Salt therapies, which include gargling with salt water, neti pots and salt caves (speleotherapy), have been used for thousands of years in both traditional and modern medical practices. They have been used for mouth infections, sore throats, upper and lower respiratory conditions such as cold and flu¹, allergy, asthma², bronchitis, cystic fibrosis, sinus infection³, hay fever and emphysema. But in this day and age of heart transplants, genetic engineering and miracle drugs, it is often hard to believe that something as simple as salt can truly have beneficial effects. However, through our ever-increasing scientific understanding of health conditions and how the body responds, we can now scientifically explore the mechanisms by which traditional remedies and treatments work. And, through science and clinical trials, we are now able to validate many such treatments and, interestingly, it appears that not only do salt therapies work, but they do so even better than we expected.^{4, 5}

Salt therapies, which include gargling with salt water, neti pots and salt caves (speleotherapy), have been used for thousands of years in both traditional and modern medical practices. They have been used for mouth infections, sore throats, upper and lower respiratory conditions such as cold and flu¹, allergy, asthma², bronchitis, cystic fibrosis, sinus infection³, hay fever and emphysema. But in this day and age of heart transplants, genetic engineering and miracle drugs, it is often hard to believe that something as simple as salt can truly have beneficial effects. However, through our ever-increasing scientific understanding of health conditions and how the body responds, we can now scientifically explore the mechanisms by which traditional remedies and treatments work. And, through science and clinical trials, we are now able to validate many such treatments and, interestingly, it appears that not only do salt therapies work, but they do so even better than we expected.^{4, 5}

The Importance of Mucus and the Mucous Membrane

In order for any microbe, virus, bacteria or mold to infect the sinuses, throat or lungs, it must first pass through or enter the body through the mucous membrane. It is the first line of defense against infection, followed by the second line of defense - the immune system.

The mucous membrane consists primarily of cells with an external surface covered by hair-like structures called cilia. The cilia are formed into bundles and act like brushes to move the mucus, microorganisms, and particles up and eventually out through the nose or mouth. Using salt water in a neti pot is believed to not just flush out hard to reach sinus areas, supporting the whole cilia matrix, but also improves cilia function by modifying the mucus.⁶ Cilia must work together to move allergens, pathogens, excess mucus and fluid out of the body.⁷ The need for uniform cilia function is well illustrated by a smoker attempting to quit or a person trying to expectorate (cough or spit out phlegm from the throat or lungs). In such cases there is a period of time when the cilia are not working together, causing a cough to develop. This is one of many issues that makes quitting difficult, but a salt cave or inhaler can support the cilia making it easier to expectorate.

On top of the mucous membrane there are two layers of mucus. The mucous membrane and mucus are specially designed to prevent any microorganisms or particles from getting into the lungs. The importance of the health of the mucus and the lining of the airways in preventing infection progressing into the lungs cannot be overstated, as seen by how colds and flu can advance into pneumonia.

Effects of Salt on Bacteria, Viruses and more, plus how it supports Mucus

What is amazing about mucus, and we still don’t understand how it does this, is that it is selective - allowing nutrients and other vital molecules to enter, but keeping out pathogens such as viruses and bacteria which are dangerous to our health.

Interestingly, the composition of mucus can differ between people and varies depending on factors such as age and diet, implying that healthy people have healthy mucus. Even the time of year can impact the composition of mucus, which may play a part in why we more often get colds or the flu during winter months. Mucus is also abundant in breast milk, protecting infants against viruses such as rotavirus and HIV. In a recent study funded by the NIH (National Institute of Health) and published in the Journal of Biomacromolecules, it was found that covering human cells with a layer of mucus trapped human papilloma virus, influenza A and Merkel cell polyomavirus (a human viral pathogen), preventing them from infecting the cells. It was also discovered in the same study that salt has a strong effect on how effectively mucus blocks viral entry. High salt concentration makes the mucus less penetrable, which offers a possible explanation for why gargling with salt water, or using a neti pot with salt water or a Himalayan Crystal Salt Inhaler often soothes symptoms.

The scientist behind this research, Dr. Ribbeck from MIT, is now investigating how salt enhances the performance of mucus and how viruses manage to overcome the defensive mucus barrier in some cases. She hypothesizes that bacteria may act as an accomplice, breaking down the sugars found in mucus and clearing the way for viruses to get through the mucus with the bacteria to the cell. Then, even more concerning, once viruses infect the cells they can “return the favor” by shutting down many of the body’s immune defenses, giving bacteria a better chance to establish their own infections.⁸ This further highlights the essential dual role salt can play as both an antiviral and antibacterial agent in conjunction with mucus.

