Those of you who know me personally or follow this blog know my focus is on addressing the underlying cause(s) of a health problem rather than simply putting band aids on its symptoms – and also that I generally react badly to pharmaceuticals. So when my sinuses became horribly stuffed up during the second long period of very hot, wet weather this past summer (mercifully over now) and the congestion kept getting worse instead of going away, I knew I had to figure out what was causing this misery in my sinus microbiome and how to fix it.
After suffering through chronic sinus problems for decades, culminating in two surgeries to remove nasal polyps, and not wanting to live that way any more, I’d set myself the task of stopping my allergies and thought I’d succeeded once and for all. Yet, after many years of relatively easy breathing, this past summer’s extreme weather did me in.
My symptoms this time around were:
- Intense pressure above and below my eyes – felt like polar bears were lodged in the sinuses behind my cheeks, pressing down on my upper teeth
- A chronically dripping nose
- Frequent, violent sneezing spells
- A raw throat from the post nasal drip
- Inability to breathe through my nose
- Lack of energy
- Molasses brain
- Momentary temperature spikes
- Feeling like Spanish moss was wrapped around my vocal cords
- Occasional laryngitis
- Coughing and need to clear my throat
- Blocked up ears
- Chronically dry mouth
- Decreased sense of smell and taste
- Gasping for air while eating
- Interrupted sleep since lying down made everything much worse
- Bad breath (not that I could smell it myself)
- Generally feeling exhausted and disgusting
I was miserable but at least I didn’t develop a sinus infection or start growing nasal polyps again before figuring out what to do.
Here’s a 3-D Animation describing how the sinuses work, what can go wrong, and a medical procedure for blockage that I’d never want to have:
WHAT I TRIED
First I turned to my old standbys for sinusitis and various promising-sounding things other people suggested, each of which provided a modicum of relief for short times – 10 minutes to a few hours:
- Washing my sinuses out with a mixture of sea salt and filtered water
- Sinusin (a homeopathic nasal spray)
- Aller-Max (a gluten free, non-drowsy supplement containing quercetin, bromelain, and Vitamin C)
- XClear (a nasal spray containing xylitol)
- Sinusalia (a homeopathic supplement)
- Firmly pressing on acupressure points on my face and chest that impact the sinuses
- Two homeopathic remedies, Drainage Tone and Aller Chord II
- Coating the inside of my nostrils with castor oil
- Dots of eucalyptus and tea tree oil below my nostrils
- Using an electric steamer/inhaler to make my sinuses drain
- A ThermalOn Dry Eye Compress (to put moist heat directly over my sinuses)
- Avoiding dairy
- Eating more fermented foods
- Belly laughing to stimulate my vagus nerves
- Himalayan Chandra Neti Wash Plus
Clearly this persistent sinus congestion was different from anything I’d experienced before. I felt frustrated and exhausted – pretty much like this but nowhere near as cute:
So I did some more research and learned about the formation of biofilms in the sinuses.
BIOFILMS: BACTERIA & FUNGI
“Biofilms are highly structured communities of microorganisms that attach to one another and to surfaces. The microorganisms group together and form a slimy, polysaccharide cover. This layer is highly protective for the organisms within it, and when new bacteria are produced they stay within the slimy layer. With the introduction of antibiotic-produced glycogen, the biofilms have an almost endless food source that can be used once antibiotic exposure has ended.” (Oak Crest Institute of Science, 2013)
Many types of bacteria clump together inside protective biofilms, making the bacteria inaccessible to pharmaceuticals and natural substances that would weaken or kill them – producing chronic misery when this happens inside our noses and sinuses.
Bacterial biofilm in a person with chronic sinusitis
And to make the sinus congestion situation worse, fungi (molds are types of fungi) have also been shown to form biofilms on the mucosal linings of the sinuses and nostrils. (Healy et al, 2008).
“You might be wondering why antibiotics and antifungal drugs are ineffective for chronic sinus infections. It’s because of the Bio-Film formation. Biofilms are colonies of microbes that form a mass which is resistant to drug therapy.
