DISCLAIMER: please discuss the recommendations below with your doctor.
UPDATE: while I discuss mostly post-covid19 anosmia reversal below, here is an account of a 5-6 month long post-covid19 anosmia case - reversing with IVM - see: https://saidit.net/s/Ivermectin/comments/972g/ivermectin_may_be_sold_or_purchased_as_an/xryd
This USA TODAY article (see below) talks about everything - except the treatments that actually work for post-covid19 anosmia reversal.
Typically this protocol will reverse post-covid19 anosmia in 1-2 days:
- Ivermectin 0.4mg/kg bodyweight per day - for 3 days
With results being visible in 12 hours. Full reversal within 1-2 days.
NOTE: Ivermectin for this use, should be taken with a fatty meal or a meal. Split into breakfast/dinner or breakfast/lunch/dinner dose if have side effects. 1 in 20 can experience dizziness (low blood pressure) on the first dose - so can test with initial low dose to see if patient is susceptible to this. In such cases can split doses as explained or reduce to half dosing (often this fixes it - though in a few even this is too much and for these should stop using Ivermectin). If taken for many days a subset of patients can experience visual disturbances at above dosing (usually at 5 days or longer at 0.4mg/kg) - in such cases should stop dose (can do a refresher dose after a week or so if needed).
If there is partial reversal, wait a week, and repeat the 3 days course.
Why is this protocol not well known
This protocol is known by early treatment doctors - nearly every early treatment doctor has used Ivermectin.
These doctors have observed the effect of Ivermectin on anosmia reversal.
However, not all may be fully convinced that IVM will reverse anosmia 100% of the time - because they may have given IVM during day1-7 of covid19 and yet some patients may still have developed anosmia.
This is typical.
Even if IVM is started day1-7 - still some patients (perhaps less that would be otherwise) do still develop anosmia by day5 or so.
This may lead some to think that IVM does not work 100% of the time.
However, when IVM is used in the post-day8 period (when usually steroids-at-day8 course has been started) - or even later when IVM is used for long haulers, there IVM seems to work 100% of the time in reversing anosmia fully (when used at above dosage).
For long haulers who have had anosmia for months, there may be partial reversal. In which case wait a week and try a refresher course of 3 days again.
Why isn't this well known by conventional doctors?
Normal doctors who haven't treated hundreds of covid19 patients will not know how to treat covid19 properly.
They will be relying on guidelines which are months old - for example a doctor who hasn't treated covid19 in large numbers (and learned from them) - will treat say:
stay at home - don't seek early treatment - wait until post-day8 hyperinflammatory stage is in full force - and you are suffering from hypoxia (oximeter readings are below 95 or below 90) before you come to hospital
large US hospitals will admit severe patients already suffering from hypoxia - at which point most hospitals will adhere to hospital protocols of Dexamethasone 6mg (capped!) + Remdesivir - even though Dexamethasone 6mg (equivalent to Prednisolone 40mg) is barely sufficient to turn around a day8 patient's hyperinflammatory stage - 6mg is insufficient to turn around a day10 patient or a patient whose oximeter is at 90. These patients then will stagnate as they are "observed" and then wind up on ventilator. Remdesivir has been shown to be of some help if used very early - and it carries risk of 20% kidney failure - the WHO has advised that Remdesivir not be used. Yet large US hospitals continue to give Remdesivir to severe patients where it is not effective (it may be effective for immunocompromised patients or for very late stage patients where there has been a resurgence of live virus after hyperinflammation has allowed live virus to expand into new territory).
Compare this to an early treatment doctor - who will treat with Ivermectin + Famotidine and other antioxidant/antiinflammatory supplements (Vitamin D3, C, B1 and NAC).
And then when day7-8 arrives - the early treatment doctor will start Prednisolone at 40mg per day for a week and then taper to zero over the next week.
This protocol prevents/anticipates the arrival of the post-day8 hyperinflammatory stage.
Since by day8 the bulk of the live virus is near zero - it is safe to start steroids at day7-8.
However the live virus is in huge numbers (live viral peak is at day1 and goes down after that). However all that live virus leads eventually to virus debris - and in simple terms that is the trigger for the hyperinflammation which is ramping up and starts becoming visible at day7-8 onwards.
For a subset of cases, if this hyperinflammation is not arrested (quelled with steroids etc.) - then it can start patient on a path to deterioration - these are some of the post-day8 hyperinflammatory signals:
oximeter readings can show daily declines
pulse rate can become 90s or 100+ even at rest (and even without fever)
anomalous fever can return at day7-8 ("hyperinflammatory fever")
The solution to quelling this is steroids - which quells the hyperinflammation and allows the patient to clear the viral debris.
