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AAFA Explains: Is Salt Therapy Safe and Effective for Asthma?

 

In our second post in our “AAFA Explains” series, we look at claims that salt treatment (also known as halotherapy) can improve your asthma.

This blog series looks at complementary and alternative medicine (CAM) aimed at asthma and allergies. The Asthma and Allergy Foundation of America wants to guide you as you decide between choices that may be “likely safe” or “potentially unsafe.”

CAM treatments usually do not go through the same rigorous scientific research as new drugs and medical procedures. As a result, whether or not CAM works (called efficacy) is unproven for most treatments.

Salt therapy – such as salt rooms, caves or lamps - falls into that category.

What is salt therapy?

“Salt rooms” are popping up in the U.S., Australia, the U.K. and elsewhere. These rooms charge you a fee to enter, like a spa. Salt crystals coat the rooms and the air is salt-laden as an attempt to mimic naturally occurring salt caves.

The history of natural salt caves as an asthma remedy is ancient. In Russia and Eastern Europe, people with asthma would descend into salt caves. The belief is that breathing in extremely small salt crystals would help open up the airways and assist with the buildup of mucus.

What does science tell us about salt therapy?

Studies evaluating salt therapy for asthma are few.

One of the largest studies to examine the use of salt caves evaluated the therapy for COPD (chronic obstructive pulmonary disease). COPD is a chronic disease of the lungs caused by smoking.

Researchers reviewed 151 articles about salt therapy. They checked for high-quality studies (randomized controlled trials), like those conducted for prescription medications.

Of the 151 studies, they found just one randomized controlled trial. Researchers reviewed three other studies to include more people. Many people in the studies reported feeling better after undergoing salt therapy. But researchers identified several quality concerns about these four studies.

As a result, researchers were unable to draw any conclusions. Some of the missing or incomplete information included:

  • Whether the subjects had COPD or asthma
  • What medications the patients took
  • How severe their breathing difficulties were at the start of the study
  • The long-term effect of the treatment (for example, people were examined only right after treatment)

In some countries, medical societies have warned that salt caves can have negative effects. For example, the salt cave could induce bronchoconstriction in some people.

Another danger is that if you have asthma, you may stop taking your regular medicine. Halotherapy is expensive. Many patients may struggle to afford both prescription medicines and salt therapy. But long-term control medications are needed to help prevent and control asthma symptoms. Take them as your healthcare provider tells you to, even if you feel well.

Is halotherapy safe?

"If your goal is to find a new way to de-stress, salt caves can do the trick. They’re cool, quiet and relaxing," said Maureen George, PhD, RN, AE-C, FAAN, a member of AAFA’s Medical Scientific Council, and an Associate Professor of Nursing at the Columbia University School of Nursing. "If you’re looking for a natural way to treat your asthma, halotherapy is not what you’re looking for. It has not been rigorously studied, despite claims from ‘experts’."

Patients should also know that inhaling concentrated salts (hypertonic saline) has been proven to irritate the airways, causing cough and mucus, which can make asthma worse for some people.

The bottom line:

Halotherapy, or sitting in a salt room, is not likely to make your asthma better. For most asthma patients, halotherapy is “likely safe.” Since you don't know how you will react, AAFA warns that it is best to err on the side of caution and avoid salt rooms.

Key definitions:

Randomized controlled trials: Participants are randomly placed into two groups. One group does not receive any treatment. The other group receives the treatment under consideration. Researchers follow both groups over time. At the end of the study, they compare results.

Efficacy: Whether or not a treatment works, and by how much.

Reference:

Rashleigh R., Smith S.M., Roberts N.J. (2014). A review of halotherapy for chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease.

Medical Review May 2016.

The Asthma and Allergy Foundation of America (AAFA) is the largest and oldest nonprofit patient organization dedicated to asthma and allergies. Our online community includes public blogs. To post a comment, you will need to register or sign in.

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Comments (23)

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This line is the article..."Patients should also know that inhaling concentrated salts (hypertonic saline) has been proven to irritate the airways, causing cough and mucus, which can make asthma worse for some people." 

