Part of the Kharrazian Institute functional medicine certification
Respiratory and Sinus Conditions
A chronic respiratory condition is rarely just a lung problem. It is often the reason the gut, the mood, and the fatigue in front of you never resolve.
Learn how respiratory function connects to the gut, the adrenal glands, the brain, and energy production, and gain a working sequence of thought for upper and lower respiratory cases, taught by Harvard-trained researcher and clinician Datis Kharrazian, PhD, DHSc, DC, MS, MMSc, FACN.
- 6 hours on-demand video
- 6 sessions
- for licensed and non-licensed practitioners
- part of the certification
★★★★★ "Hands down the most valuable training I've ever taken." — Kim Pellegri, FNTP, MRHP, CFMHC
Class Overview
Chronic respiratory conditions are usually managed with two tools: antibiotics and corticosteroids. Both are sometimes necessary. Used for years, both disrupt the lung and gut microbiome, promote resistant bacteria, and drive bone loss, insulin resistance, and mood disorders. The conventional model rarely asks why the airway keeps reacting in the first place. This course teaches how respiratory function connects to the gut, the adrenal glands, the brain, and energy production, and gives you a working method for evaluating and managing upper and lower respiratory conditions.
★★★★★
After more than 35 years in clinical practice, I can say with confidence that this is the most rigorous and clinically impactful training I have completed.
Did You Know
- In a 10-year study of more than 5,000 people, an oxygen saturation below 96 percent was independently linked to higher all-cause mortality. Many chronic patients sit between 93 and 96 percent, and no one checks.
- A chronic asthma or sinusitis can keep a gut from healing. When the lung microbiome is disrupted, the gut microbiome follows, and treating the gut alone does not reverse it.
- Dopamine and GABA production both depend on oxygen and ATP. A chronic respiratory condition can drive anxiety and depression that no one traces back to the lungs.
- Inhaled corticosteroids used for childhood asthma can suppress growth hormone and interfere with lung development, leaving shorter stature and weaker lungs into adulthood.
- Chronic sinusitis with nasal polyps is sometimes autoimmune. Researchers have found tissue-specific antibodies in these patients, which is why antibiotics and steroids never resolve it.
Why It Matters
Every practitioner has seen this patient. Years of sinus pressure, a stuffy nose that never fully clears, round after round of antibiotics, a steroid spray that helps for a while and then stops. The infection keeps returning, and the same two prescriptions keep getting written.
The deeper problem is that a chronic respiratory condition sits underneath cases that look like something else. A gut that will not heal. Fatigue that no protocol touches. Anxiety and low mood with no obvious cause. When the tissues are not getting enough oxygen, nearly every pathway for recovery slows down, and the patient stays stuck.
Antibiotics and corticosteroids do not reach any of this. They alter the mucus, the microbiome, and the immune response in ways that often make the next infection more likely. Most clinicians were never taught where else to look, so these patients get referred out or cycled through the same failing plan. That gap is what this course closes.
What You’ll Be Able to Do
Screen any chronic patient for a hidden respiratory driver
Use objective tools to catch functional hypoxia that is quietly fueling fatigue, pain, mood disorders, and poor recovery.
Recognize when a gut that will not heal is being held back by the lungs
and know when to work the lung-gut axis in both directions.
Evaluate the lung-adrenal axis by connecting cortisol rhythm
blood sugar, and airway opening, and see why weak adrenal function keeps the airway inflamed.
Build an asthma plan around triggers rather than inhalers alone
identifying allergen, exercise, oxidative, dietary, and hormonal drivers.
Restore mucociliary clearance so biofilms and mucus plugs stop driving recurring infections
Reduce a patient's need for corticosteroids and antibiotics over time by addressing the physiology behind chronic inflammation
About the Instructor
Datis Kharrazian, PhD, DHSc, DC, MS, MMSc, FACN
Dr. Kharrazian is a Harvard Medical School trained researcher, clinical research scientist, academic professor, and functional medicine health care provider. He earned a Master of Medical Science degree (MMSc) in Clinical Investigation from Harvard Medical School and is a member of the Harvard Medical Alumni Association and the American Association of Immunologists.
He is a Fellow of the American College of Nutrition. His clinical models of functional medicine are used by academic institutions and thousands of clinics worldwide.
For more than 25 years, Dr. Kharrazian has consulted with complex patients from around the world, refining the clinical sequence of thought this course teaches. He maintains a private practice near San Diego, California, focused on personalized care through diet, nutrition, and lifestyle.
