Loss of smell might seem like a minor inconvenience, but it can be tied to over 100 medical conditions – and may signal a serious health problem.

“Loss of smell (anosmia) that occurs without a cold or allergies or persists for several weeks should be evaluated by a physician,” says Dr. Ian Bushell, a medical director at BlueCross BlueShield of Tennessee.

How common is loss of smell?

Dr. Bushell: It’s more common than you may think. About 12% of U.S. adults over 40 have some loss of smell. It’s more common as we age: Nearly 40% of those over 80 have loss of smell. And about 3 percent of all adults can’t smell at all.

Loss of smell can affect how you perceive the taste of what you eat or drink. Flowers, perfumes or colognes may not have any smell or may smell less pleasant.

It also creates safety concerns. Smells help us identify spoiled food and toxic chemicals. It also alerts us to dangers, such as fire and gas leaks.

What causes loss of smell?

Dr. Bushell: The most common causes of loss of smell are colds and allergies due to the inflammation of the nose and airways. This usually improves over 7-10 days. Sometimes, head trauma, particularly concussions, may cause loss of sense of smell, which can take weeks or months to return.

Permanent loss is possible. These cases are often related to tumors, head or neck surgeries, or neurological disorders.

What else may cause loss of smell?

 Dr. Bushell: More than 95% of patients with Parkinson’s disease have loss of sense of smell. This symptom pre-dates other symptoms by 4-6 years. For that condition, it can be one of several early warning signs. Other neurologic conditions also have symptoms that include loss of sense of smell.

Many medications can cause loss of sense of smell. These include blood pressure medications, antibiotics, antidepressants and cholesterol-lowering medications. Additionally, loss of smell can be a side effect of chemotherapy.

Given the broad range of possibilities, it’s important to talk with your primary care doctor. They can assess which might be a cause for you and whether a medicine could be changed to a different one. Remember, you don’t want to stop medications without guidance from your doctor. For example, stopping blood pressure medications suddenly can put you at risk of a stroke.

When should you see a doctor?

 Dr. Bushell: See a physician if you experience loss of smell that occurs without a cold or allergies, or if it persists for several weeks. Your primary care doctor can refer you to an ear, nose, and throat specialist (ENT) for further evaluation if needed. Sometimes a neurologist may also be included if other nerve or brain causes need to be ruled out.

Physicians will review your symptoms, your family history and lab results. They’ll also do a detailed examination of your nose, mouth, throat and sinuses. They might also include doing a CT or MRI of your head. Additionally, there are “smell identification tests” that specialists can use to better understand your situation. Treatments vary depending on the condition and cause.

“The loss of smell can impact your quality of life,” Dr. Bushell says. “Don’t ignore it — see your doctor if it persists beyond a cold or occurs without explanation.”

More from Dr. Ian Bushell on WellTuned

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