Usually after 1 week of steroids and 1 week of tapering the steroids to zero - after that there is no resurgence of issues.
Patients who have been given steroids-at-day7-8 - in sufficient doses to reverse any signs of hyperinflammation - have zero long haulers.
A second path is when a patient is not given steroids-at-day8 as a matter of course.
This can happen with "mild" covid19 patients - who feel they don't have a very visible hyperinflammatory stage at day8.
However among these "mild" patients - it has been observed (I have observed this myself) - that a subset can have "creeping inflammation" - whic slowly ramps up - so that by 2 weeks it is at day8 hyperinflammatory type stage.
This matches the observation reported in mainstream media - about how "mild" covid19 cases became long haulers - typically the issues start 2 weeks after they have recovered from covid19 - and symptoms appear again. Heart rate elevation (possibly pericarditis) etc.
This is a point I have suggested to other early treatment doctors as well. That not just severe, but also "mild" i.e. all need to have a mandatory course of steroids-at-day8.
Since in a subset of cases who have "mild" - some will go on to have "creeping inflammation" which becomes visible after 2 weeks or so. This is the classic route to "long haulers in mild patients".
Giving steroids-at-day8 to all will lead to zero long haulers. Any residual symptoms like fatigue/anosmia can be treated with refresher doses of Ivermectin. And any fatigue much after that with low dose steroids as needed (at the discretion of physician).
This is why early treatments and treatments for anosmia are not well known
Given all that above - it becomes clear that most doctors who haven't treated hundreds of covid19 in an outpatient setting will not know how to treat covid19 related issues.
Most large US hospitals are not seeing the early cases - most of their exposure is in dealing with patients who are severe (after being told not to come to hospital any earlier).
Censorship and the Trusted News Initiative (TNI)
And then we have the censorship of drugs like Ivermectin.
Long before there was any justification to criticize it, there was a mass media campaign against it.
The FDA even tweeted calling it a "horse dewormer".
To understand how there is synchronized widespread opposition to Ivermectin in the mainstream media (YouTube terms of service even list Ivermectin explicitly) - you will have to understand the Trusted News Initiative (TNI) which most mainstream media outlets (including Reddit, Twitter, Facebook, LinkedIn) are signatories to:
NOTE: probably more has been spent on the media campaigns to censor Ivermectin and other generic drugs during this pandemic - than spent by the NIH on Ivermectin during the first 1.5 years of the pandemic. This was borne out by Dr Rajter's frustration on twitter how he got no funding from the NIH for the first Ivermectin study in the US (published in CHEST journal). This when the NIH has a whole Repurposed Drugs division with billions in funding at it's disposal (which wasn't used to research these generic drugs).
What is the negative evidence against Ivermectin
After tens of studies supporting the use of Ivermectin for covid19, there are 2 main studies (Lopez-Medina and TOGETHER trial) which are used to shoot down Ivermectin.
These 2 studies are riddled with issues (main one being they both were done in areas where Ivermectin use was endemic - i.e. no testing was done to ensure the placebo patients were not already taking Ivermectin).
They also had researchers who were hostile to Ivermectin - TOGETHER trial researchers were badmouthing IVM from the get go - and failing to include the suggestions of early treatment doctors regarding dosing and duration.
Lopez-Medina has hordes of issues - for example lying to participant that they were not being given Ivermectin. Giving Ivermectin to placebo group (later found and removed from data - but did they catch all the cases?). This study also noted that their placebo arm did better than expected (were a subset of placebo participants already on Ivermectin?).
These 2 studies are now used to push for an iron-clad case against Ivermectin.
You will hear doctors (who have not bothered to study beyond the headlines and the paper contents) - who will say:
- Ivermectin has been conclusively shown to not work for covid19
The answer to this is:
these 2 papers only say that their studies failed to achieve statistical significance - i.e. their placebo groups had so few deaths (fewer than expected as Lopez-Medina says) that it was unlikely to show big disparity between placebo and treatment arm. Yet these studies show Ivermectin arm had lower deaths than placebo arm in absolute numbers. Just that the numbers were small so cannot conclusively say ..
