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Nasal Mucosa in COVID-19 - Strategies for reducing infection and hospitalization

coronavirus nasal spray nasal irrigation nasal immunity

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#31 smithx

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Posted 30 September 2021 - 10:10 PM

We do, however, have evidence that nasal irrigation works to reduce the chance of hospitalization by 19x!!

 

Rapid initiation of nasal saline irrigation: hospitalizations in COVID-19 patients randomized to alkalinization or povidone-iodine compared to a national dataset

https://www.medrxiv....8.16.21262044v1

Quote

Conclusion Patients who initiated isotonic saline nasal irrigation after a positive COVID-19 PCR test were 19 times less likely to be hospitalized than the national rate.

 


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#32 geo12the

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Posted 01 October 2021 - 03:14 AM

I am a big advocate of saline nasal rinsing. I use a netty pot every night. I've had terrible sinus allergies my entire life and a netty is like a miracle cure and had allowed me to not have to ever take antihistamines which have been shown to be bad for brain aging. I wonder if anyone has looked at the correlation of nasal rinsing and anosmia (loss of sense of smell) in COVID patients?   


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#33 joelcairo

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Posted 01 October 2021 - 03:24 AM

That saline study claims the background rate of hospitalization due to COVID-19 is 19%. Doesn't that seem too high? Like WAY too high?

 

I don't have a source for the correct numbers, but by eyeballing the cumulative data I think the rate should be more like 7%, even less than that if asymptomatic or less-severe cases are being detected and put into the test group.

 

Also the study was small enough that only one test subject was actually admitted to hospital, so there's an awful lot of uncertainty built into that 19X figure.

 

[Added] I can't even see how they calculated a 19 times difference. To me, dividing one rate by the other rate produces a 15 times difference, not 19 times.


Edited by joelcairo, 01 October 2021 - 04:12 AM.

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#34 lancebr

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Posted 01 October 2021 - 07:34 AM

So based upon this study from 2019....am I to understand that inhaling H2O2 could possibly cause pneumonia?

 

https://www.nature.c...467-019-11169-x

 

"In a study published in the journal Nature Communications, a team of researchers at Umea University and Stockholm

University, Sweden, found that bacteria use hydrogen peroxide to attack and weaken the immune system, causing pneumonia"

 

https://www.news-med...une-system.aspx

 

 


Edited by lancebr, 01 October 2021 - 07:44 AM.

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#35 pamojja

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Posted 01 October 2021 - 10:18 AM

Instead of getting missleaded by a murine study modulating immunity with doses unknown to be reached in human tissue (also excercise can be found to do the same) due to dilution down to 0.04-3%, why you don't first review the list of hundreds of scientific references spanning 51! pages of Dr. Levy's latest free ebook 'Rapid Virus Recovery'? Download link down the end of this article: http://www.orthomole...ns/v17n13.shtml

 

Or also the not that extensive scientific references of Dr. Brownsteins paper: https://thepowerofoz...stein-Covid.pdf


Edited by pamojja, 01 October 2021 - 10:21 AM.

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#36 pamojja

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Posted 01 October 2021 - 11:31 AM

Most important with hydrogen peroxide nubulization beside the dilution of food-grade down to 3% - to much less than that with irritation, and alledgedly still effective at 0.04% as Brownstein is using along a drop of Lugols solution - is that it has to be deluted with isotonic saline, wich is 9% added salt to destilled water/diluted solution.

 

Otherwise with destilled water only nebulized, that alone can cause severe adverse events.


Edited by pamojja, 01 October 2021 - 11:33 AM.

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#37 Meggo

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Posted 01 October 2021 - 02:24 PM

Does anyone know how to dissolve iota carrageenan?



#38 zorba990

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Posted 01 October 2021 - 04:05 PM

White blood cells might use Hydrogen Peroxide as healing signal.
https://www.discover...cells-to-wounds

You may want to consider using glutathione afterwards if you are going to oxidize tissue with hydrogen peroxide:
https://www.ncbi.nlm...les/PMC3048347/
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#39 pamojja

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Posted 01 October 2021 - 06:23 PM

Or ascorbic acid, as Dr. Levy stresses.



#40 smithx

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Posted 02 October 2021 - 03:07 AM

That saline study claims the background rate of hospitalization due to COVID-19 is 19%. Doesn't that seem too high? Like WAY too high?

