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Recently several good books have been published about the community of microbes within us - our microbiota or microbiome. Originally I mainly saw the term human microbiome used everywhere. It referred to all the organisms living within and on us that are identified by their genomes (genetic material within the organism such as DNA and RNA). However, recently I'm seeing the term microbiota being used more. The microbiota refers to the community of microbes within and on us. Think of it this way: the human microbiota is the collection of all the microbes within and on us, and their genes are called the human microbiome. So there's a difference, but both refer to all the microbes within and on us.

The human body contains over 10 times more microbial cells than human cells - thus 90% microbes (about 100 trillion microbial cells), and 10% human cells (about ten trillion human cells). It is estimated that the weight of all these microbes in an adult is about 3 pounds, which is about the weight of the adult human brain. Different communities of microbes live in different parts of the body - and each little part of the body has its own ecosystem or community. And there is variation from person to person in the types of microbes in each niche in the body. So knowing all this, it is time that to stop thinking about yourself as ME or I, but more of a collective WE.

It is great to see some recently published books that explore this new and emerging field, discuss the importance of feeding and nurturing the microbes (and how), look at current and future medical uses of microbes. Because that's the exciting stuff. As I've been posting all along, our microbes seem to be intimately linked with our health - whether cancer or sinusitis (think how Lactobacillus sakei successfully treats chronic sinusitis) or many other ailments. I enjoyed all the books, I liked that the material was presented a little differently (as well as some different material) by each author, and that each book had reference lists.

Martin Blaser, MD - Missing Microbes: How the Overuse of Antibiotics is Fueling Our Modern Plagues   This is the most scholarly of the books (published 2014, and with lots of references), because he is writing not just from his own extensive personal and professional experiences, but also as director of the New York University Human Microbiome Program. He discusses the dangers of some modern medical advances (such as frequent use of antibiotics and Cesarean sections)  to the human microbiome and how this may ultimately result in various diseases (modern plagues). I have posted about him various times, including an NPR interview about his book. The CDC (Centers for Disease Control) book review page also said: "Despite his emphasis on missing microbes, however, Blaser is wary of using probiotics, prebiotics, and synbiotics to restore microbial balance. He reasonably cites the challenges arising from the unsubstantiated claims of manufacturers and the paucity of well-designed trials to evaluate probiotics."

Justin Sonnenburg and Erica Sonnenburg, PhDs - The Good Gut: Taking Control of Your Weight, Your Mood, and Your Long-term Health This interesting book written is  meant for the general reader, and they incorporate their personal stories (they are both PhDs working at Stanford University while raising 2 children) as well as what the latest microbiota research is regarding our health and bodies. They make the case that "caring for our gut microbes may be the most important health choice we make". They, like Dr. Blaser, argue that our microbiota are in peril from changes to the diet, overuse of antibiotics, and oversterilization, and is facing a "mass extinction event" which is leading to a number of modern ailments (allergies, asthma, etc). They even provide some menus and recipes to feed our microbes, recipes that stress dietary fiber. Some posts in the past year mentioned his research (especially the importance of dietary fiber in health).

Alanna Collen -  10% Human: How Our Body's Microbes Hold the Key to Health and Happiness  (Published 2015) This book is written in a chatty style by Alanna Collen, a British science writer with a PhD in evolutionary biology. She incorporates both her personal story and experiences with the scientific literature. There was much to like about the book and that it was "easy to read", but there were a few moments that I thought that the research in a discussion was incomplete (urinary tract infections come to mind).

This last one I haven't yet read, but Dr. Rob Knight is such a BIG name in this emerging field  (and I heard his wonderful lectures in the Coursera course on the human microbiome) that I'm including this TED talk book. He is also a co-founder of the American Gut Project. I've mentioned his work in a number of posts this past year. Rob Knight with Brendan Buhler - Follow Your Gut: The Enormous Impact of Tiny Microbes (TED BOOKS) (Published 2015)

Finding out that so many of probiotics currently contain traces of gluten is of serious concern to people wishing to avoid gluten in food products, for example those with celiac disease. Too bad the researchers didn't publish the brands.From Science Daily:

Many probiotics are contaminated with traces of gluten

More than half of popular probiotics contain traces of gluten, according to an analysis. Tests on 22 top-selling probiotics revealed that 12 of them (or 55%) had detectable gluten. Gluten is a protein found in wheat, rye, and barley, and patients with celiac disease need to eliminate it from their diet or face pain, bowel symptoms, and an increased risk of cancer.

