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Credit: Wikipedia

It turns out there are a number of simple things you can do to keep your sinuses healthy and reduce the chances of developing another sinus infection. A lot of these suggestions involve preventing nasal stuffiness and congestion, and to improve sinus drainage.

Because, as we all know - once those nasal passages get clogged, the odds of another sinus infection increases. When the nasal passages are inflamed or blocked, then mucus can't properly drain from the sinuses.

Chronic sinusitis goes hand in hand with rhinitis, which is why the medical literature refers to chronic sinusitis as chronic rhinosinusitis. It can be allergic rhinitis or non-allergic rhinitis - that is, with known or unknown triggers leading to a dripping nose, congestion, increased mucus, even sneezing or coughing. Dust, irritants, fragrances, allergies (e.g., tree pollen), spicy foods, and air pollution are all examples of triggers.

Some of the following tips are to avoid fragrances and scented products. This is because they are considered indoor air pollutants. They release chemicals that cause nasal inflammation, which can result in rhinitis symptoms, and possibly lead to sinusitis. All air pollution (whether indoors or outdoors) can cause nasal inflammation.

TWENTY TIPS FOR SINUS HEALTH:

1) Sleep with 2 or more pillows in a semi-upright position. This helps with mucus drainage in the nasal passages.

2) When needed, use an ordinary saline nasal rinse once or twice a day. This helps with nasal congestion.

3) When needed, use a 12-hour 1200 mg guaifenesin non-prescription product (e.g., Mucinex) at night. It helps to thin mucus.

4) Can use antihistamines (for allergies) and nasal corticosteroid sprays (especially for nasal polyps) when needed.

5) Can use a premade saline mist spray (e.g., Arm and Hammer simply saline mist) to help relieve minor congestion. This can be helpful any place with stuffy air.

6) Shower at night to wash away dust and allergens.

7) Use unscented personal care products as much as possible (e.g., unscented deodorant). Or if that's not possible, try for minimally scented products.

8) Avoid cigarette smoke and smoke-filled air as much as possible.

9) Consider limiting your intake of alcohol. Alcohol causes temporary nasal inflammation in everyone, but for some persons the swelling lasts a long time and can cause nasal congestion and other symptoms.

10) Avoid the use of scented products in the home, including air fresheners, scented candles, incense, essential oils, clothes detergents, and scented dryer sheets (fragrances/chemicals are air pollutants - in the air, get on our clothes, and us).

11) Frequently open windows to air out the home, even if only for a few minutes. Use bathroom fans if you have them.

12) When cooking, use a kitchen exhaust fan that vents to the outside, especially if you have a gas stove and oven.

13) Vacuum frequently with a good vacuum cleaner.

14) Wall to wall carpeting can be a problem for many, especially in the bedroom. They accumulate dust and contaminants, which are hard to clean.

15) Change your A/C and heating filters frequently.

16) Consider getting a good air purifier (check Consumer Reports and Wirecutter. Especially powerful are the Austin Air Purifiers.)

17) Make sure there isn't a hidden mold problem, and clean up any mold you find. Also, make sure that water isn't getting into the house. [CDC guidelines]

WHEN STARTING TO FEEL SINUSITIS SYMPTOMS:

18) Get enough sleep. When sleep deprived, people can feel “mucusy”. They are also more susceptible to viruses.

19) At the start of a sore throat or infection - suck on a zinc tablet or lozenge. It may stop the viral infection.

20) Use L. sakei (e.g., Lanto Sinus) at the start of a sinus infection. (Stop using it when feeling better.)

Additionally, try to boost your immune system by eating a healthy diet (one rich in fruits, vegetables, whole grains, seeds, nuts, legumes, olive oil), getting plenty of sleep, drinking plenty of  water, and getting enough exercise or physical activity (Government guidelines say at least 2 1/2 hours per week of physical activity, including walking).

Can also take a vitamin D supplement (research shows it can decrease the number of respiratory infections) or get enough sunlight. After all, vitamin D is called the sunshine vitamin.

Good health!

