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Why is boiling drinking water essential in MAC?
I am embarrassed to say that I have forgotten the science behind this basic question: why do we need to sterilize water for drinking? My new pulmonologist at Kaiser asked me this and I didn’t have an answer. He wondered how drinking would get MAC into one’s lungs. Thank you for nudging my brain on this fundamental of our protocol!
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I spoke with Steve Sunshine; he's very helpful. But I think there's other options. For example. if you have an old shower head and especially one with a hose, replace it with a new shower head where the material is coated with an antimicrobial), and 1/month remove and soak in at least 6% acetic acid vinegar for I think 30 minutes. I err on the side of caution and still take cool showers.
I like the Raintree filter (but that's only for under sink), it will filter anything above 0.02 microns, mycobacterium does build up in the filter, but it builds up on one side of the membrane, which is why low flow is an indicator to change the filter. Unlike other types of filters that eventually reach their capacity to absorb, and "breakthrough" is experienced. Breakthrough, meaning the filter becomes full of the contaminant and eventually seeps out. Since I just installed the under sink UF filter this year, I should know by January 2026, if it's working (when the flow becomes restricted)-though in meanwhile, I have thought of testing. I haven't found any showerhead filters for mycobacterium.
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3 Reactions.2 microns is smaller than .22 microns. It is adequate to filter NTM.
As long as the NTM is contained in the filter it is not a risk. Just use caution when changing it and put it in a bag and into the garbage.
Since no NTM gets to the shower head, just soak away the biofilm periodically.
PS I have chosen not to install this filter. I set my water heater to 135F and take short, well-ventilated showers with a rainwater (large droplet) head.
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4 ReactionsThe Pall filter is available for showers. It’s super expensive, and has to be changed every 62 days to be effective against mycobacteria, but it’s hospital grade and is also sold to the public, and is the one that Falkinham has confidence in. I finally bit the bullet and got it since I am very thin and can’t stand cool showers except on a very hot day. I am relieved to be able to take a nice warm shower.
I bought a Shower Clear shower head and Steve mailed it to California without a problem, but the holes were not large enough and I was afraid of it aerosolizing easily—so I returned it. The holes were just 1 mm, and though you can keep it clean more easily than a regular shower head, it doesn’t filter the MAC.
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2 ReactionsTake a shower every other day and you immediately cut risk of exposure by 50%. That and turning up water heater over 135 as Sue suggests supported by Dr Falkinham.
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1 ReactionDe. Falkinham now suggests to lower the temp of the water heater every two weeks for two weeks so that the mycobacteria doesn’t adapt to the higher temperature that presently kills the myco bacteria. During the two weeks the temp is lower the myco bacterium will begin to grow again, but that myco bacteria will be killed when the temp is raised again.
Never a dull moment in NTM land!
I think he is still working his way through that recommendation. If I could find his exact post, I would quote it here - but I think it was to lower the temperature "once in a while" for two weeks. I cannot imagine remembering to do this every two weeks.
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2 ReactionsI’ll try to find it but I’m fairly certain that’s what he said. There’s a whole thread about it on NTMir. I just started putting it on my calendar: raise heat, lower heat.