Question: I am a 75-year-old female, and I am losing my sense of smell. I have had sinus and allergy problems all my life, and I always have a tissue with me. In the past 4—5 years I have lost about 95% of my ability to smell. Taste is fine. Since I live alone, losing the sense of smell can be a real hazard. I miss this sense very much. I tried zinc. Nothing happened. Is there anything new that might bring back my ability to smell?? Thank you so much.
Answer:
Finally, there may be something new…
The loss of the sense of smell can be a devastating problem. Smell is important not just for the enjoyment of food and activities of life, but for safety – avoiding fire and spoiled foods. A person’s sense of smell becomes limited because of nasal congestion- in that case, air does not reach the smell fibers, or due to damage to the fibers themselves. Damage can occur after trauma, an upper respiratory infection, or for reasons unknown. We all do lose some sense of smell as we age.
The loss of the sense of smell should, however, get evaluated. One needs to be sure that there is no growth obstructing the smell fibers or damaging them directly. The nasal cavity should be evaluated to make sure there is no unusual congestion (polyps, chronic infection). Most otolaryngologists (ear nose and throat doctors) can do the appropriate evaluations and recommend therapy if indicated.
When these causes are ruled out, the treatment for the loss of smell is limited. We have recommended alpha lipoic acid- a vitamin that may help with nerve regrowth- but its there is no proof of its effectiveness as of yet.
A recent study, however, just published in November of 2012, is quite promising. Revealed in this study, the use of a low dose theophylline nasal spray (an old asthma drug- usually taken by mouth) helped almost all of a small group of patients improve their sense of smell, without reported side effects.
While this clearly needs to be further evaluated, the possible ill effects seem quite small- and the prospects for improvement are encouraging. We plan on doing a study shortly at the NY Sinus Center to see if we can confirm these results. Please call us for an appointment if you would be interested.
Robert Pincus MD
Co-director NY Sinus Center
Frequently Asked Questions
Loss of smell in older adults can be caused by nasal congestion, damage to the olfactory nerves due to trauma, infections, or unknown reasons. Aging naturally reduces smell sensitivity, but chronic sinus issues or nasal obstructions like polyps can also contribute significantly.
An ear, nose, and throat specialist can assess whether nasal obstructions like polyps, chronic infections, or growths are causing the loss of smell. Proper diagnosis is crucial to rule out treatable causes and to recommend appropriate therapy to potentially restore the sense of smell.
Currently, treatments are limited. Alpha lipoic acid, a vitamin thought to aid nerve regrowth, has been recommended but lacks proven effectiveness. Recent studies suggest that low dose theophylline nasal spray might improve smell without adverse effects, but further research is needed.
Theophylline nasal spray is a formulation of an old asthma medication administered via the nose. A recent study indicated that it helped most patients with smell loss improve their olfactory function without reported side effects, suggesting it may aid nerve recovery or reduce nasal inflammation.
Anyone experiencing significant loss of smell should schedule an evaluation with an otolaryngologist to determine underlying causes. Facilities like the NY Sinus Center are conducting studies on new treatments, so contacting them for an appointment can provide access to potential therapies and expert care.
Zinc has sometimes been tried for loss of smell, but there is no strong evidence supporting its effectiveness. In the described case, zinc did not improve the sense of smell, highlighting the need for professional evaluation and exploring other treatment options.
