Study: Nasal saline may prove effective in treating chronic nosebleeds
SALT LAKE CITY – Squirting a simple saline solution into the nose twice a day could alleviate chronic nosebleeds just as effectively as spraying with any one of three different medications, according to a study published online in the Journal of the American Medical Association on Sept. 6.
"This research highlights that there could be a benefit even in the simplest of interventions," stated corresponding author Kevin Whitehead, associate professor of internal medicine at the University of Utah School of Medicine and director of the Utah HHT Clinical Center. "No drug proved to be any better than the saline placebo, but the majority of patients improved over the course of treatment – even those using saline."
While nosebleeds are an occasional nuisance for most consumers, they are an unpleasant fact of life for those with hemorrhagic telangiectasia. One bloody nose per week is not uncommon, and some with the condition have more than two a day. Doctors have tried prescribing drugs off-label to treat what can be a debilitating problem, but with mixed results. The NOSE (North American Study of Epistaxis in HHT) phase 2 clinical trial was designed to determine how three of these medications – bevacizumab, estriol and tranexamic acid – stacked up against one another.
As many as 121 study participants were randomly assigned one of the drugs, or a saline placebo, to spray into their nose twice a day during a 12-week treatment period. Each day they logged how many bloody noses they had, how long they lasted and checked the boxes next to descriptions that matched their symptoms, such as whether their nosebleeds were "typically gushing or pouring." Both at the beginning and end of the treatment period, participants received a composite score between 0-10 based on their answers (10 being the most severe), a routine method for assessing severity.
The majority of participants' severity scores dropped, and by nearly identical amounts, from between 5-6 to between 3-4. A significant improvement, Whitehead said. Participants reported a positive change regardless of which drug they used, or whether they misted their nose with placebo.
"The results suggest that medicines that people all over the world have used appear to have no benefit over plain saline," stated study collaborator James Gossage, director of the Pulmonary Vascular Disease Program at Augusta University.
The idea that simple hydration from any nasal spray, even saline, could prevent nosebleeds certainly makes sense, Whitehead said. People are at higher risk for nosebleeds when their nose dries out, for instance when they're in an arid climate for extended periods of time.
Yet the investigators cannot completely rule out the possibility that symptoms may have improved because of a placebo effect: that participants reported better outcomes because they expected to see an improvement. What's more, it could be that some of the drugs would work better if taken at a higher dose, or if applied as a gel or polymer that adheres better to the inside of the nasal cavity.
Nevertheless, the results from this clinical trial were enough to convince Whitehead, Gossage and their colleagues, to routinely recommend saline nasal spray to their patients with HHT. "We stress the importance of hydration," Whitehead said. "We tell them that something as simple as a morning and night saline spray could offer them some benefit."
Nosebleeds caused by HHT are not fundamentally different from common nosebleeds, but scientists have yet to test whether saline could work just as well for anyone.
"There are no data for extrapolating these results to patients with nosebleeds who don't have HHT," Gossage said. "But certainly it's an easy thing to try."
Nature’s Truth breathes passion into aromatherapy sector through YouTube
RONKONKOMA, N.Y. – Nature's Truth announced Tuesday they will be airing original YouTube videos featuring Nature’s Truth associates. “We want customers to meet the people behind the face of Nature’s Truth, and get to know us – learning firsthand from us the different ways that we use our products daily,” stated Kimberly Vigliante, SVP sales and marketing. “Creating a Nature’s Truth YouTube channel featuring some of our favorite DIY’s helps us connect on a more personal level with consumers to create a close community.”
Nature’s Truth associates who live and breathe aromatherapy, will take viewers on a health and wellness journey to incorporate essential oils into their daily lives. With an increasing number of consumers utilizing social media to gain insight on aromatherapy, Nature’s Truth is engaging their consumers by creating an online community through videos, with relatable content and produced in-house by their very own associates.
“'DIY with Lindsay' is our first series that we are airing, which launched in August, and we have already received extensive requests for more DIY projects and tips from customers,” Vigliante said.
DEA places kratom plant onto schedule I
WASHINGTON – The Drug Enforcement Administration last week announced its intention to place the active materials in the kratom plant into Schedule I of the Controlled Substances Act in order to avoid an imminent hazard to public safety.
“Kratom has been a public health target for almost five years, and its surging growth in use and availability is an unfortunate but real example of the federal government’s unwillingness to use existing authorities to enforce the law," stated Dan Fabricant, Natural Products Association CEO and executive director. "This is a necessary and welcome step, but unless it is followed with real enforcement and penalties for those who are selling it in coffee bars, on the internet and elsewhere, it will be toothless," he said. “Kratom is not an herbal supplement: it is addictive, harmful, and worse, it may be contributing to America’s opiate epidemic. We are eager to work with the authorities and our members to help turn the tide against Kratom and ensure that it is seen as what the DEA says it is, a schedule I illegal narcotic that has no place in health or wellness."
Mitragynine and 7-hydroxymitragynine are found in kratom, which is a tropical tree indigenous to Thailand, Malaysia, Myanmar, and other areas of Southeast Asia. Kratom has been on DEA’s list of drugs and chemicals of concern for several years.
Kratom is abused for its ability to produce opioid-like effects and is often marketed as a legal alternative to controlled substances. In addition, kratom has a high potential for abuse, has no currently accepted medical use in treatment in the United States, and has a lack of accepted safety for use under medical supervision. These three factors constitute a Schedule I controlled substance according to the Controlled Substances Act passed by Congress in 1970.
The FDA has also warned the public not to use any products labeled as containing kratom due to concerns about toxicity and potential health impacts. In addition, FDA has issued and updated two import alerts related to kratom products.