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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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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.

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Today's topic: sinusitis success stories. For those suffering from chronic sinusitis or frequent sinus infections it sounds incredible, doesn't it? For more than 5 years I've posted about the probiotic Lactobacillus sakei and how it can successfully treat sinusitis - both chronic sinusitis and  acute sinusitis (sinus infections). Back in January 2013 I read a study by Abreu et al (2012) that the sinus microbiome (microbial community) in people with chronic sinusitis was imbalanced and that this beneficial bacteria could be a possible treatment. I had suffered from chronic sinusitis for years, so of course I went searching for Lactobacillus sakei. It wasn’t in any probiotics at the time, but I did find it in kimchi. Through experimentation I (and my family) successfully treated our sinusitis by dabbing and smearing a little of the kimchi juice in the nostrils once or twice a day. It felt miraculous!

By the end of 2013 I started this blog to get the word out about Lactobacillus sakei, and to also hear the experiences of others. (See results post) In the last 5 years I have heard from hundreds of people, including lots of sinusitis success stories with Lactobacillus sakei – especially using kimchi, sauerkraut made with garlic, sausage starter cultures such as Bactoferm F-RM-52, and recently with the sinusitis probiotic Lanto Sinus, which was introduced in 2018. When a Lactobacillus sakei product works as a sinusitis treatment for a person it feels absolutely wonderful and amazing. Sinus health after years of suffering! Unfortunately, it appears that Lactobacillus sakei may not work for everyone - only trying it determines if it works and how well.

The following are excerpts of some of the sinusitis success stories that people have reported - almost all are from comments after posts on this site, and a few from emails to me. Sometimes we need to hear successful treatment stories, especially if we’ve been struggling with sinusitis for a long time. Just keep in mind that these are stories of people experimenting on their own - how they used Lactobacillus sakei varies and their experiences vary. (See Sinusitis Treatment Summary for methods). Note that in Feb. 2019 the Lacto Sinus name was changed to Lanto Sinus in order to get a trademark - but the product remains exactly the same.

J. October 2017
So glad I found this site! Have been struggling with chronic sinus and gut issues go over 20 years after several rounds of antibiotics.
Immediately after reading thru this I put a dab of Kimchi juice up each nostril (had some on hand, as I eat a lot of fermented veggies). I could tell almost immediately that something was happening. Almost felt as if there was a duel going on in my sinuses between the kimchi probiotics and the nasties in my sinuses. Had some stuffiness and stiff neck but went to bed and slept great last night and woke up this morning with clearer sinuses and feeling better!

Jo. October 2015
Through the years I've tried everything for sinus infections and nothing but antibiotics helped. When I read about kimchi helping I tried that too. To my utter delight and relief, Sunja's white kimchi worked a miracle! I bought another 3 jars and keep it in the refrigerator for the next bout.

M. November 2018
I had great success in treating my chronic sinusitis with Lacto Sinus.
I’ve had sinus problems for 2 decades and tried all sorts of medicines and treatments, but nothing helped. Every single sore throat and every cold, no matter how minor, led to full-blown sinusitis and having to take antibiotics for weeks. I was always in fear of getting sick. And even when I was “healthy” I really wasn’t, I always had some symptoms. I would frequently wake up with a sore throat and with thick phlegm dripping down my throat.
I was desperate when I tried Lacto Sinus and was thrilled to see improvement within a day! I used it daily for over a week, then every other day for about 2 more weeks. And then I stopped because I didn’t need it anymore.
Getting my life and health back feels like a miracle! I don’t dread getting a cold or virus anymore – I just use some Lacto Sinus again if I get some sinus symptoms. I will always keep a bottle in my refrigerator.

T. January 2017  ...continue reading "Sinusitis Success Stories"

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Probiotics are the future of sinusitis treatment. Research found that a probiotic (beneficial bacteria) that is lacking in those with chronic sinusitis, and which can successfully treat sinusitis is Lactobacillus sakei.

[See June 2022 updated version of this post.] This article is the summary of what has been learned over the past 7 years: the best L. sakei  products (such as kimchi and Lanto Sinus - which can treat even the worst recurring sinus infections, frequently within days), results of people trying various L. sakei products, and other possibilities for sinus health.

