The ability to smell is a sense we often take for granted, but people who have lost this sense know that our sense of smell is linked to our overall quality of life. It is a major contributor in our ability to taste food, and people who lose their sense of smell often lose their appetite. If you are losing your sense of smell, you may have noticed that things taste differently. In fact, the two senses are so connected that people who are losing their sense of smell often mistakenly believe they are losing their sense of taste. Our sense of smell can also warn us when we might be in danger. For example, the smell of smoke alerts us of fire, and noxious chemical smells force us to leave an area before these chemicals can damage our lungs or other parts of our bodies. Many of us associate certain smells with pleasant memories or find certain smells comforting. For example, if your grandmother's house smelled like cinnamon rolls, you may find this smell comforts you when you're stressed out or not feeling well.
The loss of one's ability to smell is called anosmia. Many conditions can temporarily or permanently cause anosmia and, more rarely, a decreased sense of smell can signal the start of a serious condition such as Alzheimer's or Parkinson's disease. Some people are born with a diminished or heightened ability to smell when compared to others. In general, our ability to smell may wax and wane over our lifetime, and most of us begin to lose our sense of smell after the age of 60. Studies also show that most women have a more accurate sense of smell than most men.
In addition to a diminished sense of smell and taste, people who suffer from anosmia may also have other symptoms, depending on the cause of their anosmia. These symptoms vary widely, and you should report any unusual symptoms to your doctor even if you don't think they're relevant, as they may indicate an underlying condition.
If you're concerned that you might be losing your sense of smell, it's likely you have a common and temporary condition, so we will cover those first. Keep in mind that each individual and case is different, so whether or not your diminished sense of smell persists will depend on your individual circumstances.
The following conditions can cause anosmia that is often temporary or reversible:
- congestion from colds or upper respiratory infections
- nasal polyps (often must be treated surgically)
- deviated septum
- temporary fluctuations in hormone levels
- vitamin deficiencies or malnutrition (rare)
- dental problems or oral surgery
The loss of smell due to the conditions or risk factors listed below may be reversible in some people but permanent in others; or, anosmia may be only partially reversible.
- Smoking: once a person quits smoking, her sense of smell usually improves — but how much a person's ability to smell returns is variable.
- Medication side effects: may be temporary or permanent, depending on the medication. Zinc nasal sprays are known to cause permanent anosmia.
- Breathing in chemicals or environmental pollutants: certain noxious chemicals have been known to cause permanent anosmia.
- Drug abuse: the use of cocaine or other drugs which are snorted up the nose can cause anosmia; like smoking, a person's ability to smell may or may not return when the drug is stopped, or may only partially return.
The list of medications that may alter a person's ability to smell or taste is very long, but includes many antibiotics, antidepressants, blood pressure and heart medications.
The conditions listed below often cause a permanent loss of a person's sense of smell. Again, keep in mind that each case is different, and some people may regain their sense of smell even though many do not.
- loss of smell due to the normal aging process
- brain injury
- disorders that affect the nervous system including: Parkinson's disease, multiple sclerosis, Alzheimer's disease, Bell's palsy
- radiation treatment to the head and neck
Conditions that may cause anosmia in rare cases include:
- tumors of the brain, sinus cavities or nose
- Sjogren's syndrome
- systemic lupus erythematosus
- psychiatric conditions
- cerebral vascular accident
- Kallmann's syndrome
- adrenocortical insufficiency syndrome
- Cushing's syndrome
- Turner's syndrome
You may wish to try our symptom checker if you think you are losing your sense of smell or have one of the conditions mentioned in this article.
How is a Loss of Smell Diagnosed?
Your doctor will review your medical history as well as any current symptoms you might be having. Your doctor will probably also perform a physical exam, and if warranted, he or she may order the following tests:
- blood tests to rule out risk factors such as infections or hormonal disturbances
- CT scan or MRI to diagnose nasal polyps or tumors
- scratch and sniff test (you will be asked to identify certain smells)
- taste test
When Should I See a Doctor?
Any unexplained loss of smell that lasts longer than a cold virus probably should be checked out by a doctor. See a doctor immediately if your inability to smell comes on suddenly and is accompanied by other worrisome or strange symptoms. Go to the emergency room if you lose your sense of smell and experience neurological symptoms such as dizziness, slurred speech, or muscle weakness.
Can Anosmia be Treated?
As mentioned above, many conditions that can diminish your sense of smell are reversible, but it depends on the root cause of your condition. Nasal polyps or deviated septums can be treated surgically, sinusitis can sometimes be treated with antibiotics, and allergies can be treated with medications. If the anosmia is a side effect of a medication you are taking, the medication should be stopped. There is no medication or treatment specifically designed to improve or bring back your sense of smell, but finding the cause of the anosmia and resolving the underlying issue is successful in many cases. In some cases, the sense of smell may return gradually over time.
American Academy of Otolaryngology - Head and Neck Surgery. Smell and Taste. Accessed: April 24, 2013 from http://www.entnet.org/HealthInformation/smellTaste.cfm
American Family Physician. Smell and Taste Disorders: A Primary Approach. Accessed: April 24, 2013 from http://www.aafp.org/afp/2000/0115/p427.html
Medline Plus. Smell-impaired. Accessed: April 24, 2013 from http://www.nlm.nih.gov/medlineplus/ency/article/003052.htm
NIH Senior Health. Problems with smell. Accessed: April 24, 2013 from http://nihseniorhealth.gov/problemswithsmell/causesandprevention/01.html