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There is well documented variety of anosmia called steroid-dependent anosmia. The diagnostic criterion is
whether steroids such as oral prednisone or (thanks for the suggestion Karl Wuensch, it worked for me too)
an injectable steroid such as Kenalog remedy the condition, even if only temporarily.
Thanks to finally (after 8 years) being referred to an incredibly good clinic of sub-specialists devoted to sinus
problems (California Sinus Center http://www.calsinus.com/ ) I was put on a saline nasal rinse to which I add
budesonide. Better known by the brand name Pulmicort, budesonide is a steroid usually prescribed for asthma
vaporizers. The rinse gets way up to where polyps form which block air flow to the olfactory nerves, and sprays
simply do not go there. Research has also shown that budesonide is superior to steroids like prednisone in that it
does not have a systemic effect. This is not only due to its being applied locally to the affected area, it's my
understanding that it is either not systemically absorbed or that if it is, it does not have the potentially quite serious
detrimental effects from long term use that other steroids like prednisone have.
There are lots of theories, but what counts is results and given the results I've seen, I am inclined to totally believe
the above information which I learned from my doctor at the aforementioned clinic. She scoped my nasal passages,
found infected polyps which she then cultured to ensure prescription of the correct antibiotic. I was given 10 days
of antibiotic with a course of prednisone to bring things under control. After that the budesonide rinse twice daily,
which has kept me symptom free for many months.
Francis
Paul Collins wrote:
In my opinion it is definitely worth trying the steroids.
Is the pred a tablet? my experience is that locally applied steroid up the nose is more effective and has less potential for side effects. I found steroid sprays ineffective but there are liquid preps available.
If in the uk ask your GP or ENT consultant for Betnesol drops and apply these in the inverted head position - if it is going to have an effect it should within 7 days. In the UK Flixonase can be obtained as a liquid preparation (Flixonase nasules). I found this preparation is also effective but takes longer to have an effect i.e. 2 weeks as opposed to 2 days with Betnesol . Not sure about availability of these or similar in other countries.
If this works then you can try sprays which do not require the hassle of the inverted head position but i have found that these do not get the steroid high enough up the nose to have an effect.
Probably worth having the CT scan first though to get a picture of the situation before treatment.
Good luck
paul
From: Chris <cxthom@gmail.com>
To: anosmia@yahoogroups.com
Sent: Wednesday, 8 July, 2009 21:51:21
Subject: [anosmia] Prednisone
So I went to the ENT today after having hyposmia for about 6 weeks now following a URI. After having read everything there is to read about the condition (I'm something of a hypochondriac at the best of times) on the Web, I was prepared for the ENT verdict, but admittedly somewhat surprised when he finally delivered it. He basically said 'Dunno, probably viral.. dunno if you'll get it all back.. who knows.' No smell test and no assessment of continuing sinus pressure and any possible links to hyposmia.
He ordered a CT and prescribed some Prednisone and Flixonase.
Is there really no new knowledge or research done on this subject? Seems so weird to me.. I have fairly pronounced tinnitus as well (what's next?!) - a couple of years ago they were saying the same thing: nothing to do. But now we do have Neuromonics treatment which is highly effective for people with this condition, and Xanax works as well.. really wondering why sos conditions leave even experts stone cold.
Anyway, has anyone used Flixonase? I'm VERY skeptical about putting anything up my nose at this point. I've still got decent smell if I hold things up to my nose, but sense of taste is pretty poor - I downed two glasses of Maker's Mark (bourbon) this evening and it tasted like spicy water. I'd like to hold on to that at least!
Also, should I wait for the CT scan before ingesting Prednisone? Some people seem to get something out of this treatment, so I'm willing to give it a try to see if it gets me back to 'normal' (or at least clue me in on whether it is a viral or inflammatory problem). But the CT isn't for a couple of weeks, and the treatment might affect the results of the CT.. anyone have advice?
Thanks!
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