(UPDATED JULY 2017) Probiotics and sinusitis treatment go hand in hand. In the last few years researchers found that one probiotic (beneficial bacteria) that chronic sinusitis sufferers lack and that treats and cures sinusitis is Lactobacillus sakei. The researchers Abreu et al found in their 2012 study that not only do sinusitis sufferers lack L. sakei, they have too much of Corynebacterium tuberculostearicum (normally a harmless skin bacteria), and they also don't have the bacteria diversity in their sinuses that healthy people without sinusitis have. In other words, the sinus microbiome (microbial community) is out of whack (dysbiosis). A number of studies found that there is a depletion of some bacterial species, and an increase in "abundance" of other species in those with chronic sinusitis. Of course researchers are working on a beneficial bacteria nasal spray to treat or prevent sinusitis, but that will take a while.
Luckily Lactobacillus sakei is found in some foods (such as some brands of live fermented kimchi), in "starter cultures" (for sausages) called Bactoferm F-RM-52 and B-2, and also in Lactopy. One reason it is used in sausage starter cultures is because it dominates over and inhibits growth of pathogenic bacteria, including Staphylococcus aureus and Listeria. [Note that treating sinusitis with beneficial bacteria (rather than just antibiotics, corticosteroid nasal sprays, and surgery) is a major shift or paradigm change in sinusitis medical treatment, but it is the future in sinusitis treatment.]
More than 4 years ago I started using a very easy kimchi sinusitis treatment (basically dabbing and smearing kimchi at certain stages of fermentation into my nostrils like a very messy eater) and found that it cured my chronic sinusitis of many years within several weeks. Obviously it contained L. sakei. Then the rest of my family also tried the kimchi treatment and were also cured of chronic sinusitis! It felt miraculous, especially because it was so easy to do. (See SINUSITIS TREATMENT page for our background story, and see SINUSITIS TREATMENT SUMMARY page for different treatment methods.)
After 4 1/2 years we still feel great! Generally all 4 of us only need to treat again with a product containing Lactobacillus sakei after a virus which goes into sinusitis, or if for some other reason we feel like we're sliding into sinusitis. The last 2 years we've needed to do this far less than the first year. Because we no longer have chronic sinusitis, we have NOT taken antibiotics or any other bacteria killing spray or product (such as xylitol) for the last three and a half years. We do not use cortisone or antihistamine nasal sprays either.
A number of you have contacted me to report your own progress with various sinusitis treatments. Thank you! The following are the results from those commenting on this web-site or to me privately. People used terms such as "miraculous", "transformative", and "fabulous" when they had positive results with a product containing L. sakei. I am also starting to hear from you about other some other probiotic (beneficial) bacteria species that may treat sinusitis. When a treatment works, then all sinusitis symptoms go away, including post nasal drip, sinus headaches, "clogged ears", bad breath, and sinusitis-related coughs. Even tonsil stones! (Please note that trying such products to treat sinusitis is self-experimentation - effects can be positive or negative. One should always be very cautious.)
OVERALL RESULTS: The majority of people writing to me with results reported positive results (chronic sinusitis greatly improved or totally gone) from some form of L. sakei treatment. Most have been from the USA or Canada, but successes have also been reported to me from Europe, Australia, New Zealand, and Africa. But since it's from self-experimentation and not a clinical trial, then I don't know the actual percentage of positive results. (Please write!) Some of the people reporting success have had multiple operations, some currently have deviated septums, some with nasal polyps, and all have had long-standing chronic sinusitis, some for decades. Those same chronic sinusitis sufferers also reported that the same treatments also worked after acute sinusitis (e.g., after a cold). It seems that after colds, etc. they (including myself) develop acute sinusitis again and need re-treatment (apparently the L. sakei doesn't stay or colonize in the sinuses from earlier treatments) . But a minority of people reported that nothing has helped and there could be a variety of reasons for this (see below).