Back in 2012, a study by Abreu et al suggested Lactobacillus sakei as a possible treatment for sinusitis. In the past 6 years those conclusions have been supported by the experiences of hundreds of people contacting me, and my family's experiences with L. sakei products. It really is the best sinusitis treatment for most people!

When Lactobacillus sakei works as a treatment - it can seem miraculous as sinusitis symptoms gradually disappear or greatly improve. Many times within a few days! Unfortunately it doesn't work for everyone - for a minority there seems to be no effect, and it is not clear why. It also doesn't treat seasonal allergies or allergy symptoms.

Lactobacillus sakei works best when it is used only when needed, when there are sinus symptoms. No boosters needed when feeling well! (See Treatment Summary page for different ways to use products.)

The sinus microbiome is the community of microbes (bacteria, viruses, fungi) that live in the sinuses. This community can become disrupted and imbalanced (dysbiosis) from illnesses, allergies, or antibiotics and cause a sinus infection or sinusitis.

Research in the last decade has found that not only do sinusitis sufferers lack L. sakei, they have too much of some other bacteria, and they don't have the bacteria diversity in their sinuses that healthy people without sinusitis have. There is a depletion of some bacterial species, and an increase in "abundance" of other species.

Luckily Lactobacillus sakei is found in some foods (such as some brands of live fermented kimchi), some sausage starter cultures (such as B-2), and recently in some probiotic supplements (e.g. 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.

BACKGROUND STORY: Seven years ago there were no probiotics containing L. sakei. None. So instead members of my family experimented using a very easy kimchi sinusitis treatment (basically dabbing and smearing kimchi at certain stages of fermentation into the nostrils like a very messy eater) and found that it cured  chronic sinusitis of many years within several weeks. Obviously it contained L. sakei. It felt miraculous, especially because it was so easy to do.

After 7 years we still feel great! Because we no longer have chronic sinusitis and can easily treat sinusitis if it occurs with L. sakei, we have NOT taken antibiotics or any other bacteria killing spray or product (such as xylitol) for over 6 years. We do not use cortisone or antihistamine nasal sprays either.

WHEN A TREATMENT WORKS: Many of you have contacted me to report your own progress with various sinusitis treatments. People used terms such as "miraculous", "transformative", and "fabulous" when they had positive results with a product containing L. sakei.

When a treatment works, then all sinusitis symptoms go away  or there is major improvement - frequently within a few days. Symptoms that go away include post nasal drip, sinus headaches, "clogged ears", bad breath, and sinusitis-related coughs. Even tonsil stones! (Please note: trying products to treat sinusitis is self-experimentation - effects can be positive or negative. Always be cautious. Best results are to use L. sakei only when needed.)

OVERALL RESULTSThe majority of people contacting me with results reported positive results (chronic sinusitis greatly improved or totally gone) from some form of L. sakei treatment. Successes have been from the USA, Canada, Europe, Australia, New Zealand, Japan, and Africa. Since it's from self-experimentation and not a clinical trial, 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.

Chronic sinusitis sufferers also reported that the same treatments also worked to treat acute sinusitis. It seems that after colds, etc. many develop acute sinusitis again and need re-treatment (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 (perhaps only a few days) are needed over time.

Another very small group reported that other probiotic strains helped (but it is not always clear whether they also tried a L. sakei product), and minority of people reported that nothing has helped and there could be a variety of reasons for this (see below). Some people reported that one product helped, but not another - whether kimchi or a L. sakei product.

THREE MAIN PRODUCT CATEGORIES: Products containing live Lactobacillus sakei which people have reported success in treating sinusitis: kimchi (and some sauerkraut), refrigerated products (e.g. Lanto Sinus), and frozen products. Note that currently 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. (See Sinusitis Treament Summary page for methods.)

