Is bromine causal?

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BarryO
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Is bromine causal?

Postby BarryO » Thu Feb 07, 2019 10:21 pm

Bromine has long been used in hot tubs as an alternative to chlorine. After some reflection and basic "internet research," I'm wondering if there is a connection between bromine and RLS. Here's the context:

I've had RLS for nearly three decades, with frequency and severity worsening rapidly over the past five years to a very severe peak late last year. Through the years, I found temporary relief by taking a hot tub before I went to bed. As it worsened I would take tubs more frequently and for longer durations. But, like the Pramipexole, the benefit of the tub diminished pretty rapidly last year as my symptoms became severe.

Thinking back, when I refilled the floating bromine dispenser, the water would have an acrid smell, and breathing the steam slightly burned my throat and sinuses. After a couple weeks, the smell and burning would go away for the remainder of the 3-4 months it took for the bromine to dissolve. Now I'm wondering if my symptoms were at least partially caused by the bromine in the hot tub.

I Googled for a correlation and found a number of articles correlating bromine to issues with the central nervous system (CNS), but couldn't find any that correlated it specifically with RLS. I went to Google Scholar, but the "bromine : CNS" articles that came up are in the language of science that I don't understand. I communicated with my Primary Care Physician, who coincidentally has RLS, and she hadn't heard of a correlation. She contacted a neurologist colleague, who also came up empty. I contacted my sleep specialist/MD, who coincidentally has RLS too, and she was not aware of a correlation either. All are interested though and going to dig a bit deeper.

So I wonder... is there no correlation? Or am I/we surfacing a contributor that's hiding in plain sight?

Thoughts or experiences?

All the best...
Barry

stjohnh
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Re: Is bromine causal?

Postby stjohnh » Fri Feb 08, 2019 2:42 am

BarryO wrote:Bromine has long been used in hot tubs as an alternative to chlorine. After some reflection and basic "internet research," I'm wondering if there is a connection between bromine and RLS. ...

Thoughts or experiences?

All the best...
Barry


Barry,
The research is pretty clear, RLS is caused by Brain Iron Deficiency. As far as I know, there is no evidence this can be caused by bromine. Most cases have a genetic basis, predisposing people with a certain genetic make-up to be more susceptible to low iron in their diet, or other iron problems such as pregnant women, people with chronic kidney disease.

ViewsAskew
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Re: Is bromine causal?

Postby ViewsAskew » Sat Feb 09, 2019 6:59 am

I noticed that you mentioned pramipexole...do you still take it? If so, are you familiar with the problems associated with it (and all others in that class)? If not, look up the term augmentation on this website - use the search function.

I cannot say I have been in a hot tub more than 5 times in my whole life - and had RLS long before I ever did. I am guessing that this is one of those theories that sounds good to those of us who do not have a science background but that likely doesn't hold up to science scrutiny. stjohnh - Holland - who answered first knows a lot about science - much more than I - so I'd definitely go with his answer!
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Rustsmith
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Re: Is bromine causal?

Postby Rustsmith » Sat Feb 09, 2019 3:43 pm

Chemically, bromine is very similar to the chlorine chemicals used in swimming pools. Bromine is a little bit heavier, which is why it is used in your hot tub. Bromine lasts longer at the higher temperatures.

Our noses are extremely sensitive to both chlorine and bromine gas. The acrid smell you describe is actually ppb (parts per billion) concentrations of bromine being released from the water. It probably is still being released after you stop smelling it because after a while, your nose becomes somewhat desensitized to it.

Many years ago, I worked about 100 yds from a chemical plant that liquefied chlorine gas and another that extracted bromine from seawater. After a couple of days, I stopped smelling chlorine and bromine except when I was exposed to higher concentrations. Years later, I was visiting friends in the nearby town where we used to live. I asked if there had been a chlorine release at the plant because the town smelled like a swimming pool. My friends had sort of a blank look and said "we don't smell anything". My nose had regained its normal sensitivity and theirs were still desensitized.

I also scanned some of the papers on Google Scholar. Most had to do with ingesting different bromine compounds rather than exposure to bromine gas.

So, although I cannot say definitively that there is not tie to the bromine from your hot tub, I rather doubt that there is a connection.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

BarryO
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Re: Is bromine causal?