KIMCHI - A number of people reported that kimchi helped them (without naming brands), while others named brands that helped them. And one person reported a homemade kimchi worked great (he was finally symptom free after 8 years). A few have even mentioned that kimchi has helped sinusitis with fungal problems. Kimchi brands that people reported helping their chronic sinusitis: Sinto Gourmet brand kimchi, Mama-O's Premium Kimchi, the white Napa kimchi (as well as the cabbage kimchi) made by Choi's Kimchi Company (in Portland, Oregon), Farmhouse Culture Kimchi (in California), Sunja's Kimchi (medium spicy cucumber kimchi and mild white kimchi), in the United Kingdom the brand Mr Kimchi, and in Australia Kehoe's Kitchen white kimchi. We still use Sunja's Kimchi (the first year we used Sunja's medium spicy cabbage, but when that stopped working we switched to the medium spicy cucumber kimchi, and now also the mild white kimchi). I'm sure some other brands also contain L. sakei.
(Please note that not all kimchi brands or types of kimchi within brands contain L. sakei - finding one that has it is due to self-experimentation. We found that kimchi may contain L. sakei from about day 14 to about 2 to 2 1/2 months (from the day it's made). When the kimchi contained L. sakei we felt the same or started feeling better within one or 2 days. If we felt more mucusy or phlegmy over the next 2 days, or the acute sinusitis kept getting worse, than it did not contain L. sakei.)
Some people wrote in that kimchi did not help them, including various types of Sunja's kimchi. One person said that Hawthorne Valley Kim Chee had no effect, and that it was more like a sauerkraut product. (Sauerkraut had not worked for anyone until recently one person said that they improved with a homemade sauerkraut, and another person with a sauerkraut made with garlic carried by Costco). Some researchers feel that it's the garlic in kimchi that encourages L. sakei growth, and sauerkraut typically doesn't contain garlic.)
BACTOFERM F-RM-52 - A number of persons reported that a mixture of bottled water and the sausage starter culture Bactoferm F-RM-52 (Lactobacillus sakei and Staphylococcus carnosus), has successfully worked for them. This product is produced by the Danish manufacturer Chr. Hansen and sold by various sausage-making suppliers. We first tested it in January 2015 and found that - yes, it definitely does work, but it is not as gentle as kimchi. It is reliable and effective, like an army that marches in to attack the sinusitis causing bacteria. (See SINUSITIS TREATMENT SUMMARY page for details). While my family use it by dabbing/smearing or spooning the mixture into the nostrils, others reported using it in a neti pot (e.g., first Comment on the CONTACT page), and one person even a nasal aspirator (bulb syringe) for a large one time dose. Sometimes a side effect on the day we used the product was a dry mouth and throat (and they can be very dry when we overused it - so it's important to use only a little in a treatment). The person who used the nasal aspirator reported a temporary decrease in her sense of smell.
One concern is that Bactoferm F-RM-52 contains a second bacteria besides L. sakei. Very little is known about Staphylococcus carnosus - but it is considered non-pathogenic, and also no one has reported negative effects from it. Such are the perils of self-experimentation - effects are unkown.
However, several people (one in Europe) reported that Bactoferm F-RM-52 did not work for them, but then the issue is - did the L. sakei die during shipping or did it not work for some other reason? One possibility is that L. sakei does not work against all types of pathogenic bacteria. Even my family has had problems with Bactoferm F-RM-52 - one time it died during shipping. We knew because that batch had zero effect when we used it. If one batch is no good because the L. sakei has died, then I reorder or will try ordering from another source.
---[Please note: One sausage culture seller (sausagemaker) has been so upset (afraid of lawsuits?) that the Bactoferm F-RM-52 they sell has been used "off label" to treat sinusitis that they now have applied their own warnings to the back of the product package. The warnings state that the product also contains manganese sulfate monohydrate, which is used in tiny amounts as a food additive (a food grade nutritional supplement). However, the warnings listed are from the Safety Data Sheet for people handling large batches of manganese sulfate monohydrate (for "science education applications" or "laboratory and manufacturing use"). It's as if they are warning that the package contains nothing but the powdered form of manganese sulfate monohydrate, in case people might stick their heads in the package and inhale for prolonged periods. By the way, manganese can be sold in a variety of forms, and is an essential dietary nutrient for humans which is best obtained from food.]
