Saline Solutions often not worth their Salt…

Saline Mist in a handy dispensing spray bottle…what could be the harm, I thought…it’s just salt water, right? Wow, was I wrong.

Recently at an airport, stuck without my usual homemade sea salt solution, I copped out and bought a saline spray from the airport pharmacy (I wasn’t exactly spoiled for choice and they were super expensive). Usually, observing good breathing habits along with a few mists of sea salt spray in the dry air (drier than the Sahara!) prevents any of the usual travel bugs that so many people seem to suffer from.  But, the next day I had a swollen throat, sore eyes and felt like a “cold was coming on”.  This hardly ever happens to me anymore…and I knew there must have been something dodgy in that saline spray. Luckily, the symptoms corrected quickly with a good slug of sea salt in cooled boiled water…

Closer inspection of the back label revealed that this OTC saline contained preservatives…something I simply didn’t expect. After all, salt is considered the best preservative known to man… Just goes to show, you can’t drop your guard for a second – even if you have been allergy and symptom free for over twenty years…

My in-store and online research showed that many over the counter saline solutions are loaded with chemical preservatives. These preservatives can make already irritated mucosal linings very swollen and sore, and cause sensitive throats and airways.

Image from Qora re saline nasal spray solution
A similar saline bottle image found online

Benzalkonium Chloride in particular, a commonly used preservative in saline sprays, nasal decongestant sprays, eye drops and other solutions; “causes toxic reactions in the nose, eyes, ears, and lungs, and may exacerbate the symptoms of allergic rhinitis” according to a paper published in Clinical Therapeutics in October 1999. The author wrote that these findings should be noted when determining diagnosis of allergic rhinitis. In a 1998 paper entitled: Preservatives in Nebuliser Solutions: Risks Without Benefit: the authors point out that Benzalkonium Chloride (and other preservatives in nebuliser solutions used to treat asthma) are actually powerful bronchoconstrictors when inhaled; and thus should not be included in bronchodilator medicine because they reduce the medicine’s efficacy. This was reviewed again recently in 2017, and it seems that Benzalkonium Chloride is still commonly used in nebulised solutions for asthma which can exacerbate asthma symptoms and complicate treatment.

Many nasal allergy sufferers are led to believe that they need to dry out their nose. But this just makes it more sensitive. A dry nose also feels stuffy.   So, the thing that you think you have – a stuffed nose – feels the same as what you actually have – a dry nose – and using the right medicine for the wrong reason unfortunately also leads to problems….

“Rhinitis Medicamentosa” is a condition that is caused by “rebound swelling” and rhinitis that we now understand is directly related to overuse of decongestant nasal sprays.   A similar condition exists for people who overuse pain medications for headaches – stopping these medications causes “rebound” headaches, and so they are driven to seek relief by overusing medication. These cycles are hard to break but understandable, and can be directly noted as “cause and effect”.

But many people don’t use medication – or so they thought. So they’d be horrified to learn that most over-the-counter (OTC) saline preparations are preserved with Benzalkonium Chloride or other anti-microbials  – which interestingly have powerful broncho-restricting properties. This in itself will dry out the mucosa or nasal linings, causing more irritation and swelling. This is the opposite of what we actually want to achieve with saline use: to hydrate the mucosa, replace lost mineral salts and improve mucus viscosity.

So…What is the answer?

Make your own Saline Solutions of course!

If you use tap or spring water, be sure to boil it first to sterilize it. Dissolve a half to a full  teaspoon of pure unprocessed un-iodized mineral sea salt (NOT pink salt, rock salt or table salt) in a cup of cooled boiled water. Decant into several smaller bottles with droppers or spray tops. Do ensure that these bottles and caps are also sterilized regularly to prevent re-infection! Apply as needed.

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