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20131201_101300 Last week a person told an amazing story in the comments section after a post on this site. After suffering from a "constant runny nose and a bad smell" in the nose for 2 years - which was diagnosed as "fungi and staph" in the sinuses - the person started doing "kimchi treatments" (as discussed in the Sinusitis Treatment Summary page). After 2 weeks a fungal ball was loosened, which came out of the sinuses and into the mouth, and was then spit out. About an inch in size - a smelly, grey/green, round fungal ball. Wow. Which leads to the question: Are any of the microbes in live kimchi anti-fungal?

Kimchi is an amazing live fermented food, typically made with cabbage and other vegetables and a variety of seasonings. Kimchi is the national dish of Korea and so there is tremendous interest in Korea in studying kimchi to learn about the many different microbial species in kimchi, including how they change over the course of fermentation. It turns out that kimchi contains many species of bacteria, including various species of Lactobacillus - which are considered beneficial. Of course one of the species found in kimchi over the course of fermentation is Lactobacillus sakei - the bacteria that successfully treats sinusitis, and which I have written about extensively. L. sakei predominates over pathogenic bacteria (antibacterial) - which is why it is also used as a sausage starter culture (to kill off bacteria such as Listeria). One study found that the garlic, ginger, and leek used in making kimchi were the sources of L. sakei bacteria found in fermented kimchi.

Studies show that a number of the Lactobacillus species found in kimchi are antifungal against a number of different kinds of fungi.  Some of these antifungal bacteria are: Lactobacillus plantarum, L. cruvatus, L. lactis, L. casei, L. pentosus, L. acidophilus, and L. sakei (here, here.

A study from 2005 found that some Lactobacillus species found in kimchi are predominant over a fungi known to cause health problems in humans - Aspergillus fumigatus, a mold (fungi) which is the most common cause of Aspergillus infections. Aspergillus (of which there are many species) is very common both indoors and outdoors (on plants, soil, rotting plants, household dust, etc.), so people typically breathe in these fungal spores daily and without any negative effects. However, sometimes Aspergillus can cause allergic reactions, infections in the lungs and sinuses (including fungal balls), and other infections. (more information at CDC site). The study found that 5 bacterial species in kimchi were also antifungal against other species of fungi (Aspergillus flavus, Fusarium moniliforme, Penicillium commune, and Rhizopus oryzae). The 5 bacterial species in kimchi that they found to be antifungal were: Lactobacillus cruvatus, L. lactis subsp. lactis, L. casei, L. pentosus, and L. sakei.

Just keep in mind that fungi are everywhere around us, and even part of the microbes that live in and on us - this is our mycobiome (here and here). We also breathe in a variety of fungi (mold spores) every day. In healthy individuals (even babies) all the microbes (bacteria, viruses, fungi, etc) live in balanced microbial communities, but the communities can become "out of whack" (dysbiosis) for various reasons, and microbes that formerly co-existed peacefully can multiply and become problematic.  If the populations get too unbalanced (e.g., antibiotics can kill off bacteria, and then an increase in fungi populations take their place) then ordinarily non-harmful fungi can become pathogenic. Or other pathogenic microbes can enter the community (e.g., through infection), and the person becomes ill.

IN SUMMARY: Kimchi has beneficial bacteria in it that are effective not just against bacteria (antibacterial), but also against some kinds of fungi (antifungal). One 2016 review study went so far as to say: "Kimchi possesses anti-inflammatory, antibacterial, antioxidant, anticancer, antiobesity, probiotic properties, cholesterol reduction, and antiaging properties." Experiences of my family and people writing suggest that the L. sakei in kimchi (and other products) is also antibiofilm. Hopefully, there will be some research on this in the future. But in the meantime, please keep writing to me about fungal complications of sinusitis, and especially if kimchi, L. sakei products, or other probiotics helped.

20131201_101300 As you may have noticed, I write about the beneficial bacteria Lactobacillus sakei a lot. This is because it has turned out to be a great treatment for both chronic and acute sinusitis for my family and others (see post The One Probiotic That Treats Sinusitis). We originally found it in kimchi (it occurs in the kimchi during normal fermentation), but not all kimchi brands. Kimchi is a mix of vegetables (including typically cabbage) and seasonings, which is then fermented for days or weeks before it is eaten.

Why is L. sakei found in some kimchi, but not all? Which vegetable or spice is needed or important for encouraging L. sakei growth? It turns out it is not the cabbage - which is why L. sakei is not found in sauerkraut. A recent study looking at several kimchi samples found that garlic seems to be important for the development of various Lactobacillus bacteria, of which L. sakei is one. The results mean that raw garlic has very low levels of L. sakei, and it multiplies during kimchi fermentation. Note that as fermentation progresses, the bacterial species composition in the kimchi changes (this is called ecological succession). Korean studies (here and here) have consistently found L. sakei in many brands of kimchi (especially from about day 14 to about 2 or 2 1/2 months of fermentation), but not all kimchi brands or recipes. L.sakei, of which there are many strains, is so beneficial because it "outcompetes other spoilage- or disease-causing microorganisms" and so prevents them from growing (see post).

Excerpts are from the blog site Microbial Menagerie: MICROBES AT WORK IN YOUR KIMCHI

Cabbage is chopped up into large pieces and soaked in salt water allowing the water to draw out from the cabbage. Other seasonings such as spices, herbs and aromatics are prepared. Ginger, onion, garlic, and chili pepper are commonly used. The seasonings and cabbage are mixed together. Now the kimchi is ready to ferment. The mixture is packed down in a glass container and covered with the brining liquid if needed. The kimchi sits at room temperature for 1-2 days for fermentation to take place....Kimchi does not use a starter culture, but is still able to ferment. Then where do the fermentation microbes come from?

