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DocSpot: Loss of sense of smell

Dear Dr Margaret
Over the past few years I seem to be losing my sense of smell. I also think I am losing my sense of taste as well.

I don’t know how old you are, but some loss of the sense of smell is common from the 40s, gradually worsening with ageing. In the 70s and 80s, the decline can be quite rapid. Of course, this doesn’t happen to everyone; some people in their 80s and 90s have a very good sense of smell. Women and non-smokers seem to retain their sense of smell slightly better than men and smokers. Our sense of smell helps to detect flavours, so it is not surprising that your taste also affected.

Apart from ageing, the commonest cause of loss of smell is some kind of blockage in the nose. This could simply be swelling of the lining of the nasal passages, caused by an allergy similar to hay fever or sinus infection. Another possibility is nasal polyps, which are non-cancerous growths. Therefore it would be worth discussing the problem with your doctor, especially if you are aware of having a stuffy nose. A loss of sense of smell occurs with some diseases, such as Parkinson’s disease.
 
Are you taking any medications? Many medications can affect the sense of smell, especially blood pressure drugs and lipid-lowering drugs. There is a long (but not absolutely up-to-date) list on the website www.anosmiafoundation.org; anosmia means ‘loss of sense of smell’. This Canadian website contains a lot of useful information and is well worth a look, but seems not to have been updated since 2003.
 
If your doctor decides it is caused by a blockage in the nose, appropriate treatment should help. I don’t know of any remedy if it is simply caused by ageing.
 
There are a couple of things you should be aware of. Firstly, the sense of smell helps us to detect dangers such as gas leaks, so if you have gas appliances be extra careful about turning them off properly and make sure they are serviced regularly. Secondly, don’t add salt to your food to make it tasty, because this would increase your risk of high blood pressure. Instead, use pepper or other spices. 
 

Sources of information

Holbrook EH, Leopold DA. Anosmia: diagnosis and management. Current Opinion in Otolaryngolology and Head and Neck Surgery 2003;11:54–60.
Mansoor M, Prichard D. Sense of smell. Geriatric Medicine 1998;28(10):16–18.
Doty RL, Philip S, Reddy K et al. Influences of antihypertensive and antihyperlipidemic drugs on the senses of taste and smell: a review. Journal of Hypertension 2003;21:1805–13.
Schiffman SS. Taste and smell losses in normal aging and disease. Journal of the American Medical Association 1997;278:1357–62.
 

Last updated; Thursday, August 31st 2017


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