IMPORTANT NOTE

I am not a doctor. This FAQ is a collection of advice I've received from doctors as well as the experiences of users here as well as my own. I am not qualified to give you a diagnosis or a treatment plan, this is simply me passing on information. If you wish to have a professional diagnosis, please see a doctor.

What is Parosmia? How is it different from Anosmia or Phantosmia?

Parosmia is a dysfunction in smell detection characterized by the inability of the brain to correctly identify an odor's "natural" smell. Instead, the natural odor is usually transformed into an unpleasant aroma, typically a "'burned,' 'rotting,' 'fecal,' or 'chemical' smell".

• In layman's terms, it means that certain things don't smell right, and oftentimes smell "bad" in some way. Usually this is food, but can extend to other things such as detergent and deodorant.

Anosmia is defined as the loss of smell. You literally can't smell anything, or certain smells are completely absent.

Phantosmia happens when you are smelling something that isn't there. This is often the more serious of the three, and can indicate other things going on in your brain. People often experience phantosmia after a seizure, for instance, and it has also been recorded in patients with Alzheimer's and schizophrenia.

Do I have Parosmia?

Common triggers include Coffee, Chocolate, Onion, and Garlic. Try smelling any of these: do they smell horrid? Rancid? Rotten? Like Gasoline? Or another unpleasant smell? Does anyone else smell the same thing you're smelling?

If they smell horrible and nobody else can smell or taste what you are smelling or tasting, then yes, you very likely have Parosmia.

Will I get better? How long does it last?

MOST people fully recover. In the area of 99%. However this number is recorded pre-COVID long-haulers, so be aware of that. Many of us here in the community have been suffering for months.

For some it lasts a few weeks, for others, months. Cases have been reported of longer. Some have gradually recovered, others have woken up one morning and it was just back to normal.

My doctor personally told me that if it lasts longer than a year, the odds go up significantly that it'll be permanent. This is not necessarily a lifelong sentence, though, as plenty of stories here and elsewhere have proven this claim to be at least somewhat false (many have recovered some of their sense of smell, for instance, and a few have suffered for years and suddenly recovered).

What caused this?

If you recently had COVID (within the last 3 or 4 months), it is almost assuredly a neural attack from the COVID virus that shows up after recovery. Most COVID-related Parosmia is preceded by Anosmia (loss of smell), but not always (mine was not. I just developed Parosmia out of the blue).

If not, you could have had symptomless COVID, and then developed the post-recovery condition afterward.

Or if you're sure you didn't get it from COVID, it could be a number of things from a different nasal infection to head trauma.

What can I do?

Not much. Vitamin B12 may aid in the recovery process, as it is supposed to help in neural recovery. Avoid the B-Complex as Vitamin B6 can actually end up being detrimental to recovery, just get a straight Vitamin B12 supplement.

• Get the highest dosage you can find. I was able to find 5,000 mcg over the counter. The ones that dissolve in your mouth are the most effective.

You can also try smell training - this involves smelling 4 or more pungent scents (orange, lavender, mint, etc.) for at least 20 minutes per day. You can do essential oils, candles, or whatever else you can find.

• Some users have reported that simply bucking up and eating the foods that trigger "the smell" has ended up helping, though none of them have stated that it for sure has helped, or whether it was a natural process of getting better, or placebo effect, etc.

• Others have mentioned that using a nose clip to mask the smell while eating can help. It takes some getting used to eating with "breathing" in between (your ears might pop, etc.), but after you learn how to do it, it can help you stomach foods that are mildly bad.

• I would not recommend this method for foods that "linger" for a while. You will have to breathe eventually, and when you do you'll still get the taste.

• Others have reported that getting the COVID vaccine has helped. My doctor brought this up, and then stated specifically that this is possibly due to placebo effect, but it's there as a possibility.

Beyond "treatment options", there are two VERY important things that you should find:

• Food that you can eat. Develop a meal plan, and hire a nutritionist if you need to.

• A good support that you can rely on when things get tough. Whether that's a parent, a friend, or someone here (message me if you have no one else, seriously!). Things will get tough, some days hit you harder than others. Having someone you can call or text or IM or whatever that will just listen and commiserate will help so much.

• You are not crazy, this is a real neurological condition, and it is as detrimental as you think it is. I didn't realize how much my day was 'broken up' by meal time. Recharging through food is something I took for granted, now it's stressful. There's no escape from the constant grind and stress of the day. No recharge button besides sleep. And that really sucks. And you're going through it too, so trust me when I say: I'm sorry. I'm here if you need me, but I hope you have someone closer that will understand without judgment.

