Is Halotherapy (aka Salt Cave therapy) worth its salt?

Ages and ages and ages ago I wrote an initial blog post on halotherapy (salt cave therapy), and i promised you a follow up once I have looked at the available data for it.

In short, I always meant to get round to following it up, but kept forgetting or getting embroiled in something else instead. So here, dear friends, is the follow up post.

As you may recall, www.saltcave.co.uk were claiming their clinically tested, drug free treatment meant that many of their patients stopped taking their medications becuase they because symptom free. They claimed it would work for asthma, COPD, and sinusitis. So, I thought I'd test their claim for COPD, particularly since this illness can be particularly devastating and debilitating.

So here's what I did: had a look at their website, which attempts to helpfully provide a list of published studies. I the proceeded to ignore this entirely, and did my own search of Medline and Embase, the two leading medical literature databases in the world. If there was going to be any robust evidence, I would find it in those.

Now I'm interested in human clinical studies mainly as a starting point, because these are the ones that can actually tell us best whether or not something works. So I limited the searches to human trials: after all, The Salt Cave are claiming that it's a clinically tested therapy, right? I then combined the results for halotherapy, with results for chronic obstructive pulmonary disease, to see what would come up.

In Embase, I found one study. Unfortunately, it was in Russian, so I have to rely on the abstract. The study included 29 patients, and that's pretty much all that we know. The authors claim a significant positive effect, with no other information or data reported in the abstract. But frankly, a study with 29 patients in is neither here nor there- it's far too small to use to make any claims of benefit.It's worth noting, by the way, that these patients were in a "sanatorium" setting, which is likely to be a rather different setting to the middle-class-Ikea-£35 a go-UK based version that is being sold here. What other treatments would be given in a Russian sanatorium setting? How would any of this affect the patient's condition? How has this been controlled for in this study? Unfortunately, there's no way of knowing given how badly presented the abstract is.   

Okay, so what did I find in Medline? Well, in short, nothing. No results at all. 

So then I went back to the references provided by www.saltcave.co.uk and found very little to add. Another Russian-based sanatorium study, in abstract only, providing no data at al. Likewise, the study that they use on the "results" page of their website only include 26 patientswith COPD: again, too limited to draw any secure conclusions from. 

So my conclusion? The evidence for the use of salt cave therapy in COPD is far too limited to claim any benefit at this point in time. More research needs to be done in this area to be able to claim that it works. And this evidence base certainly doesn't justify £35 per hour. They can put as many testimonials as they like on their website but it still doesn't add up to good, robust clinical evidence. 

Hopefully this is a step to debunking some of the claims they are making on this website. Whilst there is a possibility that it might work, at the moment we just don't have enough information to justify the claims- and the cost. 

Further reading on halotherapy can be found at The 21st Floor and Sceptical Letter Writer

For transparency, here's my search terms: EMBASE: halotherapy.ti.ab AND Chronic obstructive ling disease/ MEDLINE: halotherapy.ti.ab AND Pulmonary disease, chronic obstructive

Halotherapy: a pinch of salt, or a pinch of nonsense?

My first subject on this blog is a result of an enquiry we encountered a while ago at work. I had never in my life heard of halotherapy, or "salt cave therapy" as its also known.

What does halotherapy involve? well, at first glance it appears to be mainly sitting on an Ikea chair in a room for an hour. Actually, on second glance, it appears to be the same. For the privilege of doing this, you pay £35 a hour.

I'm over simplifying, of course. According to The Salt Cave's website:

"The healing microclimate of a natural salt mine is recreated  inside a therapeutic salt room using the Breeze Tronic Pro medical device pharmaceutical grade salt is finely milled and accurately mixed with a regulated current of air, which is then evenly dispersed throughout the salt room.Breeze Tronic Pro is programmed to synchronise particle size, concentration, room temperature and humidity and to maintain the optimum, therapeutic environment for each client."

The website then helpfully goes on to tell us about all the other conditions that halotherapy can be used for: asthma, COPD, acne, ADHD, and various other ailments. It's packed with testimonials using words like 'miracle' and recommendations, but sadly lacking in anything like useful clinical information. We are told that:

The clinical state of 85% of the patients with mild and moderate bronchial asthma, 75 % with severe bronchial asthma, 98%- with chronic bronchitis, bronchiectasis and cystic fibrosis improved after Salt Therapy. The patients were examined 6 and 12 months after the first Salt Therapy course.

But of course there is no reference cited to have a good look at where they've gotten their figures from.

So let's think about this. I'm not that hot anymore on inhalation formulations (university was a long, long time ago folks), but i do remember than inhalation therapy was quite a complex area. Could sitting in a room with some salt on the walls really have all these health benefits? I can see the point of a steam room type situation (especially as I sit here typing with a cold, thinking how lovely a steam room would be), but a dry room?

I'm going to have a bit of a look into it, and get back to you. (That's how we medicines information pharmacists roll). In the meantime... Those Ikea chairs... I just can't take it seriously. I could always be wrong, of course.