On Your Health

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Anosmia Stinks: When You Lose Your Sense of Smell

About 30 million of us will suffer from a cold or sinus infection this year. In the midst of the aches, burning throat, lethargy, stuffy head, fever and general yuckiness, many of us will also notice that things don’t taste as good. Or that flavors seem dulled, or faint.

That’s usually due to inflamed sinus passages. Your ability to taste and smell will usually rally and return once the inflammation is gone. While a temporarily dulled sense of taste is a nuisance, for 99 percent of cold sufferers, that’s all it is: a few days of annoyance.

However, for thousands of cold sufferers each year, this loss of smell and a diminished ability to taste become persistent. Even with a full recovery from the acute nasal stuffiness that accompanies a cold or sinus infection, for some, a change in taste can last months. For an unfortunate few it can last years or even for the rest of their lives. It’s called anosmia.

What is anosmia?

Anosmia, or the loss of one’s sense of smell, is a serious condition. There's no good estimate for how many people live with smell loss, although the Anosmia Foundation estimates two million to five million American adults have taste and smell disorders. 

Congenital anosmia, being born without a sense of smell, is a rare condition, but acquired smell loss through things like an infection, smoking, nasal growths or a brain injury is more common. That loss can be total, or what's known as hyposmia, a diminished sense of smell. Aging also plays a role, and a large proportion of the population has some degree of smell loss in their 60s and beyond.

Anosmia comes with a whole host of challenges for those suffering from it, including:

  • an inability to taste food, which can lead to eating too much or too little
  • an inability to smell spoiled food, which can lead to food poisoning
  • lack of interest in social situations, which might be because someone with anosmia is unable to enjoy the food at a social gathering
  • inability to detect body odors
  • losing the ability to recall smell-related memories
  • loss of intimacy due to the inability to smell perfume or pheromones
  • increased danger in the event of a fire if you cannot smell smoke
  • losing the ability to detect chemicals or other dangerous odors in your home
  • lack of empathy from family, friends or doctors
  • mood disorders such as depression

How a disordered sense of smell and taste relate

The senses of smell and taste are very closely linked. Most people who visit a doctor because they think they have lost their sense of taste are surprised to learn they have a smell disorder instead. Generally, a smell or taste disorder will fall into these four categories:

Anosmia: Loss of sense of smell.

Ageusia: Loss of sense of taste. (This is actually very rare).

Hyposmia: Reduced ability to smell.

Hypogeusia: Reduced ability to taste sweet, sour, bitter, or salty things. (Also rare).

According to Dr. Wendy McConnell, "About 80 percent of taste disturbances are actually related to changes in a person’s sense of smell. Most often changes in smell are caused by temporary conditions that cause irritation or swelling in the nasal cavity, like a sinus infection, allergies or a cold," she says.

Dr. McConnell, who is a board certified INTEGRIS otolaryngologist and an expert in sinus disorders and rhinology, says that loss of taste, or disturbance of taste, is not uncommon with sinus infections or colds. In fact, "Most people will notice their taste is altered, and some foods may taste different or not as distinct as before," she says. Thankfully, "Treating the cause of nasal swelling will usually resolve the alteration of taste."

The first step in treating nasal swelling is to treat any active sinus infections. "We’ll use a little camera to look up inside the nose to see if there is inflammation or a sinus infection," she says. If an infection is present, she’ll prescribe antibiotics and sometimes a steroid to help shrink the swelling faster.

What about nasal polyps and other causes?

If the diminished sense of smell and taste persists after an infection has cleared, or if the patient didn’t have an infection to begin with, nasal polyps could be the cause. Nasal polyps are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. They hang down like teardrops or grapes. They result from chronic inflammation and are associated with asthma, recurring infection, allergies, drug sensitivity or certain immune disorders.

"I've seen nasal polyps so large they were literally growing out of a patient’s nostril, or so small we needed a CT scan to see them," says Dr. McConnell.

Polyps cause problems because they block the air flow to olfactory fibers. These are located in the upper part of the sinuses and deliver information about scent to the brain.

"When we inhale, the air passes over the olfactory fibers, but if they are blocked by polyps, they can’t function as well," McConnell says. Removing nasal polyps is an endoscopic, outpatient procedure. Patients should regain lost smell within three to six months of polyp removal.

Other causes of smell disorders are rare, but include underlying brain tumors, head injuries, dental problems, side effects from certain cancer treatments, Parkinson’s disease and Alzheimer’s disease.

How to enjoy food with a smell or taste disorder

If you lose your sense of taste, here are things you can try to make your food taste better:

  • Prepare foods with a variety of colors and textures.
  • Use aromatic herbs and hot spices to add more flavor; however, avoid adding more sugar or salt to foods.
  • If your diet permits, add small amounts of cheese, bacon bits, butter, olive oil or toasted nuts on vegetables.
  • Avoid combination dishes, such as casseroles, which can hide individual flavors and dilute taste.

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