TOGETHER trial researchers now say (in a zoom conference call) - that they were under pressure (from anti-IVM peer pressure from their community) to move on quickly from IVM - as a result they were under pressure to not continue the study - they say that in other circumstances perhaps they should have continued the study for longer in order to achieve statistical significance - since Ivermectin arm did show lower deaths than placebo arm in absolute numbers
yet this "failed to achieve statistical significance" reality is instead phrased as "IVM failed" - and people believe the mainstream media reports that are pushing this phrasing
The 2 studies only examine Ivermectin impact on mortality benefit - they don't examine the impact of Ivermectin as prophylaxis or for anosmia reversal (which are both more obvious effects - prophylaxis 8x lower cases according to the prophylaxis studies - and anosmia reversal studies which show 100% anosmia reversal - which is the case from my experience as well)
so the media and doctors have extrapolated their understanding of Ivermectin for "mortality benefit" to say that Ivermectin is a "horse dewormer" and has already been discredited. Yet they know nothing of and have not addressed the studies which show Ivermectin has prophylaxis and anosmia reversal benefit
Under these circumstances you are unlikely to find a doctor without early treatment experience who would know of or feel comfortable prescribing Ivermectin for anosmia reversal.
Only the early treatment doctors who have already used Ivermectin and are comfortable with it's safety and efficacy will be comfortable prescribing Ivermectin for anosmia reversal.
This is why I mentioned that one should seek out early treatment doctors for post-covid19 anosmia reversal (see References section below for lists of doctors).
Why do my dogs smell like orange slices? The latest research on how COVID messes with smell
Most people hit early with coronavirus lost their smell. Now, not so much. Scientists are starting to figure out why and what that means going forward.
April 24, 2022
Loss of smell and taste was a distinguishing feature of early COVID-19.
The majority of people infected in 2020 and 2021 lost their smell, regardless of how sick the coronavirus made them.
That began to change with the delta variant that moved into the United States last summer and took over by the fall. Between 15-50% of people infected with delta lost their smell, compared with 50% to 80% of those with earlier variants, said Danielle Reed, a smell researcher and associate director of the Monell Chemical Senses Center in Philadelphia.
And by the time omicron began sweeping though after Thanksgiving, doctors could distinguish which variant someone had by whether they lost their smell, said Cristina Menni, a molecular epidemiologist at Kings College London.
"Loss of smell is no longer frequent in those infected," she said.
Only about 17% of people infected with omicron lost their sense of smell, according to a study Menni helped lead.
It's not clear why, Menni said, other than that omicron appears to replicate better in the throat, while earlier variants replicated more in the nose and lungs. The two omicron sub-variants, BA.1 and BA.2, appear very similar in terms of symptoms and duration of symptoms, she said.
Elizabeth Byland, her husband, Todd Murray, and their dogs Daisy, a shitzupoo, and CeCe, a lhasa apso. Byland lost her sense of smell last summer after a mild bout of COVID-19. Now, as her sense of smell slowly returns, many smells are not quite right. Her dogs, for example, particularly CeCe, smell to her like orange slices.
For Elizabeth Byland, 35, the story isn't over.
An improv professor at Virginia Commonwealth University in Richmond, Byland lost her sense of smell when she was infected in July 2020, and it's still not fully back to normal.
Her dogs now have the scent of orange slices. Carrots taste like soap, her favorite body wash smells "putrid" and her beloved pizza is inedible. Her husband and nearly everything else has a background scent like a subway system.
"The sad part is, it's become my normal," Byland said. "I don't think about it as much as I used to."
Her husband, Todd Murray, got COVID-19 a full 15 months later, during the delta wave, and he still suffers from weird smells, too. She said he compares it to "a big, heavy blanket where everything has this distorted chemical smell," like the scent of an aerosol spray.
Byland used to go to him to understand certain smells and tastes, but now the roles have reversed.
"There's just this whole other level of empathy," she said.
Dr. Daniel Coelho, a professor of otolaryngology at VCU, has been studying people with smell and taste loss like Byland's since early in the pandemic.
His work, including a forthcoming paper, confirms that earlier variants caused more smell and taste loss than omicron.
Among those who lost their smell and taste earlier in the pandemic, his research shows it returned within a month for 70-80% of people, including Coelho himself. But those whose senses didn't bounce back quickly are likely to continue to suffer.
"Those numbers hold pretty steady," he said.
Loss of smell often causes a loss of taste as well, because the two are so related. And it can be debilitating, Coelho said, causing people to lose interest in food, risking their safety because they can't smell gas or fire, and often leading to depression.
Very quickly, about half the people who lose their sense of smell become clinically depressed, Coelho's research into COVID-19 patients shows.
"Smell is a very primitive and very powerful sense," he said.
The biology of smell loss
It makes sense, Coelho said, that many people like Byland and her husband complain of chemical scents. If the olfactory nerve is damaged, only the trigeminal nerve remains – and it's responsible for detecting noxious or irritating smells.
That's what appears to have happened with COVID-19, especially the earlier variants, which damaged supporting cells in the olfactory system but left the trigeminal nerve alone, he said.
