Phantosmia and sodium citrate
Phantosmia is a condition that often affects people who have had damage to their sense of smell, especially for those who have had traumatic brain injuries and post-viral loss. There can be other causes too, such as neurological conditions or a response to certain medications, but the research I will describe here was conducted with people who had had viruses.
The experience of phantosmia, which is defined as the perception of a smell in the absence of a physical trigger, means that the affected person notices a smell that goes with them wherever they are, at different times of day or constantly, troubling them to a greater or lesser degree. The characteristics of this phantom smell are described often as burning, smoky, or chemical-like. On rare occasions, the smell is pleasant or at the very least not unpleasant.
The origin of phantosmia is in the brain. These are olfactory hallucinations in the truest sense. They are a result of brain activity. Why should this be? One theory is that when something disturbs the sense of smell, the brain seeks to replace the missing information input by creating something to replace what is missing.
Phantosmia is often compared to tinnitus, a condition where a person experiences sound that originates in the brain. Often hissing, buzzing or ringing noises. With both these conditions, there is no outside source for these perceptions.
So what can be done for phantosmia? A study, published in 2021, looked at sodium citrate solution applied as drops and its usefulness in the management of quantitative (hyposmia) and qualitative (parosmia and phantosmia) smell disorders. Sodium citrate is an acidity regulator, and has many uses, for instance in preventing kidney stones and in food processing.
As mentioned above, the study looked at people with post-viral smell loss, and the drops were applied using the Kaiteki position to one nostril only, leaving the other nostril as the control. Sixty adults were enrolled in this study, which is not a large number and therefore the results should be considered preliminary and should be repeated with larger numbers. Ten to 15 drops were administered to the elected nostril twice daily for a period of 2 weeks.
Overall, the treatment did seem to be very helpful for either hyposmia or parosmia, however, the authors said:
“sodium citrate may cause short-term, temporary effects on olfactory function, that do not lead to sustained improvements in function demonstrable at the end of a treatment period”
Therefore, there may be improvement to hyposmia in the time period immediately after use, but this was not a “cure” but rather a temporary ramping up of the existing sense of smell. However, there was one very interesting finding regarding phantosmia. It’s helpful here to look at the recovery rates of phantosmia without any intervention. According to one study, without treatment, some 63% of people with phantosmia had improvement or an end to their symptoms after 5 years. By contrast, the sodium citrate drops provided significant relief from phantosmia:
“Compared to these figures, we saw an 82.4% reduction in the number of patients with phantosmia after treatment with intranasal sodium citrate, over a period of just 2 weeks”
Sodium citrate drops are not available commercially and need to be made up at home. If you wish to try this:
You will need
A bottle that holds 100ml or more
An eye dropper
Sodium citrate powder - order through online retailers. I got mine on Amazon but there are plenty of places that sell it.
A kettle for sterilising tap water
Directions
Using a 5 ml measuring spoon, two level spoonfuls of Sodium Citrate into your bottle
Add this to 100ml of tap water that has been boiled and cooled.
Mix well
Apply a few drops into each nostril using the Kaiteki position. Stay still for a minute or two after application to give it time to work. Don’t apply the whole bottle at once!
Once the solution is made up, keep it in a closed container in the fridge. Make up a new solution once a week
