The commonest 3 reasons for loss of sense of smell are
- Viral infection of the olfactory nerves that take the sensation of smell from the lining of the nose to the brain,
- Nasal problems: severe blocked nose, rhinitis, chronic rhinosinusitis with polyps.
The next most common cause is a head injury that tears the nerves.
Less common causes are problems in the brain like tumours or degenerative diseases.
The surgeon will examine your nose with an endoscope and may order a CT of the sinuses or an MRI of the brain to look for causes. A trial of tablet steroid or steroid nasal spray may be recommended and you can try olfactory training therapy at home.
Losing the sense of smell can be tough to come to terms with. Many enjoyable things in life include pleasant smells. There can be a loss of enjoyment and reduced sense of well-being. To try to live a good life despite the loss of the sense of smell try:
- Ensure enjoyment is coming from other sources. Plan nice things for yourself every day to make up for the loss of pleasant feeling from smelling and tasting. Cultivate interests that don’t revolve around food.
- Ensure meals are visually appealing with lots of colour and texture to improve your appetite.
- Be safe with gas appliances, food and smoke. Check gas appliances are turned off after use. With food, if in doubt, throw it out or have someone else check it for you. Change smoke detector batteries twice a year and check they are working once a month.
- Stop smoking and avoid smokers.
At least half of people with COVID infection lose their sense of smell.
- for around half of these people, sense of smell returns after 10 days,
- for 40% sense of smell improves, but not back to normal
- and less than 10% of people still have no sense of smell after 12 months
It’s also common to get parosmia or change in sense of smell, with an unpleasant burning or chemical smell.
As many people improve without treatment, watching and waiting is ok for the first few weeks.
If not improving at 2 weeks, your doctor may recommend steroid nasal sprays or rinses.
If not improving at 4 weeks, your doctor may recommend a short course of tablet steroid.
You can help to recover your sense of smell with olfactory retraining therapy. You can find out how to do that here.