Probiotics are commonly taken by patients for their theoretical effect in promoting gut health, though evidence of benefits is limited to a few clinical situations. "Many patients with celiac disease take dietary supplements, and probiotics are particularly popular," said Dr. Samantha Nazareth, a gastroenterologist at CUMC and the first author of the study. "We have previously reported that celiac patients who use dietary supplements have more symptoms than non-users, so we decided to test the probiotics for gluten contamination," said Dr. Nazareth.

 Most of the probiotics that tested positive for gluten contained less than 20 parts per million of the protein, and would be considered gluten-free by Food and Drug Administration (FDA) standards. However, four of the brands (18% of the total) contained in excess of that amount.

More than half of the 22 probiotics were labeled gluten-free, but this had no bearing on whether or not traces of gluten were present. Two probiotics that did not meet FDA standards carried the label.It is uncertain whether these trace amounts of gluten could cause symptoms or otherwise harm patients with celiac disease. 

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How does the medical profession currently view probiotics in the prevention and treatment of urinary tract infections (UTIs), especially recurrent infections? Answer: Only a few studies have been done, but what little is known is promising, which is good because traditional antibiotic treatment has problems (especially antibiotic resistance).

The following article excerpts are from Medscape. Medscape is a popular web resource for physicians and health professionals. It features peer-reviewed original medical journal articles, daily medical news, drug information, etc. To read the entire article without registering with Medscape (registration is free for everyone), just Google the title and then click on it.

From Medscape: Probiotics in Preventing Recurrent Urinary Tract Infections in Women: A Literature Review

Increasing antibiotic resistance and increasing resistance to commonly used antibiotics makes treatment and prevention of urinary tract infections difficult. Although more research is needed, probiotics should be considered a useful and safe alternative to antibiotics. Urinary tract infections (UTIs) are one of the most common bacterial infections in women, accounting for over 6 million primary care visits annually (Zak, 2014). Approximately 50% to 60% of women will develop a UTI in their lifetime...  ...continue reading "Studies Look at Probiotics in Preventing Urinary Tract Infections"

In a newly published study looking at how infant gut microbes change over time, once again babies had differences in gut bacteria depending on whether they were delivered vaginally or by Cesarean section.

But what's interesting is that stopping breastfeeding changed their gut bacteria  more (to more adult-like species) than just introducing solid foods. Certain types of bacteria thrive on the nutrients breast milk provides and once these nutrients are no longer available, then other bacteria emerge that are more commonly seen in adults. In other words, stopping breastfeeding seems to drive "maturation" of the gut bacteria.

From The Scientist: Maturation of the Infant Microbiome

Like babies themselves, the intestinal microbiomes of infants start out in an immature state and over time grow into communities similar to those of adults. In a new survey of 98 Swedish babies whose microbiota were sampled several times during their first year of life, researchers found that the microbiomes of breastfed infants persisted in a “younger” state longer than those of non-breastfed babies, even after the introduction of solid foods.

The conclusion that “stopping breastfeeding—rather than introducing solids—drives maturation is a new idea, because we all thought so far that solids introduction was a key factor in changing the microbiota,” said Maria Gloria Dominguez-Bello, a microbiologist at New York University School of Medicine who did not participate in the study.

Researchers from University of Gothenburg in Sweden and their colleagues found more adult-like taxa in the microbiomes of babies who stopped breastfeeding earlier, while the microbiota of babies breastfed for longer were dominated by bacteria present in breastmilk. The results, published today (May 13) in Cell Host & Microbe, are part of an effort to catalog the microbial changes that occur as children age and to note how those changes correlate with health and disease. Fredrik Bäckhed of Gothenburg and his colleagues collected stool samples from 98 moms and their newborns, and again sampled the babies’ stool at four and 12 months.

Confirming previous work, his team’s analysis found that the 15 babies born via cesarean section were colonized by different bacteria—many from oral and skin communities—than babies born vaginally, who shared numerous microbes with those present in their mothers’ stool.

For instance, in the vaginally delivered newborns’ microbiomes, genes that break down sugars in breastmilk were common. As these babies celebrated their first birthdays, the genes in their microbiomes favored the ability to breakdown starches, pectins, and more complex sugars.

