[Updated June 24, 2022] Probiotics are the future of sinusitis treatment. One probiotic (beneficial bacteria) that is lacking in those with chronic sinusitis and which successfully treats sinusitis is Lactobacillus sakei.
This page summarizes what has been learned over the past 9+ years: the best L. sakei products (such as kimchi and Lanto Sinus - which can treat even the worst recurring sinus infections, frequently within a few days), results of people trying various L. sakei products, and other possible probiotics for sinusitis and sinus health.
The sinus microbiome is the community of microbes (bacteria, viruses, fungi) that live in the sinuses. This community can become disrupted and imbalanced (dysbiosis) from illnesses, allergies, or antibiotics and cause a sinus infection or sinusitis. Research finds that not only do sinusitis sufferers lack L. sakei, they have too much of some other bacteria, and they also don't have the bacteria diversity in their sinuses that healthy people without sinusitis have.
Back in 2012, a study by Abreu et al suggested Lactobacillus sakei as a possible treatment for sinusitis. In the past 9 years those conclusions have been supported by the experiences of hundreds of people contacting me, and my family's experiences with L. sakei products. It really is the best sinusitis treatment for most people!
When Lactobacillus sakei works as a treatment - it can seem miraculous as sinusitis symptoms gradually disappear or greatly improve. Many times within a few days! Unfortunately it doesn't work for everyone - for a minority there seems to be no effect, perhaps because everyone's sinus microbiome (microbial community) is different. (See Treatment Summary page for different ways to use products.)
Another finding: only use L. sakei when needed. Not routinely and daily when feeling healthy. No boosters needed!
Luckily, Lactobacillus sakei is found in some foods (such as some brands of live fermented kimchi, and some sauerkraut), some sausage starter cultures (such as B-2), and recently in some probiotic supplements (e.g. Lanto Sinus). The food industry uses it because L. sakei dominates over and inhibits growth of pathogenic bacteria, including Staphylococcus aureus.
BACKGROUND STORY: Nine years ago there were no probiotics containing L. sakei. None. So instead family members experimented using a very easy kimchi sinusitis treatment (basically dabbing and smearing kimchi at certain stages of fermentation into the nostrils like a very messy eater) and found that it cured chronic sinusitis of many years within two weeks. Obviously this kimchi contained L. sakei. It felt miraculous!
After 9+ years we still feel great! Because we no longer have chronic sinusitis and can easily treat sinusitis if it occurs with L. sakei, we have NOT taken antibiotics or any other bacteria killing spray or product (such as xylitol) for over 9 years. We do not use cortisone or antihistamine nasal sprays either.
WHEN A TREATMENT WORKS: People used terms such as "miraculous", "transformative", and "fabulous" when they had positive results.
When a treatment works, then all sinusitis symptoms go away, or there is major improvement - frequently within days. Symptoms that go away include post nasal drip, sinus headaches, "clogged ears", bad breath, and sinusitis-related coughs. Even tonsil stones! (Note: this is self-experimentation - effects can be positive or negative. Always be cautious.)
OVERALL RESULTS: The majority of people reported positive results (chronic sinusitis improved or totally gone) from some form of L.sakei treatment. Since it's from self-experimentation and not a clinical trial, then I don't know the actual percentage of positive results.
Some of the people reporting success have had multiple operations, some have deviated septums, some with nasal polyps, and all have had long-standing chronic sinusitis, some for decades. Best results are to use only when needed.
The same treatments treat acute sinusitis or when sliding toward a sinus infection (perhaps only a few minor symptoms). After colds, etc. can develop acute sinusitis again and need re-treatment (the L. sakei usually doesn't stay in the sinuses from earlier treatments). But the sinuses do continue improving over time, so fewer and more minimal treatments are needed over time.
Another very small group reported that other probiotic strains helped, and a minority of people reported that nothing has helped and there could be a variety of reasons for this (see below). It also became clear that L. sakei does not treat seasonal allergies or allergy symptoms.
THREE MAIN PRODUCT CATEGORIES: Products containing live Lactobacillus sakei are: kimchi (and some sauerkraut), refrigerated products (e.g. Lanto Sinus), and frozen products. [Note: The FDA does not allow any probiotics to be sold as a medical treatment – they can only be sold as a dietary supplement.]
Using the following products to treat sinusitis is self-experimentation (results can vary). Always be cautious. (See Sinusitis Treatment Summary page for different treatment methods.)
KIMCHI - Many people report that kimchi helped them. One person reported a homemade kimchi worked great (he was finally symptom free after 8 years). A few mentioned that kimchi has helped sinusitis with fungal problems.