B-2 - Several persons from Australia and New Zealand have reported good results with B-2. The manufacturers of Bactoferm F-RM-52 also make a Lactobacillus sakei only product called B-2. It is part of their SafePro product line of bio-protective cultures for meat. It is used exactly like the Bactoferm F-RM-52, but a person who has used both products liked the effects of B-2 more than Bactoferm F-RM-52 ("less irritating and more effective"). Unfortunately I have not seen this culture available anywhere in the U.S., but I know B-2 is available in New Zealand (netropolitan.co.nz) and can be (and is) shipped to Australia.
LACTOPY - The Korean L.sakei probiotic Lactopy has worked well for most people who have tried it. One person reported "pouring the powder on the tongue and also rubbing it on the roof of her mouth" when needed, and this has worked successfully for her for several years. Note that Lactopy, which is sold for digestive and skin health, must be stored in the refrigerator. People had difficulty getting this product in the U.S. during 2015, so the March 24 and April 19, 2016 Comments by Keif (scroll down) of it being available again but now called Lactopy Prime, how to get it (from either the manufacturer or Gmarket) with quick airmail shipping, is welcome news. I have used it similar to kimchi (dissolved a little in bottled water and smeared/dabbed in nose like a "messy eater"), also swished it in my mouth, and found it to work well. All 4 family members like this product - it's effective, yet feels gentle.
BACTOFERM SM 160 - One person (outside of North America) recently tried Bactoferm SM 160, which contains Lactobacillus sakei, Staphylococcus carnosus and Debaryomyces hansenii, and is finding very good results in treating chronic sinusitis that he had for years. The third microbe Debaryomyces hansenii is considered "non-pathogenic", and is common in food products (cheeses, processed meat, and early stages of soy fermentation). One study said D. hansenii secretes toxins capable of killing other yeasts, and it is used on an industrial scale to produce vitamin B2. However, it is a yeast species (a fungi) so it is unknown if it can cause problems (and so he's being cautious in its use, and so far all is good).
PRIMAL SK NATUR 50 - The European company VAN HEES makes a starter culture PRIMAL SK natur 50 with the same ingredients as Bactoferm F-RM-52. The ingredients are: Lactobacillus sakei and Staphylococcus carnosus, with a carrier base of dextrose (to feed the bacteria when used as a starter culture). They ship to various European countries. I do not have any feedback yet on this product.
BITEC STARTER LS 25 (also called BITEC LS-25) - One person from Denmark wrote that they have been using the product BITEC LS-25 which contains the same 2 bacteria as Bactoferm F-RM-52, but here the ingredients listed are Staphylococcus carnosus first and Lactobacillus sakei second. This product is also sold as a sausage starter and is made by Frutarum (a global "flavor, fragrances, and fine ingredients" company) that is based in Israel and Europe. The person liked the product, but still had some ongoing problems with sinusitis, so it is unclear how good a product it is (as compared to Bactoferm F-RM-52).
SOME L.SAKEI ISSUES: I still think of L. sakei as fairly fragile - it is killed off by antibiotics, by oxygen within a week of opening a kimchi jar, and even the culture Bactoferm F-RM-52 package says that it dies off within 2 weeks at room temperature (therefore store in freezer). Please note that the L. sakei in the product can also die off during shipping if it takes too long or some other reason. Thus we order 2 day shipping (if possible) and hope for the best.