“What’s nice about this paper is that they show this maturation [of the microbiome] in normal, healthy kids in a Western population follows this transition based on diet,” said Steven Frese, a postdoc at the University of California, Davis, who penned a commentary accompanying the study with his advisor, David Mills. “Being exposed to new foods promotes the growth of new bacteria that can consume them,” Frese told The Scientist.

There has been a lot of discussion in the last few years of our gut bacteria (hundreds of species), the microbiome (the community of microbes living within and on a person (gut, nasal cavities, mouth, sinuses, etc.), probiotics, the finding of a link between bacteria and some chronic diseases, and how the modern lifestyle and antibiotics are wiping out our beneficial gut microbes. I am frequently asked how one can improve or nurture the beneficial bacteria in our bodies.

While no one knows what exactly is the "best" or "healthiest" microbial composition of the gut, it does look like a diversity of bacteria is best (may make you healthier and more able to resist diseases). Research also suggests that the diversity and balance of bacteria living in the body can be changed and improved, and changes can occur very quickly. And that the microbial communities fluctuate for various reasons (illness, diet,etc.). Diet seems to be key to the health of your gut microbial community. Prebiotics feed the beneficial bacteria in the gut, probiotics are live beneficial bacteria, and synbiotics are a combination of prebiotics and probiotics. But don't despair - you can improve your gut microbial community starting now. The following are some practical tips, based on what scientific research currently knows.

SOME STEPS TO FEED AND NURTURE YOUR GUT MICROBES:

Eat a wide variety of foods, especially whole foods that are unprocessed or as minimally processed as possible. Eat everything in moderation.

Eat a lot of plant based foods: fruits, vegetables, whole grains, seeds, nuts, and legumes. Think of Michael Pollan's advice: "Eat food. Not too much. Mostly plants."

Eat more washed and raw fruits and vegetables (lots of bacteria and fiber to feed and nurture the bacteria). Some every day would be good.

Eat more soluble and insoluble types of fiber, and increase how many servings you eat every day. A variety of  fiber foods every day, and several servings at each meal, is best. Think fruits, vegetables, whole grains, legumes, nuts, seeds. (See How Much Dietary Fiber Should We Eat? - also has a chart with high fiber foods, and Recent Studies Show Benefits of Dietary Fiber)

Eat as many organic foods as possible. There is much we don't yet know, and pesticides are like antibiotics - they kill off microbes, both good and bad. Somehow I think that lowering the levels in your body of pesticides (as measured in blood and urine) can only be beneficial. Also, organic foods don't contain added antibiotics and hormones. (Eat Organic Foods to Lower Pesticide Exposures).  But even if you can't or won't eat organic foods, it is still better to eat non-organic fruits, vegetables, and whole grains than to not eat them.

Eat some fermented foods such as kimchi and sauerkraut (they contain live bacteria), kefir, and yogurts with live bacteria. Eat other bacteria containing foods such as cheeses, and again a variety is best (different cheeses have different bacteria).

Try to avoid or eat less of mass-produced highly processed foods, fast-foods, preservatives, colors and dyes, additives, partially hydrogenated oils, and high-fructose corn syrup. Read all ingredient lists on labels, and even try to avoid as much as possible "natural flavors" (these are chemicals concocted in a lab and unnecessary). Even emulsifiers (which are very hard to avoid) are linked to inflammation and effects on gut bacteria.

Avoid the use of triclosan or other "sanitizers" in soaps and personal care products (e.g., deodorants). Triclosan promotes antibiotic resistance and also kills off beneficial bacteria. Wash with ordinary soap and water.

Avoid unnecessary antibiotics (antibiotics kill off bacteria, including beneficial bacteria).

Vaginal births are best - microbes from the birth canal populate the baby as it is being born. If one has a cesarean section, then one can immediately take a swab of microbes from the mother's vagina (e.g., using sterile gauze cloth) and swab it over the newborn baby. (See post discussing this research by Maria Gloria Dominguez Bello )

Breastfeeding is best - breastfeeding provides lots of beneficial microbes and oligosaccharides that appear to enrich good bacteria in the baby’s gut.

Live on a farm, or try to have a pet or two. Having pets, especially in the first year of life,  ups exposure to bacteria to help develop and strengthen the immune system, and prevent allergies. Pets such as dogs and cat expose humans to lots of bacteria.