“Chronic Sinusitis, nasal polyposis, asthma and eosinophilia are quite common and may co-exist as a syndrome. Chronic bacterial or fungal sinus infection with Bio-Film formation has been implicated in this syndrome. Many of these patients have been on multiple courses of antibiotics and/or antifungal drugs which are completely ineffective because of bio-film formation. Many of these patients have undergone repeated nasal sinus surgeries, and are commonly steroid dependent from chronic use of prednisone.” (Dach, 2014)
A LINK BETWEEN ANTIOBIOTICS & BIOFILM FORMATION
Here’s more evidence for how antibiotics can be harmful: ‘Scientist Finds Link between Antibiotics and Bacterial Biofilm Formation Cause of Chronic Ear, Sinus, and Lung Infections’.
From the article:
“Researchers from the University of Southern California and the Oak Crest Institute of Science have discovered the link between antibiotics and bacterial biofilm formation leading to chronic lung, sinus and ear infections. The study results, published in the current issue of PLOS ONE, illustrate how bacterial biofilms can actually thrive, rather than decrease, when given low doses of antibiotics.
“’This research addresses the long standing issues surrounding chronic ear infections and why some children experience repeated ear infections even after antibiotic treatment,’ said Paul Webster, Ph.D., lead author, senior staff scientist at USC and senior faculty at the Oak Crest Institute of Science. ‘Once the biofilm forms, it becomes stronger with each treatment of antibiotics.’” (Oak Crest Institute of Science, 2013)
And from an article called ‘Antibiotic Use Increases Risk of Developing Chronic Sinusitis’:
“Yes, of course this makes sense!…. Many rounds of antibiotics have an effect not just in one area of the body, but kill off both good and bad bacteria in many areas of the human body. The researchers in this study found that taking antibiotics for a reason OTHER THAN SINUSITIS was associated with an increased risk of developing chronic sinusitis (as compared to those people not receiving antibiotics). Use of antibiotics more than doubles the odds of developing chronic sinusitis without nasal polyps. And this effect lasted for at least 2 years. Other research has already associated antibiotic use with “decreased microbial diversity” in our microbiome and with “opportunistic infections” such as Candida albicans and Clostridium difficile. Diseases such as Crohn’s disease and diabetes are also linked to antibiotic use. In other words, when there is a disturbance in the microbiome (e.g.from antibiotics) and the community of microbes becomes “out of whack”, then pathogenic bacteria are “enriched” (increase) and can dominate.” (Silgailis, 2016)
WHAT WORKED TO BREAK DOWN THE BIOFILMS
This was helpful information. Now I knew I was probably dealing with biofilms that had started growing in my sinuses and nostrils to protect colonies of bacteria and molds. This certainly explained why nothing I’d tried was slowing down my ever increasing sinus congestion.
I remembered that a garlic supplement called Allicidin had been effective in breaking down the biofilm-covered spores containing a nasty bacterium called Clostridium difficile that had taken over my colon in 2010. I’d read that some people with sinus infections had found relief from washing their sinuses with probiotics so I decided to try the same with Allicidin. I emptied the contents of an Allicidin capsule into my neti pot, added filtered water, and irrigated my sinuses with the mixture.
This worked immediately! It was messy, involved a fairly intense burning sensation, and left a mild smell of garlic in my nose for a while afterwards – but I was able to breathe through my nose again for the first time in many weeks. If you’re going to try it, I suggest doing it in the shower.
This information about Allicidin is from Dr Johnson’s Premier Nutrition.
The Broad-Spectrum Anti-Infective Properties of Allicidin™
- ANTIBACTERIAL – Various researchers have shown that garlic extracts exhibit a wide spectrum of antibacterial activity against gram-negative and gram-positve bacteria including species of Escherichia, Salmonella, Staphylococcus, Streptococcus, Klebsiella, Bacilus, Helicobacter pylori, and Mycobacterium tuberculosis.
