Salt Cave Convert | Calming MCAS with Halotherapy

The day of my appointment, I wasn’t feeling well. Looming headache… already hovering around a 4 out of 10 on the pain scale (for reference, in my mind, 10 is unconscious from pain) I really wasn’t expecting much. I mean why would breathing in finely ground dry salt be any different from drinking salt water (which I was already doing to support low cortisol… and avoid MCAS flares).

20 minutes into the 30-minute halotherapy session at Nurtured Wellness, I noticed the headache was gone. Not slightly better. Gone. So was the raw histamine-y feeling I’d had since breakfast.

This experience was enough to convert me into a halotherapy disciple. Still, I had to know why breathing salt was different from drinking it.

Cortisol, MCAS, and Salt

If you’re struggling with MCAS (mast cell activation syndrome) and don’t already know about the link between super sensitive mast cells (ready to fire at hairpin triggers) and cortisol (or just need a quick refresher), you’ll find those juicy details in this article (hang tight for the link it's publishing soon), which is also a must read for the analytical minded who geek out on the science.

If you’re here for the Cliff notes version, well you’ve found it right here. Just keep reading.

Halotherapy: An outside in approach to better lung function and cortisol regulation

The adrenals are complex glands! They don’t just produce cortisol and adrenaline, the adrenals (one atop each kidney) also produce hormones that regulate blood pressure, salt and potassium (mineral) balance, and even produce estrogen (and DHEA/testosterone).

And, because the body is a whole(not a hodgepodge of individual organs and systems like it’s treated by Western medicine), the lungs play a huge role in regulating adrenal hormones.

In fact, blood pressure regulation involves multiple organs, the kidneys, liver, adrenals, and lungs, and this has a spillover effect into other hormones the adrenals secrete. The highest concentration of ACE, the enzyme responsible for creating angiotensin II, the hormone that prompts the pituitary to release ACTH which tells the adrenals to secrete cortisol and aldosterone (among other hormones), is in the lungs.

Specifically, ACE (angiotensin converting enzyme) is on the outside of the alveoli (air sacs) of the lungs.

How halotherapy (& salt) boosts lung function

A thin fluid layer is maintained at the surface of each air sac to aid air exchange, and there are three primary mechanisms that regulate that fluid layer.

Each one of these mechanisms (both the one passive and the two active mechanisms) transports salt across the membranes of the alveoli.

The two active mechanisms rely on the energy molecule, ATP, and in people struggling with metabolic dysfunction (MCAS, diabetes, hypothyroidism, chronic fatigue, etc.), ATP production is low compared to healthy individuals. That means even if sodium is available inside the body (from the diet), it may not be transported across the membrane of the air sacs sufficiently in energy deficient (metabolically challenged) bodies, which further impairs gas exchange (adding to the energy deficit).

How halotherapy (& salt) boosts cortisol

Expression of the ACE enzyme increases in high salt diets, especially relative to another enzyme, ACE2. When ACE increases relative to ACE2, the production of ACTH (the hormone produced by the pituitary that activates the adrenals) goes up. ACTH prompts the adrenals to release cortisol and aldosterone (among other hormones).

When aldosterone (a hormone produced by the adrenals and necessary for maintaining proper salt balance in the body) increases, it boosts retention of sodium and blood pressure in the body (great if you have low sodium or low blood pressure). As a side note, many of my clients often crave salt (a hallmark sign of low cortisol).

Interestingly, ACE2 disrupts the cascade described above, and both ACE and ACE2 are expressed on the air sacs in the lungs. Inhaled salt has been shown to block the ACE2 receptors in the lungs, and this may be another benefit of halotherapy over salt from the diet.

Halotherapy: An outside-in approach to low cortisol and calming mast cells

We just discussed two ways that targeted delivery of salt directly to the lungs via inhalation may achieve more efficient results than salt through the diet. We haven’t discussed the effect of dietary salt on other organs of the body, and while I may save these details for a future post, what’s really interesting is that halotherapy seems to offer a way to target delivery to an organ that is very sensitive to salt.

I’ve already said the body is a whole, and I’m not going to pretend that even with targeted delivery of salt to the lungs that the rest of the body isn’t affected, still let's honor nuance here.

The natural course of dietary salt

Electrolytes like salt (sodium chloride) get absorbed throughout the small and large intestines. These ions bypass first pass metabolism (because they’re actually dissolved in water and aren’t particles like carbs, fat, or protein that require distribution through chyme (part of the lymph) to carry through first-pass metabolism).

Once absorbed through the lining of the small and large intestines, salt enters the circulatory system pretty rapidly, and once it does, it’s tightly regulated. I previously mentioned a couple of active transport mechanisms for salt through the air sacs of the lungs. One of these active transport mechanisms maintains sodium (from salt) and potassium levels in every cell of the body and relies on ATP, an energy molecule to make this happen.

Interestingly, this transfer system is often off kilter in people with thyroid problems. Both low (hypo) and high (hyper) thyroid states drive the sodium/potassium ATP transport system off rhythm.

Here you might be thinking "Brandy you said this already." This piece is the crux of the whole thing.

See, in a body that's stressed and doesn't spend enough time in rest-digest-repair, energy becomes scarce. The body uses up more and more energy because it's in crisis/high alert mode. Hormone loops begin to go haywire, and this begins creating a vicious feedback loop where the body becomes more and more starved of energy.

I've spent a lot of time in other articles and one of my YouTube channels discussing how the body creates energy, talking about the hormones most linked to metabolism (Thyroid. Insulin. Cortisol.) And, how in states of chronic stress, cells are starved of these hormones at the cellular level (meaning blood work may look great but these hormones can't get into cells... specifically thyroid and insulin because of dysregulated cortisol).

