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Probiotics are the future of sinusitis treatment. Research found that a probiotic (beneficial bacteria) that is lacking in those with chronic sinusitis and which successfully treats sinusitis is Lactobacillus sakei. This article is the full summary of what has been learned over the past 6 years: the best L. sakei products (such as kimchi and Lacto Sinus - which can treat even the worst recurring sinus infections), results of people trying various L. sakei products, ways to use the products, and other possible probiotics for sinusitis and sinus health.

Back in 2012, a study by Abreu et al suggested Lactobacillus sakei as a possible treatment for sinusitis. In the past 6 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. Unfortunately it doesn't work for everyone - for a minority there seems to be no effect, and it is not clear why. (See Treatment Summary page for different ways to use products.)

Sinusitis research in the last decade has found 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. In other words, the sinus microbiome (microbial community) is out of whack (dysbiosis) in chronic sinusitis -  with a depletion of some bacterial species, and an increase in "abundance" of other species.

Luckily Lactobacillus sakei is found in some foods (such as some brands of live fermented kimchi), some sausage starter cultures (such as B-2), and recently in some probiotic supplements (e.g. Lacto Sinus). One reason it is used in sausage starter cultures is because L. sakei dominates over and inhibits growth of pathogenic bacteria, including Staphylococcus aureus.

BACKGROUND STORY: Six years ago there were no probiotics containing L. sakei. None. So instead members of my family 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 several weeks. Obviously it contained L. sakei. It felt miraculous, especially because it was so easy to do. (See Sinusitis Treatment Story page for our background story).

After 6 years we still feel great! Generally all 4 of us only need to treat again with a product containing Lactobacillus sakei (we've been using refrigerated Lacto Sinus) after a virus which goes into sinusitis, or if for some other reason we feel like we're sliding into sinusitis. The last few years we've needed to do this far less (and more minimally) than the first year because every year we have improved – fewer colds and viruses, and an improved sinus microbiome. 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 6 years. We do not use cortisone or antihistamine nasal sprays either.

WHEN A TREATMENT WORKS: Many of you have contacted me to report your own progress with various sinusitis treatments. Thank you! People used terms such as "miraculous", "transformative", and "fabulous" when they had positive results with a product containing L. sakei. I’ve also heard from a few people of some other 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 RESULTSThe majority of people contacting me with results reported positive results (chronic sinusitis greatly improved or totally gone) from some form of L. sakei treatment. Successes have been from the USA, Canada, 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. 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 to treat acute sinusitis. It seems that after colds, etc. they (including myself) may develop acute sinusitis again and need re-treatment (apparently the L. sakei frequently doesn't stay or colonize in the sinuses from earlier treatments). However, the sinuses do continue improving over time so our experience has been that fewer and more minimal treatments are needed over the years. Another very small group reported that other probiotic strains helped (but it is not always clear whether they also tried a L. sakei product), and minority of people reported that nothing has helped and there could be a variety of reasons for this (see below). Some people reported that one product helped, but not another - whether kimchi or a L. sakei product.

THREE MAIN PRODUCT CATEGORIES: Currently there are 3 main categories of products containing live Lactobacillus sakei, and which people have reported success in treating sinusitis: kimchi (and some sauerkraut), refrigerated products (e.g. Lacto Sinus), and frozen products. Note that at this time the FDA does not allow any probiotics to be sold as a medical treatment – they can only be sold as a supplement. Using the following products to treat sinusitis is self-experimentation (results are unknown and can vary). Always be cautious when testing a new product. (See Sinusitis Treament Summary page for treatment methods.)

KIMCHI - Many people report 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 kimchiMama-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), 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. I'm sure some (many?) other brands also contain L. sakei.

(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. We found that kimchi 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 or phlegmy 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 sauerkraut made with garlic. Some researchers feel that it's the garlic in kimchi that encourages L. sakei growth, and sauerkraut typically doesn't contain garlic.]

