Anosmia Loss Of Smell

Overview

Anosmia is the medical term for losing your sense of smell. You may not smell anything at all, or you may notice that things smell weaker than before. It can happen suddenly or gradually, and it affects both how you smell and how you taste food.

Yes. Losing your sense of smell is fairly common. It affects many people at some point, especially after colds, flu, or COVID-19. It becomes more common with age.

It can affect anyone, but it is more common in older adults. Men and women experience it equally. It can also affect children, often after a cold or a nasal allergy.

Symptoms

Common symptoms

• No smell at all when eating your favorite foods.
• Foods seem bland or you lose interest in eating.
• You cannot smell strong odors like coffee, flowers, or perfume.
• You may also notice that your sense of taste is weaker, because smell helps your brain recognize flavors.

Symptoms in children

• Parents might notice a child cannot smell food, or seems to lose interest in eating.
• A child might not notice smells that other family members find strong.
• They may be unable to detect danger, like smoke or burning.

Symptoms in older adults

• Older adults may not notice the loss as much, but it can affect appetite and nutrition.
• They might not smell gas leaks, smoke, or spoiled food, which increases safety risks.
• Loss of smell in later life can sometimes be linked to other health conditions, so it is worth talking to a doctor.

Causes

Main causes

• Viral infections that affect the nose and upper airways, such as colds, flu, or COVID-19.
• Nasal blockages like polyps (soft, non-cancerous growths in the nose), a deviated septum, or sinusitis.
• Damage to the nerve endings inside the nose, or to the brain areas that process smell, from injury or certain illnesses.
• Aging, which can gradually reduce your sense of smell.
• Certain neurological conditions (like Parkinson's disease or Alzheimer's disease) can affect the sense of smell.

Risk factors

• Recurring colds, flu, or sinus infections
• Chronic sinusitis or nasal allergies
• A history of head injury or nasal surgery
• Smoking, which can irritate and damage the nasal passages
• Being older than 60

When to see a doctor

See a doctor urgently if:

• Call your local emergency number if loss of smell happens together with symptoms of a stroke or after a major head injury.
• See a doctor the same day if the loss is sudden, unexplained, or happening after any head injury.

Book a routine appointment if:

• Make an appointment with your GP if your sense of smell has not returned after a few weeks.
• See your doctor if you are also experiencing pain, discharge from your nose, or repeated sinus infections.
• If the loss is affecting your appetite, your weight, or your mood, it is worth discussing this with your doctor.

Diagnosis

To find out why you have lost your sense of smell, your doctor will ask you about your symptoms, when they started, and about any infections, injuries, or allergies you have had. They will also look inside your nose to check for blockages or swelling.

Tests that may be done

• Your doctor may ask you to try smelling different things, like coffee, lemons, or soap, to check your sense of smell.
• You might have a small camera test of your nose (called an endoscopy) to see the inside of your nasal passages.
• Sometimes a CT scan or MRI of your head or nose is arranged, especially if there is a suspicion of sinus disease or nerve damage.

What to expect at your appointment

Most of the time, a careful history and a quick exam are enough. Your doctor will explain what they think is causing your symptoms and what you can do next. You may be referred to an ear, nose, and throat (ENT) specialist for further tests if the cause is not clear.

Treatment

Treatment for loss of smell depends on the cause. If it is due to a blocked nose, treating the blockage often helps. If it is due to nerve damage from a virus, smell training is the main approach. If it is caused by certain medications, changing those (under medical advice) might help. The important thing is to work with your doctor to find the best plan for you.

Self-care at home

• Smell training (olfactory training): gently expose your nose to different strong scents, like rose, lemon, clove, and eucalyptus, twice a day for several months. This can help your sense of smell recover.
• Keep your nose moist by drinking plenty of fluids and using a saline spray or rinse to keep the nasal passages clear.
• If you have allergies or a cold, getting it treated and using a humidifier can reduce congestion.
• Make your home safer for the loss of smell: install smoke alarms (with fresh batteries), check for gas leaks, and use labels and dates on food.

Medical treatments

Doctors may treat the underlying cause. For example, they might prescribe a nasal steroid spray to reduce swelling in the nose, or treat sinusitis or allergies. They may adjust or stop a medicine that is causing the problem. In some cases, they may recommend a short course of oral steroids, but this is always done under medical supervision. There is no specific medication that directly restores smell.

When is surgery considered?

If the loss of smell is caused by nasal polyps, a severely crooked nasal septum, or another blockage, surgery like a polypectomy or septoplasty may be considered. This is usually discussed with an ENT specialist.

Living with this condition

Adjusting to life without a sense of smell can take time. You can learn to rely on other senses, check expiry dates on food, and set up your home so that you have early warnings for dangerous smells. It helps to involve your family and friends so they understand what you're experiencing.

Lifestyle tips

• Install working smoke detectors and change the batteries regularly.
• Check for gas leaks by using a gas detector or asking a utility company to check, rather than relying on your nose.
• Use extra care with cooking: set timers, avoid leaving food unattended, and consider an alarm that detects burning smells.
• Label food with 'use by' dates and pay close attention to how it looks and feels even if it doesn't smell.
• Practice smell training regularly, as it has been shown to help recovery.

Diet and exercise

It is important to keep eating well even if food seems bland. Try to add more texture, color, and temperature variety to your meals. Seasoning with stronger spice, herbs, or citrus can help make food more interesting. Regular exercise and staying active can also improve your overall wellbeing.

Mental health and emotional wellbeing

Losing your sense of smell can feel isolating and can affect your mood. It may affect your appetite, your relationships, and how you experience the world. These feelings are real and it's important to talk about them with your doctor or a trusted person. If you feel low, anxious, or hopeless, please reach out to a mental health support line in your area.

Prevention

Many causes of anosmia are hard to prevent, especially those caused by viruses or aging. However, you can reduce your risk by protecting your head from injury, avoiding smoking, treating allergies and sinuses early, and washing hands regularly to reduce infections. Wearing a seatbelt and a helmet when cycling can also help prevent head injuries.

Vaccines

Staying up to date with recommended vaccinations, such as the flu vaccine, can help prevent viral infections that sometimes cause loss of smell. Talk to your pharmacist or doctor about which vaccines are recommended for you.

Screening programmes

There is no routine screening for loss of smell. However, if you have a higher risk or a health condition that affects your nose or brain, your doctor might check your sense of smell from time to time.

Complications

If left untreated

• Not being able to smell can put you at higher risk of missing smoke, gas leaks, or spoiled food.
• It can lead to poor appetite and unintentional weight loss, especially in older adults.
• It may affect your quality of life and lead to low mood or depression.

Long-term outlook

The outlook depends on the cause. Many people recover their sense of smell within a few weeks, especially after a cold or sinus infection. For viral-related loss (like COVID-19), many people improve over a few months, and smell training can help. For others, the loss may be permanent, but you can adapt and live safely. There is hope, and the right support and treatment can make a difference.

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