Phylogenetic analysis based on 16S rRNA sequencing indicates that the kimchi microbiome is dominated by lactic acid bacteria (LAB) of the genus Leuconostoc, Lactobacillus, and Weissella. Kimchi relies on the native microbes of the ingredients. That is, the microbes naturally found on the ingredients. Because of this, there may be wide variations in the taste and texture of the final kimchi product depending on the source of the ingredients. In fact, a research group from Chung-Ang University acquired the same ingredients from different markets and sampled the bacterial communities within each of the ingredients. The group found a wide variability in the same ingredient when it was bought from different markets. Surprisingly, the cabbage was not the primary source of LAB. Instead, Lactic acid bacteria was found in high abundance in the garlic samples

Note that Lactobacillus sakei is an example of a lactic acid bacteria. More study details from  the Journal of Food Science: Source Tracking and Succession of Kimchi Lactic Acid Bacteria during Fermentation.

This study aimed at evaluating raw materials as potential lactic acid bacteria (LAB) sources for kimchi fermentation and investigating LAB successions during fermentation. The bacterial abundances and communities of five different sets of raw materials were investigated using plate-counting and pyrosequencing. LAB were found to be highly abundant in all garlic samples, suggesting that garlic may be a major LAB source for kimchi fermentation. LAB were observed in three and two out of five ginger and leek samples, respectively, indicating that they can also be potential important LAB sources. LAB were identified in only one cabbage sample with low abundance, suggesting that cabbage may not be an important LAB source.

Bacterial successions during fermentation in the five kimchi samples were investigated by community analysis using pyrosequencing. LAB communities in initial kimchi were similar to the combined LAB communities of individual raw materials, suggesting that kimchi LAB were derived from their raw materials. LAB community analyses showed that species in the genera Leuconostoc, Lactobacillus, and Weissella were key players in kimchi fermentation, but their successions during fermentation varied with the species, indicating that members of the key genera may have different acid tolerance or growth competitiveness depending on their respective species.

Although W. koreensis, Leu. mesenteroides, and Lb. sakei were not detected in the raw materials of kimchi samples D and E (indicating their very low abundances in raw materials), they were found to be predominant during the late fermentation period. Several previous studies have also reported that W. koreensis, Leu. mesenteroides, and L. sakei are the predominant kimchi LAB during fermentation (Jeong and others 2013a, 2013b; Jung and others 2011, 2012, 2013a, 2014). 

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 Just wanted to say that I added an October 2016 update to the post The One Probiotic That Treats Sinusitis, which was originally posted in January 2015.  The update incorporates the latest information about treatments and products with Lactobacillus sakei  (kimchi brands, the sausage starter culture Bactoferm F-RM-52, and Lactopy Prime). According to research by Abreu et al (2012)Lactobacillus sakei is a bacteria or probiotic (beneficial bacteria) that chronic sinusitis sufferers lack and which treats chronic sinusitis. Chronic sinusitis sufferers also don't have the bacteria diversity in the sinuses that healthy people have.

Many thanks to those who have written to me about their experiences with L. sakei products and sinusitis treatment.  Please keep the updates, results, and progress reports coming. If you have had success with other kimchi brands, please let me know so that I can add it to the list. And I also want to hear if other probiotics work or don't work, or if you have found other sources of Lactobacillus sakei or new ways to use L. sakei. It all adds to the knowledge base which I will continue to update.  You can Comment after posts, the Sinus Treatment Summary page, on the CONTACT page, or write me privately (see CONTACT page).

It is now over 2 1/2 years since my family (4 people) successfully treated ourselves with Lactobacillu sakei for chronic sinusitis and acute sinusitis. We feel great! With each passing year we can tell that our sinus microbial community is bettter, and levels of inflammation are down. As a consequence, we are getting fewer colds or viruses than ever. And best of all - no antibiotics taken in over 2 1/2 years! Yes, Lactobacillus sakei absolutely works as a treatment for sinusitis.

Read the updated post: The One Probiotic That Treats Sinusitis (with October 2016 update)

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: I posted a number of posts with sinusitis treatment information, with the last updated one being January 12, 2015 -  The One Probiotic That Treats Sinusitis. This post has the updated list of brands and sources of L. sakei. I wrote the story of our Sinusitis Treatment back in December 2013, and there is also a  Sinusitis Treatment Summary page. One can also click on SINUSITIS under CATEGORIES to see more posts, such as "Which Kimchi is Best for Sinusitis Treatment: Vegan or Seafood?")

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 (UPDATED AUGUST 2017) Probiotics and sinusitis treatment go hand in hand. In the last few years researchers found that one probiotic (beneficial bacteria) that chronic sinusitis sufferers lack and that treats and cures sinusitis is Lactobacillus sakei. The researchers Abreu et al found in their 2012 study that not only do sinusitis sufferers lack L. sakei, they have too much of Corynebacterium tuberculostearicum (normally a harmless skin bacteria), and they also don't have the bacteria diversity in their sinuses that healthy people without sinusitis have. In other words, the sinus microbiome (microbial community) is out of whack (dysbiosis). A number of studies found that there is a depletion of some bacterial species, and an increase in "abundance" of other species in those with chronic sinusitis. Of course researchers are working on a beneficial bacteria nasal spray to treat or prevent sinusitis, but that will take a while.

Luckily Lactobacillus sakei is found in some foods (such as some brands of live fermented kimchi), and in "starter cultures" (for sausages) such as Bactoferm F-RM-52 and B-2. One reason it is used in sausage starter cultures is because it dominates over and inhibits growth of pathogenic bacteria, including Staphylococcus aureus and Listeria. [Note that treating sinusitis with beneficial bacteria (rather than just antibiotics, corticosteroid nasal sprays, and surgery) is a major shift or paradigm change in sinusitis medical treatment, but it is the future in sinusitis treatment.]

