Hi Donna,
Were you tested during your Pulmonary Function Tests to see if albuterol/levalbuterol is necessary? Whether it does in fact make a significant difference in opening your airways? I recently had PFTs and there was no significant improvement with albuterol so I do not use it.

Regarding the hypertonic saline, my doctor who is a BE/NTM expert, doesn't say 7% is better than 3% or for that matter .9% as there is little research to support this claim. There seems to be a feeling that hypertonic saline not only thins mucus but might be anti-microbial. Isotonic solution, like .9%, has the lowest amount of sodium chloride so perhaps it thins mucus, but is not anti-microbial.

I have all three and depending on if my voice is hoarse or if my throat is sore, I might step down from 7% to 3% or .9%. However, generally speaking, I tolerate the 7% well and might cough once or twice when I first start nebulizing but not throughout the session.

What's important is to find what is tolerable for you at this point in time and with your doctor's consent, go with that. From time to time, you can revisit your options.

Best,
Linda Esposito