REFRIGERATED LACTOBACILLUS SAKEI PRODUCTS  – A high-quality refrigerated L. sakei product specifically meant for the sinuses is sold by Lacto Health. The kimchi derived Lactobacillus sakei product called Lacto Sinus is meant to be used when needed. Lacto Sinus  is sold as a dietary supplement, holds up well in the refrigerator, is effective, reliable, 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 Lacto Health on this product and have been testing and using this product successfully for over a year (self-experimentation!).    ...continue reading "The Best Probiotic For Sinus Infections"

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I'm always on the lookout for probiotics (beneficial bacteria) that can somehow  suppress or dominate Staphylococcus aureus  - because that bacteria is implicated in many illnesses, including sinusitis. Some strains of S. aureus are antibiotic resistant and the cause of serious illnesses, such as MRSA  (Methicillin-resistant Staphylococcus aureus). However, S. aureus is also found in the microbiomes (microbial communities) of healthy people - including on the skin, nose, and gut - but it appears to reside there harmlessly in healthy people.

So finding species of bacteria that suppress or controls S. aureus is noteworthy. Researchers (from National Institute of Health and Thailand) found that in both humans and mice strains of Bacillus, especially B. subtilis, which is already added to many probiotic products, suppressed all strains of S. aureus. Interestingly, the researchers found no S. aureus in any of the gut and nasal samples from humans where Bacillus species were present.The researchers think that the Bacillus species eradicate S. aureus - in both the gut and nasal passages. So the researchers tested further using mice - they gave B. subtilis to the mice every 2 days, and it eliminated S. aureus in the guts of the mice.

But why did I title this post '"another probiotic" ? Because from research and personal experiences told to me - Lactobacillus sakei seems to have the same effect against S. aureus. Stay tuned for more research with B. subtilis and other probiotics versus S. aureus. [UPDATE: Since I posted this, I've read some concerns over B.subtilis. Be careful.]  From Science Daily:

Probiotic bacillus eliminates staphylococcus bacteria  ...continue reading "Another Probiotic That Treats Infections?"

Many people take probiotics in the belief that the probiotics will help their gut microbiome (microbial community) recover after taking antibiotics. This is because antibiotics kill both beneficial and pathogenic bacteria, and research shows it may take months for the gut to recover (it depends on the antibiotics taken). However, 2 studies (in both mice and healthy humans) conducted by a group of researchers at the Weizmann Institute of Science in Israel challenge that belief. The researchers used both mice and healthy humans in both well-done studies. They found that taking probiotics after a week of antibiotics actually delayed recovery of the gut microbial community in humans - months longer!

In summary: As expected, taking antibiotics had a big effect on the gut microbiome - the researchers wrote "a dramatic impact"  and "profound microbial depletion" (after taking one week of standard doses of "broad-spectrum antibiotics").  However, they found large differences among the 3 groups in gut microbial recovery after antibiotics. The spontaneous recovery group (they did not take probiotics after antibiotics) showed recovery of gut microbes within 3 weeks. The fecal transplant group (of their own fecal microbes which was collected before they took antibiotics) showed gut microbial recovery within 1 day of the fecal microbial transplant. In contrast, the group taking daily  probiotics for 28 days did not show full recovery (to where they were before antibiotics) by day 28, and the gut microbial community was still out of whack (dysbiosis) even 5 months after stopping probiotics (actually even at 180 days when the study ended).

What species were in the probiotics? Eleven species commonly found in ordinary probiotics: Lactobacillus acidophilus, L. casei, L. casei subsp. paracasei, L. planatrum, L. rhamnosus, Bifidobacterium longum, B. bifidum, B. breve, B. longum sbsp. infantism, Lactococcus lactis, and Streptococcus thermophilus.  These are all considered beneficial species. But keep in mind that the human gut has hundreds of microbial species - not just the few found in probiotics.

Bottom line: Eat well after taking a course of antibiotics so as to feed beneficial microbes, and do not routinely take probiotics thinking it will help the microbes in the gut.