More than 4 1/2 years ago I started using a very easy kimchi sinusitis treatment (basically dabbing and smearing kimchi at certain stages of fermentation into my nostrils like a very messy eater) and found that it cured my chronic sinusitis of many years within several weeks. Obviously it contained L. sakei. Then the rest of my family also tried the kimchi treatment and were also cured of chronic sinusitis! It felt miraculous, especially because it was so easy to do. (See SINUSITIS TREATMENT page for our background story, and see SINUSITIS TREATMENT SUMMARY page for different treatment methods.)

After 4 1/2 years we still feel great! Generally all 4 of us only need to treat again with a product containing Lactobacillus sakei after a virus which goes into sinusitis, or if for some other reason we feel like we're sliding into sinusitis. The last 2 years we've needed to do this far less than the first year. Because we no longer have chronic sinusitis, we have NOT taken antibiotics or any other bacteria killing spray or product (such as xylitol) for the last three and a half years. We do not use cortisone or antihistamine nasal sprays either.

A number of you have contacted me to report your own progress with various sinusitis treatments. Thank you! The following are the results from those commenting on this web-site or to me privately. People used terms such as "miraculous", "transformative", and "fabulous" when they had positive results with a product containing L. sakei. I am also starting to hear from you about other some other probiotic (beneficial) bacteria species that may treat sinusitis. When a treatment works, then all sinusitis symptoms go away, including post nasal drip, sinus headaches, "clogged ears", bad breath, and sinusitis-related coughs. Even tonsil stones! (Please note that trying such products to treat sinusitis is self-experimentation - effects can be positive or negative. One should always be very cautious.)

OVERALL RESULTS: The majority of people writing to me with results reported positive results (chronic sinusitis greatly improved or totally gone) from some form of L. sakei treatment. Most have been from the USA or Canada, but successes have also been reported to me from Europe, Australia, New Zealand, and Africa. But since it's from self-experimentation and not a clinical trial, then I don't know the actual percentage of positive results. (Please write!) Some of the people reporting success have had multiple operations, some currently have deviated septums, some with nasal polyps, and all have had long-standing chronic sinusitis, some for decades. Those same chronic sinusitis sufferers also reported that the same treatments also worked after acute sinusitis (e.g., after a cold). It seems that after colds, etc. they (including myself) develop acute sinusitis again and need re-treatment (apparently the L. sakei doesn't stay or colonize in the sinuses from earlier treatments) . But a minority of people reported that nothing has helped and there could be a variety of reasons for this (see below).

KIMCHI - A number of people reported that kimchi helped them (without naming brands), while others named brands that helped them. And one person reported a homemade kimchi worked great (he was finally symptom free after 8 years). A few have even mentioned that kimchi has helped sinusitis with fungal problems. Kimchi brands that people reported helping their chronic sinusitis: Sinto Gourmet brand kimchi, Mama-O's Premium Kimchi, the white Napa kimchi (as well as the cabbage kimchi) made by Choi's Kimchi Company (in Portland, Oregon), Farmhouse Culture Kimchi (in California), 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. We still use Sunja's Kimchi (the first year we used Sunja's medium spicy cabbage, but when that stopped working we switched to the medium spicy cucumber kimchi, and now also the mild white kimchi). I'm sure some other brands also contain L. sakei.

(Please note that not all kimchi brands or types of kimchi within brands contain L. sakei - finding one that has it is due to self-experimentation. We found that kimchi may contain L. sakei from about day 14 to about 2 to 2 1/2 months (from the day it's made). When the kimchi contained L. sakei we felt the same or started feeling better within one or 2 days. If we felt more mucusy or phlegmy over the next 2 days, or the acute sinusitis kept getting worse, than it did not contain L. sakei.)

Some people wrote in that kimchi did not help them, including various types of Sunja's kimchi. One person said that Hawthorne Valley Kim Chee had no effect, and that it was more like a sauerkraut product. (Sauerkraut had not worked for anyone until recently one person said that they improved with a homemade sauerkraut, and another person with a sauerkraut made with garlic carried by Costco). Some researchers feel that it's the garlic in kimchi that encourages L. sakei growth, and sauerkraut typically doesn't contain garlic.)

BACTOFERM F-RM-52 - A number of persons reported that a mixture of bottled water and the sausage starter culture Bactoferm F-RM-52  (Lactobacillus sakei and Staphylococcus carnosus), has successfully worked for them. This product is produced by the Danish manufacturer Chr. Hansen and sold by various sausage-making suppliers. It is reliable and effective, like an army that marches in to attack the sinusitis causing bacteria. (See SINUSITIS TREATMENT SUMMARY page for details). Most use it by dabbing/smearing or spooning the mixture into the nostrils, while others report using it in a neti pot (e.g., first Comment on the CONTACT page), and one person even a nasal aspirator (bulb syringe) for a large one time dose. Sometimes a side effect on the day we used the product was a dry mouth and throat (and they can be very dry when we overused it - so it's important to use only a little in a treatment). The person who used the nasal aspirator reported a temporary decrease in her sense of smell.

Bactoferm F-RM-52 contains a second bacteria besides L. sakei. Very little is known about Staphylococcus carnosus - but it is considered non-pathogenic, and also no one has reported negative effects from it. Such are the perils of self-experimentation - effects are unkown.

However, several people (one in Europe) reported that Bactoferm F-RM-52 did not work for them, but then the issue is - did the L. sakei die during shipping or did it not work for some other reason? One possibility is that  L. sakei does not work against all types of pathogenic bacteria. Even my family has had problems with Bactoferm F-RM-52  - one time it died during shipping (that batch had zero effect when we used it).

