By Grant Jacobs 08/12/2018

A few years ago I posted this startling picture. I’ll admit using neti pots looked pretty potty to me then. It still does. I thought it looked like the sort of thing someone would do for a party trick. Y’know: eww, look at the water come out my other nostril. A quick look around the internet revealed it has it’s practitioners.

It looks innocent enough, but spare a thought for a Seattle woman who died of a fatal amoebic brain infection after using a neti pot. Hannah Rodriguez’s article is an excellent piece of medical science reporting and well worth reading. (Go the Seattle Times — it’s great to see an editor taking on this sort of material.)

It might be OK for occasional use

I noted in my earlier piece that, perhaps surprisingly, there is evidence that used occasionally it can have some benefits. A randomised controlled trial and a Cochrane review support it as having some value.

There’s also some evidence that regular users more frequently get rhinosinusitis, although this is contested. It was suggested that was because (excessive) washing removes the mucus that protects against infections.

See this 2009 Science-based medicine for a summary.

That’s not to say it’s free of risk.

Brain infections

Although very rare brain infections can be caused by bacteria invading into your brain from your nose.

By using tap water, or water from that lovely stream, you’re swinging your odds the wrong way. You can force the infected water into your upper nasal passages. There it might lead to an infection. If you’re very unlucky that infection could lead to a brain infection.

Low odds, maybe, but I wouldn’t want to go there.

A slightly more subtle aspect is that viral infections can knock the immune system back, potentially leaving you more vulnerable to secondary bacterial infections. I can imagine some use neti pots to clear a congested nose from a viral infection.

As the Seattle Times article notes, these infections are more common in the southern parts of North America, suggesting the warmer climate plays a role. It’s possible that the bacteria survives better in warmer conditions. It’s also possible that we might see more of infections like this (and not just from neti pots) as climate change progresses.

You can’t rule out other causes of the Seattle woman’s death—single cases are like that. But it’s a reasonable explanation.

My thoughts: if you must use a neti pot, use sterile water (or saline solution). Any non-sterile water ought to be throughly boiled first.

Other articles on Code for life

Neti pots now validated as sound science?

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Monkey business, or is my uncle also my Dad?

Genome-edited babies – what’s the worry? (#1)

A foil to the populist scourge: towards a Science Commission for New Zealand?


Hat-tip to Dr. Yasmin who tweeted about this. The author is also on Twitter, @hrodriguez15.

About the featured image

Originally used in my earlier post about neti pots, it’s sourced from the Science-based Medicine blog.