The antibacterial function of salt works through the process of osmosis, where high concentrations of salt kill some types of bacteria through its dehydrating effect. When bacterial cells lose all of their water it dehydrates the cell, causes a loss of the cell’s structure, leads to enzyme and protein malfunction, and eventually causes the death of the cell.⁹

Salt has been used in food preparation for thousands of years due to its antimicrobial properties. More recent research has shown scientifically how salt destroys bacteria known to cause extreme illness in humans, such as Escherichia coli, Salmonella typhimuium, Staphylococcus aureus and Listeria monocytogenes.

Research at the University of Manchester has also demonstrated that salt has anti-inflammatory effects. In an animal study they tested the effects of hypertonic fluid (salt water) therapy to reduce swelling, which activates a group of proteins called NLRP3 which in turn release inflammatory mediators. These activate neighboring cells to increase inflammation and negatively impact our immune system. However, when a hypertonic salt solution was administered, it drew the water from the cells shrinking them back to their original size, resulting in deactivating the signal for inflammation.¹⁰

Another potential adjunct application to safeguard against viral contamination is the addition of salt to surgical masks which is currently being researched by Professor Choi at the University of Alberta. Dr Choi said, “surgical masks were originally designed to protect the wearer from infectious droplets in clinical settings, but they alone don’t help much to prevent the spread of respiratory diseases such as SARS, MERS or influenza”. The masks may well trap the virus-laden droplets, but the virus is still infectious on the mask. Merely handling the used mask opens up new avenues for infection. Even respirators designed to protect individuals from viral aerosols have the same issue. Masks capable of killing viruses would save lives, especially in an epidemic or pandemic situation. When an aerosol droplet carrying the influenza virus contacts the salt treated filter, the droplet absorbs salt on the filter. The virus is exposed to continually increasing concentrations of salt. As the droplet evaporates from the salt, as mentioned before with bacteria, the virus suffers fatal physical damage and is destroyed.¹¹

How Neti Pots Work

Neti pots, from Ayurvedic medicine, have become widely popular among natural health practitioners and consumers. These ceramic pots are designed to flush out the nasal passages and are often go-to products for congestion and sinus infection, whether fungal, viral, or bacterial. Besides the simple effect of water flushing away allergens and microbes, an action potentially provided by any liquid, neti pots specifically use a saline (salt) solution in order to:

✓ Thin and reduce mucus build-up

✓ As Anti-bacterial, anti-viral and anti-fungal support

✓ As Anti-inflammatory support

How Neti Pots Work

Speleotherapy, also known as cave therapy, was developed in the mid-1800s after Polish salt miners were found to have a lower incidence of pulmonary disease. Halotherapy, a more recent development of the concept, is the use of salt air to re-create the cave microclimate for therapeutic use. The popularity of these salt rooms is significant and new salt spas are popping up across the United States, with 10 one-hour sessions costing between a few hundred and a few thousand dollars.

A more recent and portable alternative to salt caves or rooms is a dry ceramic inhaler, with a salt chamber inside. This adds salt to the air as the patient breathes in - mimicking the atmosphere and process in speleotherapy and halotherapy. Just as the neti pot does for the sinus tract (nose), the Himalayan Crystal Salt Inhaler creates a salt environment in the bronchial tract (lungs) which, according to the Lung Institute, results in anti-bacterial, anti-viral, anti-inflammatory properties, thinning and reducing the build-up of excess mucus and helping to reduce congestion and support ease of breathing.*

In a pilot study of 35 patients with chronic obstructive pulmonary disease (COPD), a dry salt inhaler improved six-minute walk times. This is a frequently tracked and significant marker since COPD is not known to be a reversible condition. While dry salt inhalation does not reverse asthma or COPD, it can have therapeutic benefits in relieving mucus congestion and improving one’s ability to breathe, thereby improving quality of life for chronic sufferers of these conditions. Asthma shares some similarities with COPD and asthma treatments are becoming more holistic all the time. At the 2010 World Allergy Organization International Scientific Symposium, President, Dr. Richard Lockey, MD said, "I don't believe you can take care of an asthmatic without addressing their comorbid conditions, and there are many of them. In my opinion, diagnosis and treatment guidelines should also address these comorbid conditions."¹²

Comorbid conditions include obesity, gastroesophageal reflux or heartburn, dysfunctional breathing and mental disorders. Runny nose, watery eyes and allergies to foods are now being included as well in most doctors’ protocols. Long term use of dry salt inhalation therapy has been suggested when multiple chronic conditions may exist such as allergies and dysfunctional breathing. General recommendations are once or twice daily in the morning and evening. Duration of inhalation ranges from five to twenty minutes depending on the condition. However, because dry salt inhalation does not address the original cause of the respiratory condition, long-term, continued use may be necessary for chronic conditions. No contraindications have been observed with current pulmonary, bronchial, or asthma medications.