---[Please note: One sausage culture seller (sausagemaker) has been so upset (afraid of lawsuits?) that the Bactoferm F-RM-52 they sell has been used "off label" to treat sinusitis that they now have applied their own warnings to the back of the product package. The warnings state that the product also contains manganese sulfate monohydrate, which is used in tiny amounts as a food additive (a food grade nutritional supplement). However, the warnings listed are from the Safety Data Sheet for people handling large batches of manganese sulfate monohydrate (for "science education applications" or "laboratory and manufacturing use"). It's as if they are warning that the package contains nothing but the powdered form of manganese sulfate monohydrate, in case people might stick their heads in the package and inhale for prolonged periods.]

B-2  - Several persons from Australia and New Zealand have reported good results with B-2. The manufacturers of Bactoferm F-RM-52 also make a Lactobacillus sakei only product called B-2. It is part of their SafePro product line of bio-protective cultures for meat. It is used exactly like the Bactoferm F-RM-52, but a person who has used both products liked the effects of B-2 more than Bactoferm F-RM-52 ("less irritating and more effective").  I have not seen this culture available anywhere in the U.S., but I know B-2 is available in New Zealand and can be (and is) shipped  to Australia.

BACTOFERM  SM 160 - One person (outside of North America) tried Bactoferm SM 160, which contains Lactobacillus sakei, Staphylococcus carnosus and Debaryomyces hansenii, and is finding very good results in treating chronic sinusitis that he had for years. The third microbe Debaryomyces hansenii is considered "non-pathogenic", and is common in food products (cheeses, processed meat, and early stages of soy fermentation). One study said D. hansenii secretes toxins capable of killing other yeasts, and it is used on an industrial scale to produce vitamin B2. However, it is a yeast species (a fungi) so it is unknown if it can cause problems (and so he's being cautious in its use, and so far all is good).

PRIMAL SK NATUR 50 - The European company VAN HEES makes a starter culture PRIMAL SK natur 50 with the same ingredients as Bactoferm F-RM-52. The ingredients are: Lactobacillus sakei and Staphylococcus carnosus, with a carrier base of dextrose (to feed the bacteria when used as a starter culture). They ship to various European countries.

BITEC STARTER LS 25 (also called BITEC LS-25) - The product BITEC LS-25 (which contains the same 2 bacteria as Bactoferm F-RM-52) is available in Europe, but the ingredients listed are Staphylococcus carnosus first and Lactobacillus sakei second. This product is also sold as a sausage starter and is made by Frutarum (a global "flavor, fragrances, and fine ingredients" company) that is based in Israel and Europe.

SOME L.SAKEI ISSUES: I still think of L. sakei as fairly fragile - it is killed off by antibiotics, by oxygen within a week of opening a kimchi jar, and even the culture Bactoferm F-RM-52 package says that it dies off within 2 weeks at room temperature (therefore store in freezer). Please note that the L. sakei in the product can also die off during shipping if it takes too long or some other reason. Thus we order 2 day shipping (if possible) and hope for the best.

WHY DOESN'T L. SAKEI WORK FOR SOME PEOPLE? Some other possibilities to explain why some people trying 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 or biofilms that the Lactobacillus bacteria cannot overcome, even though it is viewed that some Lactobacillus species are anti-biofilm and anti-pathogenic. It is unclear whether the results are different if there are also nasal polyps. [Researchers now suspect that those with nasal polyps also have a problem with "primary inflammation".] We (modern medicine) know so little about the normal healthy sinus microbiome that there are many unanswered questions. (NOTE: click on the Category SINUSITIS for more posts on recent sinusitis research.)

PROBLEM WITH 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 long time. We think this might be an issue of "too much of certain microbes" - and we (family members) have found that switching to another product (e.g., from one brand or type of kimchi to another), or from a L. sakei product to kimchi, or swishing multi-strain probiotics (the powder) in the mouth has corrected the situation for us. (Finding what works is self-experimentation, and varies from time to time). And months later, we can use the original product once again.

BOTTOM LINE: When feeling good or healthy, stop using the L. sakei product. Use L.sakei products sparingly - only as needed (e.g. after developing sinusitis). L. sakei seems to be necessary for sinusitis treatment for most people, but there are also other important microbes in the sinuses - a whole community.

OTHER PROMISING PROBIOTICS - Seven people have  reported that multi-strain probiotics  (but they did not contain L. sakei) treated their sinusitis. One woman tried Pure Encapsulations Probiotic 50B in her nose (I assume similarly to how we use Bactoferm F-RM-52) and reported major improvement. This product (which must be refrigerated) contains the following bacteria:  Lactobacillus acidophilus, L. rhamnosus, L. plantarum, Bifidobacterium longum and B. lactis. Another person successfully treated his sinusitis by mixing a saline solution with a probiotic containing: Lactobacillus acidophilus, L. plantarum, L. rhamnosus, Bifidobacterium lactisL. casei, B. bifidum, B.breve, and Streptococcus thermophilus. Note that the first 4 bacteria listed here are the same as in the first person's probiotic. (Scroll down to the Comment written by Martin for more details).

Some researchers are focusing on Lactobacillus sakei, L. rhamnosus, L. plantarumL. casei, and L. Johnsonii in the treatment of sinusitis and sinus health (see below Promising Probiotic Nasal Sprays and also the June 29, 2016 post).

OTHER PROBIOTICS MAY OR MAY NOT HAVE BENEFICIAL EFFECTS - On the other hand, a few people (including my family members) reported trying various multi-strain probiotics containing various Lactobacillus and Bifidobacterium species in the nostrils, but it did not treat the sinusitis, even though it resulted in some improvement usually (but not always). Since sinusitis sufferers don't have the bacteria diversity of healthy people, and the sinus microbial community is different in each person, then adding what are viewed as beneficial bacteria to the sinus microbial community might help some people.

The possibility remains that perhaps one or more bacteria species, or a combination of species, has effects similar to L. sakei. But which ones or which combinations of bacteria? (Just remember, trying L. sakei products or multi-strain probiotics is self-experimentation, and results are unknown and can vary - can be positive, negative, or no effect.)

