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The olfactory receptors and processing centers in the brain have estrogen receptors, so when hormone levels shift, it can cause the brain to misinterpret or create false smell signals, resulting in phantosmia

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Lung irritants such as air pollution, dust, fumes, or smoke can also trigger an exacerbation

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The Chinese Athletics Association (CAA), which oversees the organization of marathons in China, also took a dim view of Smoking Big Brothers worldwide fame