KIMCHI - Many people report that kimchi helped them. And one person reported a homemade kimchi worked great (he was finally symptom free after many 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 (medium spicy cucumber kimchi and mild white kimchi), Sinto Gourmet brand kimchiMama-O's Premium Kimchi, the white Napa kimchi and cabbage kimchi made by Choi's Kimchi Company, Farmhouse Culture Kimchi, Mother-in-law's KimchiOzuke Kimchi, in the United Kingdom the brand Mr Kimchi, and in Australia Kehoe's Kitchen white kimchi.

[Finding a kimchi brand with L. sakei 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. Researchers feel that it's the garlic in kimchi that encourages L. sakei growth.

SAUERKRAUT - Sauerkraut has worked for some people if it is sauerkraut made with garlic, such as some varieties of Cleveland Kraut. Researchers feel that it's the garlic in kimchi that encourages L. sakei growth, and traditional sauerkraut typically doesn't contain garlic.

REFRIGERATED LACTOBACILLUS SAKEI PRODUCTS  – A high-quality refrigerated L. sakei product specifically meant for the sinuses and treatment of sinusitis is sold by Lanto Health. The kimchi derived Lactobacillus sakei product called Lanto Sinus is meant to be used when needed. Lanto Sinus  holds up well in the refrigerator, is effective, reliable, and easy to use. This product ships well because it holds up for a while (days) without refrigeration.

People have reported success using it mixed with bottled water (dabbing, smearing, spooning a little in nostrils), or swishing it dry in the mouth. I’ve been a consultant with Lanto Health on this product and have been testing and using this product successfully for over 2 years (self-experimentation!).    ...continue reading "The Best Probiotic For Sinus Infections"

People ask me: what's going on with research in the treatment of sinusitis with probiotics? Well, the answer is that things are moving along slowly - very slowly, but there are good signs.

Earlier this year an interesting article by researcher Anders U. Cervin at the University of Queensland (Australia) was published that specifically talked about "topical probiotics" as a potential treatment for chronic sinusitis. By this he means that probiotics (beneficial bacteria) could be directly applied to the nasal passages in the nose, such as a nasal spray. And he discussed how the prevailing view nowadays, based on scientific evidence, is that in sinusitis there is an "imbalance of the sinus microbiome" - the community of microbes living in the sinuses. Yes!!!

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

Cervin discusses how studies are needed to test nasal sprays for the treatment of sinusitis, and made a lot of good points. He looked at studies already done, wondered what bacterial strains might be beneficial, but obviously didn't read the Abreu et al study carefully to see that L. sakei might be a good candidate to test.

And Cervin didn't do an internet search to see what probiotics people are using already as a successful treatment for sinusitis (see Sinusitis Treatment Summary page). He did mention that the only good trial using nasal spray probiotics in humans with sinusitis found no effect - because they tested the wrong Lactobacillus strains - they were honeybee strains, and not ones found in humans.

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

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

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Big announcement today! The high quality product Lanto Sinus, which contains the probiotic Lactobacillus sakei specifically for sinus health (for sinusitis symptoms), is now available. This product contains an excellent strain of Lactobacillus sakei that is kimchi derived. Lactobacillus sakei is the one probiotic (beneficial bacteria) that has successfully treated sinusitis (both chronic sinusitis and acute sinusitis) of many people, including all members of my family. It's quick-acting, so frequently this occurs within a few days!

It has been an amazing journey - and since using Lactobacillus sakei (when needed) our sinuses feel great, and we have not had to use antibiotics in 8 years! A win-win.

More than 8 years ago I read research about the sinus microbiome (microbial community), and how chronic sinusitis sufferers lack the keystone bacteria Lactobacillus sakei that successfully treats sinusitis. There were no probiotics with L. sakei available back then. None. But we (my family) were able to successfully treat chronic sinusitis with live kimchi, which can contain Lactobacillus sakei (see Sinusitis Treatment Story).

Kimchi is a wonderful product, but... with kimchi you never know if you're getting L. sakei, and even then it dies off rapidly. We went on to experiment with other products for years, with none of them ideal. So it is great that finally, after all these years, a product like Lanto Sinus is now available.

Nice things about Lanto Sinus are that the product is easy to use, holds up well, is in powder form, and it only needs to be refrigerated. (That's right, it's meant to be refrigerated, and not frozen.) Since it also holds up well for a time without refrigeration, it also ships well. After all, L. sakei lives and multiplies in our body at about 98.6 degrees Fahrenheit.