What was also interesting was that in the first study where healthy individuals took the probiotics (and no antibiotics), they found that the probiotic species did not colonize the gut in everyone - only some species and in some people. It's as if there is a "resistance to colonization". This resistance is perhaps what other studies show - that within one week of discontinuing probiotics, they are gone from the gut.

From Science Daily - Human gut study questions probiotic health benefits  ...continue reading "Research Suggests Not Taking Probiotics After Antibiotics"

Is the Mediterranean style diet the future in breast cancer prevention? The following study was done in primates, but it makes sense that the results would also be true for humans: that the type of diet eaten influences the breast microbiome. This means the community of microbes that live in the breast. Yes, it's true - studies show that there is a breast microbiome and it varies between those who have breast cancer and those who don't (healthy breasts).

The study looked at macaque monkeys who were fed either a Mediterranean style diet or a Western style diet for 31 months, and then their breast tissue was examined. They found microbial differences in the breast tissue among the 2 groups, including  greater numbers (abundance) of Lactobacillus species in the primates that had been eating the Mediterranean diet.

Lactobacillus species are generally considered beneficial to humans (which is why they are added to many foods and supplements) and studies suggest they may have anti-tumor effects. Some research has found microbial differences between healthy and malignant (cancerous) human  breast tissue  - including lower Lactobacillus numbers or "abundance" in the malignant breast tissue (compared to those with benign breast lesions). Researchers say it suggests that microbial imbalances (dysbiosis) of breast tissue could be a possible driver of breast cancer .

Studies already show that a person's diet influences the gut microbiome. This study shows diet directly influences microbial communities far away from the gut - in the breasts. Unfortunately it is not stated in the study what Lactobacillus species increased in the breast tissue of primates fed a Mediterranean diet. There are many Lactobacillus species, and they are not equal in their effects (as our experiences with Lactobacillus sakei and sinusitis has shown).

Of course more studies are needed, but in the meantime - eat a diet rich in fruits, vegetables, whole grains, legumes (beans), nuts, and seeds. There are many other documented health benefits from a diet rich in those foods (frequently referred to as a Mediterranean diet). The diet is low in processed foods and high in fiber, and rich in "real foods". From Science Daily:

Diet affects the breast microbiome in mammals

Diet influences the composition of microbial populations in the mammary glands of nonhuman primates, researchers report October 2 in the journal Cell Reports. Specifically, a Mediterranean diet increased the abundance of probiotic bacteria previously shown to inhibit tumor growth in animals ...continue reading "Diet And The Breast Microbiome"

People ask me: what's going on with research in the treatment of sinusitis with probiotics? Well, the answer is that things are moving along slowly - very slowly, but there are good signs. Earlier this year an interesting article by researcher Anders U. Cervin at the University of Queensland (Australia) was published that specifically talked about "topical probiotics" as a potential treatment for chronic sinusitis. By this he means that probiotics (beneficial bacteria) could be directly applied to the nasal passages in the nose, such as a nasal spray. And he discussed how the prevailing view nowadays, based on scientific evidence, is that in sinusitis there is an "imbalance of the sinus microbiome" - the community of microbes living in the sinuses. Yes!!!

Cervin mentioned all sorts of research showing beneficial effects of using different strains of probiotics for various illnesses, mentioned the Abreu et al study (which is the reason I focused on Lactobacillus sakei as a sinusitis treatment, and which works successfully for many people), but.... nowhere did he mention Lactobacillus sakei by name. What??? There are already excellent L. sakei probiotics out there for sinusitis treatment such as Lacto Sinus.

Cervin discusses how studies are needed to test nasal sprays for the treatment of sinusitis, and made a lot of good points. He looked at studies already done, wondered what bacterial strains might be beneficial, but obviously didn't read the Abreu et al study carefully to see that L. sakei might be a good candidate to test. And he didn't do an internet search to see what probiotics people are using already as a successful treatment for sinusitis (see Sinusitis Treatment Summary page). He did mention that the only good trial using nasal spray probiotics in humans with sinusitis found no effect - because they tested the wrong Lactobacillus strains - they were honeybee strains [see post], and not ones found in humans.