Get regular exercise or physical activity. Professional athletes have more diverse gut bacterial community (considered beneficial) than sedentary people.

Can consider taking probiotics - whether in foods or supplements. They are generally considered beneficial, but not well studied, so much is unknown. The supplements are unregulated, and the ones available in stores may not be those that are most commonly found in healthy individuals. Research the specific bacteria before taking any supplements. Researchers themselves tend to stay away from probiotic supplements and focus on eating a variety of all the foods mentioned above (fruits, vegetables, whole grains, seeds, nuts, legumes, fermented foods) to feed and nurture beneficial bacteria.

This research found that the beneficial gut bacteria Lactobacillus rhamnosus GG (LGG) interacts and facilitates (modifies the activity) of other gut bacteria. This isn't surprising. All our microbiomes are communities or ecosystems of microbes. But the really important bacteria have been called keystone species by other researchers. From Medical Xpress:

New research sheds light on how popular probiotic benefits the gut

In recent years, research into the benefits of gut bacteria has exploded. Scientists across the globe are examining how these microbes can help improve health and prevent disease. One of the most well-known of these is Lactobacillus rhamnosus GG (LGG). This strain of bacteria, which is part of many popular probiotic products, has a reputation as a helpful microbe. Researchers have found evidence that it can help with intestinal problems, respiratory infections and some skin disorders. Some research suggests that it may even help with weight loss. But a key question has remained unanswered: How does LGG actually produce benefits?

Now, researchers at the University of Maryland School of Medicine (UM SOM) have come up with an explanation. It appears that LGG may act as a facilitator, modifying the activity of other gut bacteria....Claire M. Fraser, PhD, professor of medicine at the UM SOM, as well as director of the Institute for Genome Sciences, studied the effect of LGG on a group of elderly subjects.

She and her collaborator, Dr. Patricia Hibberd at Massachusetts General Hospital, tested 12 subjects, who ingested LGG twice a day for 28 days. She analyzed gut bacteria before and after this regimen, and found that ingesting LGG led to increases in several genes that foster several species of gut bacteria, including Bacteroides, Eubacterium, Faecalibacterium, Bifidobacterium and Streptococcus. These microbes have been shown to have a range of benefits in humans, including the promotion of a healthy immune system. (Fraser notes that LGG may also have direct effects, in addition to its ability to modify the overall ecosystem.)

"This is a new idea, that some probiotics may work by affecting the overall ecosystem of the gut," said Prof. Fraser. "Previously we tended to think that LGG and other probiotics worked directly on the host. I think this finding has many exciting implications." For one, Fraser says, it lends support to the idea that we need to look at the microbes in the gut as an interconnected ecosystem rather than a series of solitary bacteria. Modifying the behavior of microbes already in the gut may be just as important as adding any single species to this population.

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It is now 104 weeks being free of chronic sinusitis and off all antibiotics! Two full years since I started my easy do-it-yourself sinusitis treatment! And my sinuses feel great! I would never ever have thought such a thing was possible several years ago. Thanks to the probiotic (beneficial bacteria) Lactobacillus sakei I got my life back. Yes, I know I'm gushing...

After reading the original ground-breaking research on sinusitis done by Abreu et al (2012), it led to finding and trying L. sakei as a sinusitis treatment. Of course, there is an entire community of microbes that live in healthy sinuses (the sinus microbiome), but L. sakei seems to be a key one for sinus health. As you may have guessed, the name of this web-site Lacto Bacto is in homage to the bacteria Lactobacillus sakei.

Thank you all who have written to me  - whether publicly or privately. Please keep writing because it is adding to the sinusitis treatment knowledge base. I will keep posting updates.

I will be trying to find more sources of L. sakei this year and also look for other microbes that help treat sinusitis. And the foods or products that they're in. As of today, my family (all 4 members) have successfully used live kimchi and even sausage starter culture (both containing L. sakei) to treat both acute and chronic sinusitis these past 2 years. Based on our experiences and those of others, finding live L. sakei in kimchi (not all brands have L. sakei in it) and other products can be tricky, but when the product has live L. sakei in it - the results are absolutely great! We have also learned that L.sakei products should be used sparingly - only as needed.