Another new study suggests that inflammation causes this damage inside the nose.
The study examined brain tissue from 23 people who died of COVID-19 and 14 who died of other causes between April 2020 and September 2021.
Cheng-Ying Ho of the Johns Hopkins University School of Medicine said she and her team found damage to the olfactory bulb – the seat of smell – that was not directly caused by the virus, so it was likely caused by inflammation.
The virus that causes COVID-19 infected the cells of the blood vessels, damaging blood supply to the nerve cells involved in smell, she said.
This damage might repair with time, but if it's too severe, it can be permanent.
In people with continued smell loss, it's as if the nose doesn't realize the body has won the battle against COVID-19 and keeps on fighting, said Reed, the smell researcher from Monell.
In addition to inflammation "crawling from the nose to the brain," atrophy from lack of use may also contribute to smell loss, Reed said. "It's a double-whammy for people."
Loss of smell from viruses is quite routine, she said, but the scale of smell loss from early COVID-19 is unprecedented: "The shocker here is how common it is."
If the olfactory system still thinks it needs to fight off the coronavirus, it doesn't have the energy to begin necessary repairs.
It's even hard to know whether a sense of smell has returned to "normal," Reed said, because there are no objective tests of smell ability.
About 85% of people who lost their sense of smell say they're somewhere close to normal, she said, but because so many people were infected with COVID-19, "there's a tsunami of people who are really struggling."
Reed compared omicron and delta variants to "conventional warfare," while earlier variants effectively dropped nuclear bombs in the nose.
Older women are most likely to report parosmia, or a distorted sense of smell, though that might be a reporting bias, Reed said. Perhaps men are more stoic in the face of smell loss, she said, or women, who generally have a better sense of smell, "might have more to grieve" when it's lost.
Unfortunately, there's not much known to be effective to repair a lost sense of smell. Consistently and mindfully sniffing spices might help, Reed said, and can't hurt, though it can be frustrating.
Identifying inflammation as the cause of COVID-19-related damage might suggest a treatment approach, Ho said. But steroids, which combat inflammation, have not been shown to repair smell, Reed noted.
Ho next wants to explore whether vaccination interfered with or prevented this type of damage.
What's not clear is how worried people should be about smell loss. Bad enough on its own, smell loss can also be an early sign of larger brain problems, leading to dementia, Parkinson's or other neurodegenerative disorders.
But, Reed said, "it's a little early to say whether people who got smell loss with COVID have that same underlying susceptibility to these neurodegenerative disorders."
Contact Karen Weintraub at email@example.com
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
There is a section on Early treatment doctors in the wiki - early treatment doctors have often treated thousands of covid19 patients and have themselves seen the effect of Ivermectin and other treatments for covid19, long haulers and post-vax issues:
Here are some posts related to covid19 treatment and long haulers:
Queen Elizabeth tests positive for covid19 - what early treatments will she be getting - will those be advertised to the public? (Feb 20, 2022) - will it include Ivermectin, or at the very least steroids-at-day8 to avoid risk of death, and avoid risk of long haulers?
Update to Queen Elizabeth post - evidently she now has some mild long covid19 (which should not have had if treated correctly) (April 12, 2022) - here are some suggestions for what she could be given in her current condition (post-covid19 residual fatigue)
This post examines Ivermectin for anosmia reversal - but also examines the other treatments which have worked fully or partially for anosmia reversal - including for pre-covid19 anosmia - and some intriguing cases of anosmia since childbirth reversing (with LSD):
Survey of Anosmia treatments - IVM or other treatments - share your experiences reversing covid19 anosmia (taste/smell loss) esp. if reversal was immediately after treatment start (i.e. looks like treatment helped immediately) (April 21, 2022)
When I saw the first anosmia reversal with Ivermectin, I thought I had discovered something new - but there already was a paper by Gustavo Aguirre Chang (Peru) - a 21 patient study with near 100pct reversal with 1 or 2 cycles of IVM + Aspirin:
COVID-19 Persistent: TREATMENT WITH IVERMECTIN AND ACETYLSALICYLIC ACID OF PATIENTS WITH THE PERSISTENT SYMPTOM OF ANOSMIA OR HYPOSMIA.
Gustavo Aguirre Chang
September 26, 2020
Original post and mirrors
Mirrors linking to r/covid19anosmia:
Twitter thread: discussing this post with early treatment doctors:
USA Today article on post-covid19 anosmia - full article available along with commentary - why early treatment doctors are best placed to reverse anosmia (with IVM 0.4mg/kg bodyweight per day - for 3 days) - and why this treatment is not well known: