Frequently Asked Questions
- Anosmia – the total inability to smell
- Hyposmia – a reduced ability to smell
- Parosmia – unpleasant distortions of the odour molecules that are smelled – often described as burning rubber, raw sewage and chemicals
- Phantosmia – smell hallucinations – being able to smell something when there are no odour molecules present
- Euosmia – pleasant distortions of the odour molecules that are smelled – much more rarely presented than parosmia
- Hyperosmia – enhanced sensitivity to smells – sometimes people describe themselves as being a super-smeller
- Ageusia – total inability to taste
- Dysgeusia – distorted taste – often unpleasant
- Hypergeusia – enhanced sensitivity to taste – sometimes people describe themselves as super-tasters
- Hypogeusia – reduced ability to taste
There are several ways you can lose your sense of smell/taste or acquire a smell/taste disorder. Common causes include:
- An infection or virus, such as a cold, flu or sinusitis – this would include Covid-19
- Traumatic Brain Injury
- Allergies, such as hay fever
- Chronic Rhinosinusitis (CRS) – persistent inflammation of the sinus area
- Nasal polyps, which are benign growths in the lining of your nose this sometimes accompanies CRS
- Age related degeneration. Many people experience some changes to their ability to smell or taste as they get older. Just as our ability to hear and see can decline, so can our sense of smell and taste.
- Treatments for cancer
- Exposure to dangerous chemicals such as pesticides or solvents
- Abuse of drugs inhaled through the nose
- Pollution and poor air quality
- Some neurodegenerative conditions such as Parkinson’s disease, Alzheimer’s disease, or brain tumours
- Idiopathic loss – this means the cause is unknown
Different from losing the sense of smell is congenital anosmia where someone is born without ever being able to smell. This can be because they have no olfactory bulb or there is damage to the olfactory bulb/system. Some people who were born without the ability to smell have a rare genetic condition (inherited) called Kallmans Syndrome or congenital hypogonadotropic hypogonadism (CHH). It can also be be described as isolated GnRH deficiency.
If someone suddenly lost their ability to see they would know immediately and probably seek urgent medical assistance. If somebody woke up one day and couldn’t hear, they might not rush to the nearest emergency department but would likely seek medical advice from their GP or family doctor. Losing the ability to smell is often not noticed because the air around us doesn’t have a smell unless there are detectable odour molecules present.
It is a really common assumption to make, when someone loses their sense of smell, that they think they have lost the ability to taste. This is because they often notice it when they eat – they don’t notice necessarily that they can’t smell it.
Taste takes place on the tongue and in the mouth using tastebuds that detect 5 basic tastes: salty, sweet, sour, bitter and savoury (umami). Even when smell is lost or impaired, these tastes can be detected but we rely on our nose to work with our tongue when we eat. Even without smell we can experience these sensations.
Smell happens when we sniff something in through our nose and can identify the source – this is called ortho-nasal olfaction.
Flavour is what we detect when chew food and we breathe in through our nose. This is called retro-nasal olfaction or sometimes referred to as mouth-smell.
It’s the combination of both taste (salty, sweet, sour, bitter and umami) and smell that enables us to enjoy flavour.
The loss of true taste and true taste disorders are much less common but equally distressing. Information on taste disorders can be found here.
Often very young children do not recognise that they cannot smell and, unlike sight and hearing, it isn’t always obvious to a parent. Children often start to notice that they don’t know what smell is as they become more independent and interact with more people. Once they start school, self awareness increases and they become aware that they cant smell the fart that others are laughing about or they can’t smell the tuna sandwich someone is eating or the smelly trainers in the changing rooms.
If you notice something is wrong with your child’s ability to smell or they suddenly lose that sense or they tell you they don’t know what other children mean when they talk about smell, then seek help and make an appointment to see your family doctor. It is just as important to seek advice or help for the inability to smell as it would be about hearing and sight. We have developed guidance and support specifically for parents that can be found here
Unfortunately, there isn’t a single or simple answer. Smell/taste loss can be recovered but much depends on the cause. Post viral loss/disorders are recoverable in about 90% of people and this can happen as the affected area recovers from the damage caused by the virus. The length of time this takes is often only a few weeks but can take months and sometimes longer. Someone with nasal polyps can regain their sense of smell following surgery once the blockage is removed from the nasal cavity. Someone with a head injury or congential anosmia where the olfactory bulb is damaged or the olfactory nerve is severed however, are unlikely to recover. It is important to have the cause of your smell loss investigated to establish why and how it happened and to explore possible treatment options with your doctor.
People often describe not being able to smell and not being able to taste properly as living in a world without colour or experiencing life from behind a screen. This is because the sense of smell is closely linked to memory and emotion. It is the only sense that is part of the limbic system in the brain. Mothers know the smell of their babies and the smell of our partner can be comforting and familiar. People born with no sense of smell describe feeling isolated and envious because they have no smell memory. People who have lost their sense of smell describe feeling bereft and grieve their loss. Being excluded from a world full of smells can be distressing. If you are struggling with overwhelming and negative feelings, it’s important to talk to your doctor.
Connecting with us at Fifth Sense is a great step. Our resources are developed in conjunction with doctors, scientists and with people who live with smell and taste disorders. We are here to help you to help you.
Our SmellAbility toolkits contain smell testing and training resources, diaries and videos. Testing and recording your ability to smell is important to inform you of any changes however subtle. You can read more here.
Our #LetsTalkSmellAndTaste online events can connect you with others all over the world and hear from experts on many topics from food and drink to medical research. You can find more about this here.