WHY DIDN'T L. SAKEI WORK FOR SOME PEOPLE? Some other possibilities to explain why some people trying L. sakei mixtures (both kimchi and Bactoferm F-RM-52) has not resulted in their sinusitis improving is that perhaps some other "keystone species" (a very important microbial species for a normal healthy community) besides L. sakei is also missing in their sinus microbiomes. Or perhaps they have microbes or biofilms that the Lactobacillus bacteria cannot overcome, even though it is viewed that some Lactobacillus species are anti-biofilm and anti-pathogenic. Or perhaps not enough L. sakei is getting into the sinuses or the dose is too low for some sinus problems? (see Beth's comment after the post Three Years of Sinusitis Treatment Success). It is unclear whether the results are different if there are also nasal polyps. [Researchers now suspect that those with nasal polyps also have a problem with "primary inflammation".] We (modern medicine) know so little about the normal healthy sinus microbiome that there are many unanswered questions. (NOTE: click on the Category SINUSITIS for more posts on recent sinusitis research.)
PROBLEM WITH KIMCHI OVERUSE- Two people reported that a kimchi brand that originally worked for them suddenly stopped working, but they had used it daily or several times a day for a long time. That is why we use L.sakei products sparingly these days - only as needed.
OTHER PROMISING PROBIOTICS - Seven people have reported that multi-strain probiotics (but they did not contain L. sakei) treated their sinusitis. One woman tried Pure Encapsulations Probiotic 50B in her nose (I assume similarly to how we use Bactoferm F-RM-52) and reported major improvement. This product (which must be refrigerated) contains the following bacteria: Lactobacillus acidophilus, L. rhamnosus, L. plantarum, Bifidobacterium longum and B. lactis. Another person successfully treated his sinusitis by mixing a saline solution with a probiotic containing: Lactobacillus acidophilus, L. plantarum, L. rhamnosus, Bifidobacterium lactis, L. casei, B. bifidum, B.breve, and Streptococcus thermophilus. Note that the first 4 bacteria listed here are the same as in the first person's probiotic. (Scroll down to the Comment written by Martin for more details).
Some researchers are focusing on Lactobacillus sakei, L. rhamnosus, L. plantarum, L. casei, and L. Johnsonii in the treatment of sinusitis and sinus health (see below Promising Probiotic Nasal Sprays and also the June 29, 2016 post).
OTHER PROBIOTICS MAY OR MAY NOT HAVE BENEFICIAL EFFECTS - On the other hand, a few people (including my family members) reported trying various multi-strain probiotics containing various Lactobacillus and Bifidobacterium species in such a manner, but it did not treat the sinusitis, even though it resulted in some improvement usually (but not always). We tried Flora Udo's Choice Advanced Adult's Probiotic supplement with Lactobacillus casei, L. rhamnosus, L. acidophilus, L. plantarum, Bifidobacterium bifidum, B. breve, and B. longum (at florahealth.com). Since sinusitis sufferers don't have the bacteria diversity of healthy people, and the sinus microbial community is different in each person, then adding what are viewed as beneficial bacteria to the sinus microbial community might help some people.
The possibility remains that perhaps one or more bacteria species, or a combination of species, has effects similar to L. sakei. But which ones or which combinations of bacteria? (Just remember, trying L. sakei products or multi-strain probiotics is self-experimentation, and results are unknown and can vary - can be positive, negative, or no effect.)
STILL UNKNOWN: People have written in about 3 products that contain L. sakei, but no one has reported results. (1) From a person in Australia: Danisco's CHOOZIT® FNR 1 - a cheese starter culture that contains L. sakei and Staphylococcus vitulinus. The bacteria S. vitulinus is considered benign, but I could find almost nothing about it. So self-experimentation results are totally unknown - could be negative or positive. (2) Multi-strain Probiotic by Innovix Labs - tablets containing 26 probiotics, including L. sakei. However, I have 2 concerns with this product: A) This product does not require refrigeration, but all other L. sakei products require refrigeration (even the freezer), because at room temperature L. sakei dies within a few weeks. B) L. sakei is considered anaerobic - doesn't live when exposed to oxygen. So...while the L. sakei may be alive when the product is produced, is it alive weeks or months later at room temperature? (3) Pro-Kids ENT by Hyperbiotics are chewable tablets containing 5 strains of bacteria, including L. sakei and S. salivarius K12. I have the same concerns with this product as with product #2. In addition, the S. salivarius K12 has caused problems for some people (scroll down to "Problems With BLIS K12?") If purchasing product #2 or #3 I would consider refrigerating them to slow down the decline of bacteria numbers (which always happens over time), and add a desiccant to deal with the moisture from refrigeration (if it's not already included).