It is now my twelfth year of successfully treating sinus infections with only the probiotic Lactobacillus sakei. My twelfth year! This includes regular sinus infections, my initial chronic sinusitis, and even when there are just a few sinus symptoms (you know, the gradual slide toward sinusitis).

Amazingly, no antibiotics and no antibacterials in all this time! Just using a product with the beneficial bacteria L. sakei when needing it is all it takes. To say it feels miraculous is an understatement.

Studies show that the beneficial bacteria Lactobacillus sakei occurs naturally (in tiny amounts) in healthy sinuses, but is depleted or missing in those with sinusitis. It is normal for a community of bacteria, viruses, fungi to live in the sinuses - this is the sinus microbiome.

My journey started in the winter of 2013 after reading research in late 2012 about L. sakei. I started with kimchi back then, but in the last few years I've used the product Lanto Sinus, which contains a kimchi-derived strain of Lactobacillus sakei.

In the past decade, I have heard from hundreds of people from all over the world, and the majority agree that L. sakei works great as a sinus treatment! Other probiotic species just don't work, even though they may help with some symptoms. [See Best Probiotics For Sinusitis for details on results and products used.]

Lessons Learned Over the Past Eleven Years:

1) Lactobacillus sakei alone is enough to treat sinus infections or sinusitis. It helps with all the associated symptoms: mucus dripping down the throat (post-nasal drip), sinus pressure, sinus headaches, earaches and coughs from sinusitis, etc.

2) Using L. sakei (whether in kimchi or Lanto Sinus) should take about a minute! No fancy methods or protocols needed.

3) Only use L. sakei when needed. This means when there are sinus symptoms (e.g., lots of mucus, post nasal drip) or you're sliding towards sinusitis. No need to wait till the sinus infection is full-blown.

4) Stop using it when feeling better. Don't use it daily or as a preventive, but only when needed. There are many species of microbes living in the sinuses, so you don't want to flood the sinuses with just one species for weeks on end.

5) After using it for a few days, evaluate whether you can stop or whether you need to keep using it longer. The sinuses frequently keep improving and rebalancing after stopping L. sakei.  One can always use more if needed.

6) People use L. sakei products (e.g., Lanto Sinus) all sorts of ways. Can mix the powder with bottled/sterile water and dab/smear in nostrils (regular use). Or swish alone in the mouth - a gentle and cautious method. Or use it with saline nasal irrigation - a strong way to use. Yes, you can use less than the recommended dosage.

Please note: The only way kimchi (the juice) has an effect is by dabbing or smearing a little in the nostrils.

7) Don't overdo it. Using a little bit in the nostrils (as described in Sinusitis Treatment Summary) is sufficient. Let the little buggers travel on their own throughout the sinuses!

8) L. sakei normally lives in healthy sinuses, which is why it is such an effective sinus infection treatment for so many people. L. sakei overpowers or dominates over harmful (pathogenic bacteria), and so researchers are now studying its use for a variety of health conditions.

9) Over time a person typically needs less L. sakei to treat sinus symptoms. The L. sakei colonizes in the sinuses (can be short-term or long-term). Weeks or months can go by without needing to use it again.

10) When L. sakei works for a person, it can feel miraculous as sinusitis symptoms disappear, frequently within a few days. Others have slower improvement. Unfortunately, it doesn't work for everyone and only self-experimentation determines whether it does and how best to use it.

11) It is OK to do ordinary nasal irrigation once or twice a day on same day as using L. sakei product. Also OK, if needed, are nasal corticosteroids (e.g., Flonase), decongestants (e.g., Sudafed), and guaifenesin (e.g., Mucinex).

12) Every person's sinus and respiratory microbiome is a little different, which is why finding what works for a person is self-experimentation.

13) After using L. sakei in any product (e.g., kimchi) for an extended time, can start feeling like it's not working well anymore or some sinus symptoms may appear (e.g., mucus). This could be overuse or too much of a product - that is, flooding the respiratory system with too much of whatever you're using, and now need to add a little bit of other beneficial bacteria.

Simply stop using the product and try adding some other microbes into the respiratory system for a day or two or even more if needed - this will help rebalance the sinuses. Open a multistrain probiotic capsule and swish the powder in the mouth. [See Sinusitis Treatment Summary] Lactobacillus and Bifidobacterium species are OK to use - they are normally found in our bodies in tiny amounts.

