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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