Eh... So once again I'm heartened by the focus on the microbial community in sinusitis, and heartened that he said there it was time to get out of the laboratory and start testing probiotics as treatments on people. But I'm dismayed that the focus is so narrow that he's missing what is in front of him - what is already out there. He also missed that a "snot transplant" study is now going on in Europe, which is sure to have interesting results.

By the way, some of the questions the article raises are ones which, based on the experiences of myself and others over the past 5 years, we can already answer: living bacteria as a treatment are better than dead bacteria (using dead bacteria doesn't work), nasal treatments work but just swallowing a probiotic pill doesn't, Lactobacillus sakei works as a treatment for many, the L. sakei bacteria reduces inflammation in the nasal passages, the probiotic can be used in place of an antibiotic, and only treat when needed and not continuously (continuously treating can also result in an imbalance in the sinus microbiome). [See post The Best Probiotic For Sinus Infections where these issues are discussed and the best L. sakei products.] ...continue reading "Researcher Sees Potential for Sinusitis Nasal Probiotics"

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Big announcement today! The high quality product Lacto Sinus, which contains the probiotic Lactobacillus sakei specifically for sinus health, is now available. This product contains an excellent strain of Lactobacillus sakei that is kimchi derived. Lactobacillus sakei is the one probiotic (beneficial bacteria) that has successfully treated the chronic sinusitis of many people, including all members of my family. It has been an amazing journey - and since using Lactobacillus sakei our sinuses feel great, and we have not had to use antibiotics in 5+ years! A win-win.

More than 5 years ago I read research about the sinus microbiome (microbial community), and how chronic sinusitis sufferers lack the keystone bacteria Lactobacillus sakei that successfully treats sinusitis. There were no probiotics with L. sakei available back then. None. But we (my family) were able to successfully treat chronic sinusitis with live kimchi, which can contain Lactobacillus sakei (see Sinusitis Treatment Story). Kimchi is a wonderful product, but... with kimchi you never know if you're getting L. sakei, and even then it dies off rapidly. We went on to experiment with other products for years, with none of them ideal. So it is great that finally, after all these years, a product like Lacto Sinus is now available.

Nice things about Lacto Sinus are that the Lactobacillus sakei strain is kimchi derived (an excellent strain!), the product holds up well, it is in powder form, easy to use, and it only needs to be refrigerated. (That's right, it's meant to be refrigerated, and not frozen.) Since it also holds up well for a time without refrigeration, it also ships well. (After all, L. sakei lives and multiplies in our sinuses at 98.6 degrees Fahrenheit.) Lacto Sinus is sold by Lacto Health, and shipped from the NJ/NY metro area. Lacto Sinus is a high quality product that is produced with Good Manufacturing Practices, and is lab tested and verified.

Gentle, yet strong. It is being sold as a probiotic dietary supplement for sinus health. It comes in powder form with directions stating to mix with a little bottled water or take it dry, and swallow - after all, it is a dietary supplement. Lacto Sinus comes with a little spoon for ease of use. The product is meant to be used when needed for sinus support (when there are sinusitis symptoms).

I want to mention that I have been a consultant to the company, and have been testing the product for over a year. As usual, I self-experimented to see what works best for me - but of course, only using it when needed (for example, if I start to slide into sinusitis after a cold). After 5 years of self-experimentation (as I've described in posts) my sinus microbiome has improved, so at this point I only need to use a little bit for successful results. What has worked for me is swishing a little of the dry powder in the mouth, and then swallow, and not drink or eat for a least 30 minutes after that (to let it travel to the sinuses). Yes, I like the product a lot!

By the way, the advice to use only when needed - should be applied to any probiotic  supplement that is used as a sinusitis treatment or for sinus support. And as I describe in The One Probiotic That Treats Sinusitis - based on my family's experiences and many people contacting me - most people are helped by Lactobacillus sakei, but not all. By the way, it does not appear to treat allergies.