- ANTIFUNGAL – Garlic extracts have a strong antifungal effect and inhibit the formation of mycotoxins like the aflatoxin of Aspergillus parasiticus. Pure allicin was also found to have a high anti-candidal activity and was effective against various species of Candida, Cryptococcous, Trichophyton, Epidermphyton and Microsporum.
- ANTIPARASITIC – Garlic extract has been used for centuries to treat people suffering from dysentery, intestinal worms and intestinal protozoan parasites such as Giardia, Leishmania major, Leptomonas colosama and Crithidia fasciculate.
- ANTIVIRAL – Research shows that garlic extracts are effective against numerous viruses that cause colds and flu. Evidence points towards allicin and ajone as the main components responsible for the antiviral activitiy.
- BIOFILM DEGREDATION – Biofilms are sticky slime that surround large clumps of bacteria. These biofilms protect pathogenic bacteria and helps them spread throughout the body. Stabilized allicin has been shown to have a powerful capacity for biofilm destruction, therefore rendering bacteria helpless.
Ideal for Supporting the Following Conditions:
- Fungal (mold/candida) and Bacterial Infection
- Acne support
- Biofilm Overgrowth
- Blood Pressure, Cholesterol and Cardiovascular Health
- Bladder Infection and Frequent Nightly Urination
- Sinus Infection and Congestion
- Animals: Heartworm
Allicin Organosulfur Complex™…………………………………………………………………………….350mg
Garlic (bulb) Extract (Allium Sativum), Bear Garlic (leaf) (Allium ursinum)
Botani-Pro Blend™ ……………………………………………………………….115mg
Organic Hyssop (leaf, stem) (Hussopus officinalis), Parsley (leaf)(Petroselinum crispum), Asparagus (Stalk) (Asparagus officinalis)
(from Allicin OrganoSulfu Complex™)
Vegetable Cellulose Capsules
100% solvent-free, excipient-free vegetable capsules. No magnesium stearate (a toxic excipient), corn, milk, soy, salt, sugar, wheat, artificial colors, flavors, preservatives, binders, glues or other toxic tagalongs as found in tablets and gelatin capsules.
WHAT WORKED TO KILL THE MOLDS AND BACTERIA
Now that the biofilms growing in my sinuses had been disrupted, exposing the molds and bacterial colonies proliferating in there, I set about finding a combination of probiotics to zap those bacteria and molds.
As a starting point, I turned to Chris Kresser’s excellent article Chronic Sinus Problems: Another Role for Probiotics? and also looked through the many readers’ comments to see what other sinus sufferers had found helpful. I recommend this article to you. (Kresser, 8/18/2015)
Based on a convincing recommendation by one of Kresser’s readers, I first emptied the contents of two capsules of Bio-Kult Advanced Probiotic Multi-Strain Formula into my neti pot, added filtered water, and did a nasal irrigation with the mixture. This helped a lot – but only for a few hours.
Bio-Kult contains these live bacteria cultures:
Bacillus subtilis PXN 21
Bifidobacterium bifidum PXN 23
Bifidobacterium breve PXN 25
Bifidobacterium infantis PXN 27
Bifidobacterium longum PXN 30
Lactobacillus acidophilus PXN 35
Lactobacillus delbrueckii ssp. bulgaricus PXN 39
Lactobacillus casei PXN 37
Lactobacillus plantarum PXN 47
Lactobacillus rhamnosus PXN 54
Lactobacillus helveticus PXN 45
Lactobacillus salivarius PXN 57
Lactococcus lactis ssp. lactis PXN 63
Streptococcus thermophilus PXN 66
So I went back to Kresser’s article to search more deeply and followed some links to two articles by Silgailis, where, in her readers’ comments, I found information about the effectiveness of two probiotic bacteria, lactobacillus reuteri and lactobacillus rhamnosus, for sinusitis. (Silgailis, 2015) & (Silgailis, 2016)
Bio-Kult contains some l. rhamnosus (but not a lot) and no l. reuteri. So I did another Google search for a supplement containing only these two particular strains of probiotic bacteria and found a product called RepHresh Pro-B Probiotic Feminine Supplement that contains large amounts of l. rhamnosus GR-1 and l. reuteri RC-14. L. The box says, “Balances Yeast & Bacteria to Maintain Feminine Health”.