Session Curriculum
Session 1: Introduction to Respiratory and Sinus Conditions
Session 2: Fundamental Concepts of Clinical Immunology of Respiratory and Sinus Conditions
Session 3: Evaluation and Clinical Strategies for Upper Respiratory and Sinus Conditions
Session 4: Evaluation and Clinical Strategies for Lower Respiratory Conditions
Session 5: Evaluation and Clinical Strategies for Asthma
Session 6: Summary and Clinical Prioritization for Respiratory Conditions, with Q&A
This Course Includes
- 6 hours of on-demand video across 6 sessions
- Downloadable clinical assessment forms and resources, including the Metabolic Assessment Form and Brain Region Localization Form
- A recorded clinical Q&A session
- Counts toward the Kharrazian Institute Functional Medicine Certification (Basic and Advanced)
- Certification exam
- Certificate of completion
What Practitioners Say About the Kharrazian Institute
★★★★★
Amazing, brilliant knowledge, well organised, very comprehensive, and excellent foundational knowledge that builds with every module. You can do it at your own pace, making it cost-effective and rewarding.
★★★★★
I've been learning from Dr. Kharrazian since 2003, and his clinical framework has shaped the way I practice for over two decades. I highly recommend this program to any practitioner committed to truly leveling up their clinical care.
★★★★★
As a UK-based practitioner, the Kharrazian Institute courses have given me far greater depth and awareness in clinical cases than previous courses. Dr. Kharrazian has an unbelievable ability to translate complex science into practical, accessible knowledge we can apply in our practices.
Functional Medicine Certification and Education at the Kharrazian Institute
Respiratory and Sinus Conditions belongs to the advanced tier of the Kharrazian Institute certification, taught by Dr. Kharrazian for practitioners working chronic airway and sinus cases.
A Kharrazian Institute subscription brings up the Respiratory and Sinus Conditions course and the rest of the catalog with it, the hands-on way to work toward your functional medicine certification and keep your clinical training moving.
Your subscription includes
- Respiratory and Sinus Conditions plus all 19 Kharrazian Institute courses, more than 200 hours of functional medicine education
- Monthly Clinical Master Classes taught by leading functional medicine experts
- Full access to the 100-hour Clinical Mastery Program
- A members-only Q&A platform and practitioner community
- The Kharrazian Institute patient referral network
- Progress toward Kharrazian Institute certification
$399 per month, plus a one-time $995 enrollment fee. Cancel anytime.
What is functional medicine for respiratory and sinus conditions?
Functional medicine treats a respiratory condition as more than a lung problem. It asks what keeps the airway inflamed and reacting: airborne allergens, thick mucus, a disrupted lung and gut microbiome, weak adrenal function, or depleted antioxidants. Instead of suppressing symptoms with antibiotics and corticosteroids alone, it finds and removes the triggers, restores mucus clearance and barrier integrity, and supports the systems the lungs depend on. The goal is fewer infections, less steroid dependence, and better oxygen delivery to the whole body.
Why does chronic sinusitis keep coming back after antibiotics and steroids?
Years of sinus pressure, a nose that never fully clears, round after round of antibiotics, a steroid spray that stops working. Antibiotics and corticosteroids do not touch what actually drives chronic sinusitis, and they often make the next infection more likely. Functional medicine treats chronic sinusitis as a web of connected problems, then untangles it one strand at a time. The same thinking applies to recurring bronchitis, chronic asthma, and the respiratory patterns most clinicians refer out.
What counts as a functional respiratory condition?
Respiratory conditions fall along a spectrum. Acute infections usually resolve on their own, apart from the occasional bacterial case that needs antibiotics. Recurring and chronic inflammatory conditions are where functional medicine does its real work, because the conventional model does little to find the triggers behind them. At the far end are conditions with permanent tissue damage, such as emphysema or pulmonary fibrosis, where the goal shifts to better quality of life and fewer infections.
Knowing which part of the spectrum a patient sits on sets both the prognosis and the plan. A recurring sinusitis can often be resolved. A smoker's damaged lung cannot be reversed, but it can be protected and supported.
Why is low oxygen a whole-body problem?
A chronic respiratory condition creates a state of functional hypoxia: oxygen levels that are not low enough to alarm anyone, but low enough to change how the body works. Mitochondria need oxygen to make ATP, and nearly every pathway for recovery runs on ATP. When oxygen drops, energy drops with it.
The effects reach far beyond the lungs. Low oxygen pushes pain-sensing neurons closer to their firing threshold, so patients become more sensitive to pain. It also impairs the oxygen-dependent steps that make dopamine and the ATP-dependent steps that make GABA, which helps explain the strong links between chronic respiratory disease, anxiety, and depression. Over years, the same mechanisms raise the risk of neurodegeneration.
This is why a respiratory condition belongs near the top of the problem list. A patient with chronic asthma or sinusitis who cannot recover from anything else may be stuck there because the tissues are not getting enough oxygen.
How are the lungs and the gut connected?
The lung-gut axis runs in both directions. A disrupted lung microbiome drives dysbiosis in the gut, and gut dysbiosis feeds inflammation back to the lungs. When the gut barrier breaks down, the lung barrier tends to follow, and the reverse is true as well.
