A recent research study has shown that sodium citrate (in the form of a nasal spray) could potentially offer temporary  improvement in the ability to smell for people affected by post-viral olfactory loss or other non-obstructive causes.  The research was undertaken by the University of East Anglia (UEA) and the Smell and Taste Clinic at James Paget Hospital and involved Consultant ENT Surgeon and Fifth Sense trustee Mr Carl Philpott.

How is the spray thought to work?

Calcium is thought to have a role in ‘turning down’ the sense of smell, a bit like a volume control. Sodium citrate is known to ‘bind’ with calcium molecules, and stop them from acting in this way.  In the study, a group of people with anosmia or hyposmia were treated with a sodium citrate nasal spray, alongside a control group whose spray contained water.  Around one third of the study participants who were treated with the sodium citrate spray experienced some improvement in their ability to smell, which lasted up to two hours, with the effect peaking at 15-30 minutes.

Who could this potentially help?

The study showed that the spray seemed to be most effective in people affected by post-viral olfactory loss, although some people with idiopathic (no known cause) and post-traumatic olfactory loss (PTOL) also showed some improvement. It’s difficult to say why this is, but sometimes there can be more than one factor involved in anosmia or hyposmia.  Some cases of idiopathic olfactory loss could have been caused by an undiagnosed virus, which would help explain why the citrate spray results in an improvement.  The location and degree of damage caused in PTOL is likely to vary between people, and it is possible that the citrate boosts the function of any olfactory neurones and nerves that are still intact.

Further studies are needed to establish the effectiveness of sodium citrate in daily use as a longer-term treatment.

I want to try this myself, is it possible to purchase sodium citrate spray?

This was a research trial and sodium citrate spray is not available to purchase, although sodium citrate itself is safe to use and already licensed as a medicine for some stomach and bladder conditions.

For more information on the results of the study visit the UEA website.

For a link to the abstract of the research paper, published in Clinical Otolaryngology, visit the Wylie Online Library

Consultant ENT Surgeon Mr. Carl Philpott (who was instrumental in the setting up of Fifth Sense and sits on our board of trustees) was asked to deliver the prestigious annual Ellison-Cliffe lecture for the Royal Society of Medicine.

Mr. Philpott’s lecture covered the role and function of the senses of smell and taste and the impact that smell and taste disorders have on the lives of those affected. He also talked about his work in treating patients.

We are delighted to be able to share with you a video from the day, showing Mr. Philpott’s talk in full.

We have received some great news for anyone in the UK affected by chronic rhinosinusitis (CRS). A group of medical researchers, led by Miss Claire Hopkins and Mr Carl Philpott and with support from Fifth Sense, has been awarded a £3m grant by the National Institute for Health Research (NIHR) to undertake a 7-year study into the treatment of CRS. This is the first major NIHR grant for work on nasal and sinus conditions and recognises the large numbers of people in the UK who suffer from this debilitating condition, the symptoms of which can include olfactory loss. The award also recognises the first class team that will be supporting Carl and Claire, which includes nationally and internationally renowned experts in both medicine and research. The programme of work is called The MACRO Programme: Defining best Management for Adults with Chronic RhinOsinusitis, and its aim is to fill a number of gaps in the evidence on which the treatment of more severe cases of CRS is based.

The programme will start with a one-year study, which will include interviews with CRS patients, GPs and specialists treating CRS to find out more about the benefits and problems of the current treatments available. This work will tie in with a study of data on current treatments used by GPs and the cost of these.  Based on this and other information the team will finalise the design of the main research trial.

The research trial will look at both surgical and antibiotic treatment of CRS. Some 600 volunteers will be invited to participate, selected from patients referred to consultants at 16 sites across the UK. These are patients who have not had relief from the usual steroid nasal sprays and saline nasal rinses, which are very effective in many cases. The trial will run from year 2 to year 6 of the programme. The team will be measure any improvements in the patients 6 months after their treatment using symptom scores, examination findings and other nasal measurements. Then they intend to check whether the patients maintain the improvements over the following years.

When the trial is finished, the team will bring together all the information collected and produce guidelines for selecting the best course of treatment for use throughout the NHS. The guidelines will be used by the Clinical Commissioning Groups, who decide how NHS money in each locality will be spent on healthcare, as well as by the specialists actually treating the patients. Alongside this, the results will be widely published by conventional and electronic channels, so that everyone, whether patient or medical staff, has the best possible access to the findings.

Patients will be invited to take part in the trials during visits to recruiting ENT departments, and details of the recruitment will be posted on the Fifth Sense Research page. It may not be possible to apply to be a part of the trial outside of these departments, but the team will update members of Fifth Sense if this situation changes. It is hoped that this research programme will lead to significant improvements in care for patients with CRS, alongside less variation in standards across the UK, within the next 10 years.

We are very pleased to see such a major commitment by NIHR to this previously neglected group of patients.