A Nose for Not Much

Steps you can take when your senses of smell and taste have diminished.

by Beverly Burmeier

February 2012

Claudia never realized she wore way too much perfume. In fact, it wasn’t until she missed the aroma of her morning cup of coffee that she realized there was a problem.
She has plenty of company: Studies estimate that as many as 14 million Americans over age 55 have a smell disorder, which generally involves loss of taste as well.

While it might seem a blessing not to smell overpowering perfume or aging fish in the fridge, having a sniffer in good working order is important for more than smelling flowers. Smell and taste stimulate the desire to eat and enhance our social lives. When people complain about the taste of food, they may actually have some smell impairment, says Ronald DeVere, MD, director of the Taste and Smell Disorder Clinic in Austin, Texas, and co-author of Navigating Taste and Smell Disorders (Demos Health Publishers).

Important Senses

Loss of taste and smell affects emotional and physical health. “When a person loses these senses he loses the pleasure of eating,” says Linda M. Bartoshuk, PhD, professor of community dentistry and behavioral science at the University of Florida Smell and Taste Center in Gainesville. That loss can have a profound effect on nutrition and social life.

For instance, people with limited function may use more sugar and salt to try to create something tasty, but that could lead to high blood pressure, diabetes or weight gain. Some people lose interest in eating because nothing tastes good. Others may develop an off smell or an unpleasant taste in the mouth that doesn’t go away.

“Depression is common,” says DeVere. “Some people with smell and taste complaints cut back on dining in restaurants, spending time with friends or participating in sports. They really miss the ability to sense flavors.” Bartoshuk suggests the trick to remaining sociable is to be open to new food sensations and be willing to explore and adapt.

Safety also becomes a concern because people are more likely to burn food when cooking if their sense of smell is poor. They may eat food that has spoiled or improperly use hazardous chemicals in cleaning products or pesticides.

Sensory Detriments

Infections, disease and injuries can result in sensory changes. A quarter of all cases involving smell and taste loss result from a viral infection, such as a bad cold, in which sensory nerves are damaged.

Sinusitis, a chronic inflammation of the sinuses, also damages small nerves in the nose. This accounts for another 25% of complaints regarding diminished sense of smell and taste.

Additional cases result from head trauma. Injuries that cause even a slight shift in the brain can damage nerves that promote smell and taste.

The remaining cases result from medications, smoking, consuming alcohol, advancing age, poor dental hygiene, nasal polyps and diseases such as diabetes, Alzheimer’s or Parkinson’s. Half of all people with diabetes have changes in their smell and taste functions, and smell abnormalities are a recognized symptom of Alzheimer’s disease.

Some detective work led Claudia, who is one of DeVere’s patients, to realize that her sense of smell had been compromised by her migraine medicine. Chief drug culprits include calcium channel blockers and statins. Other medications with this potential side effect include certain antihistamines, antibiotics, cold prevention and stomach acid medications, diuretics and antidepressants.

Staying Safe

Affected people should learn strategies to minimize potential dangers. Pay attention to dates on labels or label perishable foods with dates. Prominently label household cleaning and garden products, and have working smoke detectors and natural gas monitors. Stay in the kitchen when cooking to avoid scorching food. When possible, dine with a friend who can alert you to food that’s unsuitable to eat. Bathe regularly; if someone fails to recognize body odor or overuse of fragranced products, family members should step in.

Treatment focuses on addressing the underlying cause. If a medication is the cause, the ability to smell may return when the medicine is stopped or changed. Patients with respiratory infections or seasonal allergies may improve after the illness has run its course. When obstructions such as polyps are removed, function of receptor areas may be restored, although it could take months.

Sinusitis affects 30 million Americans, according to the Centers for Disease Control, so easing sinus trouble when it first appears can help prevent sensory issues. Robert Ivker, DO, author of Sinus Survival (Tarcher/Putnam) says, “Eucalyptus and peppermint oils help with inflammation and increase blood flow. Put them in a steamer, or dab them in a tissue and inhale them that way.”

Ivker recommends echinacea, garlic and grapefruit seed extract to help control the upper respiratory infections that often lead to sinusitis. Eliminating common dietary irritants, such as sugar, alcohol, dairy and wheat, may help calm the respiratory tract, and natural practitioners often recommend bioflavonoids, vitamins A and C, selenium and zinc.

“Adaptation is the best way to improve quality of life,” says Bartoshuk. When food is appealing, dietary habits tend to improve. Specific flavors and extracts can enhance dining by tapping into the five primary taste sensations—sweet, sour, bitter, salty and savory.

For example, add texture and spice to baked potatoes with chunky salsa. Put crunch on cereal by sprinkling nuts or ground flaxseed. Vinegar, ginger, chili powder, peppers and lemon all create zest for the palate. And a pinch of MSG (if you’re not allergic) can boost the savory flavor of steak or chicken.

“Smell and taste disorders are long-term health issues,” says Bartoshuk. “They may resolve on their own or not resolve at all.” Making meals safe and enticing are crucial in coping with these deficits.

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