ACUPUNCTURE IN MEDICINE 2003;21(4):153-154.
Anosmia Treated with Acupuncture
Anosmia or hyposmia is a rare condition which is
difficult to treat especially when the cause cannot
be identified. Often patients get used to coping
with the condition since the treatments available
are considered limited and hopeless. The common
causes of anosmia or hyposmia are trauma,
tumours of the frontal lobe or atrophic rhinitis.
Another very important cause is psychological
factors, especially when a cause cannot be found.
Acupuncture is a safe and simple method to offer
to patients with anosmia.
A 55 year-old lady was attending the pain clinic
for pain in her right hypochondrium. One day she
mentioned that she had not been able to smell
things for the past two years. She had been
investigated by the Ear Nose and Throat (ENT)
department over the same period. I suggested a
trial of acupuncture for her problem, since there
had been no signs of improvement up to that point
with conventional management. She said that she
was willing to try anything.
Her inability to smell developed suddenly. She
gave no history of trauma, injury or surgery to her
head or nose or any bleeding from the nose. There
was no history of headaches, migraines or any
psychological condition to account for such an
attack, and nor was there any history of spinal or
epidural injections in the past. She was a non
smoker and did not use any inhalers. She was not
allergic to any known substances and gave no
history of hay fever. She was medically fit apart
from having hypercholesterolaemia, for which she
was taking atorvastatin 40mg daily. She had
recently been diagnosed as having non-alcoholic
steatohepatitis by a gastroenterologist. She gave
no history of previous attacks of anosmia. The
ENT assessment did not reveal a cause for her
anosmia. CT and MRI scans of her head and
sinuses were reported as normal by the radiologist.
Examination of her nervous system did not
reveal any abnormality apart from her olfactory
deficit. Her olfactory function was tested using
items available in the clinic (lime, apple, banana,
strawberry and perfumes). Tests were performed
on each nostril with the patient’s eyes open and
also blindfolded. No irritating substances were
used. She was unable to identify any of the
The acupuncture points used were Yin Tang, LI20
(Yingxiang) on both sides and GV23 (Shangxing)
and the needles were left for five minutes. She
was seen a week later. She mentioned that she
could smell almost everything. She was able to
smell her grandchild’s nappies and also the strong
smell that you get when passing a farm. Her
olfactory function was tested again blindfolded
using the same substances as before. She was able
This is a report detailing the successful treatment of a case of anosmia with acupuncture. The patient was
managed conventionally for two years with no sign of improvement. She regained the sense of smell
following one session of acupuncture. Such patients should be investigated for any detectable organic
cause prior to treatment with acupuncture.
to identify all the substances presented to her. She
was seen seven months and 20 months later, and
her sense of smell had remained intact.
This is the first occasion in which the author used
acupuncture to treat anosmia. No identifiable
cause was detected to account for the patient’s
anosmia. One of the rare potential causes of
anosmia is a frontal lobe tumour; however, CT and
MRI scans were unremarkable. She denied any
surgery or injury to her nose. She did not use
inhalers. Use of inhalers can cause some
impairment of smell. Atorvastatin was the only
medication that she took, and the British National
Formulary does not give anosmia as a side-effect
The gastroenterologist was asked
cause for her anosmia. He felt that it was very
unlikely to be the cause. The testing of olfactory
function was rather crude; however, the items used
were the best available at the time.
Yin Tang is a local point and is indicated in the
treatment of frontal headache, eye disorders,
rhinitis, sinusitis and insomnia.
LI20 in Chinese
LI20 is indicated in nasal obstruction and loss of
sense of smell. Needling LI20, in traditional
terms, helps the ‘lung’ to perform its dispersing
function, so that the nose can smell fragrant scent,
hence the name ‘welcome fragrance’.
GV23 (Shangxing) was used as a local point for
the nose and over frontal sinus. De Smul had used
low frequency electroacupuncture for 10 minutes
at LI4 and LI20.
He had treated 19 patients, with
treated 23 cases of atrophic rhinitis with
One of the symptoms of these
of the nasal mucosa. They used the acupuncture
points Yin Tang and bilateral Shangyingxiang (an
extra point 0.5cun inferior to the inner canthus of
the eye) as their main points. It was effective in 10
patients and markedly effective in seven. In six
patients it was ineffective.
A safety consideration to bear in mind when
needling points close to the nose and eyes is that
the veins in this area communicate directly with the
cavernous sinus, and therefore there is a theoretical,
albeit remote, risk of cavernous sinus infection
and thrombosis. Any advantage in disinfecting the
skin prior to needling remains debatable.
Acupuncture is a simple treatment that may be worth
considering in cases of anosmia or hyposmia.
I would like to thank Dr J Watt for his helpful criticism.
British National Formulary 45. London: British Medical
Britain; March 2003.
Hecker HU, Steveling A, Peuker E, Kastner J, Liebchen K.
Li D. Acupuncture, Meridian Theory and Acupuncture
So JTY. The Book of Acupuncture Points. Brookline:
De Smul A. Anosmia, Hyposmia Treatment with Electro-
Yang J, Zhang Q. Twenty-three cases of atrophic rhinitis