Yeasts, like molds, are fungi. So this probiotic combination looked promising for treating my sinusitis. L. rhamnosus in particular is known to be effective against both fungi and pathological bacteria. (Kiefer, 2008)
The Product Description on Amazon:
- RepHresh Pro-B is a probiotic feminine supplement taken orally once daily to balance yeast and bacteria.
- Lactobacillus, yeast, and other bacteria are all naturally present in your body and optimum feminine health occurs when there is a healthy balance of these elements to support feminine health.
- RepHresh Pro-B feminine supplement contains patented and clinically tested strains of probiotic lactobacillus that have been shown to work with your body to balance yeast and bacteria.
- RepHresh Pro-B supplement lets you take control of your feminine health every day by helping to maintain flora in a normal range.*
- RepHresh Pro-B is a natural supplement and comes in an easy-to-swallow capsule.
- RepHresh Pro-B is the #1 feminine probiotic supplement in the US in the latest 52 weeks ending 16 March 2016 according to The Nielsen Company data.
L. rhamnosus GR-1, L. reuteri RC-14, Dextrose Anhydrate, Gelatin, Potato Starch, Microcrystalline Cellulose, Magnesium Stearate, Titanium Dioxide
So, when this probiotic supplement containing large amounts of lactobacillus reuteri and lactobacillus rhamnosus arrived from Amazon, I emptied the contents of two capsules into my neti pot, added filtered water, and did a thorough nasal irrigation with the mixture. As with the Allicidin mixture, this burned a bit but was very much worth it!
Since it’s a good idea to switch up your probiotics periodically, I’m now taking the Bio-Kult probiotics supplement by mouth and RepHresh Pro-B on alternating days to maximize the variety of helpful probiotics supporting my gut microbiome.
A Note on Vaginal Infections:
Vaginal infections are most often caused by an overrun of a yeast called Candida albicans. If your gut microbiome is out of balance or you use feminine hygiene products that destroy the balance in your vaginal microbiome, you’re likely to get at least one – if not many more – vaginal infections in your lifetime. See ‘Warding Off Chronic Yeast and Bacterial Infections’ to learn how to use probiotics to prevent both chronic bacterial and yeast infections. (Kiefer, 2008)
USING A NETI POT
This video shows how to use a neti pot for sinus irrigation:
In the morning, I use my neti pot in the shower where it doesn’t matter how messy the process becomes. I’ve also installed a small, chlorine-removing water filter (available on Amazon, easy to install) so fill the pot directly with warm, filtered water from the shower head. The filter is a Rainshow’r CQ-1000-NH Dechlorinating Shower Filter. And, when I’m not using any of the supplements described above, I put some inexpensive La Baleine Fine Sea Salt in my neti pot in lieu of the salt packets the woman in the video uses.
In the evenings before bedtime, I use the neti pot over the bathroom sink.
HIMALAYAN CHANDRA NETI WASH PLUS
Over the years, I’ve found it helpful to add this neti pot wash made by Himalayan Chandra occasionally when I use my neti pot in the shower. And now that those nasty sinus biofilms have been degraded, this wash has become effective again.
The wash is available on Amazon.
“Neti Wash Plus contains zinc and herbal extracts that add anti-microbial and anti-viral support to your nasal wash. Zinc helps to tone and astringe the nasal passages reducing excess mucus and promoting clear, healthy sinuses. Studies show that Zinc reduces the duration and symptoms of the common cold, slowing the replication of rhinoviruses which typically cause colds. Neti Wash Plus contains Zinc Acetate –a form of Zinc shown to be more effective in shortening the duration of the common cold. Neti Wash Plus also contains extracts of Grapefruit Seed and Goldenseal Root, found by scientists to inhibit the growth of hundreds of strains of pathogens. Grapefruit Seed Extract has been used by the natural foods industry for over 20 years as an antibiotic, disinfectant, and antiseptic. Perfect for use with the Himalayan Institute Neti Pot.*
“Ingredients: Zinc acetate, Goldenseal root (Hydrastis canadensis), Phellodendron bark (Phellodendron amurense), Coptis root (Coptis chinensis), Barberry root bark (Berberis vulgaris), Grapefruit seed extract, vegetable glycerin and distilled, purified water.”
