinophils and kills common airborne fungi lodged in the airways. When openings from the sinus into the nasal passage become obstructed from inflammation, viruses, allergic rhinitis, foreign bodies, and polyps, mucus stagnates and MBP levels increase. In addition, less oxygen enters the sinuses, promoting bacterial overgrowth. Tichenor says, "Guaifenesin in high doses is often helpful in increasing clearance of secretions as well as thinning secretions. Efficacy has not clearly been proven, but most practitioners find that it is helpful."

Mark Konlee of Keep Hope Alive reported in his Journal of Immunity (July-Sept. 2003) that upon taking 400 mg of guaifenesin twice daily and eliminating milk, cheese, and ice cream from his diet, he became "completely free" of sinusitis after many years of suffering. Information from the US National Library of Medicine reports that "guaifenesin appears to be effective in managing HIV-infected patients with symptomatic rhinosinusitis." The 23 patients in that study received 2400 mg/day of guaifenesin or a placebo for three weeks. Those in the guaifenesin group reported less nasal congestion and thinner postnasal drainage. Konlee says that the standard dose of guaifenesin in cold medicine is about 1200 mg per day, a dosage that appears to be safe for long-term use. He says guaifenesin has been taken at doses of 3600 mg daily without toxic effects. Tichenor says that guaifenesin can cause nausea and other GI problems and suggests beginning with a low dose and gradually increasing to an effective dose. As an aside, Konlee says that his internet search found that guaifenesin is helpful for people with fibromyalgia. He wonders if guaifenesin increases IgA mucosal levels.

Konlee, Mark. Guaifenesin in the treatment of Fibromyalgia, HIV/AIDS, Chronic Fatigue Syndrome, sinusitis & respiratory infections. Journal of Immunity July-September 2003 (accessed www.keephope.net on 12 February 2004)

Tichenor, Wellington S., MD. Sinusitis for Physicians. www.sinuses.com/md.thm (accessed 9 August 2005)

US National Library of Medicine. Guaifenesin. www.aegis.com/pubs/drugs/69.html (accessed 9 August 2005)