 

No, it's correct according to:

https://www.cdc.gov/...wr/mm7034e1.htm

 

 

... The ratio of hospitalizations to cases was moderately lower among fully vaccinated (13.1 hospitalizations per 100 cases) compared with unvaccinated (19.0 hospitalizations per 100 cases) groups.

 



#41 joelcairo

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Posted 02 October 2021 - 08:23 AM

Thank you for looking that up. I found that passage and don't quite understand it. How is it possible that 13% of all cases among fully vaccinated patients end up admitted to hospital? That's almost 1 in 7 cases. COVID-19 is serious, but not that serious.

 

The answer MAY be that this data comes from the HERDS database. From the publication, "HERDS includes a statewide, daily electronic survey of all inpatient facilities in New York." If this means that only tests done in a hospital setting are counted, that might explain why the identified cases tend to be so severe.

 

 


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#42 smithx

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Posted 03 October 2021 - 12:50 AM

The answer MAY be that this data comes from the HERDS database. From the publication, "HERDS includes a statewide, daily electronic survey of all inpatient facilities in New York." If this means that only tests done in a hospital setting are counted, that might explain why the identified cases tend to be so severe.

 

You're misreading it. They had data from much larger databases and then could tell if people were hospitalized because then they get entered into HERDS.

  • They get data from the Electronic Clinical Laboratory Reporting System indicating who tested positive.
  • Then they look to see what % of those people show up in HERDs to calculate the percent hospitalized.
  • Then they check to see if the hospitalized people were vaccinated using the immunization registries.

 

Four databases (the Citywide Immunization Registry, New York State Immunization Information System, Electronic Clinical Laboratory Reporting System, and Health Electronic Response Data System [HERDS]) were linked to construct a surveillance-based cohort of adults aged ≥18 years residing in New York by using individual name-based identifiers, date of birth, and zip code of residence. The Citywide Immunization Registry and the New York State Immunization Information System are used to collect and store all COVID-19 provider vaccination data for persons residing in New York City and the rest of the state, respectively (excluding selected settings such as Veterans Affairs and military health care facilities); persons were considered fully vaccinated ≥14 days after receipt of the final vaccine dose. The Electronic Clinical Laboratory Reporting System collects all reportable COVID-19 test results (nucleic acid amplification test [NAAT] or antigen) in New York (4); a new COVID-19 case was defined as the receipt of a new positive SARS-CoV-2 NAAT or antigen test result, but not within 90 days of a previous positive result. HERDS includes a statewide, daily electronic survey of all inpatient facilities in New York; new admissions with a laboratory-confirmed COVID-19 diagnosis are entered into HERDS daily by trained hospital staff members.

 



#43 joelcairo

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Posted 03 October 2021 - 04:41 AM

I don't intend to get any more down into the weeds of how the study was conducted. Suffice it to say that since this small study didn't have a control group, I'm skeptical that we can rely on the assumptions about how patients would have fared without treatment. They can only be justified if we know that all the characteristics of the patients participating in this study match the overall population of people who came down with COVID-19.


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#44 smithx

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Posted 03 October 2021 - 05:55 AM

I don't intend to get any more down into the weeds of how the study was conducted. Suffice it to say that since this small study didn't have a control group,

 

Hmm... the weeds? You called into question the 19% hospitalization figure and suggested it only referred to people already in a hospital, which doesn't really make sense on the face of it, and now that that objection has been addressed you are moving on to other ways of undermining this study. It feels as if you have an agenda, but not sure why that would be.

 

Note that the researchers do address the issue of a control group in the paper. It is helpful to read things carefully before posting about them, by the way:

 

The primary concern without a matched control group is the generalizability of our sample. The CDC
database did not differ significantly by sex or age, but too many patients were missing race/ethnicity to
meaningfully evaluate. The greatest risk of bias comes from preferentially reporting cases with
hospitalization or death. Data suggests cases and hospitalizations are underreported rather than
over,(16) however, and the CDC admission rate of 9.14% is lower than rates in other prospective studies
with older populations. In a study of monoclonal antibodies delivered to outpatients testing positive,
Chen et al found a 15% admission rate in patients 65+ or with BMI > 35.(42) Our sample came from a
socioeconomically challenged catchment area, with average age 64 and BMI >30. In a similar health
system to ours, Price-Haywood et al found a 39.7% admission rate; a Cochran database of minority
patients’ admission rates in similar time periods and demographic location to our enrollment period
consistently found admission rates as high as 60%.(15, 43)

 

 

My point in starting this thread is to share some simple interventions each of us can do at home without risk of overdose or side effects, that have some, I think, compelling evidence supporting significant improvement in outcomes.
 