If you live in the UK, our hubs are there for you to join and engage with a wide range of people, professionals and other supportive third sector organisations. FInd out how you can get involved in your nearest hub here.
Our Food For Thought section on the website provides ideas and recipes you can utilise. To read more click here.
We provide dedicated support to young people, children and parents here.
We have information sheets to help understand causes, how to cope with smell and taste disorders and how to talk to your doctor here. (LINK TO Information sheets HERE WHEN THEY ARE READY)
We have guidance on our page dedicated to living safely when you cannot smell properly. To read more click here.
We share patient stories and experiences that might be familiar and can provide information and hop. To read these you can access them here.
In the UK, the only place where you can be formally tested with regards to your level of ability to smell, is through an ENT or similar specialist clinic. There are two main tests that specialist medical professionals use – ‘Sniffin’ Sticks’ which a a range of “pens” that are used to test your sense of smell. This test takes about an hour and takes measurements of threshold, discrimination and identification. The UPSIT (University of Pennsylvania Smell Identification Test) is a scratch and sniff card with multiple choice for identification of smells.
However, you can perform you own simple test at home that can give you a good, general indication about your sense of smell. SmellAbility is a toolkit developed by Fifth Sense that has downloadable, easy to use resources and can be accessed here.
If you are experiencing smell/taste loss or changes that persist, like any physical change to your health it is important to seek medical advice. Changes to our ability to smell and taste can sometimes be an early indicator of other conditions and it is important to get it checked. Similarly, if your inability to smell/taste is causing your anxiety, low mood or feeling frustrated, talking with your doctor can help.
Information Sheet #8 (click here), can help you prepare for a medical consultation and give you some guidance on what you might want to ask and address.
In the UK, NHS referrals via your GP is the normal route to see a consultant who specialises in smell and taste disorders. A full list of UK NHS clinics can be found here. Some consultants also offer private consultations.
Outside of the UK, we are aware of the following clinics and centres that specialise in smell and taste disorders in a number of countries. They can be found here.
Surgery: If the cause of your smell loss is obstructive or caused by damage to your olfactory system, surgery to remove this is possible. A referral to an ENT consultant will be necessary and will involve a number of scans and investigations. Speak to your GP in the first instance about whether a surgical intervention is an option for you.
Steroids: Are a type of medication used to treat inflammation or allergies and are therefore suitable for some but not all causes of smell loss. Oral (tablet form) steroids are a powerful medicine that can only be prescribed by a doctor for specific reasons/causes and cannot be prescribed for long periods of time due to the contraindications and side effects associated with long term use. However, they can be prescribed short term and prescriptions can be repeated with long intervals in between. Nasal steroids can be prescribed by a doctor and some can be bought over the counter. They can be used for longer periods of time. Speak to your doctor or pharmacist about whether this is a suitable treatment option for you.
Vitamin A: There are some limited studies that show that nasal vitamin A drops may be a effective treatment for post-viral smell loss. Vitamin A plays a decisive role in the regeneration of olfactory receptor neurons. The procedure for administration is similar to that for nasal rinsing – tip your head back slightly and place 2 drops into each nostril daily. Some people report that the “Kaiteki” position is helpful. Kaiteki means comfortable in Japanese. Lie on your side with your head tilted backwards 20 to 30 degrees and the chin turned upwards 20 to 40 degrees. The following video link may be useful:
INSERT KAITEKI VIDEO HERE
Alpha Lipoic Acid: Prof. Thomas Hummel et al of the University of Dresden in 2002 found that alpha-lipoic acid may be helpful in patients with olfactory loss after upper respiratory tract infection. However, to judge the true potential of this treatment, the outcome of double-blind, placebo-controlled studies in large groups of patients must be awaited, especially when considering the relatively high rate of spontaneous recovery in olfactory loss after upper respiratory tract infection. It is important to discuss dosage with your GP or pharmacist.
Zinc: Zinc deficiency can lead to changes to smell and taste. This is because one of the enzymes critical to maintain taste and smell function is a zinc dependent metalloenzyme called carbonic anhydrase. A supplement might help if you have low zinc levels. Its important to recognise that Zinc can have toxicity and side effects when taken in high doses for a long period of time so ensure you check with your doctor before taking any dietry supplements.
Complimentary Therapies: Many people find complementary therapy helpful always ensure you speak to a qualified practitioner – its often a good idea to check with your GP as well.
- Aromatherapy – is a holistic, healing treatment that uses natural plant extracts to promote health and well-being. Sometimes it’s called essential oil therapy. Aromatherapy uses aromatic essential oils to improve the health of the body, mind, and spirit. It enhances both physical and emotional health. Essential oils may also be used in smell training.
- Acupuncture – is a proven and accepted treatment option for many health conditions however, there isn’t yet sufficient evidence that acupuncture is a successful therapy for smell/taste loss. Always ensure you contact an approved British Acupuncture Council member (or similar if outside the UK) for advice on whether they think that acupuncture treatment may be of benefit.
- Mindfulness/Meditation: Mindful meditation involves sitting silently and paying attention to thoughts, sounds, the sensations of breathing or parts of the body, bringing your attention back whenever the mind starts to wander. It is recommended in the UK by NICE guidelines to help with depression and anxiety which can be a consequence of smell and taste disorders.
- Smell Training: SmellAbility is a raft of resources developed by Fifth Sense to help establish the ability to smell, test, track, review and monitor changes and also how to undertake mindful smell training based on the scientific studies and how to adapt this to suit you. For more information click here.
- Nasal Rinsing: Nasal or sinus rinsing is a safe and effective technique that can be undertaken at home. Full details and instructions can be found here.