Anosmia- the loss of smell, a path to the root of Long Covid?

(created with nano-banana AI by Troy Roach, March 5th 2026)

Due to the complexity of Long Covid and the tragic nature of the debilitating symptoms like fatigue, brain fog, POTS, etc I have not spent much time digging into the effects of low-dose nicotine on anosmia. The lack of smell and/or taste in many people is met with such varied responses; some feel that their life has been greatly impacted, but nobody has mentioned it as being more important than the most debilitating symptoms.

Even a chef who depends on smell and taste for their work would not be able to function without first dealing with fatigue, brain fog, gut issues, etc.

However, the loss of the sense of smell can be devastating to some people who don't suffer any other major symptoms after an acute SARS-CoV-2 infection. While investigating this symptom, I find that the complexity is a great "microcosm" from which to explore and understand the other 200+ symptoms from this devastating disease.

In The Nicotine Test research, anosmia has not been the focus, but it is still reported on in the Facebook group on a regular basis. A quick search shows that the nicotine patch alone -- as used by individuals in an uncontrolled environment -- is not always enough to solve the problem.

This is made more complex by the odd nature of how the body and brain go about repairing the sense of smell. It is not a black-and-white process, and people often report feeling like their sense of smell gets worse before getting better. And it often comes as a shock that phantom smells of urine, faeces, and putrid decomposition are actually good signs in the healing process that most people go through.

And what about all the people who taste or smell some things but not others? Most people underestimate the multisensory nature of taste and smell. 

"80% to 90% of what is perceived as "taste" is actually derived from the sense of smell"

After 2.5 years researching low-dose nicotine patches, these are my personal conclusions and doubts:

1. Sense of smell can be regained, but the timeframe can be as short as one day or as long as six months.

2. Low-dose nicotine patches alone are not always enough.

3. Might oral nicotine (gum or lozenge) provide better localised effects?

4. Could nicotine nasal spray be even more effective at localised effects? 

5. How much time living with anosmia is too long? Might it be too hard to fix after 10 years when the brain has already rerouted those neurol resources? I hope not! 

6. Do the neuroplasticity differences inherent in age have an effect?

7. Does  training with esential oils help? Is this a good combo with low-dose patches?

8. Should oral or nasal steroids be used? If so, when?

9. Might other aniinflammatory meds help?

10. Might medications (bloodthinners, thrombotics) and/or supplements (Natto/lumbrokinase) help? 

11. Is mindset, often important in neuroplasticity, an important factor?

Some research with the help of Perplexity AI, here is a list of adjunct therapies: 

Please share your experiences with one or multiple options. I assume that multiple options will be needed. Note that Perplexity AI and most researchers do not take cardiovascular health into account, which may benefit from treatments that reduce microclots, improve endothelial health, increase blood flow, or increase Cervical Spinal Fluid (CSF) flow.

 

 

Comparison of Key Adjuncts

Therapy	Evidence Level	Typical Duration	Key Benefit	Potential Drawback
Olfactory Training​	High (RCTs, meta-analyses)	12+ weeks	Neural plasticity, low cost	Requires compliance
Vitamin B12/B-Complex​	Moderate (observational)	4+ weeks	Addresses deficiency-linked anosmia	Test levels first; variable response
Intranasal Steroids​	Moderate (RCTs)	2-3 weeks	Reduces inflammation	Nasal irritation; no superiority in some trials
Oral Steroids​	Low-moderate	1-2 weeks taper	Fast for refractory cases	Systemic side effects

  

Lastly, for sceptics out there, I am including a list of benefits from using low-dose nicotine patches that should directly help with the complex issue of anosmia. Links to the research and an example quote are included.

1. Reduced inflammation: Research 
   "The results demonstrated that nicotine exerted an inhibitory effect on the lipopolysaccharide‐induced HMC3 microglia inflammation, promoted the release of neurotrophic factors, and neuronal survival by altering the immune environment. These effects appear to be mediated through the activation of α7 nAChR, leading to an increase in phosphorylation of PI3K."
   
   
2. Improved bloodflow to the brain: Research
   "in isolated larger arteries at the base of the brain from the pig and cat nicotine induces NO (nitric Oxide)-mediated neurogenic vasodilation by acting on nAChRs located on sympathetic neurons resulting in release of norepinephrine (NE) which then acts on β2-adrenoceptors located on the neighboring nitrergic neurons to release NO and therefore vasodilation"
   
   
3. Increased CSF flow: Research
   "Nicotine injected intravenously in small doses (2.5–10.0 μg/kg) produced in anaesthetised cats a rise in cerebrospinal fluid pressure which was probably secondary to an increase in cerebral blood flow."
   
   
4. Neuroplasticity: Research
   "Therefore, activating nicotinic receptors has clearly discernable effects from global cholinergic activation. These nicotine-generated plasticity alterations might be important for the effects of the drug on cognitive function."

I could go on, but my time is up today.

Here are my personal suggestions if you are suffering from loss of smell/taste:

If you have had anosmia for less than a year, you should see results with the nicotine patches within a few weeks. Some lucky people see results in days. The use of scents to test each day could be a good objective measure of changes, and it is a cheap add-on. If you do not see a response within a few weeks, then add in some of the other adjunct therapies listed above. 

I hesitate to suggest other forms of nicotine (nasal spray, lozenges, etc) due to the small risk of addiction and side effects from higher doses... but it is an option.

Unfortunately, there is a correlation... a 2x to 3x risk (not causation) between anosmia and dementia. In my opinion, anything that reduces a "primal" neurological signal can't be good for brain health; however, there is no proof that restoring olfaction prevents dementia. And there appear to be some worrying overlaps between LongCOVID biomarkers and those of Alzheimer's Disease and TBI, which makes anosmia even more relevant.

Share your experiences in our private Facebook group or write up a short case study and email it to me.

All links can be found in our linktree:

linktr.ee/thenicotinetest

Thanks for reading,

Troy Roach

"Take care of yourself, and if you can, someone else too." 
-- Stephen Dubner, host of the Freakonomics Radio podcast