Check my math: how does Enovid compare to to humming?
Nitric Oxide is an antimicrobial and immune booster. Normal nasal nitric oxide is 0.14ppm for women and 0.18ppm for men (sinus levels are 100x higher). journals.sagepub.com/doi/pdf/10.117…
Enovid is a nasal spray that produces NO. I had the damndest time quantifying Enovid, but this trial registration says 0.11ppm NO/hour. They deliver every 8h and I think that dose is amortized, so the true dose is 0.88. But maybe it’s more complicated. I’ve got an email out to the PI but am not hopeful about a response clinicaltrials.gov/study/NCT05109…
so Enovid increases nasal NO levels somewhere between 75% and 600% compared to baseline- not shabby. Except humming increases nasal NO levels by 1500-2000%. atsjournals.org/doi/pdf/10.116….
Enovid stings and humming doesn’t, so it seems like Enovid should have the larger dose. But the spray doesn’t contain NO itself, but compounds that react to form NO. Maybe that’s where the sting comes from? Cystic fibrosis and burn patients are sometimes given stratospheric levels of NO for hours or days; if the burn from Envoid came from the NO itself than those patients would be in agony.
I’m not finding any data on humming and respiratory infections. Google scholar gives me information on CF and COPD, @Elicit brought me a bunch of studies about honey.
With better keywords google scholar to bring me a bunch of descriptions of yogic breathing with no empirical backing.
There are some very circumstantial studies on illness in mouth breathers vs. nasal, but that design has too many confounders for me to take seriously.
Where I’m most likely wrong:
misinterpreted the dosage in the RCT
dosage in RCT is lower than in Enovid
Enovid’s dose per spray is 0.5ml, so pretty close to the new study. But it recommends two sprays per nostril, so real dose is 2x that. Which is still not quite as powerful as a single hum.
I found the gotcha: envoid has two other mechanisms of action. Someone pointed this out to me on my previous nitric oxide post, but it didn’t quite sink in till I did more reading.
I think that’s their guess but they don’t directly check here.
I also suspect that it doesn’t matter very much.
The sinuses have so much NO compared to the nose that this probably doesn’t materially lower sinus concentrations.
the power of humming goes down with each breath but is fully restored in 3 minutes, suggesting that whatever change happens in the sinsues is restored quickly
From my limited understanding of virology and immunology, alternating intensity of NO between sinuses and nose every three minutes is probably better than keeping sinus concentrations high[1]. The first second of NO does the most damage to microbes[2], so alternation isn’t that bad.
I’d love to test this. The device you linked works via the mouth, and we’d need something that works via the nose. From a quick google it does look like it’s the same test, so we’d just need a nasal adaptor.
Other options:
Nnoxx. Consumer skin device, meant for muscle measurements
There are lots of devices for measuring concentration in the air, maybe they could be repurporsed. Just breathing on it might be enough for useful relative metrics, even if they’re low-precision.
I’m also going to try to talk my asthma specialist into letting me use their oral machine to test my nose under multiple circumstances, but it seems unlikely she’ll go for it.
obvious question: so why didn’t evolution do that? Ancestral environment didn’t have nearly this disease (or pollution) load. This doesn’t mean I’m right but it means I’m discounting that specific evolutionary argument.
Check my math: how does Enovid compare to to humming?
Nitric Oxide is an antimicrobial and immune booster. Normal nasal nitric oxide is 0.14ppm for women and 0.18ppm for men (sinus levels are 100x higher). journals.sagepub.com/doi/pdf/10.117…
Enovid is a nasal spray that produces NO. I had the damndest time quantifying Enovid, but this trial registration says 0.11ppm NO/hour. They deliver every 8h and I think that dose is amortized, so the true dose is 0.88. But maybe it’s more complicated. I’ve got an email out to the PI but am not hopeful about a response clinicaltrials.gov/study/NCT05109…
so Enovid increases nasal NO levels somewhere between 75% and 600% compared to baseline- not shabby. Except humming increases nasal NO levels by 1500-2000%. atsjournals.org/doi/pdf/10.116….
Enovid stings and humming doesn’t, so it seems like Enovid should have the larger dose. But the spray doesn’t contain NO itself, but compounds that react to form NO. Maybe that’s where the sting comes from? Cystic fibrosis and burn patients are sometimes given stratospheric levels of NO for hours or days; if the burn from Envoid came from the NO itself than those patients would be in agony.
I’m not finding any data on humming and respiratory infections. Google scholar gives me information on CF and COPD, @Elicit brought me a bunch of studies about honey.
With better keywords google scholar to bring me a bunch of descriptions of yogic breathing with no empirical backing.
There are some very circumstantial studies on illness in mouth breathers vs. nasal, but that design has too many confounders for me to take seriously.
Where I’m most likely wrong:
misinterpreted the dosage in the RCT
dosage in RCT is lower than in Enovid
Enovid’s dose per spray is 0.5ml, so pretty close to the new study. But it recommends two sprays per nostril, so real dose is 2x that. Which is still not quite as powerful as a single hum.
I found the gotcha: envoid has two other mechanisms of action. Someone pointed this out to me on my previous nitric oxide post, but it didn’t quite sink in till I did more reading.
What are the two other mechanisms of action?
citric acid and a polymer
Enovid is also adding NO to the body, whereas humming is pulling it from the sinuses, right? (based on a quick skim of the paper).
I found a consumer FeNO-measuring device for €550. I might be interested in contributing to a replication
I think that’s their guess but they don’t directly check here.
I also suspect that it doesn’t matter very much.
The sinuses have so much NO compared to the nose that this probably doesn’t materially lower sinus concentrations.
the power of humming goes down with each breath but is fully restored in 3 minutes, suggesting that whatever change happens in the sinsues is restored quickly
From my limited understanding of virology and immunology, alternating intensity of NO between sinuses and nose every three minutes is probably better than keeping sinus concentrations high[1]. The first second of NO does the most damage to microbes[2], so alternation isn’t that bad.
I’d love to test this. The device you linked works via the mouth, and we’d need something that works via the nose. From a quick google it does look like it’s the same test, so we’d just need a nasal adaptor.
Other options:
Nnoxx. Consumer skin device, meant for muscle measurements
There are lots of devices for measuring concentration in the air, maybe they could be repurporsed. Just breathing on it might be enough for useful relative metrics, even if they’re low-precision.
I’m also going to try to talk my asthma specialist into letting me use their oral machine to test my nose under multiple circumstances, but it seems unlikely she’ll go for it.
obvious question: so why didn’t evolution do that? Ancestral environment didn’t have nearly this disease (or pollution) load. This doesn’t mean I’m right but it means I’m discounting that specific evolutionary argument.
although NO is also an immune system signal molecule, so the average does matter.