Smelling disorders, including phantom smells and a lack of smell, can be a sign of serious health problems.
In a 2009 episode of “Mad Men,” a character with some major health issues — stroke and dementia — mysteriously smelled oranges while eating chocolate ice cream. Shortly after, the man dies while standing in line at the A&P.
Was the phantom orange scent a warning sign of his impending doom?
It’s possible, says Dr. Alan Hirsch of the Smell & Taste Treatment and Research Foundation in Chicago.
“By all means, a phantom smell could mean something serious,” says the psychiatrist and nationally recognized smell and taste expert. “It absolutely needs to be evaluated. It could be a tumor – that’s on the top of your list of things to rule out — but it could also be a cyst or some infectious agent housed in the area of the brain where the smell is processed.”
Brief episodes of phantom smells or phantosmia — smelling something that’s not there — can be triggered by temporal lobe seizures, epilepsy, or head trauma. Phantosmia is also associated with Alzheimer’s and occasionally with the onset of a migraine.
But it’s not typically something sweet that’s conjured up by the brain.
“It’s usually more unpleasant stuff or odors that are hard to describe,” says Hirsch. “People will say it’s chemical-like or talk about a burning smell.”
Common olfactory hallucinations include lots of icky odors. Sufferers report smelling hydrogen sulfide (rotten eggs), bad perfume, garbage, a gas leak, wet dog, pungent body odor or spoiled fish or feces. The brain may trigger such sickening odors instead of agreeable ones because humans learned very early to avoid noxious smells for survival.
“I think a larger area of the brain is represented by bad smells than good smells,” says Hirsch. “And they also may be easier to ‘fire off.’”
Smell disorders aren’t that rare. According to a 1994 survey, 2.7 million Americans have some type of olfactory problem, including anosmia (the inability to smell); hyposmia (a decreased ability to smell); parosmia (a distorted perception, instead of flowers, you smell rotten meat), and phantosmia. Another 1.1 million people have issues with taste (smell and taste are inextricably linked) including ageusia (the inability to taste); hypogeusia (a decreased ability to taste) and dysgeusia (a distorted ability to taste).
Phantom fragrances can be produced by one or both nostrils and can waft in and out of a person’s life over the course of a few hours or a few days or a few weeks. In some cases, such as that of a 35-year-old New Zealand woman who said her nose caused everything to “smell blimmin’ awful” for 17 years, the condition can come and go for no apparent reason for decades.
In a New York Times story, a woman suffered a succession of unpleasant phantom odors, from dank earth to burnt chili. When antibiotics failed to treat the condition, she simply learned to live with it — and avoid disagreeable odors.
Even if there is no underlying tumor, epilepsy or some other infection, problems with your sense of smell can be very disabling.
“Frequently, [patients will] lose a substantial amount of weight because they can’t stand the way everything tastes,” says Hirsch.
Furthermore, doctors will often treat it like a psychiatric problem, with patients visiting an average of seven physicians before getting help, says Hirsch. The irony is, some people with phantosmia will develop psychiatric disorders, depression or suicidal behavior as a result of their condition.
“Approximately half of my patients who have sought surgery for their distortions have at one time considered suicide because of the hopelessness of living a life where all food smelled like spoiled meat or worse,” Dr. Donald Leopold of the University of Nebraska Medical Center’s otolaryngology department wrote in the 2002 edition of Chemical Senses.
Sometimes people think the stink is coming from themselves, which can lead to a condition known as olfactory reference syndrome, says Hirsch.“They’ll wash frequently and won’t go out. It will start with phantosmia, but then they’ll develop secondary paranoia as a result.”
Medical tests such as MRIs, CT scans and EEGs can find common physiological triggers such as tumor, sinus infection and epilepsy, but some patients never understand why they’re suddenly inundated by the smell of garbage or rotting fish or burned coffee or cheese. While pinpointing the cause of phantosmia can sometimes be difficult, treatment is available, including nasal saline drops, anti-depressants, sedatives and anti-epileptic drugs.
Most patients respond to medication, however, a surgical procedure involving the olfactory bulb has also been shown to provide relief. Although normal aging brings a gradual loss of smell, phantosmia sometimes occurs with a reduced ability to smell real scents, another matter that can have serious ramifications, Hirsch says.
“AIDS can initially present with smell loss,” he says. “Or it could be anything from vitamin deficiency to Alzheimer’s to hypothyroidism to head trauma to stroke to diabetes to medication to leprosy.”
One quick way to test whether your sense of smell is diminished is to dish up a bowl of ice cream.
“Take some vanilla ice cream and some chocolate ice cream and see if you can taste the difference,” says Hirsch, who says ninety percent of taste is smell. “If you can’t smell, they both taste the same.”
