Among all the symptoms of COVID-19, loss of smell and taste is perplexing, annoying and honestly, one that can really affect your mood. How could a virus be responsible for your coffee now tasting like a big pot of dirt? Or your mint body wash now smelling like…nothing at all?
This kind of olfactory loss can happen as a result of sinusitis, nasal allergies and respiratory viral illnesses like COVID-19, among other reasons, notes a July 2015 paper in JAMA Otolaryngology – Head & Neck Surgery.
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How does it happen? Well, the virus enters the body by binding to a specific protein (ACE2 receptor). There are also ACE2 receptors on supporting cells of the olfactory system located high up in the nose, Zara Patel, MD, associate professor of otolaryngology at Stanford, who has conducted research on olfactory training, tells LIVESTRONG.com. Ultimately, that causes damage to these receptors, which leads to a loss of smell.
Get tips on how to stay healthy, safe and sane during the novel coronavirus pandemic.
In addition, inflammation surrounding tissues in the nasal cavity can impair the function of nerves, which also affects your ability to smell, Dr. Patel says.
Don't let someone tell you this isn't a big deal. "Smell is integral in our quality of life," Dr. Patel says, noting that 80 to 90 percent of the flavor we detect from food depends on the ability to smell it.
And so, it matters when it comes to enjoying food and drink, but also consider that dining with friends and family is an integral part of our lives and one of the ways we maintain close connections with the people we love. This can have mental health consequences. In fact, among adults with COVID-19 who lost their sense of smell and taste, 43 percent reported depression, per July–August 2021 research in the American Journal of Otolaryngology.
If you got sick with COVID-19 and lost your sense of taste and smell, you're probably very eager to know when it will come back. "About 70 to 75 percent of people will be able to spontaneously recover smell about a month after the initial loss," Dr. Patel says. That still leaves about one-quarter of people who won't be able to.
There's no way of knowing what side you'll be on, Dr. Patel says, but you can help yourself regain your sense of smell with smell (or olfactory) training, which can help regenerate the nerves in the olfactory system. She advises starting this process as soon as you lose your sense of smell. "That will make it more likely that you'll be in the group who can recover," she notes.
How to Do Smell Training
OK, you know to start it right away. You might have to continue to do it for six months, but stick with it. The longer you wait to start, the more difficult it is to recover your sense of smell. That's all the more reason to start ASAP.
Here's how to do it:
1. Gather Your Four Scents
You'll want to get four essential oils: rose, lemon, eucalyptus and clove. "These four are all in different categories of smell, meaning they will stimulate different types of olfactory neurons inside your nose," Dr. Patel says.
After one or two months, switch to four new scents.
Also important: The brand, purity, cost or concentration of the scents doesn't matter when it comes to regaining your sense of smell, according to a randomized controlled trial that Dr. Patel authored. (This study was published in Laryngoscope Investigative Otolaryngology in April 2017.)
"People will spend huge amounts of money saying that you need 'pure rose,' but that's extremely expensive. All you need is an essential oil that has a scent," she says.
2. Open the Scent
All you need to do is open up the bottle and put it under your nose. There are many how-tos out there that will advise putting the scent onto something like a cotton pad or fragrance strip, but that's not necessary, Dr. Patel says. "The point is to present the odor. Your nerves will be able to pick up on that odorant in a jar or not," she says.
3. Breathe In and Out
Holding one scent, take nice slow breaths in and out for 15 seconds. (No need to sniff really hard.)
"Focus your memory on what the scent used to smell like," Dr. Patel says. This will reinforce the neural connections you're trying to rebuild.
Wait 15 seconds. Then move to the next scent. Repeat the process.
4. Try Twice a Day
Aim to do smell training twice a day (though more often may help increase your chances of success).
It will be frustrating when you take that nice big inhale and still can't smell anything. But that's normal. "Don't expect to be able to smell things right away or even after a month," Dr. Patel says.
Remember, it's OK if this process takes six months. Just don't give up, even if you're not seeing an improvement initially.
6. Boost Your Results
More of Dr. Patel's research, published in the International Forum of Allergy & Rhinology in September 2018, found that adding steroid nasal irrigation to the regimen of olfactory training improved the chances of regaining a sense of smell better than another group that used olfactory training plus a saline rinse. Ask your doctor or pharmacist to recommend an over-the-counter steroid nasal irrigation.
Another option is to take an omega-3 supplement along with smell training, which may aid in nerve regeneration.
"In our research, we saw a highly significant drop in the number of people who had long-term smell issues," says Dr. Patel. This study, in Neurosurgery in August 2020, was based on a patient population who received endoscopic skull-based surgery. Though this is a completely different patient group, "I tell my patients about that study so they have the option of taking omega-3, which I think may be helpful in this type of smell loss, as well," she says.
Read more stories to help you navigate the novel coronavirus pandemic:
- JAMA Otolaryngology – Head & Neck Surgery: “Olfactory Loss and Olfactory Training”
- American Journal of Otolaryngology: “Quality of life and safety impact of COVID-19 associated smell and taste disturbances”
- Laryngoscope Investigative Otolaryngology: “Randomized Controlled Trial Demonstrating Cost-Effective Method of Olfactory Training in Clinical Practice: Essential Oils at Uncontrolled Concentration.”
- International Forum of Allergy & Rhinology: “Budesonide irritation with olfactory training improves outcomes compared with olfactory training alone in patients with olfactory loss”
- Neurosurgery: “Effect of Omega-3 Supplementation in Patients With Smell Dysfunction Following Endoscopic Sellar and Parasellar Tumor Resection: A Multicenter Prospective Randomized Controlled Trial”
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.