Some kimchi brands that people reported helping their chronic sinusitis: Sunja's Kimchi (mild white kimchi and medium spicy cucumber kimchi), Sinto Gourmet brand kimchi, Mama-O's Premium Kimchi, the white Napa kimchi and cabbage kimchi made by Choi's Kimchi Company (in Portland, Oregon), Farmhouse Culture Kimchi (in California), Ozuke Kimchi (in Colorado), in the United Kingdom the brand Mr Kimchi, and in Australia Kehoe's Kitchen white kimchi.
Not all kimchi brands or types of kimchi within brands contain L. sakei - finding one that has it is due to self-experimentation. The kimchi must be live, and not pasteurized. Some kimchi brands may contain L. sakei from about day 14 (or earlier) 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 over the next 2 days, or the acute sinusitis kept getting worse, than it did not contain L. sakei. Some researchers feel that it's the garlic in kimchi that encourages L. sakei growth.
SAUERKRAUT - Sauerkraut has worked for some people if it is a sauerkraut made with garlic, such as some varieties of Cleveland Kraut. Some researchers feel that it's the garlic in kimchi that encourages L. sakei growth, and traditional sauerkraut typically doesn't contain garlic.
REFRIGERATED LACTOBACILLUS SAKEI PRODUCTS – A high-quality refrigerated L. sakei product specifically meant for the sinuses and treatment of sinusitis is sold by Lanto Health. The kimchi derived L. sakei product called Lanto Sinus is meant to be used when needed (when there are symptoms). Lanto Sinus holds up well in the refrigerator, is quick-acting, and easy to use. This product ships well because it holds up for a while (days) without refrigeration.
People have reported success using it mixed with bottled water (dabbing, smearing, spooning a little in nostrils), or swishing it dry in the mouth. I’ve been a consultant with Lanto Health on this product and have been testing and using this product successfully for over 5 years when needed (self-experimentation!).
FROZEN LACTOBACILLUS SAKEI PRODUCTS – The main frozen L. sakei products available in many countries are frozen sausage starter cultures. All L.sakei products needing to be kept frozen are generally reliable and effective for sinusitis treatment. Only use when needed. Negatives with all frozen L.sakei products are that they must be kept frozen, they don’t hold up well once the package is opened, and they can easily die off during shipping.
Sausage starter cultures include BACTOFERM F-RM-52 (many countries, made by Chr. Hansen), PRIMAL SK NATUR 50 (Europe, made by Van Hees), and BITEC LS-25 (Europe, made by Frusarum). These contain 2 types of bacteria (L.sakei and Staphylococcus carnosus) – little is known about S. carnosus, but it is considered non-pathogenic, and no one has reported negative effects from it. B-2, which is only L. sakei (made by Chr Hansen), is available in New Zealand and some EU countries. The starter culture BACTOFERM SM 160 (L. sakei, Staphylococcus carnosus and Debaryomyces hansenii) has also been used successfully, but be very cautious (the third bacteria is considered non-pathogenic, is common in food products, is used commercially, but it is a yeast species - fungi).
Most use a frozen product by dabbing/smearing or spooning a little of the mixture (L. sakei and bottled water) into the nostrils, while a few others report using it in a neti pot. Sometimes a side effect on the day the product is used is a dry mouth and throat (and they can be very dry when overused - so only use a little).
OVERUSE CONCERNS: I have overuse concerns (too strong a dose) with using L. sakei in a neti pot or nasal syringe. Let the little suckers travel up to the sinuses on their own. And they do. Always start with the most cautious way to see if that works. [See Sinusitis Treatment Summary page for ways people report using products.]
SOME L.SAKEI ISSUES: It is fairly fragile – it is killed off by antibiotics, by oxygen, and it only lives a limited amount of time at room temperature. [For ex.: the culture Bactoferm F-RM-52 package says it dies off in under 2 weeks at room temperature - therefore store in freezer.] On the other hand, Lactobacillus species live and multiply in our bodies at 98.6 degrees Fahrenheit - so L. sakei can handle warm temperatures just fine for a while.
Please note that the L. sakei in any product can also die off during shipping if it takes too long, it’s too hot (e.g. inside hot postal vehicles in extreme heat), or some other reason. Shorter shipping times are best in hot months. [Note: Consider overnight shipping during heat waves, especially when 100+ degrees Fahrenheit. USPS delivers to mailboxes while UPS typically delivers to the door.]
WHY DOESN'T L. SAKEI WORK FOR SOME PEOPLE? Some possibilities why L. sakei products have not resulted in sinus improvement for some is that perhaps some other "keystone species" (a very important microbial species for a normal healthy community) is missing in their sinus microbiomes. Or perhaps they have microbes that the Lactobacillus sakei bacteria cannot overcome. Perhaps there are also nasal polyps. [Researchers think that those with nasal polyps have a "primary inflammation" problem.]
So little is known about the normal healthy sinus microbiome that there are many unanswered questions.
