From Dr Ditchek facebook
Stuart Ditchek
For those people struggling with post COVID-19 difficulty with smell, I thought that you would find this outline from Northwell Health helpful. The original source(citation) for the data is documented at the end of the post.
Smell Loss and Olfactory Training
- A viral infection of the nose or sinuses is one of the reasons people may suddenly lose their
sense of smell. Sometimes patients will recall having had a cold or a flu just prior to losing
their sense of smell. Other times these viral infections are so mild the person may not
remember much at all about having been ill.
- Corona virus 2019 (COVID-19) is one of the viral infections that could lead to smell loss and
there are also lots of other types of viruses that can cause smell loss, e.g., other types of
coronaviruses, rhinoviruses and influenza viruses.
- When people lose their sense of smell, they often feel like they’ve also lost their sense of
taste. Because the flavor of food (ability to make out the difference between watermelon vs.
cherry) is dependent on the ability to smell it. The only ‘tastes’ left are the basic ones of
sweet/salty/sour/bitter that the tongue delivers directly to the brain.
- People are sometimes able to recover their sense of smell after a viral infection. If this is
going to happen, the majority of recovery usually happens in the first several months after
being sick. A slower recovery could possible still happen over the next year or so.
Unfortunately, there are many people who do not recover.
- Losing your sense of smell and taste can really affect a person’s quality of life. It may be
hard to enjoy food and drink. It may be hard to judge personal hygiene. It may be hard to
detect dangerous things such as smoke, natural gas, and food that has turned bad.
- Unfortunately, no medications have been proven to help people recover their sense of smell
after a virus. Even though medications may not be helpful, there is a treatment called
olfactory training (OT) that can be helpful. OT is a very simple protocol that a person can do
themselves at home to help retrain their brain to smell again. OT actually has high-level
evidence showing that it works. OT may not bring all the sense of smell back, but it is simple
and can help many improve.
- Losing the sense of smell and taste can be an early sign of COVID-19 infection and is
sometimes the only symptom people have. If this happens to you without any other
symptoms, consider self-isolating if possible so you do not transmit the infection to others.
If you develop other symptoms of COVID-19 in addition to your smell loss, contact your
healthcare provider to be screened and possibly tested.
This technique of olfactory training (OT) is based on the idea that the nerves responsible for providing our sense of smell can be strengthened through exercise. OT has been shown to be effective in multiple clinical studies. However, these results are averaged across multiple patients and it should be remembered that each individual person may improve by different amounts. The improvement in smell is often slow and occurs over many months, even up to two years.
Technique
A. The training consists of smelling four different odors: rose, eucalyptus, lemon, and clove, twice a day, every day.
1. Choose one odor and smell it for approximately 15 seconds while trying to remember what it once smelled like.
2. Rest for about 10 seconds.
3. Smell the next odor for approximately 15 seconds.
4. Rest for about 10 seconds.
5. Repeat until all 4 odors have been sampled
B. After 3 months switch to a new set of odors: menthol, thyme, tangerine, and jasmine and train with them as described in part A.
C. After 3 months switch to another new set of odors: green tea, bergamot, rosemary, and gardenia and train with them again as described in part A.
Note: if there is a particular smell you want to be able to smell again, add this to your training. The actual substance is not required to produce an effect. Most people purchase essential oils containing the odors listed above. The advantage is ease of use and ability to cap the bottles to prevent gradual decreasing strength of the odor. These can be purchased through multiple online vendors, some holistic medicine shops, and health food stores.
Source: International Forum of Allergy & Rhinology, Vol. 10, No. 7, July 2020