The clinical point is direct. A practitioner can treat the gut with every tool available and still fail, because a chronic asthma or sinusitis is holding the gut back. Sometimes the gut has to be treated to support the lungs. Sometimes the lungs have to be addressed to settle the gut. Often both are needed at once, and the course teaches how to read which pattern is in front of you.
What does the lung-adrenal axis have to do with breathing?
The adrenal glands shape respiratory function in two ways. The adrenal medulla releases epinephrine and norepinephrine, which open the airways. The adrenal cortex releases cortisol, which activates the immune response against pathogens and then helps resolve the inflammation it created.
When adrenal function is weak, both steps fail. The airway stays inflamed because the body cannot make enough of its own cortisol, and the patient becomes prone to recurring infections because the immune response never fully switches on. Air pollution, poor sleep, blood sugar swings, and long-term steroid use all dysregulate this axis, which is why stress resiliency and blood sugar stability belong in a respiratory workup.
Why does mucus matter so much?
Mucus is the first thing to manage in almost any respiratory case. Healthy mucus traps particles and is cleared by the cilia. When it becomes thick and the mucin proteins aggregate, it forms plugs that block airflow and biofilms that shield pathogens from the immune system and from any treatment you give.
Dr. Kharrazian teaches mucus management as a clear sequence of thought: remove the triggers that produce mucus, thin it, break it up, and help the patient expel it. Restoring mucociliary clearance is part of the same work. Antioxidants sit underneath all of it. Glutathione protects the airway barrier and the alveoli, and its depletion is where tissue breakdown and severe inflammation begin.
What actually drives chronic sinusitis?
Chronic sinusitis is best understood as a web rather than a single infection. The literature points to reduced microbiome diversity, a breakdown of the sinus barrier, damaged cilia and stalled clearance, biofilm that protects pathogens, gut dysbiosis, low vitamin D, and a background of systemic inflammation. Each strand feeds the others, and antibiotics and steroids pull on none of them.
A subset of patients, especially those with nasal polyps, have an autoimmune process behind the inflammation. These are the hardest cases, and they call for the autoimmune strategies taught elsewhere in the program. For the rest, the course teaches an immune-tolerance approach grounded in diversifying the microbiome, distinguishing the triggers, and downregulating the overactive immune response.
Where do you start with a complex respiratory patient?
The hardest part of chronic care is sequencing. Across every respiratory condition, two priorities come first: manage the mucus and restore antioxidant status. From there, the course lays out how to keep oxygen as functional as possible through the day, measured with objective tools rather than how the patient says they feel, and how to address the physiology that drives the need for corticosteroids and antibiotics so that need declines.
Realistic goals hold the plan together. Fewer infections a year, less steroid dependence, and more good days are honest outcomes, and for a patient with permanent lung damage they are the right ones.
For related reading, see Beyond Pharmaceuticals: Integrative Migraine Management, Metabolic Dysfunction as Hidden Driver of Chronic Migraines, Mucosal Immune System Dysfunction in Chronic Sinusitis, and Functional Hypoxia: Hidden Driver of Cognitive Decline.
Frequently Asked Questions
What is the functional medicine approach to asthma?
It builds the plan around triggers and physiology rather than inhalers alone. That means identifying allergen, exercise, oxidative, dietary, and hormonal triggers, supporting the gut and nasal microbiome, stabilizing blood sugar and adrenal function, and tracking the response over time.
Why do asthma symptoms flare at certain times?
Asthma is defined by a trigger. Common ones are allergens, exercise, cold or hot air, poor air quality, specific foods, and stress. In women, hormone shifts around the menstrual cycle, perimenopause, and menopause can also flare symptoms.
Are long-term inhaled steroids harmful?
They can be, and the course details the mechanisms. Long-term corticosteroids disrupt the lung and gut microbiome, break down barriers, suppress secretory IgA, and contribute to bone loss, insulin resistance, and mood disorders. The clinical goal is to reduce the need for them, not to stop a prescribed medication abruptly.
Can chronic sinusitis be autoimmune?
Yes. Some patients, especially those with nasal polyps, have tissue-specific antibodies and an autoimmune process behind the inflammation. These cases rarely respond to standard care and are managed with the autoimmune strategies taught across the program.
Who is the Respiratory and Sinus Conditions course for?
It is built for healthcare professionals across specialties, licensed and non-licensed, who work with chronic and complex patients. Respiratory and sinus conditions sit underneath many cases that will not resolve, so the material applies well beyond pulmonary complaints.
Is the Respiratory and Sinus Conditions course part of the certification?
Yes. Respiratory and Sinus Conditions is part of the Kharrazian Institute functional medicine education pathway and counts toward the Functional Medicine Certification at the Advanced level.
Last updated: October 13, 2026
