What it’s like to live without a sense of smell?

In 4BC Hippocrates, the father of medicine was reputed to have said: ‘The way to health is to have an aromatic bath and scented massage every day’.

But even without such pleasures, most of us enjoy the smell of cut grass, freshly baked bread, and the childhood memories and thoughts of lost loved ones that can be invoked by certain smells.

What happens when the sense of smell has gone? What happens when we can no longer enjoy those simple pleasures in the same way? What’s it like to live without a sense of smell?

Of our five basis senses – sight, hearing, taste, touch and smell – the latter is perhaps the one that we think is least important.

And yet, according to new research by the University of East Anglia (UEA), as many as one in twenty people live without smell and the range of emotional and practical impacts this has disrupts almost every aspect of their lives, from everyday concerns about personal hygiene to a loss of sexual intimacy and the break-down of personal relationships.Depression and anxiety is common.

The loss of smell, either total or partial, is called anosmia and can be congenital or caused by external factors. If the anosmia is congenital, there is no known cure or treatment. However, other types of anosmia may be improved or cured if the underlying condition is treatable.

The researchers hope that their findings will help motivate clinicians to take smell problems more seriously, with better help and support offered to patients.

Many of the participants of the study described a lot of negative and unhelpful interactions with healthcare professionals before coming to the James Paget Smell and Taste clinic. The limited number that did manage to get help and support were very grateful for advice and understanding even if nothing could be done about their condition.

Prof Carl Philpott, from UEA’s Norwich Medical School, said:

Smell disorders affect around five per cent of the population and cause people to lose their sense of smell, or change the way they perceive odours. Some people perceive smells that aren’t there at all.

There are many causes – from infections and injury to neurological diseases such as Alzheimer’s and as a side effect of some medications.

Most patients suffer a loss of flavour perception which can affect appetite and can be made even worse if distortions in their sense of smell also co-exist.

Previous research has shown that people who have lost their sense of smell also report high rates of depression, anxiety, isolation and relationship difficulties.

We wanted to find out more about how a loss of smell affects people.”

The researchers worked with the Smell and Taste Clinic at the James Paget University Hospital, Gorleston-On-Sea. The clinic opened in 2010 and was the UK’s first clinic dedicated to taste and smell.

The study involved 71 participants aged between 31-80 who had written to the clinic about their experiences. It was carried out in collaboration with Fifth Sense, the charity for people affected by smell and taste disorders.

These are some of the problems people faced:

Losing the enjoyment of eating

Many of the participants no longer enjoyed eating. Some had lost their appetites resulting in weight loss, while others were eating more ready meals and fast food that was high in fat salt and sugar and consequently had gained weight.

Many also felt uncomfortable preparing food for others which impacted their social lives.

The loss of happy memories

Many of us link smells to specific occasions such as bonfire night; Christmas smells of turkey cooking, fir trees and brandied Christmas pudding; perfumes that certain loved ones always wore; the smell of the sea from family holidays. All gone.

Hygiene issues

Participants couldn’t smell themselves and this caused a lot of anxiety and embarrassment for many of the participants. For parents of young children, not being able to smell a dirty nappy and therefore failure to change their babies in a timely manner caused feelings of failure.

Inability to bond

Many parents talk about the unique smell of their newborn. It is something most of us remember fondly for many years. For some, especially mothers, this inability to smell their child caused bonding issues.

Hazard perception

Not being able to smell that food has gone off, or the smell of gas or smoke, for example, is a big problem and some of the participants had had serious near misses.

Duncan Boak, Founder and Chair of Fifth Sense, said:

Anosmia can have a huge impact on people’s quality of life in many ways, as this research demonstrates.  An important part of Fifth Sense’s work is giving our beneficiaries a voice and the opportunity to change the way society understands smell and taste disorders, whether through volunteering or participating in research studies like this one. The results of this study will be a big help in our ongoing work to improve the lives of those affected by anosmia.”