TWO HOMEOPATHIC REMEDIES FOR ALLERGIES AND SINUS CONGESTION
Before Allicidin succeeded in disrupting the biofilms, I’d started taking two homeopathic remedies my chiropractor had recommended for this summer sinus misery but then stopped when the congestion just kept getting worse. Now that the molds and bacteria living inside those biofilms have been exposed and destroyed, I’ve started taking these remedies again and am finding them helpful.
ALLER-CHORD F – a homeopathic remedy for food allergens
DRAINAGE-TONE – a homeopathic remedy for swollen glands, sinus congestion, and skin eruptions
Both are made by energetix.
SOME ADDITIONAL IDEAS
While researching this post, I came across this interesting idea for breaking down biofilms in the nose and sinus cavities:
“New sinus therapeutics, including baby shampoo sinus irrigation and probiotic sinus rinses, can lessen symptoms and ward off sinus infections, according to doctors at Baylor College of Medicine.
“These new therapies are targeting the bacteria in ways that haven’t been utilized in the past,” said Dr. Mas Takashima, director of the Sinus Center at Baylor. “These techniques are helping those with chronic and acute sinusitis. Whenever I tell my patients about the new therapeutic protocols they’re very surprised, but they get the results they want and need.
“He said the concept behind baby shampoo irrigation is cleansing the naval cavity with a surfactant. By doing this, the biofilms, or oily layers that bad bacteria create to protect itself from irrigation, are broken down.” (Parsons, 2015)
I haven’t tried the Johnson’s Baby Shampoo technique myself (and don’t think I will because of the product’s toxic ingredients*), but here’s a report from someone who did and found it tremendously helpful. (Mertes, 12/4/2013)
* Ingredients in Johnson’s Baby Shampoo:
Water, Cocamidopropyl Betaine, PEG-80 Sorbitan Laurate, Sodium Trideceth Sulfate, PEG-150 Distearate, Phenoxyethanol, Sodium Chloride, Glycerin, Citric Acid, Sodium Benzoate, Tetrasodium EDTA, Polyquaternium-10, Ethylhexylglycerin, Sodium Hydroxide, Potassium Acrylates Copolymer, Yellow 6, Yellow 10, Parfum.
At least it doesn’t contain carcinogenic parabens.
Perhaps there’s a baby shampoo that’s free of toxic ingredients and still acts as a surfactant to break down biofilms. Please let me know if you come across one.
Another suggestion from my chiropractor, Denice Hilty Siedzik:
“You may want to consider emptying a probiotic capsule in a little water and swishing it in your mouth and swallowing just before bed. Be sure to not drink anything after. This may also help healthy bacteria migrate to your sinuses.” (Siedzik, 2016)
CLIMATE CHANGE AND MOLDS: LOOKING AHEAD
Unless you’re in steadfast denial, it’s obvious that climate change is real and that here in the Northeast US we’re likely in for warmer winters with fewer or no hard freezes plus longer, hotter, and wetter summers – ideal conditions for molds to proliferate. I know that Lower Manhattan, where I live, receives waves of pollens (which I’ve never been allergic to) blowing in from the west in the spring and fall so it eventually occurred to me that greatly increased numbers of mold spores were probably also blowing in now. I’ve been reactive to molds for as long as I can remember.
And if this wet, warming trend continues, it will be increasingly difficult to cope with molds in future years. So I was highly motivated to figure out how to improve my ability to deal with these minuscule airborne fungi and keep my airways open.