Another condition which is believed to benefit from dry salt inhalation is cystic fibrosis^13,14 - a very complex disease of the lungs and bronchial tract. In the lungs, the layer of salt and water that our body creates to coat airways is only about a millionth of an inch thick. When it becomes irritated, mucus thickens excessively and can be difficult to clear. It appears then, that while the normal defenses of the body help to trap and segregate invaders, too much of a good thing can be a problem. Everyone who has ever had a sinus infection has experienced this. Cystic Fibrosis patients have been found to have lower naturally occurring salt concentrations in their bronchial tissue. Researchers have also identified a genetic predisposition in these patients that means the mucus is not thinned appropriately. Therefore, salt inhalation, which reaches the bronchus, has symptomatic benefit for Cystic Fibrosis patients due to mucus thinning. Similarly, ex-smokers report a lot of phlegm (mucus) in their throat for 12-18 months after quitting. Dry salt inhalation supports this process by breaking down the excess phlegm and helping expectoration (e.g. coughing and spitting).

The Type of Salt Matters

The type of salt used for inhalation may play an important role as well. Commercial salts have different size mineral particles and structures which will determine ease of absorption. Industrial salts may have chemicals added, which can damage the sensitive tissues of the respiratory tract. Original Himalayan Crystal Salt is formed under enormous pressure, with particles and structures so small and perfectly formed that they can be instantaneously absorbed into a cell. Practitioners of Energy Medicine also prefer crystal salts over rock salts for their vibrational quality. Original Himalayan Crystal Salt has the highest number of trace minerals of any salt, including many monatomic elements which have been shown to have the highest vibration of all. However, with so many “Himalayan Salts” on the market it is important to choose those with appropriate certification verifying both origin and all the trace minerals claimed. Original Himalayan Crystal Salt Inhalers are hand-made in the US using lead-free decals and coating. The high-quality ceramic inhaler is filled with premium coarse ground Original Himalayan Crystal Salt which contains 84 trace and ultra-trace minerals. Certificates of analysis showing all 84 trace minerals, structural analysis showing the perfect crystalline form, and clinical research provide validation. The Original Himalayan Crystal Salt Inhaler is refillable using a BPA- free rubber stopper with a standard refill lasting up to 18 months.

For direct patient fulfillment or Natural Partners click on the links below to go directly to their respective inhaler pages

References:

1. Ramalingam, S., Graham, C., Dove, J. et al. A pilot, open labelled, randomised controlled trial of hypertonic saline nasal irrigation and gargling for the common cold. Sci Rep 9, 1015 (2019). https://doi.org/10.1038/s41598-018-37703-3
2. Tsao CH, Chen LC, Yeh KW, Huang JL. Concomitant chronic sinusitis treatment in children with mild asthma: the effect on bronchial hyperresponsiveness. Chest. 2003;123(3):757–764. doi:10.1378/chest.123.3.757
3. Kurtaran H, Karadag A, Catal F, Avci Z. A reappraisal of nasal saline solution use in chronic sinusitis. Chest. 2003;124(5):2036–2038. doi:10.1378/chest.124.5.2036
4. Talbot AR, Herr TM, Parsons DS. Mucociliary clearance and buffered hypertonic saline solution. Laryngoscope. 1997;107(4):500–503. doi:10.1097/00005537-199704000-00013
5. Rabago, D., Guerard, E., & Bukstein, D. (2008). Nasal irrigation for chronic sinus symptoms in patients with allergic rhinitis, asthma, and nasal polyposis: a hypothesis generating study. WMJ : official publication of the State Medical Society of Wisconsin, 107(2), 69–75.
6. Shay Gueron, Konstantin Levit-Gurevich, Nadav Liron, Jacob J. Blum. Cilia internal mechanism and metachronal coordination as the result of hydrodynamical coupling. Proceedings of the National Academy of Sciences Jun 1997, 94 (12) 6001-6006; DOI: 10.1073/pnas.94.12.6001
7. Gueron S, Levit-Gurevich K, Liron N, Blum JJ. Cilia internal mechanism and metachronal coordination as the result of hydrodynamical coupling. Proc Natl Acad Sci U S A. 1997;94(12):6001–6006. doi:10.1073/pnas.94.12.6001
8. Biomacromolecules 2012, 13, 6, 1724-1732 April 4, 2012 https://doi.org/10.1021/bm3001292
9. Elliot Walsh. How to Kill Bacteria With Salt July 02, 2019
10. University of Manchester. A Solution To Reducing Inflammation. September 20, 2012
11. University of Alberta. New surgical mask doesn't just trap viruses, it renders them harmless. January 5, 2017

12. Becky McCall. WAO President Calls for Focus on Asthma Comorbidities. Medscape. December 07, 2010

13. Boucher RC. New concepts of the pathogenesis of cystic fibrosis lung disease. Eur Respir J. 2004;23(1):146–158. doi:10.1183/09031936.03.00057003
14. Cernomaz TA, Bolog SG, Mihăescu T. The effect of a dry salt inhaler in adults with COPD. Pneumologia. 2007;56(3):124–127.
15. Hendel, B. Water & Salt. ISBN 0-9744515-1-17. Natural Resources 2003