This first happened in 2013 when I kept using kimchi even when sinuses felt healthy - I thought I needed a boost several times a week. Nope. After many months I started developing sinus symptoms and only switching to a different type of kimchi got rid of the symptoms. Over the years I've done this with every L. sakei product, and adding other microbes for a day or more solved the problem, and I could go back to the original product when next needed.

14) One possibility why sinus infections keep occurring over the years, even if less frequently, is because other bacterial species are also diminished in those with sinus infections (as shown by sinus microbiome studies). And these species are not available in probiotics.

15) People report that using L. sakei has helped bacterial conditions other than sinusitis. This includes earaches, coughs (bronchitis), tonsil stones. Sounds like lots of self-experimentation going on!

Good health!

Over the years I've received many questions about vegan versus kimchi that contains seafood. Are the microbes in the kimchi the same?

One reason this is an important question is because at certain stages of kimchi fermentation the beneficial bacteria Lactobacillus sakei (which treat sinusitis in many people) appears for a time. And during that time when L.sakei is present, dabbing a little kimchi juice in the nostrils helps and treats many individuals with sinusitis. Amazing, yes?

Many people prefer to treat sinusitis with vegan kimchi - which is also my personal preference. I don't want to worry about what is in the seafood used in kimchi. Therefore, it's vegan kimchi for me.

Earlier studies have suggested that even though kimchi is made with cabbage, the L. sakei grows from the surface of raw garlic used in making  the kimchi. From the M.A. Zabat et al (2018) study:

"Because kimchi is made without the use of a starter culture, the raw ingredients play a key role in establishing the bacterial community that is responsible for fermenting kimchi (Jung et al., 2011; Lee et al., 2015)".

"Large amounts of garlic are associated with more kimchi-associated LAB [lactic acid bacteria] in the final product (Lee et al., 2015)." [Note: L. sakei is one of the lactic acid bacteria in kimchi]

This is why the 2018 study, which I just read, is so interesting. The researchers found that both vegan (no seafood)and kimchi made with seafood (e.g., fish sauce) contain the same microbes after fermentation. They may have started out with different populations of microbes, but during fermentation the microbes become similar.

"We found that, despite initial differences in microbial composition between vegan and non-vegan kimchi, there was no notable difference in the final products. Ultimately, the microbial community of both vegan and non-vegan kimchi is dominated by Lactobacillaceae and Leuconostocaceae, and lacks the Enterobacteriaceae found in the fish sauce or miso paste."

Well... that's a relief. What kimchi you choose to eat and use as a sinusitis treatment is personal preference. It's all good. And yes, fermented foods such as kimchi are great for the gut microbiome. They increase gut microbial diversity (good!) and reduce inflammation.

From Physics News: Vegan and traditional kimchi have same microbes, study finds

Good news, vegans: A new study finds that kimchi made without fish products has the same type of bacteria as more traditionally made kimchi. That finding suggests that any "probiotic" benefits associated with traditional kimchi could be present in vegan versions as well. ...continue reading "Kimchi Made With Seafood and Vegan Kimchi Contain the Same Microbes"

Over the years I've talked to many people who have had sinus surgeries for chronic sinusitis, many of whom have had more than one surgery. And yet they keep suffering from chronic sinusitis for years . The big question: How many people are actually helped or cured by standard sinus surgery such as FESS (Functional Endoscopic Sinus Surgery)?

Well, I came across a study from 2016 looking at long-term sinus surgery (FESS) results on 560 adults. Three to 5 years after the FESS surgery, the results were pretty shocking - about 43.7% of persons were still suffering from chronic sinusitis (the researchers called it "uncontrolled"), 36.8% were somewhat better (partly controlled), and only 19.5% were feeling healthy (well controlled). Common sinus symptoms in the "uncontrolled" group were: headache, sleep disturbance, postnasal drip/secretions, and altered sense of smell.

The researchers mentioned another smaller study with similar results that looked at persons 12 years after FESS surgery: 47.4% still had chronic sinusitis (uncontrolled) and only 26.3% were doing well (controlled). They also concluded: "Therefore, better treatment strategies leading to higher disease control are warranted in CRS (chronic rhinosinusitis) care." 

