The Inability to Smell Causes Big Issues

What to do if you've lost your sense of smell

The late rocker Warren Zevon, after being diagnosed with inoperable cancer, wryly but wisely noted that each of us should “enjoy every sandwich.” Although you might think that our ability to follow Zevon’s suggestion in a literal sense depends mostly on a working set of taste buds, in reality, an estimated 80 percent of our ability to taste is tied to our sense of smell.

Indeed, the significance of our sense of smell goes way beyond savoring the aroma of baking bread or delighting in summer’s scents of flowers and freshly cut grass. The human nose might be the weakling of the animal kingdom compared to the scent detection powers of many other mammals, but our sense of smell plays an important role in our lives and well-being nonetheless, evoking time and place and affecting how we interact with the world on many levels.

When we breathe in an odor, we inhale odor molecules, explains Peter Ihm, MD, an otolaryngologist at Core Physicians’ Comprehensive Otolaryngology & Audiology in Exeter and Portsmouth. Nerve receptors in the upper part of the nasal passages pass along odor-related information to the brain, where it is mentally processed. While we perceive some primary aspects of taste, such as the sweetness or saltiness of a particular food, through taste buds in our mouth, our sense of smell contributes substantially to how we detect flavor. “Our ability to smell enhances our ability to taste,” Ihm says. He adds that smell helps “to really pick up on flavors and details related to the taste of food.” Consequently, the nuances of food are likely to be lost on a person who cannot effectively sense aromas.

A range of factors can interfere with our ability to smell, including the common cold, smoking, medication, brain injury and disease. Age can also stifle the sense of smell. Just as many older people find that they can’t hear as well as they used to, Ihm says, many individuals notice a weakened ability to smell over the years. With age, “some things just don’t work as well as they used to,” Ihm says. “We have a finite number of receptors and once they die off, they don’t come back.”

Toxic exposure can also harm our ability to smell. Factory workers and people who do cleaning work, for example, often experience inflammation from frequent chemical exposure, says Andrew R. Spector, MD, an otolaryngologist at Dartmouth-Hitchcock Ear, Nose & Throat Specialists of Southern NH in Manchester. More rarely, people are born unable to smell, a condition known as congenital anosmia. In some instances of an impaired sense of smell, no cause is ever identified.

Most often, a diminished sense of smell is due to something temporary and typically fairly innocuous, such as a cold, but in some instances, a weakened sense of smell signals a serious underlying health problem, as it did in Dick Ludders of Henniker. Ludders says the erosion of his ability to detect scents “was so gradual and happened so slowly, I didn’t even realize it was happening.” Over time, though, he noticed that food had lost much of its flavor. “People would comment on the taste of something, and I wouldn’t be experiencing the same level of flavor,” he says. “It would taste more bland to me.” In the end, Ludders’s faded sense of smell helped confirm a life-changing diagnosis: Ludders has Parkinson’s disease. People who have degenerative neurological disorders such as Parkinson’s often find their sense of smell degrades over time in tandem with the progression of their disease, Spector says.

Treatment for a decreased ability to smell depends on the root cause of the problem. A cold that plugs up nasal passages, for example, will typically pass on its own and take the problem with it. Other times, treatment might call for antihistamines, nasal spray, steroids or surgery to open up the sinuses. In some instances involving head trauma or diseases that result in nerve damage, however, there is not much doctors can do, Spector says.

While some patients simply adapt to a changed sense of smell as best they can, others become depressed. In particular, individuals whose livelihood revolves around food — people in the restaurant business, for example — might be understandably shaken to learn that their sense of smell, and therefore taste, is forever changed. “Especially if it affects your vocation, it can be devastating,” Spector says. “This is a problem that affects people profoundly.”

Victoria Tane, a 64-year-old Parkinson’s patient and former Nashua resident who recently relocated out of state, would agree. “I absolutely miss being able to smell,” she says. “I remember what it smells like in New England when you open the windows for the first time in spring — that woodsy, earthy smell. I miss it.” In Tane’s view, “smell and taste are how you experience the world.”

Tane’s sense of humor appears to remain fully intact, however. “My husband can’t hear, and I can’t smell and taste,” she says, “but between the two of us, we’ve got the five senses covered.”