STILL UNKNOWN: People have written in about 3 products that contain L. sakei, but no one has reported results. (1) From a person in Australia: Danisco's CHOOZIT® FNR 1 - a cheese starter culture that contains L. sakei and Staphylococcus vitulinus. The bacteria S. vitulinus is considered benign, but I could find almost nothing about it. So self-experimentation results are totally unknown - could be negative or positive. (2) Multi-strain Probiotic by Innovix Labs - tablets containing 26 probiotics, including L. sakei. However, I have 2 concerns with this product: A) This product does not require refrigeration, but all other L. sakei products require refrigeration (even the freezer), because at room temperature L. sakei dies within a few weeks. B) L. sakei is considered anaerobic  - doesn't live when exposed to oxygen. So...while the L. sakei may be alive when the product is produced, is it alive weeks or months later at room temperature?  (3) Pro-Kids ENT by Hyperbiotics are chewable tablets containing 5 strains of bacteria, including L. sakei and S. salivarius K12. I have the same concerns with this product as with product #2. In addition, the S. salivarius K12 has caused problems for some people (scroll down to "Problems With BLIS K12?") If purchasing product #2 or #3 I would consider refrigerating them to slow down the decline of bacteria numbers (which always happens over time), and add a desiccant to deal with the moisture from refrigeration (if it's not already included).

PROMISING PROBIOTIC NASAL SPRAYS - The original sinusitis researchers (Susan Lynch, A. Goldberg) are still working on a probiotic nasal spray containing L. sakei. Another research group (at the Univ. of Antwerp in Belgium) is developing a nasal spray with Lactobacillus rhamnosus, Lactobacillus plantarum, Lactobacillus caseiand other Lactobacillus species, including L. sakei. They are calling the nasal spray "Oronasopharyngeal probiotics", and say that these Lactobacillus  species (especially L. rhamnosus) are "anti-pathogenic and antibiofilm agents". 

NO EVIDENCE FOR JUST SWALLOWING PROBIOTIC SUPPLEMENTS: Evidence (my family, people writing in, research) so far has been that only directly dabbing/smearing/spraying probiotics in the nose, or even swishing a paste of probiotics in the mouth may help treat sinusitis. I have not found any studies finding that ingesting/swallowing a probiotic pill has helped sinusitis (including a 2009 study looking at swallowing L. rhamnosus tablets 2 times daily for 4 weeks).

PROBIOTICS TO AVOID - The product NatureWise Maximum Care Time-Release Probiotics: 30 Strains, 30 Billion CFU contains a number of probiotic bacteria, including L. sakei. Lactobacillus and Bifidobacterium bacteria are generally viewed as beneficial. However, it also contains E. faecium (Enterococcus faecium) which is considered very controversial. This is because strains of this specific bacteria show multi-drug resistance (including to antibiotics). (See my Sept 2, 2016 Comment after the August 30, 2016 post for more information.)

PROMISING PHAGE THERAPY - Some researchers in the USA and Australia are currently testing phage therapy to see if it could be used as a treatment for various conditions, including chronic sinusitis. A bacteriophage is a virus that infects bacteria, and the name literally means "bacteria eater". Phage therapy is the therapeutic use of bacteriophages to treat bacterial infections. See the June 3, 2016 post Phage Therapy May Help Sinusitis Sufferers for more information. The authors of one study I posted there said that they had found evidence for people having "virus-like particles" in their sinuses, which they thought were bacteriophages.

PROBLEMS WITH BLIS K12 ? - On a side note, two of us, plus one person writing in, tried BLIS K12 bacteria tablets (containing Streptococcus salivarius BLIS K12) for several weeks because scientific research had found it to be an immune booster, that it is good for oral health, and it lowers the incidence of upper respiratory infections. However, from the first tablet (ate it by slowly dissolving it in the  mouth) there were problems - feeling phlegmy and yellow mucus. After several weeks, we stopped the experiment and had to do kimchi treatments to recover. Two persons reported similar negative effects with PRO-dental tablets, which also contains BLIS K12. The message here is clear: that specific bacteria did not react well with our sinus and oral bacterial communities. Remember, whenever one introduces new bacteria into the human organism, there can be positive or negative effects.

PLEASE WRITE!  I would really like to hear how you are treating and curing your sinusitis, especially chronic sinusitis. Or even what hasn't worked. It all adds to the knowledge base. And let me also know if you've had additional problems or complications such as sinus operations, nasal polyps, a fungal problem, diagnosed with antibiotic resistant bacteria (for example: Pseudomonas aeruginosa), etc. Has L. sakei or another probiotic helped? Write to me privately, or can comment after any post.  (Note that most comments are after this post, the SINUSITIS TREATMENT SUMMARY page, the CONTACT page, and  other sinusitis posts - see category SINUSITIS).

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[PLEASE NOTE THAT AN UPDATED VERSION OF THIS POST WITH NEW INFORMATION, INCLUDING NEW PRODUCTS, WAS PUBLISHED IN OCTOBER 2016: The One Probiotic That Treats SinusitisComments can be posted there.]

We now know that antibiotics, especially repeated courses of antibiotics, kills off bacteria and alters the microbial community in the sinuses (sinus biome). Research by Abreu et al (in 2012) showed that it is Lactobacillus sakei that is missing in chronic sinusitis sufferers, and that Lactobacillus sakei successfully treats sinusitis. From this research it is clear that Lactobacillus sakei is a  beneficial bacteria that can be used as a probiotic to cure sinustis.

It turns out that many brands of live fermented kimchi contain Lactobacillus sakei, and this is what my family used to treat and cure ourselves of chronic sinusitis (and acute sinusitis). So yes, kimchi can be probiotics for sinusitis. It is now over 85 weeks since I've been off all antibiotics and feeling great!