PROMISING PROBIOTIC NASAL SPRAYS - The original sinusitis researchers (Susan Lynch, A. Goldberg) are still working on a probiotic nasal spray containing L. sakei. Another research group (at the Univ. of Antwerp in Belgium) is developing a nasal spray with Lactobacillus rhamnosus, Lactobacillus plantarum, Lactobacillus casei, and other Lactobacillus species, including L. sakei. They are calling the nasal spray "Oronasopharyngeal probiotics", and say that these Lactobacillus species (especially L. rhamnosus) are "anti-pathogenic and antibiofilm agents".
NO EVIDENCE FOR JUST SWALLOWING PROBIOTIC SUPPLEMENTS: Evidence (my family, people writing in, research) so far has been that only directly dabbing/smearing/spraying probiotics in the nose, or even swishing a paste of probiotics (such as Lactopy) in the mouth may help treat sinusitis. I have not found any studies finding that ingesting/swallowing a probiotic pill has helped sinusitis (including a 2009 study looking at swallowing L. rhamnosus tablets 2 times daily for 4 weeks).
PROBIOTICS TO AVOID - The product NatureWise Maximum Care Time-Release Probiotics: 30 Strains, 30 Billion CFU contains a number of probiotic bacteria, including L. sakei. Lactobacillus and Bifidobacterium bacteria are generally viewed as beneficial. However, it also contains E. faecium (Enterococcus faecium) which is considered very controversial. This is because strains of this specific bacteria show multi-drug resistance (including to antibiotics). (See my Sept 2, 2016 Comment after the August 30, 2016 post for more information.)
PROMISING PHAGE THERAPY - Some researchers in the USA and Australia are currently testing phage therapy to see if it could be used as a treatment for various conditions, including chronic sinusitis. A bacteriophage is a virus that infects bacteria, and the name literally means "bacteria eater". Phage therapy is the therapeutic use of bacteriophages to treat bacterial infections. See the June 3, 2016 post Phage Therapy May Help Sinusitis Sufferers for more information. The authors of one study I posted there said that they had found evidence for people having "virus-like particles" in their sinuses, which they thought were bacteriophages.
PROBLEMS WITH BLIS K12 ? - On a side note, two of us, plus one person writing in, tried BLIS K12 bacteria tablets (containing Streptococcus salivarius BLIS K12) for several weeks because scientific research had found it to be an immune booster, that it is good for oral health, and it lowers the incidence of upper respiratory infections. However, from the first tablet (ate it by slowly dissolving it in the mouth) there were problems - feeling phlegmy and yellow mucus. After several weeks, we stopped the experiment and had to do kimchi treatments to recover. Two persons reported similar negative effects with PRO-dental tablets, which also contains BLIS K12. The message here is clear: that specific bacteria did not react well with our sinus and oral bacterial communities. Remember, whenever one introduces new bacteria into the human organism, there can be positive or negative effects.
PLEASE WRITE! I would really like to hear how you are treating and curing your sinusitis, especially chronic sinusitis. Or even what hasn't worked. It all adds to the knowledge base. And let me also know if you've had additional problems or complications such as sinus operations, nasal polyps, a fungal problem, diagnosed with antibiotic resistant bacteria (for example: Pseudomonas aeruginosa), etc. Has L. sakei or another probiotic helped? Write to me privately, or can comment after any post. (Note that most comments are after this post, the SINUSITIS TREATMENT SUMMARY page, the CONTACT page, and other sinusitis posts - see category SINUSITIS).