Medication can mess up your sense of Smell. This post links to the Magna Farta post on david healy, which tells the story of Zicam and Matrixx Pharmaceuticals. For anyone interested in adverse events, this is one of the most important stories in medicine. It also links to the SHIT Happens and SHIT happens 2 posts.
There are three Tables. The first shows drugs that cause Anosmia and the second the treatments that cause Parosmia. Sandwiched in between is an account of the horrors of Parosmia by Louise Woollam that first ran in the Observer Magazine in February. Louise’s Parosmia Diaries which track this problem are a compelling read.
Below Louise’s account is a Table with reports of Parosmia and after that there are some comments on Varenicline as the new Snuff. Louise does not link her problem to the xylometazoline she was on – this is the metazoline sold in the UK where oxymetazoline is the version in the US. The RxISK data in these tables comes from the US.
Parosmia is important to anyone suffering from PSSD or Antidepressant Withdrawal as we may have here in pure form the basic problem underpinning PSSD and Withdrawal – a drug induced peripheral neuropathy. Treatments that solve parosmia might be of benefit in withdrawal and PSSD.
Parosmia and smell is critical for lovers.
| Drug | Reports | PRR |
|---|---|---|
| Oxymetazoline | 3147 | 961 |
| Zinc gluconate | 4 | 258 |
| Chlorpheniramine | 143 | 192 |
| Zinc sulphate | 7 | 101 |
| Mometasone | 123 | 42 |
| Fluticasone | 202 | 30 |
| Xylometazoline | 11 | 28 |
| Azithromycin | 122 | 12 |
| Terbinafine | 58 | 9 |
| Clarithromycin | 69 | 6 |
| Telithromycin | 28 | 5.4 |
| Moxifloxacin | 61 | 3.5 |
| Doxycycline | 12 | 2.7 |
| Levofloxacin | 56 | 2.7 |
| Alendronate | 75 | 1.5 |
| Topiramate | 20 | 1.3 |
| Varenicline | 114 | 1.25 |
Everything smelt like sewage to me
The cold was unremarkable, although bad enough for me to need a few days in bed. It was spring last year, and a week after going back to work I went to a perfume event. That was when the first alarm bells rang. My alter ego is Get Lippie, a fragrance writer and beauty blogger, so it’s my job to smell perfume. But that day I couldn’t smell anything. See the Parosmia Diaries.
My GP told me I was anosmic – that I’d lost my sense of smell, and taste alongside it, probably due to damage to the olfactory nerve during my cold. He couldn’t say how long it would last. I was devastated, but I’d give anything to still be anosmic now. After about three months, the anosmia became intermittent phases of phantosmia (smelling unpleasant smells where no smells actually exist), along with constant parosmia (when real smells and tastes are distorted into unpleasant ones), and occasional cacosmia (when everything smells, and tastes, exactly like faeces).
The first clue I had to my problem becoming more serious was one evening when I could smell burning meat and sent my husband on a wild goose chase checking everything was switched off. I hadn’t smelt anything at all in three months, so I was excited that my sense of smell had returned – until I woke the next morning with the scent still in my nostrils. That day, we went to visit family and had some bacon sandwiches. I couldn’t eat mine – the bacon tasted disgusting, kind of chemical. That was just the start of it. With parosmia, there are few things that I can eat that don’t taste of sewage or mud, and most things smell disgusting, too. The irony isn’t lost on me – I’m a fragrance writer who lost her sense of smell – but this is no joke. I have had days when everything smells like faeces, making me retch. I thought I was losing my mind.
I could see no end in sight. I was hungry and nauseated all the time, and very upset. I remember standing in the supermarket, nearly in tears, trying to work out what I could eat, only to buy something and, two mouthfuls into it, gagging. To me, chocolate tastes like biting into raw sewage, chicken is muddy and rubbery, peanut butter and Marmite are like trying to eat diarrhoea. There are a couple of exceptions: raspberries, carrots and parsnips don’t taste vile. Nor does gin, which really helps.
I went to see an ENT specialist who told me the damaged nerves might regenerate, or they might not. It might clear up tomorrow, or it could take years. “One day,” he told me, “you will look back at this and laugh.” It was one of the worst days of my life.