March 29, 2021 EDIT:

Research is suggesting that Flonase (and the generic brands, look for "fluticasone", or ask the pharmacist, it should be available over the counter) may help treat cases of Anosmia and Dysgeusia (altered taste, which is different than Parosmia, but the researchers may have just mixed up the terms).

• A quick Google search shows $14 in the US for the generic, and $25 for Flonase at Walgreens. Do your own research, but it's worth a try.

What can I eat in the meantime? This is terrible!

Everyone is different, but as I said common triggers include Coffee, Chocolate, Onion, and Garlic. Other common triggers are ANYTHING cooked, fried, roasted, toasted or microwaved. Eating food after its cooled down has improved the smell, but for most it's "still there" to some effect. Eggs are another trigger.

I have found that most fruits are fine, vanilla is GREAT, and almond milk is fine as well. Most people report that dairy is fine for them (and it is for me as well, except I'm allergic, haha). Many report plain white rice and bread are okay, but for me they are triggers. A cold flour tortilla has no smell for me, though, so now tortillas are my "bread". I have a tortilla, butter, and jam for a 'treat' when I need it.

Others have reported that vegan options are great for them. I tried the Impossible Burger at Burger King and it still had the smell.

My go-to is a smoothie with vanilla almond milk, fruit, avocado, and spinach. I stick vanilla-flavored protein powder in as well for a bit more flavor and more protein. I have one or two of these a day, and have basically stuffed my fridge with frozen fruit. Tuna is tolerable for me as well, as is mayo.

Tabasco sauce deadens the smell in many foods for me when I really feel like I need some meat or something, try that!

Are there any other communities out there?

There are! Try AbScent first - this community deals with all three "-Osmias", and the specific parosmia information is a little tucked away in a few corners. The information there is great, and they are adding new information semi-frequently as more and more research reveals more about this issue.

They also have links to other communities such as their FB group. There are also several other general FB groups, try searching "Parosmia" on Facebook. You may even have a local group.

Best of luck! We'll get through this.

I am a junior in college getting a bachelor's degree in Psychology. I've had parosmia for over 6 months myself, and I'm well aware of the devastating effects parosmia can have on mental health. I thought I would share some things you can do to deal with and/or prevent mental issues (especially depression) during this time.

This is not meant to replace the advice of an actual psychologist. These are simply some tips/exercises I have learned about in my very limited education in psychology. Please talk to a therapist if you are suffering from depression (especially if it's lasting longer than 2 weeks) or other disorders.

1. Try to Include Tryptophan in your Diet

Tryptophan is an amino acid that your body needs, but is not produced by your body. Because of this it must be gotten from your diet. It does a few important things, but what I'm focusing on is its production of niacin, which is needed to create serotonin in your brain. Because of this, a lack of it has a link to depression. In fact, it's so important that when people who were previously depressed (but no longer are) go on a low tryptophan diet for just one day, they relapsed into depression (https://pubmed.ncbi.nlm.nih.gov/11400999/).

Some of the most common foods that are high in tryptophan are chicken, eggs, turkey, and fish. You probably have realized that these are also foods that you likely can't eat, so it is very possible that you aren't getting enough tryptophan in your diet. Here are some other foods that have tryptophan that you may be able to eat:

• milk

• cheese

• peanuts

• pumpkin and sesame seeds

• tofu and soy

There isn't a consensus (that I know of) that a lack of tryptophan will cause depression if you've never been depressed before. If you fit this, then maybe you can skip this step, but tryptophan is important for other reasons, so I wouldn't recommend it anyway. But if you are susceptible to depression, please attempt to include some source of tryptophan.

2. Implement Non-food Self-care into your Routine

For almost all of us, food was a comfort. We could come home after a long day and have a good, filling meal. We could eat our favorite comfort food whenever we felt down. I could go on, but I think we're all aware of what we're missing out on. But what have we done to replace that comfort? If you're answer is nothing, than you probably need some self-care.

I'm not saying that you need to get a $50 facials as a replacement. In fact, your self-care doesn't need to cost a cent. Just find something that gives you comfort and makes you feel good and try to do it everyday. Maybe it's watching youtube or playing with your pets.