BETTER EQUIPPED TO DEAL WITH THIS ASPECT OF CLIMATE CHANGE
After breaking down the biofilms in my sinuses and nose with Allicidin and then zapping the molds and bacteria with the probiotics in RepHresh, the things and techniques listed in the WHAT I TRIED section above now help again to reduce sinus inflammation and keep me breathing through my nose.
Now that it’s October, the hot, humid weather has mercifully stopped, but I know my sinuses are still being exposed to an increased level of molds in the air. Since the initial irrigations with Allicidin and RepHresh in September, I needed to repeat the two-step treatment once last week when we had a return of some warm, humid days and the mold levels were high again.
Having these tools in my ongoing battle with nasal allergies, I now feel better equipped to deal with the hot, rainy summers in our future.
This is my earlier post on Probiotics for Sinusitis and Sinus Infection. (Hardin, 9/16/2014) in case you want to read more about sinuses and the gut microbiome.
And here’s a link to my 2011 article Successful holistic treatment of Clostridium difficile gut infection: case study in case you’re interested in how I vanquished C. diff without resorting to any antibiotics – which had degraded by gut microbiome over the years and set the stage for my colon’s being colonized by that nasty bacterium in the first place.
Dach, J. (12/30/2014). BioFilms in Chronic Rhino Sinusitis. See: http://jeffreydachmd.com/2014/12/biofilms-chronic-rhino-sinusitis/
Dr Johnson’s Premier Nutrition. (2016). Allicidin. See: http://www.drjsupplements.com/allicidin/
Hardin, J.R. (2011). Successful holistic treatment of Clostridium difficile gut infection: case study. Oriental Medicine Journal, 19:4, 24-37. See http://issuu.com/davidmiller4/docs/c._difficile_omj_article_lo_res
Hardin, J.R. (9.14.2014). Probiotics for Sinusitis and Sinus Infection. See: http://allergiesandyourgut.com/2014/09/18/probiotics-sinusitis-sinus-infection/
Healy, D.Y. et al. (2008). Biofilms with fungi in chronic rhinosinusitis. Otolaryngology – Head and Neck Surgery, 138:5, 641-647. See: http://www.sciencedirect.com/science/article/pii/S0194599808001058
Kiefer, D. (2008). Warding Off Chronic Yeast and Bacterial Infections. Life Extension Magazine. See: http://www.lifeextension.com/magazine/2008/3/warding-off-chronic-yeast-and-bacterial-infections/page-01
Kresser, C. (8/18/2015). Chronic Sinus Problems: Another Role for Probiotics? See: https://chriskresser.com/chronic-sinus-problems-another-role-for-probiotics/
Mertes, M. (12/4/2013). How I beat my sinusitis by snorting baby shampoo. See: http://www.omaha.com/livewellnebraska/how-i-beat-my-sinusitis-by-snorting-baby-shampoo/article_f5086ea0-b9a6-5a9c-9fc3-f96090a4ac1e.html
Oak Crest Institute of Science. (2013). Scientist Finds Link between Antibiotics and Bacterial Biofilm Formation Cause of Chronic Ear, Sinus, and Lung Infections. See: http://www.oak-crest.org/oakcrest-news/scientist-finds-link-between-antibiotics-and-bacterial-biofilm-formation-cause-of-chronic-ear-sinus-and-lung-infections/
Parsons, J. (4/6/2015). New ways to flush out sinus infections. See: https://www.bcm.edu/news/head-and-neck/new-ways-to-flush-sinus-infection
Siedzik, D.H. (2016). Personal communication.
Silgailis, M. (2015). The One Probiotic That Treats Sinusitis. See: http://lactobacto.com/2015/01/12/the-one-probiotic-that-cures-sinusitis/
Silgailis, M. (2016). Antibiotic Use Increases Risk of Developing Chronic Sinusitis. See: http://lactobacto.com/2016/08/30/any-antibiotic-use-increases-risk-of-developing-chronic-sinusitis/
© Copyright 2016. Joan Rothchild Hardin. All Rights Reserved.
DISCLAIMER: Nothing on this site or blog is intended to provide medical advice, diagnosis or treatment.