Why I Test for Micronutrients: The ENT Connection (Part 2)

As an integrative ENT, I see every day how small deficiencies can have big effects on the ears, nose, and throat. When patients come in with chronic sinus infections, lingering fatigue, or slow to heal after surgery, I don’t just look at the surface. One of the most powerful tools in my diagnostic approach is micronutrient testing.

Magnesium: The Calming Mineral

Magnesium is a cofactor in over 300 enzymatic reactions-supporting nerve conduction, muscle relaxation, and vascular tone. It’s crucial for balanced immune and nervous system function, helping to regulate inflammation, stress response, and sleep quality.

In ENT health, magnesium plays a subtle but powerful role. Low levels can contribute to tension headaches, migraine-related dizziness, Eustachian tube dysfunction, and bruxism, all of which affect ear and sinus comfort. Magnesium also supports smooth muscle relaxation in the upper airway, which can improve nasal breathing and sleep quality in those with mild airway obstruction or snoring.

Functional range: Serum magnesium of 2.0–2.2 mg/dL is common, but intracellular testing (RBC magnesium) of 5.0–6.5 mg/dL better reflects tissue stores.

Typical dosing:

• Adults: 200–400 mg elemental magnesium daily (divided doses if needed).

• Children: 5–10 mg/kg/day.

• Higher doses may loosen stools-an easy sign to scale back.

Preferred forms: Magnesium glycinate or malate for full body effects; magnesium threonate for neurologic or migraine concerns.

Natural sources: Leafy greens, avocado, almonds, pumpkin seeds, dark chocolate, and mineral water.

Zinc: The Guardian of the Epithelial Barrier

Zinc is essential for tissue repair, immune regulation, and mucosal integrity making it a front-line nutrient for ENT resilience. It supports the growth and function of cilia in the nasal passages and sinuses, helping to clear mucus and defend against pathogens.

Deficiency can impair the mucosal barrier, increasing susceptibility to allergic rhinitis, chronic sinusitis, and recurrent upper respiratory infections. Zinc also modulates inflammation and oxidative stress, key drivers in chronic ENT disease.

Functional range: Serum zinc levels ideally 80–100 µg/dL; lower-normal levels may still indicate functional deficiency, especially in inflammatory states. Urine and hair levels are less reliable.

Typical dosing:

• Adults: 10–30 mg elemental zinc daily for maintenance; up to 80 mg/day short term for immune support (such as during the early stage of viral upper respiratory tract infection)

• Children: 5-10 mg/day depending on age and diet.

• Supplementation beyond 8 weeks should be balanced with copper (1–2 mg/day) to avoid depletion.

Preferred forms: Zinc glycinate, citrate, or gluconate for high absorption.

Natural sources: Oysters, pumpkin seeds, beef, lentils, and cashews.

Omega-3 Fatty Acids: The Anti-Inflammatory Signal

Omega-3 fatty acids-particularly EPA and DHA-act as precursors to anti-inflammatory mediators that help the immune system resolve inflammation efficiently. In ENT medicine, this translates to healthier mucosal membranes, reduced allergic inflammation, and better post-surgical healing.

A low omega-3 index (the percentage of EPA + DHA in red blood cells) is associated with chronic inflammation, poor wound repair, and vascular dysfunction-all of which can worsen sinus and ear conditions. Optimizing this index can help regulate immune activity and support neurologic and vestibular health, important for balance and migraine-related dizziness.

Functional range: Optimal omega-3 index is 8–12% (average in the U.S. is <5%).

Typical dosing:

• Adults: 1,000–2,000 mg combined EPA + DHA daily for maintenance; higher therapeutic doses (2–3 g/day) may be used under physician guidance for inflammation or migraine.

• Children: 250–500 mg combined EPA + DHA daily.

Preferred forms: Triglyceride-form or re-esterified omega-3 oils (better absorbed than ethyl ester forms).

Natural sources: Wild salmon, sardines, anchovies, chia seeds, flaxseeds, and walnuts.

Each of these nutrients—magnesium, zinc, and omega-3s—helps your ENT system function as part of your whole-body health. I love guiding my patients toward replenishment through real food first, but when deficiencies or inflammation persist, targeted supplementation bridges the gap to help restore balance and resilience.

Disclaimer: This information is for educational purposes only and not a substitute for medical advice. Always consult your healthcare provider before starting or changing supplements.