FAQs
Phantosmia is not usually a cause for concern, and it often clears up by itself. It can also be a symptom of a more serious condition, so people experiencing phantom smells should see their doctor to check for underlying conditions or complications.
Can phantosmia be serious? ›
Smelling things that aren't there is called phantosmia. It can be unpleasant and affect how things taste. But it isn't usually serious and may go away by itself in a few weeks or months. See your GP if the strange smell doesn't go away in a few weeks.
Are phantom smells a sign of stroke? ›
Is smelling burnt toast a sign of a stroke? There's no evidence that suggests phantosmia is a sign of a stroke. However, it's important to be aware of the warnings signs of a stroke so that you can take quick action if one occurs.
Are phantom smells neurological? ›
The sensation may originate in the peripheral nervous system at the level of the olfactory sensory neurons, may reflect damage to the olfactory nerve, or may originate in the central brain. We found phantom odor perception to be inversely associated with age predominantly among women.
What type of brain tumor causes phantom smells? ›
When a cancer starts specifically in the nerves that affect your sense of smell, it is known as olfactory neuroblastoma. (Esthesioneuroblastoma is another name for this type of cancer.) An olfactory neuroblastoma often happens on the roof of the nasal cavity.
Can phantom smells be caused by anxiety? ›
Phantom Smells, such as odd, strong, acrid, metallic, blood-like, sour, ammonia-like, acidy, and repugnant smells, to name a few, are common anxiety disorder symptoms. Many anxious people report having phantom and odd smells as an anxiety symptom.
What can phantosmia lead to? ›
Problems Phantosmia Can Cause
It might also cause: Depression. Loss of appetite. Weight loss.
How often is phantosmia serious? ›
Phantosmia is relatively uncommon. It makes up around 10-20% of disorders related to the sense of smell. In most cases, phantosmia is not a cause for concern and will go away on its own.
What is the cure for phantosmia? ›
Phantosmia Treatment
Medications: Antipsychotics, antimigraine medicine, and antiseizure drugs can all be used to treat phantosmia. Surgery: Olfactory mucosa excision surgery may relieve phantosmia while preserving olfactory function.
Are phantom smells a sign of dementia? ›
Brief episodes of phantom smells or phantosmia — smelling something that's not there — can be triggered by temporal lobe seizures, epilepsy, or head trauma. Phantosmia is also associated with Alzheimer's and occasionally with the onset of a migraine.
Adults with diagnosed, but controlled, high blood pressure reported phantom odors more frequently than those without high blood pressure. We observed a threefold greater odds of phantom odor perception among adults aged 60 years and older with diabetes, but only among those who use both insulin and oral medications.
What smell comes before a stroke? ›
Other signs and symptoms
There is a common myth that during a stroke, the victim will perceive the smell of burning toast. The medical term for this is phantosmia; an olfactory hallucination. In other words, a phantom smell, or a smell that isn't really there.
Can diabetes cause phantom smells? ›
Interestingly, participants with diabetes treated with insulin showed a higher prevalence of phantom odours as compared with participants without diabetes (OR 2.98, 95% CI 1.41–6.32) [15].
Does stress cause phantosmia? ›
Anxiety can cause a wide variety of symptoms, including phantom smells (phantosmia or olfactory hallucinations). Many people with anxiety report smelling odd smells that other people do not smell.
What medications cause phantosmia? ›
V. Causes: Miscellaneous
- Chemotherapy. Antiproliferative drugs (e.g. Cisplatin)
- Antirheumatic Drugs (e.g. Penicillamine)
- Antithyroid Medications.
- Antidepressants.
- Anticonvulsants.
- Azelastine (Antihistamine)
- Zopiclone (for Insomnia)
These may include: seizures, difficulty thinking or speaking, changes in personality, anxiety, depression, disorientation, fatigue, abnormal eye movements, numbness or tingling on one side of the body, weakness on one side of the body, loss of balance, vision changes, memory loss, nausea, generalized pain, trouble ...
What do you smell when you have a tumor? ›
Ulcerating tumors are rare. If you have one, it's quite possible it will have an unpleasant odor. The odor would be the result of dead or necrotic tissue or of bacteria within the wound. If you have a bad odor coming from an ulcerating tumor, see your doctor.
What are the two most common presenting symptoms of brain tumor in adults? ›
Some of the more common signs and symptoms caused by brain tumors include the following: Headaches. Seizures.
Does phantom smell go away? ›
Phantom Smell: Sinus Infection
The phantom smell usually goes away on its own in a few weeks or months. Your doctor might suggest that you rinse your sinuses with a saltwater solution.
Can coronavirus cause phantom smells? ›
While most patients recover from this, some report an unpleasant new symptom following COVID-19 infection called parosmia. It's a condition where otherwise normal smells now smell and taste unpleasant or even disgusting.
A significantly higher rate of parosmia/phantosmia symptoms was reported by patients with severe depression compared to patients with minimal to moderate depression.