Postby BarryO » Sat Feb 09, 2019 5:36 pm

stjohnh wrote:Barry,
The research is pretty clear, RLS is caused by Brain Iron Deficiency. As far as I know, there is no evidence this can be caused by bromine. Most cases have a genetic basis, predisposing people with a certain genetic make-up to be more susceptible to low iron in their diet, or other iron problems such as pregnant women, people with chronic kidney disease.



I appreciate your comment stjohnh. Could you elaborate?
Does the Brain Iron Deficiency, and genetic predisposition findings rule out other chemical contributors, like bromine? I read that a variety of chemicals contribute to RLS; e.g. tannins, caffeine, etc. So it's a sincere question.

stjohnh
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Re: Is bromine causal?

Postby stjohnh » Sat Feb 09, 2019 6:11 pm

BarryO wrote:
I appreciate your comment stjohnh. Could you elaborate?
Does the Brain Iron Deficiency, and genetic predisposition findings rule out other chemical contributors, like bromine? I read that a variety of chemicals contribute to RLS; e.g. tannins, caffeine, etc. So it's a sincere question.


Here is a link to a paper that summarizes much of the evidence.
https://www.sciencedirect.com/science/a ... 5717315599

And no, brain iron deficiency does not rule out chemicals causing it.

Caffeine is a direct adenosine receptor antagonist. Brain Iron Deficiency causes adenosine to accumulate in the cells, so the reason caffeine increases RLS symptoms is known. I don't know about the tannins.
Blessings,
Holland

Rustsmith
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Re: Is bromine causal?

Postby Rustsmith » Sat Feb 09, 2019 6:26 pm

Does the Brain Iron Deficiency, and genetic predisposition findings rule out other chemical contributors, like bromine? I read that a variety of chemicals contribute to RLS; e.g. tannins, caffeine, etc. So it's a sincere question.
Top


First we need to remember that RLS is a relatively new condition to medical science (even though it was first described several centuries ago). For example, the understanding of the role of low iron in the brain in RLS was only published in Jan 2018. Therefore, there is still a great deal to be learned, but substantial headway is being made.

The issue with low iron in the brain has to do with the way that our brains do not correctly process several neurotransmitters. One of these (dopamine) is responsible for our movement problems and another (glutamate) is responsible for our insomnia. Things like caffeine, sugar, low magnesium and alcohol are regularly mentioned based on anecdotes as things that can be RLS triggers. Caffeine is sort of obvious. Anything that works as a stimulant should be avoinded when we have issues with insomnia and cannot get good sleep. Alcohol can also play a role in the quality of sleep, so that one also makes sense. Sugar, that might be a bit of a reach but for those who are sensitive to it and get hyped up on a sugar "high", then okay.

As for bromine, first you need to understand that bromine occurs in a variety of chemical states and it doesn't easily shift from one form to another. The bromine you smell in your hot tub is elemental bromine. That means that it is not chemically bound to anything else. There are also inorganic bromine compounds (sodium bromide is very probably a contaminant in the salt shaker on your table) and there are organic bromine compounds. What you saw referenced on Google Scholar are mostly organic bromine compounds. These are the ones that are most easily picked up by the body and are often the ones that are the most difficult to get rid of. As I stated in my last note, the amount of bromine that you smell in your hot tub is VERY dilute. Since much more bromine than you smell would be extremely irritating to your lungs, it is highly unlikely that you would be exposed to enough to result in any appreciable concentration in your body. And then if you did get much into the blood stream (which you didn't), the bromine would then need to cross the blood-brain barrier in order to have any impact on your RLS. The role of the blood-brain barrier is to prevent harmful things from getting into the brain (which may be part of the genetics of RLS - we cannot get enough iron across the barrier).

Finally, although chemical safety issues associated with bromine gas are well known, bromine compounds (either organic or inorganic) are not known to be particularly dangerous when compared to a wide variety of other chemicals (like heavy metals, strong acids, etc). Bromine was even present in the leaded gasoline that was used prior to the late '70s. Therefore, although I cannot be 100% certain that bromine does not play a role in RLS, I would be extremely surprised to find out that it is involved, especially from exposure to your hot tub chemicals.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

BarryO
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Joined: Wed Mar 07, 2018 5:29 pm

Re: Is bromine causal?

Postby BarryO » Mon Feb 11, 2019 3:38 pm

Thank you Holland and Steve for the great information!!


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