Sore Throat: Antibiotic or natural remedy?

Warning: This post may contain surprising opinions

Happy New Year!

I started 2014 with a serious sore throat  (tonsillitis) caused by a Strep A infection. Strep throat. For the next 10 days I took Biaxin, an antibiotic.

Antibiotics you say? But why? How could this be?

As naturopathic doctor, I know many of you have been conditioned to believe that because an MD prescribes a medication, I’m automatically opposed to it; That MDs are in one camp, and NDs in another. The truth is, there are no camps; there is only balance. The key to effective health care is using the most appropriate tools and therapies. Sometimes that’s herbal medicines, diet modifications or homeopathics, and sometimes that’s antibiotics and pain killers. Anyone who makes you choose one or the other is not acting in your best interest.

What is tonsillitis?

Tonsillitis, or inflammation of the tonsils, (and the lymphatic system in general — the lymph nodes and tonsils are part of this system) can be viral or bacterial.

Viral

With viral tonsillitis you may have a runny nose, congestion, and sometimes a cough with a fever. Your tonsils will be sore, swollen, and red. The sore throat associated with viral tonsillitis will go away on its own, generally within a week.

Bacterial

Bacterial tonsillitis is a different story altogether and is normally caused by Group A β-hemolytic streptococcus bacteria. Tonsillitis caused by Group A streptococcus bacteria (strep A) does not have a cough, and rarely a runny nose. The tonsils will generally be very swollen, may have exudates (white patches or clump-looking pieces), and are reported to feel like razor blades. It can be very painful to swallow. You may also get a rash.

Which is it?

To know for sure if your sore throat is a strep infection, you will need to have a throat swab sent to a lab for analysis. In-office Quick Strep A tests are can be helpful but often provide a false negative. That leaves the swab test as the gold standard. It takes a few days to get the results back, but don't worry, the wait time for getting the results back has not shown to make much difference in a strep infection.

What now?

While it is true that some strep throat infections can be treated with natural supports and it is also true that antibiotics will clear up the infection, the trouble with strep is that there can be very serious complications from not treating it properly. These include PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) or worsening of tics (OCD) disorders in susceptible kids, rashes, sepsis, and worse. Yes, a little scary.

I started with my moderate, naturopathic approach (which really is just a common sense approach):

  • Throat swab culture (taken Day 1, results reported Day 4)
  • Anti-inflammatories for the pain (Advil)
  • Antibacterial and immune-supporting herbal medicines: Echinacea, Goldenseal, Garlic, Propolis, and Sage (see below for their explanations)
  • Probiotics (To build up my own good bacteria)
  • Garlic lemonade (courtesy of Dr Aviva Romm MD, it’s awesome and super-tasty) and very soothing. Not so great on the breath however:
    • 3 medium-sized garlic cloves, chopped
    • Juice of 1 lemon
    • Maple syrup or honey to taste
    • Place the garlic in a 1-quart jar and fill the jar with boiling water. Let the garlic steep for 20 minutes and then strain it out. Add the lemon juice and sweeten with the maple syrup or honey.

When the call came on day 4 that indeed it was strep, I took the antibiotics. Why?

  • I had never had a sore throat appear so quickly or be so painful.
  • The presence of strep on day 1 indeed means that on day 4 it is still present (strep can be in the mouth even without a true infection), but it was more my other symptoms that I was paying attention to which were swollen lymph nodes, no runny nose, no cough and…
  • My symptoms had changed only slightly (the razor blades in the back of my mouth were now more like dull knives, but there was a new and exciting raw sensation in the base of my throat)
  • The pain, even with Advil, was so bad it was keeping me from sleeping.

There are strep prediction criteria to indicate whether you may have strep. Click here to see how your MD decides to give you antibiotics or not

For me, antibiotics were the right decision. Throughout my round of antibiotics, I took a probiotic at a different time of day (I have a sensitive digestive tract) to ensure the antibiotics would not upset my stomach. I also continued with echinacea, propolis, and my garlic lemonade to be sure that my now-weakened immune system would not succumb to another infection. For those of you who have suffered in the past with chronic strep infections, this is an important step.

Be Prepared

Natural Remedies to Support a Sore Throat

Stock up your cabinets with the following herbs:

Echinacea angustifolia

Known to support infection and boost immunity, the good stuff makes your tongue tingle.

Sage

Absolutely more bitter than when in stuffing for a turkey dinner, sage is excellent for sore throats especially when gargled!

Bee Propolis Throat Spray

Quite soothing when sprayed right into the throat and combats infection. Do not use if you are allergic to bee stings.

Garlic

As your grandmother insisted upon in chicken soup, is antimicrobial (bacterial and viral) but does not get rid of your own good bacteria (only the not-good) so get in as much as you can

Goldenseal

An infection-fighting herb, but absolutely tastes like socks, and so you may prefer the garlic!

A homeopathic combination in a topical cream for lymphatic swelling and congestion, is remarkably soothing when rubbed on the neck over your sore swollen lymph nodes

Above all, make sure to stay hydrated! Dehydration is very common with sore throats because it hurts so much to swallow. Warm water and warm tea are my favourite choices, and I chose cleavers tea -- a lymphatic herb that helps with swelling -- to drink throughout the day, with honey. Above all, making an informed decision is important. If you think there's a chance it's strep, go to an MD to get a swab. Much of my ideas are shared by Dr Aviva Romm MD, a midwife and herbalist. Check out her post from last year on the same topic.

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