Yes, because hypertonic saline is used to induce a reaction for testing.  That is a known. The water is what makes that happen.  However, that does not happen to that degree with dry salt therapy. It may make your throat tickle, and cause you to cough up more mucus, but that is what it's supposed to do. Like a natural decongestant and expectorant. NO DRUGS involved.

Hi Gina! Welcome to AAFA! How long have you been dealing with asthma or allergies?

Melissa

Grace: seasonal allergies, asthma

Josh: allergic to peanuts and tree nuts, asthma

Bekah: allergic to most foods, currently eating peaches, pears, apples and bacon, asthma, g-j tube fed, portacath for hydration

Will you help us raise visibility for our work by posting a brief story of your experience with us on GreatNonprofits?
Last edited by Melissa G

First, I want to give full disclosure. I am commenting as a member of the salt therapy industry. Specifically, for even fuller disclosure, I'm chiming in on behalf of Halomed, a manufacturer of dry salt therapy equipment, which micronizes and disperses pharmaceutical grade salt in salt therapy room. In controlled halotherapy, the concentration of salt in the air is controlled by a sensor, which continuously measures the level of the salt in the air and signals the halogenerator to maintain the preset concentration. Halomed's parent company, Aeromed, pioneered salt therapy and has, since the early 1990s, been manufacturing and further developing the technology that makes salt therapy possible.

We dearly appreciate that the Asthma and Allergy Foundation of America has included an article on salt therapy. And we wish to emphasize that salt therapy should never replace the care of a professional healthcare provider, and that even though you may be receiving salt therapy, any changes in your treatment protocol should be done with your healthcare provider. That said, we are glad to report that studies continue on the role of salt therapy in providing relief for asthma and related respiratory conditions. Enough researchers in the field of respiratory health are intrigued by the results they are hearing of to advance the efforts to learn more so that clinicians can best serve their patients.  

If you are interested in trying salt therapy, please do some research before you visit a salt room. There are some salt rooms that are quite lovely, with salt paneled walls, loose salt on the floors and other effects. All of this is great and relaxing. But unless a salt room is equipped with a halogenerator, it cannot deliver salt therapy. There are claims salt on the walls and on the floor can deliver benefits, but we know of no evidence to support that. The air of natural salt caves does contain micronized salt, but that's because the air in these caves travels many miles before reaching the outer sections where people visit to receive salt therapy. The air picks up salt particles as it whooshes through the miles of walls of these enormous salt caves. If you want modern, above-ground salt therapy, in which you will be inhaling micronized salt, you want to visit a salt room equipped with a halogenerator, one that uses low to moderate salt concentration settings and is supported by effective ventilation.

Also, there is information to share with your healthcare provider about halotherapy from the American Lung Association. The ALA's senior scientific adviser, Dr. Norman Edelman, has commented that salt therapy can potentially confer more than just a placebo effect. On the ALA’s website (as of Aug. 24, 2018), Dr. Edelman states:

“Most people with obstructive lung disease such as asthma or COPD cough sputum (a thick mixture of saliva and mucus), and trying to bring it up can be distressing. (Think about the last time you had bronchitis, for instance.)

"When fine salt particles are inhaled, they will fall on the airway linings and draw water into the airway, thinning the mucous and making it easier to raise, thus making people feel better," said Dr. Edelman. "Also, these environments are allergen-free and thus good for people with allergies affecting their lungs."

You can see his comments at Promising or Placebo? Halo Salt Therapy: Resurgence of a Salt Cave Spa Treatment

Any good salt room operator will gladly explain how their halotherapy room works, and, as Halomed does, respect the importance of clinical care you are receiving. In fact, there are salt room owners who themselves are members of the healthcare community.  

A quick and important fact: Halotherapy's introduction to the United States occurred at a 1994 Virginia Commonwealth University-Virginia Biotechnology Research Park exhibition of Russian life-science technologies. Halotherapy was among numerous contenders who were evaluated for inclusion in this event after on-site visits were conducted in St. Petersburg and Moscow. 

 

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