Finally, I want to point out that currently all probiotics in the United States are sold as dietary supplements and not as treatments. The FDA (Food and Drug Administration) at this time does not allow any medical treatment claims for any probiotic sold. Using a probiotic dietary supplement in ways other than label directions is SELF-EXPERIMENTATION. [See Sinusitis Treatment Summary page for self-experimentation details - the different ways people use L. sakei products.]

[UPDATE: Read the The Best Probiotic For Sinus Infections - results from many people using Lactobacillus sakei and other probiotic sinusitis treatments.]

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It's official. This month is 5 whole years being free of chronic sinusitis and off all antibiotics! Yes, that's correct - 5 whole years for all 4 family members, and our sinuses feel great!

Back in February 2013 - first I, and then the rest of my family, started using easy do-it-yourself sinusitis treatments containing the probiotic (beneficial bacteria) Lactobacillus sakei. Now we only treat with a L. sakei  product when occasionally needed - and it still works great. And it still feels miraculous.

After reading the original ground-breaking research on sinusitis done by Abreu et al (2012), it led to me trying L. sakei as a sinusitis treatment. Of course, there is an entire community of microbes (bacteria, fungi, viruses) that live in healthy sinuses - the sinus microbiome - but L. sakei seems to be a key one for sinus health. Since that original 2012 study, other studies have also found that in people with chronic sinusitis, the sinus microbial community is out of whack (dysbiosis). 

The one thing different this past year is that our sinus microbial community (sinus microbiome) seems better. If we need to treat (for example, after a virus that goes into sinusitis), then all four of us noticed that we need to use much less of a product than in the past. Incredibly little. So it seems that our sinus microbial community has definitely improved over time.

The post The One Probiotic That Treats Sinusitis (originally posted January 2015 and with many updates since then) contains information using my family's experiences (lots of self-experimentation!) and all the information that people have given me over the years. Thanks everyone! The post has a list of brands and products with L. sakei, treatment results, as well as information about some other promising probiotics (beneficial bacteria).

Thank you all who have contacted me  - whether publicly or privately. Please keep writing and tell me what has worked or hasn't worked for you as a sinusitis treatment. If you find another bacteria or microbe or product that works for you - please let me know. It all adds to the sinusitis treatment knowledge base. I will keep posting updates. 

(NOTE: I wrote our background story - Sinusitis Treatment Story back in December 2013, there is a  Sinusitis Treatment Summary page with the various treatment methods quickly discussed, and the latest information on The Best Probiotic For Sinus Infections. One can also click on SINUSITIS under CATEGORIES to see more posts about what is going on in the world of sinusitis research.)

A recent study tested a variety of probiotic (beneficial) Lactobacillus and Bifidobacteria species of bacteria as a treatment for chronic sinusitis. Unfortunately, it found that the microbes tested had NO effect on chronic sinusitis symptoms. It was a nice study conducted in Sweden, with 21 people with chronic sinusitis (but without nasal polyps) randomly assigned to receive a nasal spray (that they used 2 x daily for 14 days) containing either a mixture of 13 bacteria or a "sham" nasal spray. No one knew who received what, and then after a few weeks they did a crossover - meaning who got what was switched for another 2 weeks.

But...the main finding is that after 14 days of using the nasal sprays, there was no improvement in either group, no improvement in symptoms, no effect on the sinus "microbial flora", and no effect on inflammation. In fact, 2 individuals wound up taking antibiotics while testing the bacteria nasal spray. In other words, a big fat zero.

The bacteria tested were what the researchers called a honeybee lactic acid (LAB) microbiome, with both Lactobacillus and Bifidobacteria species: Lactobacillus apinorumL. melliferL. mellis, L. kimbladiiL. melliventrisL. helsingborgensisL. kullabergensisL. kunkeei, L. apisBifidobacterium asteroidesB. coryneforme, Bifidobacterium Bin7N, and Bifidobacterium Hma3N. These species are not typically found in probiotic supplements.

