A randomised controlled trial of sodium citrate spray for non-conductive olfactory disorders

Carl Philpott, Sally Erskine, Allan Clark, Alexander Leeper, Mahmoud Salam, Rishi Sharma, George Murty, Thomas Hummel

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Background: Previous research has suggested that sodium citrate improves hyposmia by decreasing mucus calcium levels in the nose. This study aimed to confirm or refute this effect in a single application and assess potential side effects. Methodology: Study design was a randomised double-blind controlled trial of sodium citrate nasal spray (intervention) versus sterile water (control) in a tertiary care clinic. Fifty-five patients with non-conductive olfactory loss were randomised to receive the intervention or placebo. The primary outcome measure was improvement in measured olfactory thresholds for phenyl ethyl alcohol (PEA) over 2 hours. Other outcome measures assessed were Improvement in olfactory thresholds in 1-butanol, eucalyptol and acetic acid; number of responders with a clinically relevant response in each arm; adverse effects. Results: A significant effect was seen in the intervention arm for PEA and for 1-butanol and eucalyptol when compared to the control arm (P<0.05); 32% of the intervention arm responded in terms of improved sensitivity towards some of the odours. Minor adverse effects noted included sore throat, nasal paraesthesia, slight rhinorrhoea and itching. The duration of effect of the citrate is transient, peaking at 30-60 minutes after application. Conclusions: Sodium citrate yields some potential as a treatment for non-conductive olfactory loss, however these findings require corroboration in further clinical trials looking at longer-term regular use of the spray as a viable therapeutic option for patients where it would be applied at frequent intervals such as before meal times.
Original languageEnglish
Pages (from-to)1295–1302
Number of pages8
JournalClinical Otolaryngology
Issue number6
Early online date17 Apr 2017
Publication statusPublished - Dec 2017


  • olfaction disorders
  • clinical trial
  • smell
  • sodium citrate
  • viral respiratory tract infections

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