Until now I avoided naming the kimchi brand we used on this site because I believe that many brands of fermented kimchi (with cabbage) contain Lactobacillus sakei, and should be effective in curing sinusitis (this is by dabbing or smearing it in the nostrils - see Sinusitis Treatment Summary link for the METHOD and details).

WHAT BRANDS OR PRODUCTS WITH Lactobacillus sakei WORK?

The brand I use is Sunja's Kimchi (from Vermont). We originally were successful with the Medium Spicy Cabbage Kimchi and when that stopped being fully effective last winter (from overuse? recipe change?), we switched to Sunja's Medium Spicy Cucumber Kimchi (fermented at least 14 days and the jar opened less than 1 week).

Recently I heard from a woman in Nevada who wrote me stating that smearing/dabbing Sinto Gourmet Mild White Napa Cabbage Kimchi into her nostrils was successfully treating her chronic sinusitis (using the method described in the Sinusitis Treatment page)

One person wrote that he successfully cured chronic and acute sinusitis with a fermented sausage starter from Chr. Hansen containing L. sakei and another bacteria. He used it after mixing very small amounts in his  Neti pot - initially used it 1 x per day until cured, and then sparingly only as needed (after a cold) or as a maintenance booster once every 3 or 4 months (see his comment in the Contact page for more details). (UPDATE: one name for this product is Bactoferm F-RM-52, which contains Lactobacillus sakei and Staphylococcus carnosus  . See 1/12/15 post for more, including my experience with it.)

The Korean product Lactopy shows definite promise because they advertise it as L. sakei from kimchi. However, everything on the package is written in Korean, it needs to be refrigerated, and it is shipped from Korea. One person has written that she has been using it for several months and that it is working (she is using it in her "nose bottle" - in the same manner as one would use a neti pot or by swabbing the inside of her nostrils with a Q-tip). However, trying another method of using Lactopy  in a paste with water and then keeping it in the mouth for a while (like a soft lozenge) did not work when my family tried it last winter.

Eating kimchi does not seem to treat sinusitis, even though it may be good for the gut. Only smearing or dabbing it in the nostrils works.

Several people have reported that using sauerkraut has not helped their sinusitis, and scientific studies report that sauerkraut contains minimal L.sakei, if at all.

Others have also mentioned thinking about using lactic acid starter cultures containing L. sakei , whether using it alone or making kimchi with it, but I don't know how it went.

Finally, I would like feedback from you: 1) What brands of kimchi have worked for you in treating or curing sinusitis?     2) What other products containing Lactobacillus sakei have worked successfully for you? And how did you use it?   3) What other bacteria have worked for you in curing sinusitis?

Please let me know by commenting in the comments section or writing me an email. This way I can update this list.  The goal is to find ways to improve the beneficial bacteria in the sinuses and so treat, cure, and eventually prevent sinusitis.   Thanks!

[PLEASE NOTE THAT AN UPDATED VERSION OF THIS POST WITH NEW INFORMATION WAS PUBLISHED IN OCTOBER 2016: The One Probiotic That Treats SinusitisComments can be posted there.]

20131201_101300 Several people have recently written to me about kimchi and asked why I originally chose vegan kimchi over kimchi containing a seafood ingredient (typically fish or shrimp sauce) for sinusitis treatment. I have also been asked whether vegan kimchi has enough Lactobacillus sakei bacteria in it as compared to kimchi made with a seafood seasoning. (see Sinusitis Treatment Summary page and/or Sinusitis posts for in-depth discussions of Lactobacillus sakei in successful sinusitis treatment).

Korean kimchi is a fermented food typically made with cabbage and other vegetables and seasonings, and can contain some seafood (perhaps fish or shrimp sauce) as a seasoning, or just be vegan (no seafood ingredients). It can also be made using a starter culture.

These questions arose because Lactobacillus sakei (L.sakei) is commonly found on meat and fish, and plays a role in the fermentation and preservation of meat. L.sakei "outcompetes other spoilage- or disease-causing microorganisms" and so prevents them from growing. Thus it is considered beneficial and is used commercially in lactic acid starter cultures (for example, in making European salami and sausages).

L. sakei was originally isolated from sake or rice wine (thus plant origin), is found in very low levels in some fermented sauerkraut, and according to the studies I looked at, is found during fermentation in most brands of Korean kimchi.

Currently there are over 230 different strains of L.sakei isolated from meat, seafood, or vegetables from all over the world (from S. Chaillou et al 2013 study looking at population genetics of L.sakei). So this bacteria, which is found by using state of the art genetic analysis, turns out to be quite common.

So why did I only use vegan kimchi and only mention vegan kimchi in our Sinusitis Treatment method?

It's because when I first started dabbing kimchi juice in my nose about 1 1/2 years ago, I was in uncharted territory. I was desperate for something with L.sakei in it, and from my reading I found kimchi. However, putting (by dabbing or smearing) a live fermented product in my nostrils was a big unknown. When I first opened some jars, the kimchi juice would bubble and sometimes overflow and run down the sides of the jar. Would the microbes in kimchi harm or benefit me? Obviously I was conducting an experiment with unknown results.

I settled on vegan (no seafood) kimchi because a totally plant-based product sounded safer to me. I wondered what other microbes are in the kimchi with seafood. Could any of them be harmful?  And my choice of vegan kimchi turned out great.

Our experiences with kimchi are that it works amazingly well in treating sinusitis and causes no harm (as far as we can tell). This is the best I've felt in many, many years - back to normal!

But I don't know if other brands of vegan kimchi, with different recipes and ingredients and thus different microbial communities, would have worked out so well. The levels of L.sakei and other beneficial microbes in the many kimchi brands are unknown.

