Frequently asked questions
Answering your questions about smell disorders, treatment for smell loss, how long it will take to recover from smell loss and managing your health.
General Questions
There are a number of ways you can lose your sense of smell. The most common causes are:
An upper respiratory tract infection (such as a cold, or the flu)
A blow to the head
Other sinus diseases and conditions such as rhinosinusitis or polyps
Allergies, medications and cancer treatment can also play a role
In some cases, loss of smell can be an indicator of neurodegenerative disease such as Parkinson’s and Alzheimer’s disease
For a full list of the causes of smell loss see here
Losing your sense of smell can make it hard to cope. Smell and emotion are closely linked in the brain. If you are struggling with overwhelming and negative feelings, it’s important to talk to your doctor.
Many people think that they have lost both their sense of smell and taste and say that they “can’t taste anything”. However, generally it is only the sense of smell that is lost.
In order to recognise what is happening, it’s important to understand the technical definitions, and differences between, the experiences of both taste and smell:
- True taste refers to that experience we have on the tongue and in the mouth: salty, sweet, sour, bitter and savoury (umami). The tongue has receptors for these basic tastes and other things like creaminess. Even without smell we can experience these sensations. Most people with smell loss can still tell the difference between sugar and salt, for example.
- Smell happens either when we sniff something (also called ortho-nasal olfaction), or when we chew food and the molecules that deliver smell waft up the back of our throat (also called retro-nasal olfaction).
It’s the combination of both true taste (salty, sweet, sour, bitter and savoury) and retro-nasal olfaction that equals flavour. And it is flavour that disappears with smell loss. Because flavour happens in the mouth people often wrongly assume that their sense of taste has gone. However, in most cases, people with smell loss will retain their full sense of taste.
Ageusia and dysgeusia are the terms given to dysfunctions of taste.
In the vast majority of cases smell loss is temporary. However, recovery can take a long time – sometimes years.
In most cases, the sense of smell recovers naturally but it can take a long time – months, sometimes a couple of years.
You can help yourself by being well informed. Read up on your type of smell loss and keep an eye on research updates.
Keeping a diary to record your smell sensations will help you see any changes in the way you are experiencing smell.
Try not to assume that you are returning to a ‘normal’ sense of smell. Normal is very subjective and smell tests often show a patient has a better – or worse – sense of smell than they think.
Don’t give up asking for help. A diary can help you chart your progress and can be useful when you’re meeting healthcare professionals.
Medical support for smell loss
Yes. It’s very important to mention a change in your sense of smell to your doctor in order to determine its cause and potential outcomes. A change in the sense of smell can be the result of a virus or a physical trauma, or can be an early indicator of other diseases.
There is not usually any medical treatment for smell loss, but a doctor can help you manage the impact of smell loss. Explain clearly how smell loss has affected your life. Is it causing low mood? Do you find yourself thinking about your smell loss throughout the day? Are you feeling anxious about safety issues? Have there been changes in your social life and your interactions with people?
Are you worried that it will affect your job? These are all valid reasons for mentioning smell loss to your doctor.
It may help to download this brochure and take it with you when you visit your doctor
If you’ve already seen your GP and they don’t seem to think your condition is important, it might be worth making a second appointment. It may help to download the Patient and GP discussion brochure and take this with you when you go.
The emotional impact of smell loss can have profound consequences for your quality of life, and this should be taken seriously.
At the moment, the only place where you can be tested for smell loss is at a specialist clinic. There are a number of tests available, and the test you receive will depend on your geographic location.
In Europe, the ‘Sniffin’ Sticks’ test is the standard. This takes about an hour and measures 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.
There are a number of other tests available, some specific to individual countries, such as the Scandinavian Odour Identification Test (SOIT). If you don’t have access to a clinic, you can download a simple self-assessment form.
Treatments for smell loss
Steroids reduce inflammation. They are prescribed either in tablet form or in a nasal spray/nose drops. They are often prescribed by ENT doctors.
They can be used as a course of tablets, with the dose tapering after a number of days. There are side-effects, however, so your doctor will need to discuss these with you so that you can make an informed decision.