Pulling back into the particular symptom at hand... many people with MCAS also struggle with a hypothyroid state at the cellular level.

Which brings us back to why the mode of entry into the body is important when we're talking about salt.

Halotherapy: A powerful tool in an energy depleted body

SalSalt is necessary for life. It’s one of the essential minerals a body needs for energy production and enzymatic processes and water regulation and even to bring life giving oxygen to cells and remove carbon dioxide waste from the body.

Why is breathing salt different from drinking it? In a body that’s already dysregulated and already struggling with energy production (usually hallmarked by low or dysregulated cortisol rhythms), breathing salt is a way to bypass the need for energy and help break the feedback loop of energy crisis and help the body make more cortisol (also vital to life despite popular opinion).

If you’re looking for halotherapy in the Encinitas area, here’s how to book Dr. Kristy’s Nurture Wellness Halotherapy room.

Looking for one-on-one support for MCAS? Book your appointment with me here.

P.S. It's not lost on me that coastal San Diego is ocean adjacent. And, yes, if you are ocean adjacent simply walking the beach daily would be free halotherapy. How's that translate into a halotherapy room? Spend time at both and see for yourself😊

Before you head out, what are your thoughts on this post and what questions popped up as you were reading? (Looking for references? Scroll on down.)

References

Huijghebaert S, Hoste L, Vanham G. Essentials in saline pharmacology for nasal or respiratory hygiene in times of COVID-19. Eur J Clin Pharmacol. 2021 Sep;77(9):1275-1293. doi: 10.1007/s00228-021-03102-3. Epub 2021 Mar 27. Erratum in: Eur J Clin Pharmacol. 2021 Sep;77(9):1295. doi: 10.1007/s00228-021-03141-w. PMID: 33772626; PMCID: PMC7998085. If you only look at one reference, this might be the one to check out

Xu, W., Cao, Z., Wang, L. et al. Halotherapy improves the prognosis of acute respiratory distress syndrome and alleviated pyroptosis related biomarkers. Discov Med 2, 151 (2025). https://doi.org/10.1007/s44337-025-00336-3

Stimulation of growth hormone and corticotropin release by angiotensin II in man. Degli Uberti, E.C. et al. Metabolism - Clinical and Experimental, Volume 39, Issue 10, 1063 - 1067

Xiaoli Zhang, Liping Liu, Mohamed M.S. Gaballa, Ahmed A. Hasan, Yingquan Xiong, Li Xie, Thomas Klein, Denis Delic, Burkhard Kleuser, Bernhard K. Krämer, Jian Li, Berthold Hocher; Impact of Salt Intake and Renin-Angiotensin-Aldosterone System Blockade on Lung Severe Acute Respiratory Syndrome Coronavirus 2 Host Factors. Kidney Blood Press Res 12 October 2022; 47 (9): 565–575. https://doi.org/10.1159/000525368 (ACE2 only need source for ACE + ACE2 increase in high-salt)

Aldosterone Deficiency and Resistance. Keiko Arai, MD, Nektaria Papadopoulou-Marketou, MD, PhD, and George P. Chrousos, MD. https://www.ncbi.nlm.nih.gov/books/NBK279079/#:~:text=Aldosterone%20is%20crucial%20for%20regulating,%2C%20WWW.ENDOTEXT.ORG.

Zhang C, Zhu W, Meng Q, Lian N, Wu J, Liu B, Wang H, Wang X, Gu S, Wen J, Shen X, Li Y, Qi X. Halotherapy relieves chronic obstructive pulmonary disease by alleviating NLRP3 inflammasome-mediated pyroptosis. Ann Transl Med. 2022 Dec;10(23):1279. doi: 10.21037/atm-22-5632. PMID: 36618788; PMCID: PMC9816841.

Gould NS, Gauthier S, Kariya CT, Min E, Huang J, Brian DJ. Hypertonic saline increases lung epithelial lining fluid glutathione and thiocyanate: two protective CFTR-dependent thiols against oxidative injury. Respir Res. 2010 Aug 27;11(1):119. doi: 10.1186/1465-9921-11-119. PMID: 20799947; PMCID: PMC2936384.

Gábor B. Makara, Ferenc A. Antoni, Ervin Stark, Mihály Kárteszi,Chapter 2 - Hypothalamic organization of corticotropin releasing factor (CRF) producing structures,Editor(s): Eugenio E. Müller, Robert M. MacLeod,

Neuroendocrine Perspectives,Elsevier,1984,Pages 71-119,ISBN 9780444903778, https://doi.org/10.1016/B978-0-444-90377-8.50006-5.(https://www.sciencedirect.com/science/article/pii/B9780444903778500065) Ann Allergy. 1978 Jan;40(1):51-7.

Serum angiotensin converting enzyme level in bronchial asthma. S Mue, M Takahashi, T Ohmi, S Shibahara, K Yamauchi, S Fujimoto, H Okayama, T Takishima

Vatsala Khurana, Binita Goswami,Angiotensin converting enzyme (ACE),Clinica Chimica Acta,Volume 524,2022,Pages 113-122,ISSN 0009-8981,https://doi.org/10.1016/j.cca.2021.10.029.(https://www.sciencedirect.com/science/article/pii/S0009898121003739)

Roisman GL, Danel CJ, Lacronique JG, Alhenc-Gelas F, Dusser DJ. Decreased expression of angiotensin-converting enzyme in the airway epithelium of asthmatic subjects is associated with eosinophil inflammation. J Allergy Clin Immunol. 1999 Aug;104(2 Pt 1):402-10. doi: 10.1016/s0091-6749(99)70385-4. PMID: 10452763.