So now I wonder- if L. sakei is so pervasive on meat and seafood, perhaps kimchi with a seafood ingredient in it would be even better, with consistently higher amounts of L. sakei. Or maybe there is no difference between the two kinds of kimchi. Only the very expensive state-of-art genetic testing would give me the answer to that question.

Based on my successful 1 1/2 years of vegan kimchi experience, I may be willing to experiment further and try non-vegan kimchi. Or maybe not. Perhaps it is better. But I'm very cautious.... 

It is now more than 69 weeks since I first successfully started using kimchi to treat the chronic sinusitis that had plagued me (and my family) for so many years. I originally reported on the Sinusitis Treatment on Dec. 6, 2013 (the method is described there) and followed up on Feb. 21, 2014.

Based on the sinus microbiome research of N. Abreu et al (from Sept. 2012 in Sci.Transl.Med.) that discussed Lactobacillus sakei as a sinusitis treatment, I had looked for a natural source of L.sakei and found it in kimchi. Since dabbing the kimchi juice in our nostrils as needed, all 4 of us are still free of chronic sinusitis and off all antibiotics at close to a year and a half (I'm optimistic). So how is year two shaping up?

Well, it is different and even better than year one. Much of the first year seemed to be about needing to build up our beneficial bacteria sinus community (sinus microbiome) through kimchi treatments, eating fermented foods (such as kimchi, kefir, yogurt), whole grains, vegetables, and fruits. And of course not having to take antibiotics helped our sinus microbial community.

But now in year two we notice that we absolutely don't need or want frequent kimchi treatments - even when sick. Daily kimchi treatments, even during acute sinusitis (after a cold), actually seems to be too much and makes us feel worse (for ex., the throat becomes so dry, almost like a sore throat). But one treatment every 2 or 3 days while sick is good. In fact, this year we have done so few treatments, that even when ill, each time the sick person stopped doing kimchi treatments before he/she was fully recovered, and any sinusitis symptoms kept improving on their own until full recovery! Amazing!

To us, this is a sign that all of us have much improved sinus microbiomes from a year ago. And interestingly, we are getting fewer colds/viruses than ever.  Our guiding principle this year is: "Less is more." In other words, at this point only do a kimchi sinus treatment when absolutely needed, and then only do it sparingly. Looking back, we think we should have adopted the "less is more" last year after the first 6 months of kimchi treatments.

The other thing we've done is cut back on daily saline nasal irrigation, especially when ill and doing kimchi treatments. We've started thinking that the saline irrigation also flushes out beneficial bacteria.

The conclusion is: YES, a person's microbiome can improve, even after years or decades of chronic sinusitis. It is truly amazing and wonderful to not struggle with it, and to feel normal.

(UPDATE: See Sinusitis Treatment Summary page and The One Probiotic That Treats Sinusitis for more information, more probiotics one can use, and more L. sakei treatment information.)

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SUMMARY OF TREATMENT METHOD

The following is a quick summary of the method we use (from the Dec.6, 2013 post - Sinus Treatment page).   Please read the original post for complete descriptions and explanations. We use live (fermented and not pasteurized) vegan (no seafood added) kimchi. Choosing vegan (no seafood added) kimchi is a personal preference. Lactobacillus sakei is found in meat, seafood, and some vegetables.

Treatment Method: 1) Wash hands, and then use a clean teaspoon to put a little juice from the kimchi jar into a small clean bowl. 2) Dip finger in the kimchi juice and dab it or smear it along the insides of one nostril (about 1/2" into the nostril). 3) Dip finger in kimchi juice again and repeat in other nostril. 4) Do this several times. If I needed to blow my nose at this point I would, and afterwards I would put more kimchi juice up each nostril (again repeating the procedure) and then not blow my nose for at least an hour (or more). 5) Afterwards, any unused kimchi in the little bowl was thrown out and not replaced in the main kimchi jar. (Note: Put the main kimchi jar back in the refrigerator. Also, once opened, take kimchi juice from it for no more than 6 days.)

My rationale was that I was inhaling the bacteria this way and that it would travel up the nasal passages on their own to my sinuses. I did this regimen once or twice a day initially until I started feeling better, then started doing it less frequently, and eventually only as needed.

It is now over a year since I successfully started treating chronic sinusitis with kimchi, and almost a year for the other 3 family members. The kimchi treatment continues to be amazingly effective. We all continue to feel great and we have not taken any antibiotics in all this time. (See my December 6, 2013 post or the Sinusitis Treatment Summary page for details on how we do various easy Sinusitis Treatments.)

No more symptoms of acute or chronic sinusitis! We have made some recent changes though. We decided to stop doing frequent kimchi "booster" or "maintenance" treatments. Instead, we decided to only use kimchi when there is a definite need, for example after a cold or other virus when we have gone into acute sinusitis, or when our sinuses don't feel right for several days. Since adopting this policy we haven't done a kimchi treatment in over a month and continue to feel great. (Our new motto: If it ain't broke, don't fix it.)

We came to this decision because in December two of us noticed we were only getting a partial response to the brand of kimchi we had been using for almost a year, but when we switched to a new kind of kimchi (but again vegan) we once again felt fantastic. Why did this occur? I have two possible hypotheses: 1) Since kimchi contains so many types of bacteria, perhaps frequent "booster applications" also increased other bacteria in the sinuses that competed with the Lactobacillus sakei, and switching to a new kind of kimchi corrected this problem. OR 2) Perhaps the kimchi company changed their kimchi recipe or ingredients, and thus the Lactobacillus sakei numbers went way down.