[NOTE: Since then I've posted a number of posts with sinusitis treatment information. The updated (November 2018) The Best Probiotic For Sinus Infections has products and sources of L. sakei. The Sinusitis Treatment Summary page has treatment methods. And news about a Lactobacillus sakei product which I really like - Lacto Sinus. One can also click on SINUSITIS under CATEGORIES to see more posts, such as "Which Kimchi is Best for Sinusitis Treatment: Vegan or Seafood?"]

An amazing breakthrough for those suffering from peanut allergies. The bacteria Lactobacillus rhamnosus is added to some yogurts and kefir, but in smaller amounts.From The Telegraph:

Fatal peanut allergies could be cured by probiotic bacteria, say Australian doctors

A strain of probiotic bacteria could offer a cure for potentially fatal peanut allergies, according to scientists in Australia. The breakthrough followed a trial in which a group of children were given increasing amounts of peanut flour, along with a probiotic called Lactobacillus rhamnosus, over an 18-month period. About 80 per cent of the children who had peanut allergies were subsequently able to tolerate peanuts.

Mimi Tang, the lead researcher, said the families involved believed the treatment had "changed their lives". "These findings provide the vital first step towards developing a cure for peanut allergy and possibly for all food allergies," she told Melbourne's Herald Sun.

The randomised trial, involving a group of about 30 children, was conducted by Murdoch Childrens Research Institute in Melbourne. The children, aged one to ten, were given small amounts of peanut flour, gradually building up to two grams, or the equivalent of six or seven nuts.They were also given daily doses of Lactobacillus rhamnosus, which is found in yoghurt but was given in quantities equivalent to the amount found in 44 pounds of yoghurt.

Following the treatment, about 80 per cent of the children were able to tolerate four grams of peanut protein, equivalent to about 14 peanuts. Typically, about four per cent of children would have overcome their peanut allergy during this time.

Rates of peanut allergies have dramatically increased in the past two decades, particularly in developed countries. For most sufferers, the condition is lifelong.

A link to the press release from the Murdoch Childrens Research Institute (their researchers are doing the research), has more:

Oral Therapy Could Provide Treatment For Peanut Allergies

Over 60 peanut allergic children in the study were either given a dose of a probiotic, Lactobacillus rhamnosus, together with peanut protein in increasing amounts, or a placebo over 18 months to assess whether children would become tolerant to peanut.

The probiotic was a fixed daily dose, while the peanut oral immunotherapy was a daily dose of peanut protein starting at very low doses followed by a dose increase every two weeks until the maintenance dose (2 grams peanut protein) was reached. At the end of the treatment, the child's ability to tolerate peanut was assessed by a peanut challenge performed two to five weeks after stopping treatment.

23 of 28 (82.1%) probiotic treated children and one of 28 (3.6%) placebo-treated children were able to include peanut in their diet at the end of the trial. The likelihood of success was high - if nine children were given probiotic and peanut therapy, seven would benefit.

The need for a curative treatment is greatest for peanut allergy since this is usually lifelong, and is the most common cause of fatality due to food induced anaphylaxis. Further research is now required to confirm whether patients can still tolerate peanut years after the study has finished.

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[Please go to updated June 2022 version of this post.]

(Oct. 2018) 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.  And for many, major improvement may take only days!

The researchers Abreu et al found in their 2012 study 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). A number of studies since then also found that there is a depletion of some bacterial species, and an increase in "abundance" of other species in those with chronic sinusitis.

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. Lanto 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. This post discusses these L. sakei products and other possible probiotic treatments for sinusitis.

Treating sinusitis with beneficial bacteria (rather than with antibiotics, corticosteroid nasal sprays, and surgery) is the future in sinusitis treatment.

BACKGROUND STORY: More than 5 years ago there were no probiotics containing L. sakei. None. So I experimented 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 two weeks. Obviously it contained L. sakei. Then the rest of my family also tried the kimchi treatment and were also quickly cured of chronic sinusitis! It felt miraculous, especially because it was so easy to do.

After 5 years we still feel great! Generally we only need to treat again with a product containing Lactobacillus sakei (we've been using refrigerated Lanto Sinus) after a virus which goes into sinusitis, or if for some other reason we feel like we're sliding into sinusitis. We've improved every year so need to do it less and more minimally.

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 5 years. We do not use cortisone or antihistamine nasal sprays either.