[Please note: Even though it is shipped with an ice pack, shorter shipping (1 or 2 day shipping) in hot summer months is always preferable. Generally USPS delivers to mailboxes, while UPS delivers packages to the door.]

Lanto Sinus is sold by Lanto Health, and shipped from the NJ/NY metro area. Lanto Sinus is a high quality probiotic dietary supplement that is produced with Good Manufacturing Practices, and is lab tested and verified.

It feels gentle, yet it is strong. It comes in powder form with easy directions for using it two ways: in the nose (for maximum boost) or in the mouth (regular use). The product is meant to be used when needed for sinus support - that is, when there are some sinusitis symptoms.

I want to mention that I have been a consultant to the company, and have been testing and using the product for over 3 years. As usual, I experimented various ways (both in my nostrils and mouth) to see what works best for me - but only using it when needed (for example, if I start to slide into sinusitis after a virus). After 8 years of self-experimentation in various ways my sinus microbiome has improved, so at this point I only need to use a little bit for successful results. 

By the way, the advice to use only when needed - should be applied to any probiotic  supplement that is used as a sinusitis treatment or for sinus support. And as I describe in The Best Probiotic For Sinus Infections - based on my family's experiences and many people contacting me - most people are helped by Lactobacillus sakei, but not all. Unfortunately there is no way to know if L. sakei will treat a person's sinusitis unless it is tried.

This is because everyone's sinus microbiome (microbial community) is different - and so how one reacts to different probiotics can vary. By the way, L. sakei does not appear to treat allergies or allergy symptoms.

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

And on a final note, some other news about L. sakei: According to several studies, when taken orally (swallowed) Lactobacillus sakei appears to be beneficial in certain skin conditions such as atopic eczema-dermatitis syndrome and atopic dermatitis. Another study found that patients with ischemic strokes had decreased numbers of Lactobacillus sakei in the gut (as compared to healthy individuals).  It's an interesting microbe!

[This post was updated January 29, 2021.]

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

Back in February 2013 - first I, and then the rest of my family, started using easy do-it-yourself sinusitis treatments containing the probiotic (beneficial bacteria) Lactobacillus sakei. Now we only treat with a L. sakei  product when occasionally needed - and it still works great. In fact, the best way to use Lactobacillus sakei is to use only when there are sinusitis symptoms, and not when feeling well. The whole process still feels miraculous.

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

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

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

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

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

Just read a small study that compared the microbes in the sinus microbiome between 12 healthy people with no sinusitis (controls) and 14 with chronic sinusitis, their neurotransmitter levels (serotonin, dopamine, and GABA), and also looked at depression scores in the 2 groups. Well, of course they found some microbial differences between healthy people and those with chronic rhinosinusitis (CRS), but they also found that those with the most severe chronic sinusitis tended to have the most depressive symptoms, and lower amounts of the neurotransmitters studied, but they did not find significant differences overall.

I found their summary and conclusions problematic, since they discussed that "possibly" the sinus microbes influence brain neurotransmitters. And they pointed out that as certain disease associated microbes increased (especially Moraxella), the neurotransmitter concentrations tended to decrease in those with sinusitis. But since there were no significant group differences, they did not prove their hypotheses, and conclusions can not be made. So saying there is "the potential for downstream effects of the sinonasal microbiota on neural signaling and, subsequently, brain function and behavior" is misleading and overreaching. The researchers also said it was "difficult to discern disease associations from natural variation." Hah!

It should be obvious that the worse the chronic sinusitis, the more depressive symptoms, because having chronic sinusitis is DEPRESSING. One suffers with it. Some people have told me how chronic sinusitis has destroyed their life - whether their health, financially, with relationships, etc. Of course they will have higher depressive scores! And when a Lactobacillus sakei product or other probiotic successfully treats sinusitis (usually very quickly), then the mood is one of elation as symptoms go away (finally health!).

