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Is Your Shower Head Making You Sick?

This information has been reviewed and approved by David E. Griffith, MD (March 2024).

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Summary: Is Your Shower Head Making You Sick? NTM Could Be The Answer

A disease called nontuberculous mycobacteria (NTM) may be spread through water from contaminated shower heads into the lungs.”

What is NTM?

  • NTM stands for nontuberculous mycobacteria
  • Bacteria similar to tuberculosis (TB)
  • There are over 200 different species of NTM
  • Spread through environment, not person to person
  • Cure rate is about 65-80%.

NTM Symptoms

  • Chronic or recurring cough
  • Fever
  • Weight loss
  • Lack of appetite
  • Night sweats
  • Loss of energy

Who can get NTM?

Anyone can get nontuberculous mycobacteria, but it mostly affects:

  • People with underlying lung disease (e.g., COPD, bronchiectasis)
  • Tall, thin women often with skeletal abnormalities such as scoliosis
  • Immune compromised individuals
  • 30,000 new NTM infections are diagnosed each year

Where is NTM Found?

  • NTM bacteria are abundant in soil and water
  • NTM can live in the shower head, indoor plumbing and charcoal filters
  • Water droplets and steam in showers can carry the bacteria and be inhaled when showering
  • Soil particles containing NTM can be inhaled when soil is disturbed
  • NTM are found in all parts of the world

Preventing NTM

  • Clean your showerhead by soaking in vinegar or a diluted bleach solution
  • Replace showerheads periodically as needed
  • Set water heater to 140° (use caution to avoid scalding)
  • Remove the shower head completely
  • Take baths instead of showers
  • Avoid steam rooms, steam showers, hot tubs, and indoor pools etc. where steam or droplets with bacteria particles could be inhaled
  • Wear a mask and gloves while gardening

Treating NTM

  • Different species require different treatments
  • The treatment duration is long, typically 12-18 months
  • The goal of treatment is to render sputum cultures “negative” for one year

What is MAC NTM?

  • Caused by group of bacteria called Mycobacterium avium complex (MAC)
  • Most common NTM species
  • Most common cause of NTM in the U.S.
  • Cure rate 65%
  • Usually treated with 3 antibiotics