Is phantosmia a mental disorder? ›
Phantosmia has been clinically related to schizophrenia and mood disorders: these mental diseases and perception of phantom smells have been linked to abnormal levels of several neurotransmitters such as acetylcholine, dopamine, and norepinephrine (27).
What are the three stages of dementia that are linked to its signs and symptoms? ›
It can be helpful to think of dementia progressing in three stages – early, middle and late. These are sometimes called mild, moderate and severe, because this describes how much the symptoms affect a person.
Are phantom smells seizures? ›
The perception of an odor by one person that is undetectable by others is called phantosmia. This is often due to a temporal lobe seizure, described as an uncinate fit. The hallucination is brief, and accompanied or followed by altered consciousness, or other epileptic manifestations.
Can iron deficiency cause phantom smells? ›
As a result of this research, they have found that iron deficiency changes the smelling behavior. 3 This study supports the fact that oddity in smelling behavior of our cases caused by iron deficiency.
Do you smell weird things before a stroke? ›
Although lots of people think smelling something burning is a sign of a stroke, there's no solid evidence this is true. The idea of smelling phantom burning toast may be kind of amusing — but strokes are serious. They affect approximately 795,000 Americans each year — and around 137,000 of those people die as a result.
Can a stroke cause you to smell things? ›
A stroke can cause changes to any of your senses, including vision, hearing, touch, taste and smell. If a stroke damages the parts of the brain that interpret information about taste and smell from your nose and tongue, it causes changes to your senses of taste and smell.
What are the 7 signs someone is having a stroke? ›
Call 9-1-1 immediately if any of these signs of stroke appear: Numbness or weakness in the face, arm, or leg; Confusion or trouble speaking or understanding speech; Trouble seeing in one or both eyes; Trouble walking, dizziness, or problems with balance; severe headache with no known cause.
What is the smell of death and its cause? ›
A pungent component of this scent is emitted by putrescine, a volatile diamine that results from the breakdown of fatty acids in the putrefying tissue of dead bodies (Hussain et al., 2013).
What are three signs that someone may be having a stroke? ›
The following signs of stroke may occur alone or in combination:
- Weakness or numbness or paralysis of the face, arm or leg on either or both sides of the body.
- Difficulty speaking or understanding.
- Dizziness, loss of balance or an unexplained fall.
- Loss of vision, sudden blurring or decreased vision in one or both eyes.
Ketones. When your cells are deprived of energy from glucose, they begin to burn fat instead. This fat burning process creates a byproduct called ketones, which is a type of acid produced by the liver. Ketones tend to produce an odor that's similar to acetone.
What does diabetes odor smell like? ›
Some people with diabetes compare the smell of insulin to the scent of Band-Aids, printer ink, Lysol, or new plastic shower curtain liners (4). Apparently, phenols are responsible for the aroma associated with insulin (5).
What does diabetic ketoacidosis smell like? ›
a smell of ketones on your breath, which can smell like pear drops or nail varnish remover. confusion. drowsiness or loss of consciousness (coma)
Does depression cause olfactory hallucinations? ›
Olfactory hallucinations are considered important for the biological interpretation of affective disorders. In this regard disturbed olfactory perception can be understood as an example of disturbed brain function in the state of depression.
What does stress smell like? ›
But your apocrine glands, usually only found in your armpit area, are activated when you're under psychological stress, explains Preti. This sweat produces a strong, sometimes even sulfurous odor when you're anxious or scared.
How common is phantosmia? ›
Phantosmia is relatively uncommon. It makes up around 10-20% of disorders related to the sense of smell. In most cases, phantosmia is not a cause for concern and will go away on its own.
Does Covid cause you to smell things that aren't there? ›
While most patients recover from this, some report an unpleasant new symptom following COVID-19 infection called parosmia. It's a condition where otherwise normal smells now smell and taste unpleasant or even disgusting.
How do I get rid of phantosmia? ›
Phantosmia is a condition that causes you to smell odors that aren't actually present.
...
How is it treated?
- rinsing your nasal passages with a saline solution (for example, with a neti pot)
- using oxymetazoline spray to reduce nasal congestion.
- using an anesthetic spray to numb your olfactory nerve cells.
How are smell disorders diagnosed and treated? Both smell and taste disorders are treated by an otolaryngologist, a doctor who specializes in diseases of the ear, nose, throat, head, and neck (sometimes called an ENT).
Can parosmia be cured? ›
If parosmia is a symptom of nasal polyps or a brain tumor, then your healthcare provider may recommend surgery. Sometimes, a surgeon can remove the damaged sensory receptors in your nose to restore your sense of smell.
Nasal polyps are painless, benign growths that form in the nasal passages and sinuses. They can cause smell problems such as phantosmia, as well as nasal congestion and nosebleeds.