All one can say (based on studies) is: the sinus microbiomes in healthy people (normal sinus microbial community) are somewhat different from those with chronic sinusitis (out-of-whack microbial community or dysbiosis). And one would expect that those with less severe/milder sinusitis have a "better" community of sinus microbes - that is, more microbes that are associated with health, and fewer of those associated with sickness, than sicker people. Which is what this study suggested. Excerpts from the International Forum of Allergy & Rhinology:

The sinonasal microbiota, neural signaling, and depression in chronic rhinosinusitis

The complex relationships between the human microbiota, the immune system, and the brain play important roles in both health and disease, and have been of increasing interest in the study of chronic inflammatory mucosal conditions. We hypothesized that the sinonasal microbiota may act as a modifier of interkingdom neural signaling and, subsequently, mental health, in the upper respiratory inflammatory condition chronic rhinosinusitis (CRS). In this study we investigated associations between the sinonasal microbiota; local concentrations of the neurotransmitters serotonin, dopamine, and γ-aminobutyric acid (GABA); and depression severity in a cohort of 14 CRS patients and 12 healthy controls.

Several commonly “health-associated” sinonasal bacterial taxa were positively associated with higher neurotransmitter concentrations and negatively associated with depression severity. In contrast, several taxa commonly associated with an imbalanced sinonasal microbiota negatively associated with neurotransmitters and positively with depression severity. Few significant differences were identified when comparing between control and CRS subject groups, including neurotransmitter concentrations, depression scores, or sinonasal microbiota composition or abundance. Conclusion: The findings obtained lend support to the potential for downstream effects of the sinonasal microbiota on neural signaling and, subsequently, brain function and behavior.

SOME OTHER EXCERPTS: Depression scores were also not significantly different between controls and CRS patients. .... The serotonin levels in CRS patients compared with control subjects tended to be lower, but not significantly so. Although median values for dopamine, GABA, and serotonin were generally lower in CRS patients than controls, all 3 neurotransmitters had a greater range among those with CRS, and no differences were significant. ... For both CRS and control individuals, bacterial communities were generally dominated by OTUs of the genera Corynebacterium and Staphylococcus.

Correlation analyses identified associations between members of the genera Staphylococcus, Finegoldia, Propionibacterium, Peptoniphilus, and Anaerococcus, as well as bacterial community diversity overall. Members of these genera have been previously identified as representative of more “health-associated” sinonasal bacterial community types, whereas their depletion has been associated with lower bacterial community diversity, increased bacterial load, increased rates of asthma, and elevated markers of inflammation. Similarly, members of the genera Burkholderia and Propionibacterium have been identified as 2 potential “gatekeepers” that help maintain bacterial community stability in the sinonasal tract. In the present study, several of these same bacterial taxa were significantly positively correlated with neurotransmitter levels and negatively with depression severity, whereas several other OTUs (including members of Streptococcus, Rothia, Enterobacteriaceae, Corynebacterium, and Moraxella) showed the opposite pattern (negatively associated with neurotransmitter levels and positively with depression severity). 

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An amazing new study is about to start in Sweden - this study will see if "snot transplants" work for the treatment for chronic sinusitis! Will this turn out to be a permanent treatment? While studies show that probiotic supplements tend not to stick around in the gut (they're gone after about a week), people receiving a fecal microbiota transplant (FMT) find that these microbial communities do stick around (colonize).  So there is something about getting an entire microbial community (bacteria, fungi, viruses) that is more effective than just a few species that are in typical probiotic supplements.

We have found the same problem in sinusitis treatment - the Lactobacillus sakei treatment works to treat sinusitis, but then doesn't stick around - as evidenced by having to treat again after a cold or sore throat.  And so we treat again - and again it's successful. And this happens again and again. Sooo.... it's important to find out if a transplant of the entire microbial community of snot (the sinonasal microbiome) works. And if works, will the treatment be a permanent one? I also wonder.... Several people have mentioned this idea to me, but has anyone with sinusitis tried a "snot transplant" at home? (And yes, this is self-experimentation.)

