Sinus Cleansing- How Strong Should

My Saline Solution Be?

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“Isotonic or Hypertonic Saline, by Dr. Murray Grossan

Currently there are several products on the market that use hypertonic saline to spray in the nose. What is hypertonic? In the body, there are chambers of fluid, mostly salt containing. When you are dehydrated in the hospital, they used to give you isotonic solution. Iso means equal. This refers to the fact that it is perfectly balanced, and exactly right for your body. The way the body works, there is a barrier like a cellophane between fluid systems. If both sides have the same concentration of salt, then no fluid is passed through this membrane, called a semi permeable membrane. When you want to put liquid into one area, you increase the amount of salt. This then becomes hypertonic – hyper meaning excess or increased. The fluid will flow through the membrane until both sides are equal in salt concentration. The fluid goes to the higher salt level. 

Hypotonic means less salt. If one side is hypotonic, the fluid will go from that side to the hypertonic side. This is the reason why persons with heart conditions limit their salt intake. Less salt means the body holds less fluids. If a heart patient takes hypertonic, his fluid in the body will increase resulting in swollen legs. Thus if a person drowns in a fresh water pond, the water will be sucked into his lungs because the osmotic pressure is higher in the lungs. If he drowns in an ocean, which is hypertonic, the water will be sucked out of his lungs. There has been some literature claiming that hypertonic saline is of value when the membranes of the nose are extremely swollen. That is the principle behind the hypertonic products. Exactly what effect these hypertonic solutions have on nasal function is still being investigated.”

Comment from W.B.- I tried hypertonic solutions when performing sinus cleansing some years ago before becoming aware of Dr. Grossan and his Breathe-ease® XL product.  These didn’t help me at all, and in some ways seemed to make things worse.  For me, sinus cleansing through nasal irrigation using an isotonic solution is by far the best choice.  Dr. Grossan’s article continues below.

“If you wish to try a hypertonic nasal solution, there are distinct advantages to using our Breathe-ease® XL solution. You start with a product, a modified Ringer’s solution, which all hospitals now use for intravenous solution instead of saline. Numerous articles show that this solution is best for restoring nasal function.  Breathe-ease® XL is free of preservatives, especially Benzalkonium, known to impair cilia function. When used in the nasal spray it may give a burning sensation. Best of all, Breathe-ease® XL made hypertonic is much less expensive than the leading hypertonic solutions. When you make Breathe-ease® XL for spray, from a standard 190 gm bottle you can make 20 pints or 9,460 ounces of a 2x hypertonic solution. Or you can make it 3x hypertonic and make 14 pints or 3,890 ounces. Compare this to the size of the other leading hypertonic solutions. A 190gm bottle of Breathe-ease® XL will make up to 320 oz. of hypertonic saline equivalent to 40 single use bottles of the 8oz hypertonic solutions marketed by other manufacturers. Using Breathe.ease® XL in this manner allows our customers to adjust the concentration of the solution to meet their individual needs and comfort level – instead of a one size fits all mixture that may not be right for you. The purpose of any spray or irrigation is to get the nose healthy. If regular isotonic Breathe.ease® XL works – 1/4 teaspoon to four ounces, fine. You can use one ounce at a time and store the 3 ounces in the refrigerator and change it once a week – there is no preservative.  

·         If you want to try 2x hypertonic, just add the 1/4 teaspoon to 2 ounces of water or two 1/4 teaspoons to four ounces. Again, you can store the remainder in the refrigerator and change once a week.  Breathe.ease® XL comes with its own accurate 1/4 teaspoon measuring spoon. 

·         If you decide to go 3x hypertonic, just add 3 1/4 teaspoons to four ounces of water. One ounce goes into the spray bottle and 3 into the refrigerator, so, changing once a week, this lasts a month. So even using 3x the isotonic dose you should have enough to last 20+ months! Compare that to the price of ENTsol and Saltaire!

Again you may decide that the isotonic strength is best for you, so you don’t need to buy anything else, just mix a fresh batch. Or you may decide on 2x hypertonic. Whichever you use this week, you can change it next week. Most important, you don’t need to worry about preservatives. The ability to change concentration without the need to buy a new product is very important. For example if your nose is dry, the hypertonic can make the nose drier by taking liquid out. Here isotonic is much better, especially the Breathe.ease® XL formula. If the nose is very swollen, you may find the hypertonic works best for you. But you can always start with isotonic and move slowly into hypertonic. Some persons find that hypertonic too strong and must cut back. There is no one size that fits everyone all the time.”

Comments from W.B.- Once again, isotonic sinus cleansing using an irrigator is the best solution for me.  You can, however, experiment with hypertonic sinus cleansing and adapt your strategy as appropriate.  I can only say that following Dr Grossan’s advice for sinus cleansing using an irrigator has saved me from the misery of constant sinus infections.  For more information about the products I use click here.