We think that since we still get acute sinusitis after a cold or flu-type virus means that our sinus bacterial communities (sinus microbiome) are still not quite right, even thought they must be better than they've been in years (after all, we feel great and not ill, and have not taken antibiotics in over a year). Thus we are making every effort to eat fermented and pickled foods, fruits, vegetables, whole grains, yogurt, raw cheeses, and kefir to naturally increase our beneficial bacteria numbers. We are not taking probiotics because no brand of probiotics currently available contains Lactobacillus sakei. We are also planning to test other brands of kimchi to see what brands are effective. And, of course, I'm always looking for new sources of Lactobacillus sakei and other effective natural sinusitis treatments.

This is the story of my family's successful Sinusitis Treatment using an all natural, easy home remedy. (UPDATE: The treatment worked so well that we all have been cured of chronic sinusitis, and we have been off all antibiotics for over 3 years.)

Ten months ago my family was struggling with chronic sinusitis that no longer responded well to antibiotics. My oldest son had just been told to get another CAT scan and to prepare for ENT surgery to "open up the sinuses more". We were desperate for something that would help us that didn't involve antibiotics or surgery.

Background: This story started many years ago when we (husband, myself, 2 sons) moved into a house with an incorrectly installed central air conditioning system. We all developed mold allergies and repeated bouts of acute sinusitis, which then led to chronic sinusitis. Eventually we discovered the problem, ripped out and replaced the air conditioning system and all ductwork, but by then the damage was done. Even though antibiotics helped acute sinusitis symptoms which occurred after every cold and sore throat, we always felt like we had chronic sinusitis. Over the years we tried everything we could think of, including antibiotics, decongestants, allergy pills, nasal sprays, daily sinus rinsing with salt water, vitamins, steam inhalation, etc. Both sons even had balloon sinuplasties, which had helped for a short while, but no longer. We had avoided sinus surgeries because we didn't know of anyone who had been "cured" going that route, even with repeat surgeries.

The research:  But then last winter I read with great interest all the latest research about bacteria and how all of us have hundreds of species of microorganisms (our microbiome), and how they may play a role in our health.  In fact we are more microbes than cells!

Especially exciting was a small study published in September 2012 which looked at 20 patients about to undergo nasal surgery - 10 healthy patients (the controls) and 10 chronic rhinosinusitis (sinusitis) patients. The researchers found that the chronic rhinosinusitis sufferers had reduced bacterial diversity in their sinuses, especially depletion of lactic acid bacteria (including Lactobacillus sakei) and an increase in Corynebacterium tuberculostearicum (which is normally considered a harmless skin bacteria). They then did a second study in mice which found that Lactobacillus sakei  bacteria protected against sinusitis, even in the presence of Corynebacterium tuberculostearicum. The researchers were going forward with more research in this area with the hope, that if all goes well, of developing a nasal spray with the beneficial bacteria, but that was a few years away. (Source: Nicole A. Abreu et al - Sinus Microbiome Diversity Depletion and Corynebacteriumt uberculostearicum Enrichment Mediates Rhinosinusitis. Science Translational Medicine, September 12, 2012. http://www.ncbi.nlm.nih.gov/pubmed/22972842 )

But we were desperate now and didn't want to wait. What to do? 

The Experiment: I thought that the answer lay with Lactobacillus sakei (or L.sakei) and I read everything I could find on it. I tried to find a natural and safe source for it, and eventually decided on kimchi. Kimchi is a Korean fermented vegetable product which can be made with varying ingredients, usually with cabbage. According to studies done in Korea, many (but not all) brands of traditionally made kimchi contain L. sakei  (as well as many other species of bacteria) after fermentation. It seemed to me that my best bet was to try an all natural kimchi made with cabbage, without any additives, preservatives, and no fish or seafood in it (this last was personal preference). The kimchi brands I bought had to be refrigerated before and after opening. They could not be pasteurized because it was bacteria that I wanted, lots of bacteria. Kimchi fermentation is carried out by the various microorganisms in the kimchi ingredients, and among the bacteria formed are the lactic acid bacteria, one of which can be L. sakei.

In February of 2013 I was off all antibiotics, but feeling sicker (with sinusitis) each day, when I decided to go ahead with the Sinusitis Experiment and purchased several brands of cabbage kimchi (all natural, vegan). Over the next  2 weeks I tried two brands, one after another. Not only did I eat a little bit every day , but I also smeared a little bit of the kimchi juice in my nose, going up about 1/2" in each nostril - as if I were an extremely messy eater. I did this once or twice a day initially. And yes, I was nervous about what I was doing for this was absolutely NOT medically approved. Obviously I did not discuss this with any doctor.

What if harmful bacteria got up in my sinuses and overwhelmed my system?  What if the microbes in the kimchi did harm, even permanent harm?  What really was in the kimchi? Even if the kimchi contained L. sakei, it also contained many other species of bacteria. The studies said that the bacteria in kimchi varied depending on kimchi ingredients (and each brand was different), length of fermentation, and temperature of fermentation.  L.sakei is found in meat (and used in preserving meat), seafood, and some vegetables, but I was nervous about other microbes found in sea food. This was a major reason I avoided any kimchi with seafood in it. After all, the labels on the kimchi I purchased said it was a "live product" (fermentation). When I opened the jars sometimes the liquid inside was bubbling and sometimes even overflowed down the sides of the jar. It takes a leap of faith to put a bubbling strong smelling liquid in the nose!

Results of the Sinusitis Experiment: By the end of the week I found that the one brand worked and it truly felt like a miracle!  Within 24 hours of first applying it I was feeling better, and day by day my sinusitis improved. All the problematic sinusitis symptoms (yellow mucus, constant sore throat from postnasal drip, aching teeth, etc.) slowly went away and within about 2 to 3 weeks I felt great - the sinusitis was gone. After a few weeks the rest of the family followed, one by one, in the Sinusitis Experiment. All improved to the point of feeling great (healthy) and have been off all antibiotics since then. All four of us feel we no longer have chronic sinusitis. We are very, very pleased with the results.

To continue reading the story...