Anosmia (loss of smell) — Wokingham, Berkshire

Acupuncture and Chinese herbal medicine for anosmia and parosmia at my clinic in Wokingham, Berkshire. Loss of sense of smell — total (anosmia), partial (hyposmia) or distorted (parosmia) — became dramatically more common after the COVID-19 pandemic, with around 5% of infected adults left with persistent smell disturbance. Conventional treatment options are limited; smell training is the only evidence-based intervention widely offered. Traditional Chinese medicine treats anosmia as a disorder of the Lung opening to the nose, with acupuncture trial evidence demonstrating measurable improvement in olfactory function. Over 25 years of clinical experience.

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What is anosmia?
Anosmia, hyposmia and parosmia
Causes of smell loss
Anosmia in traditional Chinese medicine
Acupuncture for anosmia
Chinese herbal medicine
Smell training & self-care
Commonly asked questions

1. What is anosmia?

Anosmia is the total loss of sense of smell. Smell is mediated by olfactory receptor neurones in the upper nasal cavity, which project directly to the olfactory bulb at the base of the frontal brain. Unlike other sensory neurones, olfactory neurones regenerate — which is why post-viral smell loss has potential for recovery, often over many months. Around 80% of post-COVID anosmia resolves within 6 months, but a significant minority persist long-term and benefit from active intervention.

Loss of smell has substantial life impact: it removes the pleasure of food and flavour, creates safety risks (cannot smell gas, smoke, spoiled food), and is linked to higher rates of depression. It is also associated with reduced overall life satisfaction.

2. Anosmia, hyposmia and parosmia

Anosmia — complete loss of smell
Hyposmia — reduced ability to smell
Parosmia — distorted smell perception; familiar smells (coffee, food) become unpleasant or repulsive. Common in post-COVID recovery as smell returns.
Phantosmia — smelling odours that are not present
Ageusia / dysgeusia — loss or distortion of taste, usually accompanying smell loss because flavour perception depends mainly on smell

3. Causes of smell loss

Post-viral — especially COVID-19 (SARS-CoV-2), but also other respiratory viruses; the most common acute cause in the 2020s
Nasal obstruction — from chronic sinusitis, nasal polyps, allergic rhinitis, severely deviated septum
Head injury — shearing of olfactory nerve filaments at the cribriform plate
Neurodegenerative disease — early-onset anosmia in Parkinson’s and Alzheimer’s disease
Medication side effects — certain antibiotics, antihypertensives, chemotherapy
Smoking and chronic alcohol
Congenital anosmia — rare, lifelong
Aging — smell sensitivity declines naturally after the sixth decade

Sudden unexplained loss of smell warrants ENT assessment, particularly if associated with other neurological signs, persistent nasal obstruction or one-sided symptoms.

4. Anosmia in traditional Chinese medicine

In TCM, the nose is the “orifice of the Lung” — and the sense of smell depends on clear Lung Qi reaching and opening the nasal passages. Anosmia is differentiated by pattern:

Wind-Cold or Wind-Heat blocking the nose — acute presentation during or after an upper respiratory infection
Damp-Phlegm obstructing the upper orifices — chronic blocked nose with thick mucus; common with chronic sinusitis
Lung Qi deficiency — chronic post-viral anosmia with weak voice, susceptibility to colds; the predominant pattern in post-COVID smell loss
Spleen Qi deficiency with Damp — chronic blocked nose with sticky discharge and digestive sluggishness
Kidney essence deficiency — in age-related smell loss and post-head-injury anosmia
Blood stasis blocking the channels — in post-traumatic anosmia from head injury

5. Acupuncture for anosmia

A 2009 German trial (Vent et al.) showed acupuncture significantly improved olfactory function in patients with post-viral anosmia compared with vitamin B supplementation alone, with around 60% of treated patients showing measurable improvement. Subsequent studies have replicated these findings for post-COVID anosmia.

Mechanisms include local stimulation of olfactory nerve regeneration via periocular and perinasal points, improved local microcirculation, and modulation of central olfactory processing. Treatment combines:

Local periocular and perinasal points — LI 20 (Yingxiang — literally “Welcome Fragrance”), BL 2 (Cuanzhu), Yintang, Bitong (Extra), GV 23 (Shangxing)
Lung-tonifying points — LU 7 (Lieque), LU 9 (Taiyuan), BL 13 (Feishu)
Constitutional support — ST 36, SP 6, KD 3 for the underlying Lung-Spleen-Kidney axis

Twice-weekly treatment for the first 4 weeks, then weekly for 8–12 weeks, is the typical protocol for established post-viral anosmia. Earlier intervention produces better outcomes — treatment within the first 3 months of onset has the highest recovery rate.

6. Chinese herbal medicine for anosmia

For Wind-Cold or Wind-Heat blocking the nose: Xin Yi San or Xin Yi Qing Fei Yin respectively. For Damp-Phlegm with chronic sinusitis: Cang Er Zi San as the base, with additions to resolve Damp-Phlegm. For chronic Lung Qi deficiency post-viral anosmia: Yu Ping Feng San combined with channel-opening herbs. The herbs I prescribe are pharmaceutical-grade granules from Sun Ten in Taiwan.

7. Smell training and self-care

Smell training

This is the single most evidence-based self-help intervention for post-viral anosmia. Twice daily, sniff each of four strong odours (typically rose, lemon, eucalyptus and clove essential oils) for 15–20 seconds each, focusing attention on the smell while consciously trying to remember what it should smell like. Continue for at least 3–6 months. Trial evidence shows around 30–40% of patients show measurable improvement that would not have occurred spontaneously.

Address underlying nasal pathology

If anosmia is associated with chronic sinusitis, allergic rhinitis or nasal polyps, treating these primary conditions is essential before, or alongside, work on the smell itself.

Avoid further olfactory damage

Stop smoking. Limit alcohol. Avoid intranasal steroid sprays unless prescribed for a specific reason. Avoid strong nasal decongestant sprays for more than 3–5 days (rebound congestion can worsen smell).

Safety adaptations

While smell is impaired, install or check smoke alarms and carbon monoxide detectors at home. Use date labels and visual inspection for food spoilage. Be cautious with gas appliances.

8. Commonly asked questions about acupuncture for anosmia

Can acupuncture restore my smell after COVID?

For many post-COVID patients with persistent smell loss, acupuncture combined with smell training produces measurable recovery. Outcomes are best with earlier intervention — ideally within the first 3 months of onset — but recovery can still occur years after the initial loss with sustained treatment. Around 60% of treated patients in published trials show meaningful improvement.

How long should I have acupuncture for anosmia?

An initial course of 8–12 sessions (weekly or twice-weekly) is the typical starting protocol. Recovery is usually progressive rather than sudden — smell returns in fragments, often distorted (parosmia) before normalising. Continuation depends on response.

Is parosmia worse before it gets better?

For many post-viral patients, parosmia (distorted smells) is actually a sign of recovery beginning. The olfactory neurones are regenerating but not yet wired correctly — familiar smells temporarily register as unpleasant or different. This phase typically lasts weeks to months and gradually resolves as the neural wiring matures.