There may be some people who will only accept large-scale randomized placebo-controlled clinical trials (unlikely to happen at all for something that can't be monopolized and monetized, like saline irrigation, supplements, etc.), and such individuals are of course free to ignore this information.

 

If anyone wants to take advantage of this information and perhaps try nasal irrigation if they are diagnosed with COVID-19, or perhaps obtain some iota-carrageenan nasal spray and use it as a prophylactic when going into less safe situations, then they can do so.

 

I do urge everyone to carefully read the papers and use their own judgement.


Edited by smithx, 03 October 2021 - 05:57 AM.

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#45 joelcairo

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Posted 03 October 2021 - 08:28 AM

The only agenda is I don't believe their conclusion that saline sinus treatment reduces serious cases by 95%. I'm not arguing there is no benefit but come on, that's not plausible. And the study is way too small and uncontrolled to make that claim.

 

... I just noticed the publisher has posted a corrected but not yet peer-reviewed version of this study, where the improvement has been reduced from 19 times to 8 times oops.

 


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#46 smithx

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Posted 03 October 2021 - 05:40 PM

I just noticed the publisher has posted a corrected but not yet peer-reviewed version of this study, where the improvement has been reduced from 19 times to 8 times oops.

 

Good catch.

 

An 8X reduction in hospitalization is still the very best intervention I've seen in the literature.

 

If I tested positive, I'd be doing nasal irrigation at least twice a day because its easy to do, there's evidence that it could be incredibly helpful, and it's extremely unlikely to have negative side effects. 


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#47 joelcairo

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Posted 03 October 2021 - 07:13 PM

Again I'm not a denier, saying the therapy doesn't work. It's very imaginable to me that it has the potential to cut hospitalizations in half let's say, and an expensive drug that does this caused a sensation in the media just the other day. I still find an 7/8 reduction to be hard to believe, given that the patients have already tested positive and have had COVID-19 in their system for days, but if I'm proven wrong by follow-up studies then so be it. Obviously I hope to be wrong.


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#48 Lady4T

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Posted 04 October 2021 - 03:13 AM

Here is the product - Closys oral rinse

 

 

I would gargle for 30 seconds after getting the saliva mixed.

 

Thanks for that info, Gal220. I researched it and bought a bottle of Closys UN-flavored. The main attraction is that, as opposed to diluted H2O2 or saline (both of which I have used), is not irritating, so it's comfortable to use as a nasal rinse or spray..


Edited by Lady4T, 04 October 2021 - 03:16 AM.


#49 Lady4T

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Posted 04 October 2021 - 04:19 AM

My point in starting this thread is to share some simple interventions each of us can do at home without risk of overdose or side effects, that have some, I think, compelling evidence supporting significant improvement in outcomes.

 

In that spirit, let me share my humble tips that involve virgin coconut oil, saline and newly added Closys mouthwash. Why these?

 

Coconut oil is a known antiviral, mainly due to its high content of Lauric Acid and Monolaurin. It dissolves a virus lipid envelope, and may prevent attachment.

 

Saline is a well-known traditional antiseptic.

 

Closys mouthwash contains stabilized chlorine dioxide (ClO2), a very effective antiseptic.

 

So before I go out to run errands and such, I apply some coconut oil to the inside of my nostrils and ears, just to coat the inside. I have put a drop in each orifice, but that gets kind of messy, so I usually just apply with a cotton swab.

 

When I return home I, of course, first wash my hands, then rinse my mouth and gargle with either the mouthwash or the saline. Then I dip a couple of tissues in coconut oil to wipe inside my ears and nostril. Lastly, depending on if I feel that I need to, I use some of the Closys mouthwash as a nasal rinse. Sometimes I even wipe my face and neck with the coconut oil. It just depends on how "exposed" I feel I got on that outing.

 

Easy and quick little preventative measures with cheap, effective and harmless items. Well, harmless to me. Deadly to "germs."  :)


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#50 DanCG

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Posted 06 October 2021 - 12:47 AM

 

Coconut oil is a known antiviral, mainly due to its high content of Lauric Acid and Monolaurin. It dissolves a virus lipid envelope, and may prevent attachment.