WHEN A TREATMENT WORKS: A number of you have contacted me to report your own progress with various sinusitis treatments. People used terms such as "miraculous", "transformative", and "fabulous" when they had positive results with a product containing L. sakei  -  and many with major improvement happening within a few days. 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  --sometimes within days, sometimes longer. This includes 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 cautious.)

OVERALL RESULTS: The 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 reported to me 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. Interestingly,  Lactobacillus sakei works best when it is used only when needed, when there are sinus symptoms. Don't use when feeling healthy.

Those same chronic sinusitis sufferers also reported that the same treatments also worked to treat acute sinusitis or sinus infections. It seems that after colds or viruses may develop acute sinusitis again and need re-treatment (apparently the L. sakei frequently doesn't stay in the sinuses from earlier treatments). However, the sinuses do continue improving over time so fewer and more minimal treatments are needed over the years.

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). Some people reported that one product helped, but not another - whether kimchi or a L. sakei product. It also became clear that L. sakei does not treat seasonal allergies or allergy symptoms.

THREE MAIN PRODUCT CATEGORIES: The main categories of products containing live Lactobacillus sakei are:: kimchi (and some sauerkraut), refrigerated products, 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. 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: 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), Mother-in-law's Kimchi, 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. 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 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 - Some people improved with 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 refrigerated L. sakei product specifically meant for the sinuses is now available. The company Lanto Health has introduced a kimchi derived Lactobacillus sakei product called Lanto Sinus - to be used when needed (when there are symptoms). Lanto Sinus  is sold as a dietary supplement, holds up well in the refrigerator, is effective, quick-acting, and easy to use. This high-quality 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 a year (self-experimentation!).

FROZEN LACTOBACILLUS SAKEI PRODUCTS  – The main L. sakei products available in many countries throughout the world are various frozen sausage starter cultures. All L. sakei products needing to be kept frozen are generally reliable and effective for sinusitis treatment. They should only be used when needed. But 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 starter cultures 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 for chronic sinusitis. But one should be very cautious because while the third bacteria is considered non-pathogenic, is common in food products, is used commercially to make B12 - 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. 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 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.

[NOTE: I personally have overuse concerns (too strong a dose) with using L. sakei in a neti pot or nasal syringe, and so have never used any L. sakei product that way. My personal view: let the little suckers travel up to the sinuses on their own. And they do. And I always start first with the most cautious way to see if that works.]

SOME L.SAKEI ISSUES: I still think of L. sakei as fairly fragile – for example, 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 that it dies off in less than 2 weeks at room temperature - therefore store in freezer.] On the other hand, many different Lactobacillus strains live and multiply in our bodies at 98.6 degrees Fahrenheit - so L. sakei can handle warm temperatures just fine for a while.

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. Thus we order 2 day shipping (if possible) and hope for the best. (Note: Consider overnight shipping during 100+degree Fahrenheit heat waves. Also, USPS delivers to mailboxes, while UPS typically delivers to the door.)

WHY DOESN'T L. SAKEI WORK FOR SOME PEOPLE? Some possibilities to explain why some people trying various L. sakei products 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  missing in their sinus microbiomes. Or perhaps they have microbes that the L.sakei bacteria cannot overcome.

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.

PROBLEM WITH A PRODUCT SUDDENLY NOT WORKING, OR OVERUSE - Several people reported that a kimchi brand 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 may be a feeling of "imbalance" or on rare occasion some symptoms (e.g. more mucus, sore throat). We think this might be an issue of "too much of certain microbes".

Then we (family members) have 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 an opened capsule (the dry powder) of multi-strain probiotics, or refrigerated L.sakei in the mouth (this last if switching from kimchi)  has corrected the situation for us. (Finding what works is self-experimentation, and varies from time to time.). 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 or healthy, stop using the L. sakei product. Use L. sakei products sparingly - only as needed (e.g. when developing sinusitis). Using less is better than more over time – probably due to sinus microbial communities improving over the years. L. sakei seems to be necessary for sinusitis treatment for most people (a keystone bacteria), but there are also other important microbes in the sinuses - a whole community.

OTHER PROBIOTICS MAY OR MAY NOT HAVE BENEFICIAL EFFECTS - Rarely some people have reported that multi- strain probiotics (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 (this last was rare). Different brands containing different mixtures of bacteria (Lactobacillus and Bifidobacterium) have been mentioned - but all were refrigerated probiotics - so nothing stands out.