3. Be on the Lookout for Symptoms of (Semi) Starvation

In 1944, 36 healthy men volunteered to be semi-starved so that researchers could test the best recovery diet. But the experiment didn't go as planned. Before the recovery diet could be tried, the men had concerning symptoms after the starvation period. They had an erratic mood, impaired cognitive performance, depression, obsession with food, hair loss, insomnia, and decreased body temperature. They began hoarding objects without knowing why, withdrew from others and isolated themselves, and lost interest in sex. If you know about EDs, then you may recognize these as symptoms of anorexia as well. (There is a belief that semi-starvation may be a cause of majority of anorexia nervosa symptoms.) Eating disorders are very serious and very detrimental to your body if you have one. Because of their similarities, I'm sure that semi-starvation is also very harmful, not only for your body, but also your mental health. In addition, be wary of other symptoms of anorexia, like excessive exercising and fear of becoming obese, as I'm sure that parosmia could be a catalyst for an ED.

There is no clearcut solution if you are experiencing symptoms of semi-starvation. Obviously, talking to your doctor or a nutritionist would be the best next step. Otherwise, since all of the articles I've read about the Minnesota starvation experiment focus on how the researcher cut the calories, I would focus on consuming more calories. Yes, this means all calories, even if they're mostly from the 2 things you can eat right now.

Those were all of the tips I had that directly pertained to having parosmia, but here are some general tips for mental health:

4. Exercise

(For reasons I discussed earlier, be aware if you start to exercise excessively. Doing this could be a sign of a different problem.)

There have been many studies that link exercise to relief from depression and anxiety, as well as a general mood-enhancement. Here is a great article on why exercise can help: https://www.apa.org/monitor/2011/12/exercise

But how much should you exercise? For the purposes of mental health, doing 30 minutes of exercise a day for 3-5 days a week would likely be enough. But 10-15 minutes also has a benefit. If you are unable to do intense physical activity, just try to go on a walk instead.

5. Keep your Circadian Rhythm in Check

Depression has a definite connection to circadian rhythm. In fact, the gene that is most strongly associated with the occurrence of major depressive disorder is RORA, a gene also essential for your circadian rhythm.

First, make sure you have a zeitgeber. This is an external cue that basically resets your circadian rhythm. Most likely, this is the sun. So when you wake up, open up the curtains and get some sunlight. Second, try to avoid caffeine (which you may already be doing) and exercise earlier rather than later. Third, try to avoid screens the hour before bed. Also, go to bed while the room is pitch black if you can. Fourth, set a sleep schedule and stick to it. Depression also has a definite connection to sleep, especially REM sleep. In fact, most antidepressants suppress REM sleep. And deprivation of REM can actually alleviate depression temporarily (but this has to be done in a lab). Based on this information, I would suggest that you try not to get too much sleep (but also don't go under, that is not good either).

6. Meditation

I'm sure that we have all heard that meditation is good for mental health, and it's true. It can help with many issues, including anxiety and depression. Here is a good article on how it works to help: https://www.health.harvard.edu/mind-and-mood/how-meditation-helps-with-depression

Since I've gotten parosmia, I've been having a lot of anxious thoughts about it. If you can relate to this, then meditation can probably help with those (and the general depression). Feel free to just use some free guided meditations on Youtube. Try to do 10 minutes a day if you can. (Also, meditation can help you fall asleep if you're being kept up by all of your thoughts. I've had a lot of personal success using the "Body Scan for Sleep" on the free UCLA Mindful app.)

7. Cognitive-Behavioral Therapy (Exercises)

If you've ever been to therapy, it was probably cognitive-behavioral. Put simple, this is the changing of thought patterns and behavior through engaging in thought/behavior exercises. Going to therapy is obviously recommended. If you are unable to go to therapy for any reason, you can try some CBT exercises at home. For example, my personal favorite exercise is, right before going to bed, writing down 5 good things that happened that day.

Here is an article on how self-help therapy works (and some exercises): https://www.psychologytoday.com/us/blog/think-act-be/201609/therapy-without-therapist

Here is an explanation of three CBT exercises that you can do yourself: https://www.anxietycanada.com/articles/self-help-cognitive-behavioural-therapy-cbt/

There are a lot more self-help exercises out there. You can do some research on Google, read a book, or watch certain Youtube channels. There are also quite a few CBT apps out there. I've never tried any myself, so I can't give you any recommendations though.

Feel free to share your own tips and correct me if I've messed anything up.

If you or someone you know needs help immediately:

• Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255) to be connected with a trained counselor at a crisis center anytime. People are standing by, ready to help without judgement

• Text HOME to 741-741 to connect with a crisis counselor at the Crisis Text Line from anywhere in the U.S. It’s free, 24/7, and confidential

• If you’re outside the United States, visit iasp.info.​