Hello??   Instead of surgery, try focusing on the sinus microbiome by using beneficial bacteria such as L. sakei (in Lanto Sinus, kimchi). Researchers are looking at using beneficial bacteria in the future for sinusitis treatment.

The abstract or study summary from Allergy (the European Journal of Allergy and Clinical Immunology): Real-life study showing uncontrolled rhinosinusitis after sinus surgery in a tertiary referral centre

ABSTRACT: Objectives: To study the degree of CRS control using novel EPOS control criteria at 3–5 years after a functional endoscopic sinus surgery (FESS) and correlate these data to symptoms scores. ...continue reading "Study Shows High Levels of Chronic Sinusitis After Sinus Surgery"

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It is now my eleventh year of successfully treating sinus infections with only the probiotic Lactobacillus sakei. This includes regular sinus infections, chronic sinusitis, and even when there are just a few sinus symptoms (you know, the gradual slide toward sinusitis). No antibiotics and no antibacterials in all this time! Yes, it still feels miraculous!

Studies show that the beneficial bacteria Lactobacillus sakei occurs naturally (in tiny amounts) in healthy sinuses, but is depleted or missing in those with sinusitis. It is normal for a community of bacteria, viruses, fungi to live in the sinuses - this is the sinus microbiome.

My journey started in the winter of 2013 after reading research in late 2012 about L. sakei. I started with kimchi back then, but in the last few years I've used the product Lanto Sinus, which contains a kimchi-derived strain of Lactobacillus sakei.

Since starting this blog in 2013, I have heard from hundreds of people and the majority agree that L. sakei works great as a sinus treatment! Other probiotic species just don't work, even though they may help with some symptoms. [See Best Probiotics For Sinusitis for details on results and products used.]

Lessons Learned Over the Past Decade:

1) Lactobacillus sakei alone is enough to treat sinus infections or sinusitis. It helps with all the associated symptoms: mucus dripping down the throat (post-nasal drip), sinus pressure, sinus headaches, earaches and coughs from sinusitis, etc.

2) Using L. sakei (whether in kimchi or Lanto Sinus) should take about a minute! No fancy methods or protocols needed.

3) Only use L. sakei when needed. This means when there are sinus symptoms (e.g., lots of mucus, post nasal drip) or you're sliding towards sinusitis. No need to wait till the sinus infection is full-blown.

4) Stop using it when feeling better. Don't use it daily or as a preventive, but only when needed. There are many species of microbes living in the sinuses, so you don't want to flood the sinuses with just one species for weeks on end.

5) After using it for a few days, evaluate whether you can stop or whether you need to keep using it longer. The sinuses frequently keep improving and rebalancing after stopping L. sakei.  One can always use more if needed. ...continue reading "Ten Plus Years of Successfully Treating Sinus Infections With Probiotics"

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This month a number of persons asked me about the probiotic Lactococcus lactis (in Probiorinse) and whether it works. This product is marketed to people with sinusitis or sinus infections, with the message that it improves the sinus microbiome and sinus health. Does it?

Unfortunately, the research says no. A well-done study published last year found that the bacteria Lactococcus lactis (Probiorinse) doesn't help to improve sinus symptoms in those with sinus issues. Yes, that bacteria is found in the sinuses, but it is not a keystone bacteria (one with a big effect) in sinus health.

The study compared the Probiorinse (Lactococcus lactis) product to Xlear (xylitol) and regular saline rinses.

The researchers tested xylitol, the probiotic Lactococcus lactisand ordinary saline rinses separately for one month in a group of persons with chronic sinusitis. They found that none of these improved sinusitis symptoms or sinus microbial diversity (the sinus microbiome). In other words, there were no significant differences among the 3 groups.

Those with chronic sinus problems still had them at the end of the study, and their sinus microbiomes and symptoms were still very different from those of the healthy participants.

