We know that smell training is widely accepted as the best intervention for smell loss, but a team of researchers in Italy have been working on the hypothesis that taking palmitoylethanolamide and luteolin (PEA-LUT) tablets could make smell training even more effective. Chrissi, our founder, spoke with one of the key researchers, Arianna di Stadio to find out more.

Hello Arianna, Firstly, please can you tell us about your research interests before the pandemic.

Since 2017, my research interests have been focused on the relationship between hearing problems and multiple sclerosis (MS), an autoimmune neuro-inflammatory disease. I have also been seeking to identify new treatments for neuro-inflammation.

How did you come upon the hypothesis that PEA LUT might be useful in smell loss?

In my research, I approach MS both from an ENT as well as a neurology perspective. In February 2020 during the first part of the pandemic, we observed many patients with persistent smell dysfunction after COVID-19. I speculated that the symptom had a central cause (brain inflammation) rather than a peripheral cause (nasal problem). Because PEA-LUT is used for neuro-inflammation, I thought that this supplement could help patients to recover their sense of smell. 

What is the hypothesis?

The hypothesis is that the supplement can reduce inflammation in the olfactory bulbs and help natural recovery of olfactory function. By solving the problem of inflammation, and using this together with  olfactory training, we create a favourable combination that stimulates the sense of smell both peripherally (in the nose) and centrally (in the olfactory bulbs). 

What are your findings?

We carried out several studies (clinical trial, observational, case-control) and these studies
suggest that by combining PEA-LUT and olfactory training recovery is likely. An interesting finding is that this combination allowed the recovery of smell even in those patients who had been without function for over 12 months.

How does it work?

PEA-LUT reduces inflammation in the olfactory bulbs which creates just the right environment for recovery of the neural pathways. Smell training, combined with PEA LUT, creates a favourable opportunity for recovery. It is like ploughing a field first (PEA-LUT) before planting seeds (olfactory training). 

Can you explain the reclassification from supplement to drug, and what the implications are for patients?

Currently, PEA-LUT is classified as a food supplement for medical purposes. This means it is a  natural molecule that has a medical effect. Now that several studies have confirmed its
efficacy,  it will be reclassified  as a drug. This change will allow PEA-LUT to be on the list of medical drugs prescribed in Italy without cost to patients as part of the health system here. 

How is PEA-LUT administered?

PEA LUT is administered under the tongue where it can be absorbed quickly into the bloodstream. The product we used in our studies is an ultra micro-ionised powder that makes fast uptake through the mucosa (lining of the mouth) possible. This makes it different from capsules, taken orally that you can buy online. That is an important distinction. The micro-ionised product is the one we have evidence for as being helpful. We have not done research on the capsules and can therefore not vouch for the efficacy of capsules. The results discussed here are for the ultra micro-ionised PEA LUT only.

What is your message for patients?

The pandemic has been terrible for everybody, and many patients had symptoms that were  related to neuro-inflammation. Through our research, we propose a way to treat neuro-inflammation. We continue to refine this research. The treatment of neuro-inflammation could be the key to reduce the risk of developing neuro-degenerative diseases, not just smell problems from Covid 19. 

You can read more about the study above here.

October 17, 2022