1. < MAC & Bronchiectasis

Anyone familiar with pH balanced 7% saline, rather than acidic type?

Posted by poodledoc @poodledoc, May 12, 2022

I was searching for information on how Upper Airway Reflux may influence Bronchiectasis and came across this interesting 7% saline called PulmoSal™ 7% (pH+) Bio-Balanced™ Hypertonic Saline. Which may be better than the more acidic type that most of us are probably using. Does anyone use this or know anything about it? The information on their website is compelling.
https://www.pharmacaribe.com/our-products/pulmosal-7-ph/

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sweethighland | @sweethighland | Oct 21, 2022
In reply to @poodledoc "@lorifilipek You make a good point and it did make me wonder a bit if the..." + (show)
@poodledoc

@lorifilipek You make a good point and it did make me wonder a bit if the results could have been skewed to show PulmoSal killed the bacteria better to better sell their product. For me it's all about the acidity. In the early stages of my coughing history I was diagnosed with LPR (laryngopharyngeal reflux) or Upper Airway Reflux as the reflux can actually get down into your bronchi. Long story there but I got that under control with lifestyle changes. But I believe the damage to my airways from that reflux caused my bronchiectasis, I believe then I got NTM/MAC which made the BE even worse.
Reflux consists mainly of HCl (acid) and pepsin. It has been shown that pepsin is the really bad player in LPR as it is the enzyme that breaks down protein in your stomach. Pepsin has the ability to attach itself to tissue such as the delicate lining of your airways for a long time until it is activated by anything acidic in nature, at which point it starts to eat away at the lining of your airways causing damage. So I want to always make sure I am not inhaling anything acidic into my lungs. I used a pH strip to compare the acidity of PulmoSal (the pH was about 7) vs HyperSal (the pH was about 6). On the pH scale a 6 is 10X more acidic than 7.

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Thank you so much. What are you using now? You once told me I can get it from Sam's club, right? After reading your post, I think I might have damaged lining of my airways. I also lay flat on my back and do deep breathing, so that the mucus moves up and cough up. I think the lining of my airways got damage while mucus are moving up due to its acidity. My airways are very dry now and it is worst in the mornings. Please advise me again on the saline you use from Sams club.

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1 reply
irenea8 | @irenea8 | Oct 22, 2022

Someone had posted that the PulmoSal was not available but it is and i have ordered it from my Pharmacy for only $27 for a months worth (60 vials). I also spoke with the manufacturer of it who was very nice and sincere. Pseudomonas likes an acidic environment. So i definitely felt it was worth trying the PulmoSal plus i will be paying way less than the saline i was getting on Amazon.

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1 reply
poodledoc | @poodledoc | Oct 23, 2022
In reply to @sweethighland "Thank you so much. What are you using now? You once told me I can get..." + (show)
@sweethighland

Thank you so much. What are you using now? You once told me I can get it from Sam's club, right? After reading your post, I think I might have damaged lining of my airways. I also lay flat on my back and do deep breathing, so that the mucus moves up and cough up. I think the lining of my airways got damage while mucus are moving up due to its acidity. My airways are very dry now and it is worst in the mornings. Please advise me again on the saline you use from Sams club.

Jump to this post

@sweethighland I get PulmoSal 7% from Sam's club. I also lie on my back as part of airway clearance, for me it is a very effective sputum producer. I do not believe sputum is acidic and would not cause damage to your airways. Make sure to have an empty stomach when you are lying on your back trying to get the sputum up. Less likely to have reflux come up and cause problems.

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1 reply
med08 | @med08 | Oct 23, 2022
In reply to @poodledoc "@sweethighland I get PulmoSal 7% from Sam's club. I also lie on my back as part..." + (show)
@poodledoc

@sweethighland I get PulmoSal 7% from Sam's club. I also lie on my back as part of airway clearance, for me it is a very effective sputum producer. I do not believe sputum is acidic and would not cause damage to your airways. Make sure to have an empty stomach when you are lying on your back trying to get the sputum up. Less likely to have reflux come up and cause problems.

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Can you explain lying on your back as a sputum producer? Do lie on your back while using nebulizer? Sleeping? I’m sorry. This may be a really stupid question? Nobody has told me about airway clearance. Except for this forums. I now nebulize every day, but also am looking for what else to be doing. Thank you.

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1 reply
poodledoc | @poodledoc | Oct 23, 2022
In reply to @irenea8 "Someone had posted that the PulmoSal was not available but it is and i have ordered..." + (show)
@irenea8

Someone had posted that the PulmoSal was not available but it is and i have ordered it from my Pharmacy for only $27 for a months worth (60 vials). I also spoke with the manufacturer of it who was very nice and sincere. Pseudomonas likes an acidic environment. So i definitely felt it was worth trying the PulmoSal plus i will be paying way less than the saline i was getting on Amazon.

Jump to this post

@irenea8 I find the statement "Pseudomonas likes an acidic environment" very interesting. So I did a little research and found this article https://pubmed.ncbi.nlm.nih.gov/34867864/ It makes me wonder if the same holds true for NTM/MAC. I can't find any info on that. You have a contact number for the manufacturer of PulmoSal, would you mind calling back for more information regarding the effect of an acidic environment on Mycobacteria? Thanks, Bill

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2 replies
poodledoc | @poodledoc | Oct 23, 2022
In reply to @med08 "Can you explain lying on your back as a sputum producer? Do lie on your back..." + (show)
@med08

Can you explain lying on your back as a sputum producer? Do lie on your back while using nebulizer? Sleeping? I’m sorry. This may be a really stupid question? Nobody has told me about airway clearance. Except for this forums. I now nebulize every day, but also am looking for what else to be doing. Thank you.

Jump to this post

@med08 Lying on your back is one way to do "Postural drainage" using gravity to help get the sputum out. I do not nebulize at the same time but sometimes will use my Aerobika. I will also do manual percussion as I am lying on my back, makes it work even better for me. Here is a great video by Dr McShane on all aspects of Airway Clearance, it should help you understand all the methods and why it is so important to do. https://www.youtube.com/watch?v=L-EHohMe7II Good luck, Bill

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1 reply
med08 | @med08 | Oct 23, 2022
In reply to @poodledoc "@med08 Lying on your back is one way to do "Postural drainage" using gravity to help..." + (show)
@poodledoc

@med08 Lying on your back is one way to do "Postural drainage" using gravity to help get the sputum out. I do not nebulize at the same time but sometimes will use my Aerobika. I will also do manual percussion as I am lying on my back, makes it work even better for me. Here is a great video by Dr McShane on all aspects of Airway Clearance, it should help you understand all the methods and why it is so important to do. https://www.youtube.com/watch?v=L-EHohMe7II Good luck, Bill

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Thank you so much!

REPLY
irenea8 | @irenea8 | Oct 23, 2022
In reply to @poodledoc "@irenea8 I find the statement "Pseudomonas likes an acidic environment" very interesting. So I did a..." + (show)
@poodledoc

@irenea8 I find the statement "Pseudomonas likes an acidic environment" very interesting. So I did a little research and found this article https://pubmed.ncbi.nlm.nih.gov/34867864/ It makes me wonder if the same holds true for NTM/MAC. I can't find any info on that. You have a contact number for the manufacturer of PulmoSal, would you mind calling back for more information regarding the effect of an acidic environment on Mycobacteria? Thanks, Bill

Jump to this post

Hello Bill, The only information I have seen that this manufacturer has put out is about Pseudomonas. The studies were done in vitro but it did seem that Pseudomonas was better controlled using a less acidic saline. So worth a try for me! If they have information about NTM/MAC i would not know but i do not think so. Here is their website.
https://www.pharmacaribe.com/our-products/ordering-information/

REPLY
lorifilipek | @lorifilipek | Oct 23, 2022
In reply to @poodledoc "@lorifilipek You make a good point and it did make me wonder a bit if the..." + (show)
@poodledoc

@lorifilipek You make a good point and it did make me wonder a bit if the results could have been skewed to show PulmoSal killed the bacteria better to better sell their product. For me it's all about the acidity. In the early stages of my coughing history I was diagnosed with LPR (laryngopharyngeal reflux) or Upper Airway Reflux as the reflux can actually get down into your bronchi. Long story there but I got that under control with lifestyle changes. But I believe the damage to my airways from that reflux caused my bronchiectasis, I believe then I got NTM/MAC which made the BE even worse.
Reflux consists mainly of HCl (acid) and pepsin. It has been shown that pepsin is the really bad player in LPR as it is the enzyme that breaks down protein in your stomach. Pepsin has the ability to attach itself to tissue such as the delicate lining of your airways for a long time until it is activated by anything acidic in nature, at which point it starts to eat away at the lining of your airways causing damage. So I want to always make sure I am not inhaling anything acidic into my lungs. I used a pH strip to compare the acidity of PulmoSal (the pH was about 7) vs HyperSal (the pH was about 6). On the pH scale a 6 is 10X more acidic than 7.

Jump to this post

@poodledoc I agree that acid reflux is a problem. I’m not as convinced that the measured acidic pH of many 7% saline solutions is. I’m a retired aqueous environmental geochemist. (I dealt with water quality issues, especially acid and metal laden waters produced by mining companies.) The question is the buffering capacity of the saline solution. Sodium and chloride have no buffering effect because salts of a strong acid (e.g. HCl) and a strong base (e.g. NaOH) have a neutral pH (pH 7). Distilled/deionized water in equilibrium with atmospheric carbon dioxide (a weak acid—H2CO3) has a pH of about 5.5, which is most likely why some hypersaline solutions have that pH. I’d need to know how well buffered the various saline solutions are, as well as how buffered our lungs are. If water is purged with an inert gas, such as nitrogen, the pH would rise to pH 7. However, it would have no buffering capacity when exposed to air.
Some articles suggest that PulmoSal is buffered with bicarbonate. However, I cannot find that info on the PharmaCaribe website itself. Depending on how PulmoSal is buffered, it’s possible that the nebulization process, pumping compressed air at atmospheric CO2 concentration to make fine particles, might lower its pH before it gets to the lungs. Perhaps you could do an experiment by using your pH paper with nebulized PulmoSal, say, at the end of your nebulization(?). (I don't have PulmoSal, so I can't try it myself.)

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heathert | @heathert | Oct 23, 2022
In reply to @poodledoc "@irenea8 I find the statement "Pseudomonas likes an acidic environment" very interesting. So I did a..." + (show)
@poodledoc

@irenea8 I find the statement "Pseudomonas likes an acidic environment" very interesting. So I did a little research and found this article https://pubmed.ncbi.nlm.nih.gov/34867864/ It makes me wonder if the same holds true for NTM/MAC. I can't find any info on that. You have a contact number for the manufacturer of PulmoSal, would you mind calling back for more information regarding the effect of an acidic environment on Mycobacteria? Thanks, Bill

Jump to this post

THE ROLE OF THE CELL ENVELOPE IN ACID RESISTANCE

At an external pH of 5, the internal pH of M tuberculosis H37Ra was close to 7, indicating that mycobacteria are able to maintain a neutral internal pH in an acidic environment (105), and other studies have confirmed this observation in M. smegmatis and virulent M.22/05/2009

Acid Resistance in Mycobacterium tuberculosis - PMC - NCBIhttps://www.ncbi.nlm.nih.gov › articles › PMC2715723

Not Quite what you were after @poodledoc but quite interesting.

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