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The question

About 3 months ago, I had a coughing bout that lasted for about two months. I never really had much of a cold, mostly a cough. But about 2 weeks after this subsided, I realized I could no longer smell anything. What is this - and will I get my smell back? Anything I can do?

The answer

While the loss of the sense of smell is generally due to benign causes, it can lead to severe impairment of quality of life which can lead to poor appetite, weight loss and in more severe cases, depression. Smell is important to fully appreciate flavours and serves a protective factor of recognizing specific odors such as spoiled food, chemicals or smoke - so it is a condition that warrants proper attention.

Treatment of the loss of smell depends upon the underlying cause. For you, the reassuring news is that for the vast majority of cases due to infection, the sense of smell will resolve over time without any treatment.

If the infection was severe and lingering, the inflammation can take longer than a few days to resolve. If you have allergies as well, a short trial of antihistamines may help to decrease this inflammation and blockage of the nasal passages. If you smoke or work in an environment that you are exposed to chemicals, cutting back or quitting while you are recovering or wearing a mask at work may help to decrease inflammation and hasten recovery.

You are experiencing something called anosmia, or the loss of the ability to smell. This condition can occur when there is damage to the olfactory system, which is responsible for the detection and recognition of odors.

In your case, it sounds like your loss of smell is due to the preceding upper respiratory tract infection. Although the infection has cleared, there may be residual inflammation that is blocking the nasal passages. If you are prone to allergies or have nasal polyps, the cold may have triggered further inflammation and blockage of the nasal passages and resulted in the loss of smell.

Other potential causes of anosmia includes certain medications, such as those used to treat blood pressure, and exposure to pollution or cigarette smoke.

Some types of nasal sprays that are used to treat allergies can directly damage the smell centres in the nose - so use these with caution and for only short periods of time as directed by your doctor.

More permanent causes of anosmia can be due to damage to the nerves in the brain that are responsible for processing smells. This can occur with any traumatic head injury and in degenerative brain disease such as Parkinson's disease and Alzheimers.

If the loss of smell persists beyond a couple of weeks, check in with your doctor to make sure there is nothing else causing the loss of smell and for other potential suggestions for treatment.



Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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