By the way, another study analyzed Lactoccocus lactis (using the product Probiorinse) against some strains of harmful bacteria (Pseudomonas aeruginosa) collected from persons with chronic sinusitis and found "no effect on 4 strains, a modest inhibitory effect on one strain, and a modest proliferative effect on one" (it increased this harmful strain!). Basically no effect - not a good result.

Bottom line: Stick with ordinary saline rinses to help with sinus congestion. The medical view is that saline nasal irrigation is recommended because it helps a little with nasal stuffiness or congestion, even though this effect is temporary (a few hours?). Also, try the probiotic Lactobacillus sakei, which is a keystone bacteria in the sinuses and which kills/dominates over many harmful bacteria (e.g., Staphylococcus aureus - a problem bacteria in many with sinusitis).

Excerpt from the 2021 study by Lambert PA, et al., in the medical journal  Laryngoscope Investigative Otolaryngology:  Microbiomics of irrigation with xylitol or Lactococcus lactis in chronic rhinosinusitis

No significant trends in alpha or beta diversity as a result of treatment were observed. SNOT‐22 score did not change significantly following treatment with xylitol, L. lactis, or saline. [Translation: the microbiome (alpha and beta diversity) didn't change, and symptoms (SNOT-22 score) didn't change]

15

It is now 9 full years since I first started successfully treating both chronic sinusitis and regular sinus infections using only  the probiotic Lactobacillus sakei. This means no antibiotics or any other antibacterial has been used in more than 9 years! This is amazing – ten years ago I didn't believe this to be possible.

Research shows that the beneficial bacteria Lactobacillus sakei occurs naturally (in tiny amounts) in healthy sinuses, but is depleted or missing in those with sinusitis. (You know we all have a sinus microbiome - bacteria, fungi, and viruses living in the sinuses, yes?) I started by using kimchi after reading research in late 2012, but the last few years I've used the refrigerated product Lanto Sinus, which contains a kimchi-derived strain of Lactobacillus sakei. 

I have heard from hundreds of people since the blog started, and the majority agree - Lactobacillus sakei works great as a sinusitis treatment! (Other probiotic species just don't work.) [See Best Probiotics For Sinusitis for details on results and products used.]

Lessons Learned During Past 9 Years:

  1. Lactobacillus sakei alone is enough to treat sinusitis or sinus infections. Don't need fancy concoctions or fancy protocols when using it. Using it (whether in kimchi or Lanto Sinus) should take under 1 minute a day!
  2. Only use Lactobacillus sakei when needed - when there are some sinus symptoms (e.g., lots of mucus, post nasal drip) or you're sliding towards sinusitis. No need to wait till the sinus infection is full-blown.
  3. Stop using it when feeling better. Just like with antibiotics, don't take it daily and routinely, but only when needed.
  4. Use for a few days and evaluate whether you can stop or whether you need to keep using it longer. Frequently the sinuses keep improving even after stopping Lactobacillus sakei. One can always use more if needed.
  5. Lactobacillus sakei normally lives in healthy sinuses, which is why it is such an effective sinus infection treatment for so many people.
  6. Over time (whether weeks or months) a person typically needs less Lactobacillus sakei to treat sinus symptoms. The L. sakei colonizes in the sinuses - whether short-term or long-term.
  7. Swishing a product like Lanto Sinus in the mouth alone is a gentle and cautious way to use the product. Using it in the nostrils is a stronger way to use the product.
  8. Don't overdo it. Using a little bit in the nostrils (as described in Sinusitis Treatment Summary) is sufficient. Let the little buggers travel on their own throughout the sinuses!
  9. If Lactobacillus sakei works for a person, it can feel miraculous as sinusitis symptoms disappear, frequently within a few days. Others have slower improvement. Unfortunately, it doesn't work for everyone and only self-experimentation determines whether it does - after all, everyone's sinus microbiome is different.

Hopefully this offers hope to sinus infection sufferers. Good health!

2

According to a recent study, two commonly available treatments for chronic sinusitis don't work. Researchers tested xylitol, the probiotic Lactococcus lactis, and ordinary saline rinses separately for one month in a group of persons with chronic sinusitis. They found that none of these improved sinusitis symptoms or sinus microbial diversity (the sinus microbiome).