Why did they choose those strains of bacteria? Because "in vitro" testing (meaning in a test tube or culture dish) suggested that they would be effective against the pathogenic bacteria frequently found in chronic sinusitis (that they were antimicrobial). But real world testing in actual humans in this study showed that those specific Lactobacillus and Bifidobacteria microbes had no effect on sinusitis symptoms. Their premise was good - that the sinus microbiome was "disturbed" or out of whack (dysbiosis) in chronic sinusitis, but unfortunately they chose the wrong bacteria to test as a treatment.

The SNOT-22 questionnaire that asked questions of sinusitis sufferers at several points in the study to see if there was improvement in sinusitis symptoms, is one typically given to those with chronic sinusitis. [By the way, when reviewing the questionnaire, I realized it left out some major sinusitis symptoms such as "gagging on phlegm", "waking up with sore throat", "teeth hurt", "headache" - all of which are frequently mentioned by many contacting me, and which I remember well from pre-L. sakei days. In other words - it is incomplete, yet it is the questionnaire typically used to assess quality of life and symptoms for those with chronic sinusitis.]

The researchers end the journal article by stating "Further studies are warranted to explore whether other tentative probiotic assemblages [other bacterial species] can confer positive health effects to patients suffering from inflammatory conditions of the upper airways." Huh... If only they had asked...  I've been writing about Lactobacillus sakei as an excellent treatment for chronic sinusitis since 2013 (based on results of Abreu et al study), and I've been getting positive feedback from others about L. sakei since early 2014. For those who find that L. sakei works as a sinusitis treatment, the results seem miraculous - typically with major improvement within a few days. (Please note: Perhaps other microbes may also work as a sinusitis treatment.) Excerpts from Laryngoscope Investigative Otolaryngology:

Clinical efficacy of a topical lactic acid bacterial microbiome in chronic rhinosinusitis: A randomized controlled trial

A locally disturbed commensal microbiome might be an etiological factor in chronic rhinosinusitis (CRS) in general and in CRS without nasal polyps (CRSsNP) in particular. Lactic acid bacteria (LAB) have been suggested to restore commensal microbiomes. A honeybee LAB microbiome consisting of various lactobacilli and bifidobacteria have been found potent against CRS pathogens in vitro. Recently, we examined effects of single nasal administrations of this microbiome in healthy subjects and found it inert. In this study, we examined effects of repeated such administrations in patients with CRSsNP.

The study was of a randomized, double‐blinded, crossover, and sham‐controlled design. Twenty patients received 2 weeks' treatment administered using a nasal spray‐device. The subjects were monitored with regard to symptoms (SNOT‐22 questionnaire, i.e., the primary efficacy variable), changes to their microbiome, and inflammatory products (IL‐6, IL‐8, TNF‐, IL‐8,a, and MPO) in nasal lavage fluids.

ResultsNeither symptom scores, microbiological explorations, nor levels of inflammatory products in nasal lavage fluids were affected by LAB (c.f. sham). Conclusion: Two weeks' nasal administration of a honeybee LAB microbiome to patients with CRSsNP is well tolerated but affects neither symptom severity nor the microbiological flora/local inflammatory activity.

 In this study, involving patients with well‐defined CRSsNP, we demonstrate that repeated nasal administration of a LAB microbiota composed of several species of lactobacilli and bifidobacteria over 2 weeks neither affects symptoms as assessed by SNOT‐22 questionnaire nor the bacterial composition or the inflammatory activity in the nasal cavity. The observations are of relevance to the evaluation of topical LAB treatment in the management of upper respiratory tract conditions such as CRS.

