Comment by arkades | Hacker News Reader

Comment by arkades | Hacker News Reader

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It’s not a mental model that CF is something in the lungs; it’s a treatment aimed at the pulmonary manifestations of the disease. No one is positing that saline inhalations are going to preserve pancreatic function, but that’s not because they forgot about the pancreas.

People with CF get a high salt diet because the same transporter defect causes an inability to reclaim sodium from sweat. This results in an inability to regulate water content, causing a hypovolemia. It’s not a “treatment modality” in that it directly treats the CF. It mitigates one consequence of CF: losing excess salt in sweat. That has nothing to do with dietary salt intake affecting the course of the disease generally.

And I don’t know where you got the information that surfers are absorbing salt through their skin. As far as I know (https://www.sciencedirect.com/science/article/pii/0167273892..., https://ac.els-cdn.com/S0022202X15470599/1-s2.0-S0022202X154..., http://www.comprehensivephysiology.com/WileyCDA/CompPhysArti...) that’s not a thing, but if you have any sources to the contrary I’d be interested in reading them.

What can be absorbed through the skin depends on various factors: https://en.m.wikipedia.org/wiki/Absorption_(skin)

People with CF are prone to aquagenic wrinkling. In layman's terms, they get extremely pruney when they bath. This suggests they absorb the water at a higher rate than is normal due to their genetic disorder impacting epidermal function.

https://jamanetwork.com/journals/jamadermatology/fullarticle...

No one is positing that saline inhalations are going to preserve pancreatic function, but that’s not because they forgot about the pancreas.

What I recall reading is that when people with CF surfed, their general prognosis was overall better. So if no one is positing that it has any impact on pancreatic function, then it seems to me they are viewing the data in highly selective terms and assuming it only impacts lung function and nothing else when the data does not suggest that.

Granted, I haven't dug deeply into the original data because it wasn't important to me. I was only trying to understand the positive results I was getting for my own edification. My recollection is the study was done in Australia if you want to try to find it.

I will add that it isn't actually necessary to prove people with CF absorb it through the skin. The article we are discussing states that surfers swallow a great deal more sea water than swimmers, 10x iirc. So surfers are, in fact, consuming sea salt.

> What I recall reading is that when people with CF surfed, their general prognosis was overall better.

Why would you think of sea salt as the relevant factor instead of the very well known positive effects on breathing and lung capacity caused by swimming?

Firsthand personal experience. I was consuming sea salt to great benefit and looking for studies that might cast light on the relationship between sea salt and cystic fibrosis.

Exercise also has played a significant role in my improvement. I am not discounting the impact it has. I just am baffled that they found that surfing benefits people with CF and their primary takeaway is that it must be beneficial to breath damp, salty air. There is a lot more going on when you surf than breathing damp, salty air. But that's the piece they turned into a medically prescribed treatment.

Exercise in conditions that involved inhalation of hypertonic saline during a period of increased tidal respiration, in a setting that reduces the amount of sweating typically experienced during exercise.

It’s not baffling.

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