Interestingly, studies find that Lactococcus lactis occurs naturally in the sinuses of some people, yet in the study it didn't seem to have healing properties (in other words, not a keystone bacteria in sinus health). The finding of xylitol not helping with sinusitis symptoms is what most people have reported to me for years - so not a surprising finding.

Plain saline rinses may temporarily improve breathing, and are especially helpful when suffering from allergies, but it has long been known that they don't treat sinusitis.

The University of Rochester Medical Center researchers had study participants doing 1 treatment (either L. lactis or xylitol nasal rinse) for 1 month, then 1 month of saline rinse alone (the "wash-out" period), and then 1 month of the other treatment rinse. So each person tried all 3 methods. Their symptoms were assessed 4 different times with the SNOT-22 symptom questionnaire [some SNOT-22 problems]. 25 persons with chronic sinusitis (and a past history of sinus surgery) were enrolled, and 10 healthy controls (no chronic sinusitis).

So what should one try if suffering from sinusitis? Try  Lactobacillus sakei (it has helped many because it is a keystone bacteria, and also kills/dominates over many harmful bacteria). However, use it only when needed (when sinusitis symptoms start to appear) and stop when feeling better.

A month of using any product, as described in this xylitol and L. lactis study, may also be too long. One month could even lead to a sinus "imbalance".

For example, a few days or 1 week of L. sakei (whether kimchi or Lanto Sinus) may be enough! No need to repeatedly flood the sinuses with 1 product - normally healthy sinuses contain multitudes of species living in balance. ...continue reading "Some Treatments Don’t Work For Sinusitis"

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Oral microbes Credit: Wikipedia

We all have millions of microbes living in our sinuses – bacteria, viruses, and fungi. This is normal.

An amazing fact is that living together are beneficial, benign, and what we normally consider harmful microbes. And this is normal. This rich and diverse community of microbes living in the sinuses is called the sinus microbiome or microbiota.

OUR SINUSES: We have 4 pairs of sinuses in our heads, which are air-filled and lined with a mucus membrane with cilia. The cilia steadily beat (700 to 800 times a minute!) in order to move mucous into the nasal cavity. Microbes live in the mucous lining.

For years it was thought that the sinuses were sterile, and a sinus infection meant that a harmful microbe (pathogen) had invaded. In the 1990s a popular view was that fungi were the cause of chronic sinusitis. But with the development of new technologies (genetic sequencing) in the last 2 decades, it was discovered that millions of all sorts of microbes live in the sinuses in both healthy and sick persons. And yes, that it was normal to have fungi in the sinuses (so that theory was dropped).

THE CURRENT VIEW: Millions of microbes live in complex communities, interact with one another, and with us (we’re their host!). In healthy persons all the microbial species are in equilibrium, and potentially harmful species are kept in check. But sometimes the communities can become disrupted and imbalanced – this is called dysbiosis.

When there is disruption (e.g., from an infection, allergies), then there can be an overgrowth or a big increase in the potentially harmful microbes living in the sinuses. This can make you more susceptible to an infection or it can result in sinusitis symptoms. (In chronic sinusitis there is an imbalanced sinus microbiome and also inflammation of the sinus mucous lining.)

Staphylococcus Credit: Wikipedia

A HEALTHY SINUS MICROBIOME: It turns out that what is a healthy sinus microbiome varies from person to person. Yes, there is a “core” sinus microbiome of species that are shared throughout the world. (For example: Corynebacterium and Staphylococcus species)

Everyone’s sinus microbiome is unique – you may have more of some species, less or none of others. Generally a heathy sinus microbiome has more richness of species and diversity, which is diminished in people with chronic sinusitis.

But guess what? Even if a person has fewer or more species – the total number of bacteria present is the same. Think of it this way – if there is an empty space, microbes will move in to occupy it.

A big surprise in the last 2 decades is that healthy sinuses have low levels of harmful microbes (e.g.  Staphylococcus aureus) coexisting with beneficial microbes. They are considered to be “opportunistic pathogens”, which means they can become harmful if the conditions are right. For example, if the sinus microbial community becomes disrupted by an infection. Which is why so many people develop sinusitis after a cold or other respiratory infection.

