A reader wrote me about problems with chronic congestion. While in theory, altering gut bacteria may be able to influence this is a roundabout way (alter metabolites circulating in the body), this does not seem the most direct and best route.
Recently I wrote about Chronic fatigue syndrome patients have alterations in their oral microbiome composition and function. [Sep 2018] in this post. The purpose of the post was to try to explicitly address the oral microbiome found with ME/CFS. There are very very few studies looking at the oral microbiome.
As a result of this post, I did some ‘biohack’ experiments that had surprising good results. I used two probiotics available as hard tablets (not capsules) under the tongue at bed time. Chronic low grade congestion disappeared in a few days. A little further digging over the weekend end up revealing that it may also help with periodontal issues! (I have seen some improvement there also)
What dd I take?
- Miyarisan Clostridium butyricum MIYAIRI 588
- Biofermin “S”
- Streptococcus faecalis 129 BIO 3B (SF3B: strain currently classified as Enterococcus faecium. Human sourced).
- Lactobacillus Acidophilus KS-13
- Bifidobacterium Bifidum G9-1
Before explaining what this may be happening, let us check what is in the literature:
What is on PubMed
- Probiotics Streptococcus salivarius 24SMB and Streptococcus oralis 89a interfere with biofilm formation of pathogens of the upper respiratory tract.  In Lab environment…
- Clinical efficacy of a topical lactic acid bacterial microbiome in chronic rhinosinusitis: A randomized controlled trial.  – Nasal Spray containing 9 lactobacilli and 4 bifidobacteria
- ” We conclude that 2 weeks’ nasal administration of a honeybee LAB microbiome to patients diagnosed with CRSsNP is well tolerated, but neither affects symptom severity nor the microbiological flora/local inflammatory activity. “
- Topical probiotics as a therapeutic alternative for chronic rhinosinusitis: A preclinical proof of concept.  “We identified a well-tolerated, nonpathogenic, gram-positive bacterium(L.lactis)with anti-inflammatory properties.Topical probiotics in the management of CRS represents a promising and novel therapeutic alternative worthy of further clinical research“. i.e. Lab work only
- [Reduction of acute recurrence in patients with chronic recurrent hypertrophic sinusitis by treatment with a bacterial immunostimulant (Enterococcus faecalis Bacteriae of human origin].  – Symbioflor-1
- “The time interval to the first relapse was clearly longer under verum (513 days) than under placebo (311 days). “
- [The effect of a bacterial immunostimulant (human Enterococcus faecalis bacteria) on the occurrence of relapse in patients with]. 
- ” This better clinical efficiency of the test preparation was particularly observed during the treatment period, with 12 vs. 27 relapses (p = 0.013), but less during the follow-up observation period, with 27 vs. 39 relapses (p = 0.127). In addition, the time span until occurrence of the first relapse was clearly longer under verum (699 days) than under placebo (334 days) and after the end of the observation period 91% of patients under verum experienced only one relapse compared to 62% in the placebo group (p = 0.01).
Oral Microbiome Studies of Interest
- Lollipop containing Glycyrrhiza uralensis extract reduces Streptococcus mutans colonization and maintains oral microbial diversity in Chinese preschool children. 
- Dietary nitrate supplementation alters the oral microbiome but does not improve the vascular responses to an acute nitrate dose. 
- Sociodemographic variation in the oral microbiome. 
- The oral microbiome of early stage Parkinson’s disease and its relationship with functional measures of motor and non-motor function. 
- Is the Oral Microbiome Associated with Blood Pressure in Older Women?  ”
Sixty-five bacterial species demonstrated significant differences in relative abundance in women with elevated BP or using hypertension medication as compared to those with normal BP. After correction for multiple testing, two species, Prevotella oral (species 317) and Streptococcus oralis, “
- Association of the oral microbiome with the progression of impaired fasting glucose in a Chinese elderly population. 
- Analysis of oral microbiota in patients with obstructive sleep apnea-associated hypertension. 
- Oral microbiomes in children with asthma and dental caries. 
And many more.
- So far, I have had 4-6 mouth and nose samples uploaded. Not sufficient to do any analysis on 😦
- There is practically no literature on modifying the oral microbiome.
- Modifying the gut microbiome addresses systemic issues, the impact on the sinus, mouth and eye would be very indirect.
What is known (and explaining my results)
Symbioflor-1 is studied with positive results, it is a human source Enterococcus faecalis. Biofermin S is also Enterococcus faecalis, so the positive effects seen are not a surprise.
For Miyarisan (Clostridium butyricum MIYAIRI 588) we have no direct studies but there is plausible explanation based on studies. First I need to introduce you to LL-37
Next, we find that that it increases with severe periodontitis, Gingival crevicular fluid and serum hCAP18/LL-37 levels in generalized aggressive periodontitis. Since it is an antimicrobial, it is reasonable to speculate that the increase was the body way to fight the peridontitis!
We now add in butyrate – what is produced by Miyarisan
Recent studies demonstrated that butyrate induces LL-37 mRNA in colonic epithelial cells, however the underlying molecular mechanisms have not been elucidated…. Our results clearly demonstrate that butyrate-mediated up-regulation of LL-37 is influenced by several signalling pathways and receptors including MAPKs as well as VDR and TGF-beta1, but not by PPARgamma.Role of nuclear hormone receptors in butyrate-mediated up-regulation of the antimicrobial peptide cathelicidin in epithelial colorectal cells.
So the chain is this: Miyarisan increases butyrate in the oral cavity, this then pushes up the output of LL-37 and periodontitis is reduced. In theory, using sodium butyrate under the tongue may have similar effects. The advantage of Miyarisan is that it will likely contribute longer and have other antimicrobial actions.
This post is closer to bio-hacking speculation than my usual “Just the studies, ma’am. Just the studies”.
If the critical issue is in these areas, the suggestions for the entire body from http://microbiomeprescription.com/ may be a poor fit. The studies on enterococcus faecalis and LL-37 suggests that the above may be able to effect sinus, periodontitis and perhaps dry-eye issues. They are in the same sphere and far removed from the gut.
If I get at least 16 samples for each of these non-gut areas, I will spin out some of the charts for them. A suggestion engines needs facts from studies — and that we do not have. What I have is on this page.
- Symbioflor-1 (read directions here!), ( Paul’s Mart ships world wide)
An alternative if you intend to do a nasal wash could be: AOR/Probiotic-3 which contains the same key items. It is a capsule.