PROBLEM WITH A PRODUCT SUDDENLY NOT WORKING, OR OVERUSE - Some reported that a kimchi or L. sakei product that originally worked for them suddenly stopped working or not as well, but usually it had been the only product used for a while. There can be a feeling of "imbalance" or occasionally symptoms such as increased mucus, sore throat, etc. This might be an issue of "too much of certain microbes" - need to get some other microbes up there.
We found that immediately switching to another product (e.g., from one brand or type of kimchi to another), or from a L. sakei product to kimchi, or swishing multi-strain probiotics (the dry powder) in the mouth, or switching to refrigerated L.sakei in the mouth (if using kimchi before that) has corrected the situation for us.
We have even done this the same day when using another product - if we feel the need. (Finding what works is self-experimentation, and varies from time to time. May need to do this once or more times - as needed). And weeks later, we can use the original product once again. This is also why we only use a product when needed.
BOTTOM LINE: When feeling good, stop using the L. sakei product. Use L. sakei products sparingly - use only as needed (e.g. when developing symptoms). Using less is better – esp. as sinus microbial communities improve over time. L. sakei seems to be necessary for sinusitis treatment for most, but there are also other important microbes in the sinuses.
New research is finding that this advice - use only when needed - applies to all probiotics, and probiotic species. Whether for the gut or sinuses or whatever. [See post about daily use & gut health.]
OTHER PROBIOTICS AND PRODUCTS - Studies looking at other probiotic species have been generally disappointing. One well done study found that some sinusitis treatment products don't work, specifically the probiotic Lactococcus lactis, xylitol , and ordinary saline rinses. They don't improve sinusitis symptoms and don't improve the sinus microbiome. This is similar to what people have reported to me over the years.
Only rarely some people reported that multi- strain probiotics (the species varied, but they did not contain L. sakei) treated their sinusitis. They mixed the powder in the capsules with water and smeared or dabbed the mixture in the nose, or even used it in a saline rinse.
OTHER PROBIOTICS SOMETIMES HELP A LITTLE - Many people (including family members) reported trying various multi-strain probiotics containing various Lactobacillus and Bifidobacterium species in the nostrils and found they did not treat sinusitis. But if feeling a little “imbalanced” – perhaps a cough or mucusy – then swishing the dry powder from one capsule in the mouth and then swallowing it, can result in some improvement.
STILL UNKNOWN: Some multi-strain probiotics now contain L. sakei, but may be problematic if they don’t need refrigeration (e.g. Multi-strain Probiotic by Innovix Labs). L.sakei products typically die after a few weeks without refrigeration, and die when exposed to oxygen (anaerobic). Also, multi-strain probiotics containing both L. sakei and S. salivarius K12 together may make things worse. (Scroll to "Problems With BLIS K12?").
PROBIOTIC NASAL SPRAYS - Currently the FDA does not allow any probiotic supplement or probiotic nasal spray to be sold as a "medical treatment". So far studies have not found any evidence of other Lactobacillus or Bifidobacterium species being effective in treating sinus infections.
NO EVIDENCE FOR JUST SWALLOWING PROBIOTIC SUPPLEMENTS: Evidence so far has been that only directly dabbing/smearing/spraying probiotics in the nose, or even swishing probiotics in the mouth may help treat sinusitis. No studies find that just swallowing a probiotic pill has helped sinusitis (including a 2009 study looking at swallowing L. rhamnosus tablets 2 times daily for 4 weeks).
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 post Phage Therapy May Help Sinusitis Sufferers for more information. The authors of one study said they found evidence for "virus-like particles" in sinuses, which they thought were bacteriophages.
SNOT TRANSPLANTS IN THE FUTURE? – Currently “snot transplant” studies from healthy persons to sinusitis sufferers are going on in Europe and Canada to see if it works as a sinusitis treatment. This may work great, but researchers have the same concerns as with fecal microbial transplants (stool transplant) for the gut. For example, are diseases also being transplanted?
PROBLEMS WITH BLIS K12 ? - Some people report that the probiotic BLIS K12 bacteria (also known as Streptococcus salivarius BLIS K12), can bring on sinusitis-type symptoms. Scientific research finds it to be an immune booster, good for oral health, etc. But for many: from the first tablet (slowly dissolving it in the mouth) there were problems - feeling mucusy, with yellow mucus.
Several persons reported similar negative effects with PRO-dental tablets, which also contains BLIS K12. The message here is clear: these 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 your sinusitis, especially chronic sinusitis. Or even what hasn't worked. Write to me privately, or can comment after any post.
Some other sinusitis posts to read:
Some Treatments Don’t Work For Sinusitis (June 2021)
Microbes Live In Our Sinuses (May 2021)
Mold and Sinusitis (August 2020)