Most research has looked at the multitudes of bacterial species living in our sinuses. But there are also species of viruses and fungi, and much is still unknown about them. The viruses (our “virome”) can be a stable part of our microbial community or only there briefly. Healthy persons (and those with sinusitis) also have fungi living in the sinuses.

In addition, some people have archaea living in their sinuses – one-celled organisms that don’t have a cell nucleus. A minority of people have archaea in their sinuses, but it is unknown why they are there, what is their role (if any), and why only some people have them. They can also be found in the human gut.

It turns out that we all (both healthy and sick) have biofilms living on the mucus lining of the sinuses. However, research suggests that they may be a little different in healthy persons – they are smaller (microcolonies), don’t cause an inflammatory response, and are kept in check by the other microbes. (Biofilms are bacteria communities sticking to one another, and with a protective slime coating.)

Some microbes have an important role in the health of the sinus microbiome, even if they are there only in tiny amounts – these are keystone bacteria. Lactobacillus sakei is one of them (in Lanto Sinus), and research shows it s depleted in persons with chronic sinusitis.

What else influences the species of microbes in the sinus microbiome? The list includes illnesses, allergies, asthma, cigarette smoking, age of the person, antibiotics, and whether sinus surgery has been done. All these factors help explain why in both health and sickness, every person’s sinus microbiome is unique.

Bottom line: We have trillions of microbes living in our bodies, and this includes the sinus microbiome. Bacteria, viruses, fungi, and for some people also archaea. The field is still in its infancy and so we still have much to learn.

Everyone has millions of microbes living in complex communities in their sinuses. All these hundreds of species of bacteria, fungi, and viruses are the sinus microbiome or sinus microbiota. In addition, some (many?) people also have tiny organisms called archaea living in their sinuses.

What are archaea? Archaea are single-celled organisms that lack cell nuclei, and have a unique cell wall membrane. Very little is known about them, what their role is in the sinuses (that is, what are they doing there?), how do they interact with the host (the person), and whether their presence is beneficial or not.

There are only a few studies looking at archaea in humans, and while very little is known, the current view is that there are no known harmful archaea ("archaeal pathogens or parasites").

In a 2019 study, French researchers found archaea in the sinuses of 9 of their patients with chronic sinusitis - and therefore thought they were linked to disease. But unfortunately they didn't look to see if archaea are also found in the sinuses of healthy persons, thus there wasn't a comparison group. They found methanogenic archaea (the only microorganisms able to produce methane) in these nine patients, and they thought that the archaea were contributing to or causing the chronic sinusitis.

The Methanobrevibacter species they found were  M. smithii, M. oralis, and M. massiliense, of which 2 have been found in dental plaque and periodontitis lesions, and one is a gut methanogen. [Note: This means it is found in the gut and is methane producing - but that doesn't mean it is harmful.]

Finally, a more recent and comprehensive study looked at archaea and bacteria in the sinuses of both healthy persons and those with chronic sinusitis. University of Auckland researchers found that only 6 out of 70 persons (both healthy and with sinusitis) had archaea in the sinuses, and they were very low in numbers and in diversity. In those with archaea, there was a lot of variation between people. They did not see any archaea associated with chronic sinusitis.

Archaea found were from Euryarchaeota, Thaumarchaeota, and Methanobrevibacteriaceae phyla.

One can only wonder what the archaea are doing in the sinuses in those with them. Especially, as the researchers point out that archaea are characterized by a unique cell wall membrane that "assists survival in extreme conditions such as hydrothermal vents, salt lakes, anoxic and highly acidic or alkaline environments". Also, that recent studies suggest that the human immune system recognizes and can be "activated" by archaea.

Archaea. Credit: Wikipedia

Finally, studies also mention that archaea are resistant to many antibiotics (because of lack of peptidoglycan in their cell wall). It is unknown how this influences their role (if any) in human health and disease.

As you can see, much is unknown right now. Even how many people have archaea in their sinuses, and what kinds of archaea. Stay tuned.

Article by B.W. Mackenzie et al in Frontiers in Cellular Infection and Microbiology: A Novel Description of the Human Sinus Archaeome During Health and Chronic Rhinosinusitis