 

 

For those who say “needs references” try this about coconut oil. Too bad only the abstract is freely available. The abstract does not mention dissolving viral membranes, but it makes chemical sense. I have seen that allegation elsewhere but I can’t find a reference.


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#51 Gal220

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Posted 08 October 2021 - 02:07 PM

How it starts

 

"The findings suggest the virus tends to become firmly established first in the nasal cavity. Then, in some cases, the virus is aspirated into the lungs where it may cause more serious disease, including potentially fatal pneumonia."

 

From another user on city data

 

"Respiratory viruses initially are located in the nasal cavity and upper throat for several days. Varies on opinions but, at least, 3 days. Then, they slowly lower into trachea."

 

IMO daily gargle and nasal rinse are the most important prevention 


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#52 Hip

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Posted 24 October 2021 - 04:51 PM

While I agree, like hand washing, daily gargle/nasal rinse would kill the virus where the infection starts and cut down on spread tremendously. Thus saving lives

 

Nasal irrigation plus mouthwash gargling with 3% saline performed three times a day has been demonstrated antiviral for cold viruses including coronavirus. It reduces the duration of the common cold by around 2 days, and is also shown to reduce viral transmission of the cold to other household members by 35%. Article here. Salt is converted by the immune cells into a bleach called hypochlorous acid, which has an antiviral action. So this would be a good thing to do if you caught COVID.

 

But as a daily routine that the whole populous does constantly, few people would comply with that. You have to consider the practicalities of trying to get the whole population to remember to gargle and irrigate their nose several times a day for the duration of the pandemic. People will get fed up doing that. It's OK to do that for a few days while you have a cold, but I don't think people are going to perform nasal irrigation and gargling thrice daily for years on end, until the pandemic is over (which it may never be). 

 

So nasal irrigation and gargling is not a practical solution to preventing coronavirus transmission, but it would be a good thing to do if you caught COVID.

 

Whereas with the vaccine, you get your injections, and it requires no further effort from you. You have constant protection all the time, without you needing to do anything, apart from getting boosters every now and then.


Edited by Hip, 24 October 2021 - 04:53 PM.

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#53 DanCG

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Posted 25 October 2021 - 02:49 AM

Nasal irrigation plus mouthwash gargling with 3% saline performed three times a day has been demonstrated antiviral for cold viruses including coronavirus. It reduces the duration of the common cold by around 2 days, and is also shown to reduce viral transmission of the cold to other household members by 35%. ...

But as a daily routine that the whole populous does constantly, few people would comply with that. ...

So nasal irrigation and gargling is not a practical solution to preventing coronavirus transmission, but it would be a good thing to do if you caught COVID.

 

Whereas with the vaccine, you get your injections, and it requires no further effort from you. You have constant protection all the time, without you needing to do anything, apart from getting boosters every now and then.

I agree that a daily routine of nasal irrigation plus mouthwash is a tough sell. But you can’t convince anybody of anything if you don’t try. If public heath officials put as much effort into educating the public about these practices as they do promoting vaccines, at least more people would be aware that there are easy things that they can do to help themselves. Even if people can’t be convinced to do nasal irrigation for prevention, they should at least be made aware that it would be good thing to do if you are infected. Just using mouthwash alone would be of some benefit—that’s not hard to do. The failure of public heath officials to promote these practices erodes public trust. Why should we trust what we are told about vaccines from the people who would not even tell us about vitamin D, mouthwash, or nasal irrigation? I don’t understand why people see these matters as either/or propositions. Why not both/and? It has become clear that the vaccines are not enough. We need to also include other methods of prevention and early treatment.


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#54 Hip

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Posted 25 October 2021 - 03:41 AM

Even if people can’t be convinced to do nasal irrigation for prevention, they should at least be made aware that it would be good thing to do if you are infected.

 

Before recommending it, you would need evidence that nasal irrigation plus gargling with saline was effective for preventing hospitalization and death from COVID. 

 

It's up to research institutions such as universities to get that evidence, by trying to raise money to conduct a large clinical trial, or applying for a research grant. But of course raising money is easier said than done, especially when there is no profit to be made from a salt water gargle. Who is going to invest in that, if there is no return on investment? You might convince science funding bodies to invest, but it is extremely hard to get any research grants for any science research. If you actually speak to scientific researchers, they will tell you that money is always tight, and getting grants can be very difficult.

