Smelling salts are ammonia-based products that have traditionally been used to help people regain consciousness after fainting. More recently, there has been a growing interest among athletes to use smelling salts to enhance alertness and boost performance.

Smelling salts are also known as ammonia inhalants. When smelling salts are breathed in, the chemicals in them cause a change in breathing pattern which is thought to help people become alert.

While smelling salts are generally safe when used sparingly and as directed, they can cause irritation in your nose and throat. Prolonged inhalation could potentially cause complications like lung damage.¹

How Do Smelling Salts Work?

Smelling salts—which come in packets, capsules, or liquid form—can be purchased over-the-counter in most pharmacies. The products contain low-concentrated ammonia or ammonium compounds. Some smelling salts also contain essential oils.

When smelling salts are inhaled, the strong odor—similar to that of a household cleaner—triggers your inhalation reflex. This reflex activation causes a temporary increase in your heart rate, respiration rate, and blood pressure. Blood flow within your brain is also enhanced. These effects are typically quick, occurring within 15 seconds of inhalation. The effects go away about a minute later.²¹

Smelling salts have historically been used to help revive people who have fainted. When someone faints, it’s typically because there’s a lack of oxygen to their brain. Without enough oxygen, the brain starts to shut down and you can pass out.

When a packet of smelling salts is placed about four to six inches from the nose, the fumes begin to erode the membranes in the nasal passages. The lungs respond by breathing in and out deeply in an attempt to rid the airways of the painful fumes. These deep breaths pump more oxygen into the body, which is ultimately carried to the brain. Once the brain has the oxygen it needs, the person who fainted regains consciousness.¹³

Potential Benefits of Smelling Salts

Smelling salts have been used since the 13th century to treat fainting and lightheadedness.

Smelling salts are also used by some athletes as a stimulant. Using smelling salts before or during competition, the athletes hope to increase their energy and respiratory rate and improve their alertness, focus, and reaction time.

Using smelling salts is especially popular among football players, hockey players, and powerlifters. In fact, it’s estimated that up to half of powerlifters use smelling salts. They will most often use it before two or three lifts during a competition as well as before the last event, the deadlift.⁴¹

The International Powerlifting Federation allows the use of smelling salts as long as they are used in private.⁴ The World Anti-Doping Agency, which oversees banned substances lists to promote fair and healthy international competition, has not banned ammonia.¹

But the evidence for the benefits of smelling salts is limited. For instance, one 2022 study on the effectiveness of smelling salts found that while they do elevate alertness and improve a person’s perception of their physical performance, they do not increase power, strength, or neuromuscular drive. And while smelling salts may be useful as a psychological stimulant, researchers noted that it is unlikely the products will improve performance.²

Another study found the use of smelling salts did impact peak force development during a strength test. But scientists note this improvement may have occurred because the inhalants psychologically stimulated the participants.⁵

Side Effects of Smelling Salts

When the ammonia in smelling salts comes into contact with moist areas of your body like your eyes, nose, and throat, it causes immediate irritation. You may notice that your eyes, nose, and throat burn. Your eyes might also tear up. You might cough and have a runny nose, as well. You also could experience upper airway swelling, leading to airway obstruction.⁶

If you are particularly sensitive—or if you put the salts too close to your nose—you could experience some minor chemical burns to your soft tissues.

It’s also possible that smelling salts can cause an allergic reaction or worsen conditions like asthma.¹

Dangers of Misusing Smelling Salts

The single-dose capsule of low-concentrated ammonia used to revive a person who has fainted or to potentially improve athletic performance is typically considered safe when used as directed. However, ammonia is a toxic substance. For this reason, there are potential health risks if smelling salts are misused, abused, or over used.

Frequently using smelling salts could cause pulmonary congestion and skin irritation.⁴ Permanent lung damage, or even death, is possible.¹

Using smelling salts for an extended period of time could also lead to olfactory fatigue, a phenomenon where your ability to detect an odor decreases over time.¹ When you are unable to detect the presence of ammonia in situations other than the use of smelling salts, you may unknowingly remain in an area where you are over-exposing yourself to the compound. Doing so can cause irreparable damage to your nose and lungs and potentially even death.⁷

Can I Use Smelling Salts Safely?

Smelling salts have not been studied for use as performance-enhancing supplements and are not approved by the U.S. Food and Drug Administration (FDA) as stimulant drugs.¹

The FDA has even issued a warning to consumers about using certain smelling salts because the products were marketed as promoting alertness and boost energy even though they had not been approved for those benefits. The FDA had also received reports of people experiencing adverse events such as shortness of breath, seizures, migraine, vomiting, diarrhea, and fainting from using the products.⁶

If you are interested in using smelling salts, talk to a healthcare provider first to determine if they are right for you. They also can advise you on how often to use them, if at all, and which products might be best. Keep in mind that smelling salts are not suitable for some people. For instance, if you have the following medical conditions, smelling salts may not be right for you:⁸

• Asthma
• Allergies
• Bronchitis
• Emphysema
• Chronic lung conditions

If you do decide to use smelling salts, keep them four to six inches from your nose when inhaling, and limit your exposure. Remember, extended use of smelling salts increases your risk of adverse health outcomes and can cause irreversible damage if misused.⁸

 If after using smelling salts you develop unexplained or unexpected symptoms, contact Poison Control immediately at 1-800-222-1222.

A Quick Review

Smelling salts are ammonia-based products that are placed under your nose when you have fainted or are feeling faint. When breathed in, the smelling salts causes a change in breathing pattern which makes you regain consciousness. Athletes may use smelling salts to increase their alertness and reaction time. However, there is limited evidence to support the use of smelling salts for athletic performance. When used infrequently and as directed, smelling salts are largely safe. But using smelling salts is not without risks. Not only do they immediately cause eye, nose, and throat irritation, but they also can cause coughing and watery eyes. Overusing smelling salts can lead to a number of more serious issues including breathing difficulties, irreversible lung damage, and even death. If you are considering using smelling salts, speak with a healthcare provider to determine if they are right for you.

Sources:

1. National Poison Control. Are smelling salts bad for you?
2. Campbell AK, Williamson CE, Macgregor LJ, Hamilton DL. Elevated arousal following acute ammonia inhalation is not associated with increased neuromuscular performance. Eur J Sport Sci. 2022;22(9):1391-1400. doi:10.1080/17461391.2021.1953150
3. The Society for Neuroscience. The abrasive aroma behind smelling salts.
4. Vigil JN, Sabatini PL, Hill LC, Swain DP, Branch JD. Ammonia inhalation does not increase deadlift 1-repetition maximum in college-aged male and female weight lifters. J Strength Cond Res. 2018;32(12):3383-3388. doi:10.1519/JSC.0000000000001854.
5. Bartolomei S, Nigro F, Gubellini L, et al. Acute effects of ammonia inhalants on strength and power performance in trained men. Journal of Strength and Conditioning Research. 2018;32(1):244-247. doi:10.1519/JSC.0000000000002171
6. Food and Drug Administration. FDA roundup: May 2, 2023.
7. Agency for Toxic Substances and Disease Registry. Medical management guidelines for ammonia.
8. PHE Centre for Radiation, Chemical and Environmental Hazards. Compendium of chemical hazards: Ammonia.

Important Notice: This article was also published at www.health.com by Sherri Gordon where all credits are due. Medically reviewed by Brian H Wetchler, DO