On the other hand, other people (including my family members) reported trying various multi-strain probiotics containing various Lactobacillus and Bifidobacterium species in the nostrils and found it did not help sinusitis. However, we found that when we feel a little “imbalanced” – perhaps a cough or mucusy – then swishing the dry powder from one capsule in the mouth and then swallowing it - frequently results in some improvement (perhaps with a cough).

I have concerns with products that also contain titanium dioxide – this is because it may be in nanoparticle form, and recent studies have raised concerns that the nanoparticles can travel to other organs in the body, and are also inflammatory. So read the ingredients!

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).  So...while the L. sakei may be alive when the product is produced, is it alive weeks or months later at room temperature?

Also, will a multi-strain probiotic containing both L. sakei and S. salivarius K12 (such as Pro-Kids ENT by Hyperbiotics) help or make things worse for those with sinusitis?  S. salivarius K12 has caused problems for some people (scroll down to "Problems With BLIS K12?").

NO EVIDENCE FOR JUST SWALLOWING PROBIOTIC SUPPLEMENTS: Evidence (my family, people writing in, research) so far has been that only directly dabbing/applying probiotics in the nose, or even swishing probiotics in the mouth may help treat sinusitis. I have not found any studies finding 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 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 said that they had found evidence for people having "virus-like particles" in their sinuses, which they thought were bacteriophages.

SNOT TRANSPLANTS IN THE FUTURE? – Currently a “snot transplant” study from healthy persons to sinusitis sufferers is going on in Europe to see if it works as a sinusitis treatment. This possibility 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 (and family members) tried the probiotic BLIS K12 bacteria (also known as Streptococcus salivarius BLIS K12), but found it brought on sinusitis-type symptoms. Scientific research finds it to be an immune booster and it lowers the incidence of upper respiratory infections. But not for us - from the first tablet (ate it by slowly dissolving it in the mouth) there were problems - feeling phlegmy and 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 and curing your sinusitis, especially chronic sinusitis. Or even what hasn't worked. It all adds to the knowledge base. 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).

Interesting research using probiotics (beneficial bacteria) to treat a nickel allergy. What other allergies could be treated with probiotics? From the American Microbiome Institute:

Treating severe nickel allergies with probiotics

Systematic nickel allergy syndrome (SNAS) is a severe reaction to nickel, a metal that is found in nature and most human food sources. An allergic reaction to nickel can manifest cutaneously, causing inflammation and irritation of the skin, or it can be gastrointestinal, causing diarrhea. Studies in which balanced diets are used as a way of reintroducing nickel to SNAS patients have been conducted to find possible treatments of this allergy; however no cure has been found. Research by a group in Italy was  published last month in the Journal of Applied Microbiology that examined the use of probiotics such as Lactobacillus reuteri to treat SNAS patients.

A double blind study was performed using twenty-two adult women who had both systematic and cutaneous reactions to nickel. A control group received a placebo, while an experimental group received the L. reuteri probiotic. Fecal sampling and clinical evaluations were performed at the start of the study, before any pills were taken, as well as after two weeks of supplementation and two weeks after the end of the trial. Throughout the entire evaluation period the patients followed a low-nickel diet.

Both groups prior to experimentation had low diversity of lactic acid bacteria (LAB) communities in their gut.  After the trial, they found that the control group had stable LAB communities while the experimental group resulted in greater diversity of LAB than prior to the study. They found that only the experimental group showed the presence of L. reuteri meaning that the bacteria in the probiotic had successfully colonized and survived in the gut, an essential feature if a probiotic is to be used in a clinical setting.

They also found a significant improvement in cutaneous symptoms after two weeks in both the group being given the probiotic with a low-nickel diet, as well as the strictly low-nickel diet patient group, however the improvement was more pronounced in the group getting the probiotic. Only patients receiving the supplementary L. reuteri showed a significant reduction in gastrointestinal symptoms. Eating a diet low in nickel will cause less averse reactions than an uncontrolled diet; however, this study strongly suggests that probiotics can significantly decrease the severity of allergy symptoms in SNAS patients. The study also suggests that a combination of diet and probiotics could increase bacteria’s ability to colonize in the intestines.