Shucks... A randomized controlled trial (the best kind of study) found that probiotics and xylitol did NOT help sore throat symptoms. Sore throats are medically known as pharyngitis. Xylitol is a birch sugar that causes local “bacterial interference” by inhibiting bacterial growth and the adherence of bacteria to the pharyngeal wall (the throat). The probiotics (beneficial bacteria) that they tested were strains of  Lactobacillus acidophilus, Bifidobacterium bifidum, and Bifidobacterium animalis. They also tested sorbitol chewing gum, which does not have any antiviral or antibacterial properties. Not one of these alone or combined had any effect on sore throat symptoms.

My take on this: perhaps other species of probiotics might help - maybe yes, maybe no. Just testing 3 strains of bacteria is too soon to rule out probiotics. This view is based on our (and others) experiences with chronic sinusitis - that it takes very specific bacteria species (especially Lactobacillus sakei) to treat sinusitis, and just taking some random strains may not help at all. From Science Daily:

New RCT shows no benefit from probiotics, xylitol chewing gum in alleviating sore throats

The use of probiotics and xylitol chewing gum to alleviate sore throat symptoms -- as an alternative to antibiotics -- appears to have no effect, according to a randomized controlled trial (RCT) published in CMAJ (Canadian Medical Association Journal).

Evidence exists that indicates probiotics and xylitol, a birch sugar that prevents bacterial growth, can help reduce recurrence of upper respiratory tract infections.

The study included 934 people in the UK during the four year study period (June 2010 to 2014), of whom 689 provided complete data for the trial. Using a symptom diary, participants reported the number of probiotic capsules and sticks of chewing gum used each day, as well as the severity of symptoms. They were study "compliant" if they had taken 75% of their allotted treatment.

Researchers found no significant effect of either probiotics or xylitol on sore throat (pharyngitis) symptoms. "There were no significant differences between groups for both the xylitol and the probiotic groups, which suggests that neither intervention helped in controlling acute symptoms," the authors write. [Original study.]

 Sore throat. Credit: Wikipedia

 A study was just published by researchers at the University of California that reviewed the role of Lactobacillus bacteria in a variety of diseases and conditions. What was surprising was that while we generally think of Lactobacillus bacteria as beneficial, some studies suggest that in certain diseases or conditions they may not be. But it is unknown if in those cases whether they're causing harm or why they are there in increased amounts.

Studies have found that Lactobacillus numbers are decreased ("depleted") in: some infectious diseases such as human immunodeficiency virus (HIV), in diarrhea-dominant irritable bowel syndrome (IBS) patients, type 1 diabetes, multiple sclerosis, colorectal cancer, and maternal prenatal stress (resulted in the infant having decreased levels of Lactobacillus bacteria). Lactobacillus levels were found to be either increased or decreased (depending on the study) in: cancer [but breast cancer, head and neck squamous cell cancer had increases in Lactobacillus levels], type 2 diabetes, and obesity. Increased amounts (intestinal "abundance") of Lactobacillus species has been found in: Crohn’s disease (CD) patients and rheumatoid arthritis (RA) patients. Studies also found benefits for consuming probiotics (with varying strains of Lactobacillus) for treating most of these diseases and conditions.

It used to be thought that Lactobacillus species were main species of the gut, but as genetic sequencing tests were developed, it became clear that Lactobacillus species are less than 1% of the bacterial species of the gut - thus a "minor member" of the gut microbiome. But as can be seen in the review study - much is still unknown about Lactobacillus species. What is true for one Lactobacillus species may not apply to another one. Studies find that feeding or nourishing beneficial microbes in the gut is good (e.g., eat foods with lots of fiber), as well as eating foods with lots of naturally occurring microbes (e.g., raw fruits and vegetables, cheeses, and fermented foods).

NOTE: In the following excerpts autochthonous = native (to the gut), and allochthonous - not native (originates elsewhere - such as from ingested probiotics). Excerpts from Current Opinion in Biotechnology:

Intestinal Lactobacillus in health and disease, a driver or just along for the ride?