The description and purpose of the study refer to what this site has discussed for several years: the sinus microbiome is out of whack (dysbiosis) in chronic rhinosinusitis (CRS), whether due to antibiotics or something else (viruses, etc). The study will enroll 30 people, start May 15, 2017, and end December 31, 2018. The purpose of the study is to have patients with chronic rhinosinusits without nasal polyps (CRSsNP) receive microbiome transplants from healthy donors without any sinus problems. They would receive a snot transplant for 5 days in a row. Unfortunately we'll have to wait at least 1 1/2 years for any results. Excerpts from clinical trails.gov:

Sinonasal Microbiome Transplant as a Therapy for Chronic Rhinosinusitis Without Nasal Polyps (CRSsNP)

Purpose: Chronic rhinosinusitis (CRS) is a disease associated with impaired quality of life and substantial societal costs. Though sometimes co-appearing with other conditions, such as asthma, allergy, and nasal polyps, many cases present without co-morbidities. Micro-biological diagnostic procedures are frequently undertaken, but the results are often inconclusive. Nevertheless, antibiotics are usually prescribed, but invariably with limited and temporary success. Accordingly, there is a need for new treatments for CRS.

Recent studies indicate that the sinuses are colonized by a commensal microbiome of bacteria and that damage to this natural microbiome, by pathogens or antibiotics, may cause an imbalance that may promote CRS. Therefore, treatments that restore the commensal microbiome may offer an alternative to current protocols. Arguably, as suggested by studies on patients with intestinal infections (next paragraph), one such possibility may be to transfer a "normal microbiome" to patients with CRS.

A disrupted microbiome is linked to intestinal clostridium difficile infections. Probiotic restitution therapy may be effective even in cases recalcitrant to antibiotic treatment. However, a key to effective probiotic restitution is selecting the bacteria that facilitate regrowth of normal microbiome. As an answer to this, researchers have chosen to simply transplant the entire microbiome from a healthy donor. In the case of clostridium difficile infection in the form of faecal transplants.

In this study, we will examine the possibility to treat patients with chronic rhinosinusitis without polyps (CRSsNP) with complete sinonasal microbiomes obtained from healthy donors. Our analysis will focus on symptoms and signs of disease as well as on nasal inflammatory and microbiological indices.

Detailed DescriptionOver the last few years the theory of a damaged microbiome as a cause or promoting factor behind chronic rhinosinusitis has gained increasing interest from the scientific community. A number of studies aimed at investigating the microbiota of the nose and paranasal sinuses in health and disease has been published with very varying outcomes. Furthermore, other studies have been aimed at probiotic treatment of sinonasal disease either locally or through immunologic manipulation via the gastrointestinal microbiota.

A problem common to all these studies is that studies examining the normal nasal microbiota have identified a great amount of different bacterial species. It is as of today not known which individual species or combinations of species that promotes health

In this study the investigators aim at recruiting patients suffering from chronic rhinosinusitis without polyps (CRSsNP) and healthy participants without any history sinonasal disease. The patients and the healthy participants will be examined for infectious diseases in a manner similar to other medical transplant procedures to minimize the risk for the recipients. The patients will then be treated with antibiotics to reduce the bacterial load of the nose and the paranasal sinuses. After the patient has finished the antibiotic treatment a microbiome transplant will be harvested from the healthy participant as a nasal lavage. The raw lavage fluid will then be used to transplant the microbiome to the patient. The procedure will be repeated for five consecutive daysThe outcome measures analysed will focus on subjective sinonasal health and symptoms of the patients but also include nasal inflammatory and microbiological indices.

It's now 4 years being free of chronic sinusitis and off all antibiotics! Four amazing years since I (and then the rest of my family) started using easy do-it-yourself sinusitis treatments containing the probiotic (beneficial bacteria) Lactobacillus sakei. My sinuses feel great! And yes, it still feels miraculous.

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 (bacteria, fungi, viruses) that live in healthy sinuses - the sinus microbiome - but L. sakei seems to be a key one for sinus health.

I just updated the post The One Probiotic That Treats Sinusitis (originally posted January 2015) using my family's experiences (lots of self-experimentation!) and all the information that people have sent me. The post has a list of brands and products with L. sakei, treatment results, as well as information about some other promising probiotics (beneficial bacteria). Thank you so much!

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

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