Applying steroids directly to the nose means fewer side-effects, but application needs to be done properly so that the product gets where it needs to go and doesn’t either run down the back of the throat or out of your nose .
Find out more about how to use drops and sprays correctly.
For more information, click here to read an interview with Simon Gane of the Royal National Throat, Nose and Ear on the use of steroids for patients with smell loss.
The evidence to support the use of alpha lipoic acid (ALA) has been inconclusive but you can give a try and see for yourself. Use dosages as listed on the label.
As with anything, if you are going to try a complementary therapy, then make sure you follow the directions carefully, and always speak to a qualified practitioner. It’s a good idea to check with your GP first.
Because Vitamin A plays a role in the regeneration of olfactory neurons, Vitamin A nose drops are sometimes used as a treatment for post-viral smell loss. However, they aren’t available everywhere and not all doctors agree that it is helpful.
For more information, click here to read an interview with Katherine Whitcroft, ENT and researcher, on the use of Vitamin A.
A deficiency of zinc can lead to disturbances in sense of smell, so a supplement might help if you have low zinc levels. It’s a good idea to check with your doctor first.
Smell training
Smell training is a technique that can help to stimulate the sense of smell and encourage regeneration of the olfactory nerve. The first scientific research about smell training was published in 2009.
When smell training, it is important to give your full attention to the task at hand. Try not to have too many other distractions. It may help to close your eyes. Concentrate on what you are doing.
Whatever your experience, it is important to be accepting of that experience but continue to be curious about it. This form of concentration during smell training is similar to a mindfulness practice.
The most important aspect of smell training is to do it regularly, twice daily, for a minimum of four months. Sniff each oil for 20 seconds and then pause for 15 seconds before moving on. First thing on waking and last thing before bed is a good way to start.
The more you smell train, the better the outcome. Once it becomes part of your routine, it can also be fun to add new smells to your line up.
Aromatherapy is the belief that different plant oils have specific therapeutic effects on the body, and that different oils have different uses.
Smell training only focuses on the specific fragrances of the oils, and not any potential therapeutic effects of them. Smell training isn’t a ‘cure’, more of a ‘workout’ for your nose and the smell-memory area of your brain.
Smell training works by stimulating the sense of smell. It is this stimulation of the nerve that encourages regeneration of the olfactory nerve. Think of it as a form of physiotherapy for your nose.
No, they do not. Organic refers to the way the plant materials were grown.
The use of essential oils for smell training is purely as a stimulant for the sense of smell. In fact, you don’t need to use essential oils at all for smell training. Herbs and spices from your pantry would also work. It’s not about the *thing* you smell train with, but about the *smelling*
Smell training might help if you’ve lost your sense of smell after a virus or have received a mild head injury. If you experience any kind of smell messages at all – whether they are indistinct, unrecognisable or distorted – it means you have some limited function of the olfactory nerve. In that case, you could try smell training.
Think of it as a type of physiotherapy for your nose.
Managing smell loss and getting on with life
Everyone who has lost their sense of smell from a virus feels anxiety about getting another infection and this is entirely natural. It’s important to remember, however, that complete smell loss from a virus is actually quite rare.
It’s a good idea to take sensible precautions to avoid colds and flu and, if you think you have an infection, arrange to see your doctor for advice.
Click here for more information on managing a cold.
Yes, you can. You may find that your sense of smell will often fluctuate over time. It’s worth making a note when changes happen and any other symptoms that come with it. If you’re concerned about a persistent change with no apparent cause, please see your doctor.
Nasal rinse bottles are a great way to keep the nose healthy. A daily rinse (or two) can wash away allergens and excess mucus that would otherwise make your nose drip (post-nasal drip). Not only is nasal rinsing effective, it is inexpensive too.
Some people feel squeamish about squirting water up their noses, but it usually gets easier once you feel the benefits. Watch our video which demonstrates the correct use of nasal rinse bottles.
A number of brands of nasal rinses are available. You can buy the pre-mixed packets of rinsing salts or mix your own.