 

Once the evidence is there, then government health officials can recommend it. But it is not the job of government to do the research; research is the responsibility of universities or private for-profit research institutions like drug companies. Drug companies have very smart people who take calculated risks on what drugs to invest money into, and when their calculations pay off, there are billions to be made. But there are also many drugs which fail to reach the market, so then the investment does not pay off, and the drug companies lose out. 

 

There are other nasal sprays as well, such as the nitric oxide nasal spray that in a small-scale trial showed beneficial for COVID. I posted about that on this forum. Again, a larger better controlled trial would be required before it can be recommended by government officials. So that would require the company that makes this nitric oxide nasal spray to invest heavily in a large clinical trial. And if it the trial shows poor results, then the company may go bankrupt. 

 

These are the realities of life. 


Edited by Hip, 25 October 2021 - 03:42 AM.

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#55 Gal220

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Posted 25 October 2021 - 06:46 AM

I agree that a daily routine of nasal irrigation plus mouthwash is a tough sell

Qtips pretty quick and easy - 50:10 in this video

https://vimeo.com/591952240


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#56 Hip

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Posted 25 October 2021 - 02:29 PM

As an aside: at the beginning of the pandemic, I was experimenting with povidone-iodine nasal sprays and mouthwashes. I did this on theoretical grounds, given that povidone-iodine is a potent antiseptic for viruses, and a study found that 0.25% povidone-iodine can kill SARS-CoV-1 in 15 seconds.  

 

But later a randomised placebo-controlled study on 606 COVID patients in Bangladesh found 1% povidone-iodine nasal spray, throat gargle and eye drops, when administered by the patient every 4 hours, reduced the COVID death rate by 8.5 times.

 

In the 303 COVID patients in the study who administered 1% povidone-iodine every 4 hours as a nasal spray, gargle (mouthwash) and eye drops, and doing this for four weeks, there were only 2 deaths.

 
But in the 303 COVID patient placebo group applying just water, the study recorded 17 deaths.
 
So that is an 8.5-fold reduction in death from povidone-iodine. Which is not far behind a vaccine, which reduces death by about 20-fold.
 
If you are both vaccinated and use povidone-iodine, you may reduce your chances of death by 20 x 8.5 = 170 times!
 
So for someone who is in their 80s, for example, an age group which when unvaccinated has around a 29% chance of death once they develop symptoms and become a COVID case (ref here), vaccination would reduce their chances of death to about 1.5%, and vaccination combined with povidone-iodine would further reduce the risk of death down to around 0.2% (or 1 in 500).
 
 
 
This is another third world study, so given the reliability issues of studies from developing countries, we should take this result with a pinch of salt. But at least for povidone-iodine, there are good theoretical reasons to believe it might work, given that we know it can kill coronavirus in 15 seconds on surfaces. 
 
Unfortunately in my experiments with a 0.25% povidone-iodine nasal sprays and mouthwashes, I found povidone-iodine was fine sometimes, but on other occasions caused pain and stinging in the nose. It was always fine by oral mouthwash, but spraying into the nose would often cause pain.
 
I don't know if my nose is more sensitive than other people's, but I found nasal pain to limit the usefulness of povidone-iodine. If there were a way to prevent this nasal pain, I would probably apply povidone-iodine regularly, as a COVID prophylactic (preventative) when I am in high risk environments. 
 
 

Edited by Hip, 25 October 2021 - 02:34 PM.

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#57 Hip

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Posted 25 October 2021 - 02:35 PM

If you want to make your own povidone-iodine nasal spray and gargle, this article contains important info: it says the povidone-iodine for sale in the US is not intended for gargling:
 

In the United States, povidone-iodine solutions are sold as skin disinfectants, which contain ingredients that can cause serious harm if ingested; preparations that are suitable for gargling are not generally available in this country. It’s critical that people not gargle with skin disinfectant solutions, including those that contain povidone-iodine. In Canada, a povidone-iodine gargle solution is sold under the brand name Betadine.

 
So you would want to got hold of some povidone-iodine that is intended for gargling.


Edited by Hip, 25 October 2021 - 02:35 PM.

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