Similarly, a number of recent publications in which culture independent methods were employed (e.g. 16S rRNA gene amplicon sequencing) identified Lactobacillus as being significantly enriched in the distal gut during either health or disease.....Lactobacillus species have been isolated from the entirety of the human GI tract (oral cavity to feces) as well as the skin and vagina. This genus is estimated to constitute 6% of the total bacterial cell numbers in the human duodenum and approximately 0.3% of all bacteria in the colon..... Lactobacillus can also dominate the human vaginal microbiota (90 to 100% of total bacteria present) and is found on the skin, but in much lower relative abundance.

Only a few out of the >200 known Lactobacillus species  have been consistently and repeatedly associated with the human GI tract. Recently, this number was increased to over 50 Lactobacillus species that were repeatedly detected in the stools of healthy volunteers. The most abundant Lactobacilli included L. casei, L. delbruckeii, L.murinus, L. plantarum, L.rhamnosus, and L. ruminus. Some of these species (e.g. L. rhamnosus and L. murinus) are rarely isolated from environments outside the intestine and are considered gut-autochthonous microorganisms. Other mucosal sites are colonized by distinct species (e.g. L. crispatus in the vagina). 

Both human immunodeficiency virus (HIV)-infected humans and simian immunodeficiency virus (SIV)- infected rhesus macaques harbor reduced numbers of intestinal Lactobacillus..... Several recent animal studies have indicated a broader role for Lactobacillus in prevention and resolution of infectious disease. Tryptophan metabolites (indole aldehydes) produced by indigenous L. reuteri strains activate host aryl hydrocarbon receptors (AHR) to promote gut and vaginal epithelial barrier and antimicrobial responses required for limiting the expansion of Candida albicans, an opportunistic pathogen. Autochthonous Lactobacillus might also have a role in the resolution of infectious disease and recovery of immune homeostasis.

A meta-analysis of reports investigating the fecal microbiomes from IBS patients and healthy subjects concluded Lactobacillus was depleted in diarrhea-dominant, IBS patients..... Consistent with these results, meta-analysis of probiotic intervention studies randomized controlled trials (RCTs)) for treatment of IBS concluded that multi-species probiotics diminish symptoms (abdominal pain, bloating, and flatulence scores). Conversely, intestinal abundance of Lactobacillus and other genera including Bifidobacterium were recently positively correlated with Crohn’s disease (CD)patients .... These findings contrast with ulcerative colitis (UC) in which probiotic Lactobacillus consumption has been with improved clinical symptoms.

The intestinal microbiota of patients with severe and early onset rheumatoid arthritis (RA) were shown to have increased proportions of L. salivarius, L. ruminus, and L. iners when compared to healthy, age-matched individuals..... These results are in opposition to recent RCTs of probiotics in RA patients.... Such findings might indicate species or strain-specific differences between autochthonous and allochthonous Lactobacillus on RA disease activity.

There are conflicting reports on the association of intestinal Lactobacillus with obesity in humans..... Moreover, metaanalysis of RCT studies found that probiotic Lactobacillus improved weight management outcomes in obese adults. Consumption of yogurt and other dairy products fermented by Lactobacillus is also correlated with protection from T2D and obesity. Because Lactobacillus species appear to be either associated with weight gain or weight loss, the disparate findings among obese individuals might be due to genetic differences among the lactobacilli. Strain and species distinctions could result in variations in carbohydrate metabolism and production of fermentation end-products, such as lactate.

In a systematic review of thirty-one studies, Lactobacillus along with a limited number of butyrogenic genera were consistently diminished in colorectal cancer patients. Preventative and therapeutic roles of Lactobacillus in cancer are supported in studies with preclinical, rodent models, including a recently study in which a multi-strain probiotic altered Th-cell polarization away from Th17 cells in a mouse model of hepatocellular carcinoma. However, Lactobacillus might not always be beneficial in certain extra-intestinal sites as shown by the higher levels of Lactobacillus in malignant breast cancer compared to benign-disease tissues. There was also a positive association between the levels of this genus in the oral microbiome and head and neck squamous cell carcinoma.