I found a charity that helps people with rare olfactory disorders like mine, called Fifth Sense. In November last year, I went to their annual conference and learned that 98% of the people there had anosmia – with just 2% suffering from parosmia, phantosmia and cacosmia like me. I was so relieved that I was finally with people who understood. We shared stories about our experiences and swapped tips, such as making meals more visually appealing, and asking people to share what food tastes like.
The following week, I went to the Osmothèque perfume museum in Versailles. Like the conference, it was a turning point that has given me hope: I found that I could smell a couple of the perfumes properly. It seems to be violets and lilies that my brain can “process” normally, so a perfumer friend of mine is designing me my own fragrance. It smells good to me, and has given me great joy. I’m hoping other parosmics will be able to smell it, too.
This condition has had a huge impact on my life. I rarely eat out, as I can’t be sure someone around me won’t drink coffee, which is one of the worst smells imaginable. I carry a parosmia first aid kit: cinnamon drops to make drinks palatable; hot sauce to mask the taste of food. At home I’ve changed soaps and toothpaste. My husband and I are learning to adapt. I have lost a sense, and I feel it is a disability that’s similar to being blind or deaf – it’s just harder for others to notice, or understand.
| Drug | Reports | PRR |
|---|---|---|
| Varenicline | 294 | 8.6 |
| Oxymetazoline | 162 | 77 |
| Ribavirin | 148 | 5.9 |
| Peginterferon | 90 | 5.1 |
| Paroxetine | 69 | |
| Exenatide | 63 | |
| Duloxetine | 45 | 3.2 |
| Pregabalin | 45 | 1.4 |
| Bupropion | 45 | 3.5 |
| Quetiapine | 43 | 1.4 |
| Oxycodone | 43 | |
| Fluticasone | 42 | 17 |
| Mirtazapine | 39 | 6.9 |
| Escitalopram | 22 | 3.2 |
| Venlafaxine | 17 | 1.3 |
| Sertraline | 16 | 1.2 |
Varenicline: the new snuff?
These tables are intriguing. The data don’t necessarily show drugs causing problems. After all the nasal problem is often there before someone sniffs oxymetazoline or a steroid nasal spray. And even in the case of Varenicline (Chantix – Champix), smoking or nicotine withdrawal might be linked to problems. People do strange things with drugs. Nicotine provides an even stronger hit snorted as Snuff. And it seems that the human body comes designed with a Snuff box in the wrist – so it could be that some enterprising dude has found that there is a hit from Varenicline snorted as Snuff.
The plot thickens if you look at the Table below on Drugs that Make you Smell – where some Varenicline also shows up.
In the near future with a relaunched RxISK – we will be giving everyone a new tool to explore with – a facility to interrogate the FDA data to find the top 10 drugs that cause X or cause Y and the hope is that people using this will be able to make links between issues and ultimately perhaps find answers to Parosmia, PSSD and Antidepressant Withdrawal.
It would also be great if anyone reading any newspaper or magazine and finding health stories like this Parosmia story, where drugs might be involved, put together a story and submitted it to RxISK. And the other way around we are looking for Health and Beauty Consultants and Hair Consultants or Lifestyle Coaches who might be interested to specialize in the effects of medications on Hair, Skin, Smell, and other areas which are neglected by traditional medicine but are often of huge importance to our sense of self.
| Drugs | Reports |
|---|---|
| Omega 3 | 41 |
| Humira Adalimumab | 36 |
| Levonorgestrel | 33 |
| Orlistat Xenical | 28 |
| Etanercept | 27 |
| Zoledronic Acid | 24 |
| Varenicline | 23 |
| Bupropion | 23 |
| pamidronate | 18 |
The tables here are abbreviated. See the full tables for anosmia and parosmia.
jay says
With Chantix and Oxymetazoline I assume you are talking about Visene-eye drops??? Does Anosmia go away when you stop using the drug??? Chantix seems to be implicated in many terrible side effects. Each time I Come on RISK it seems a New one pops up. What about Anosmia and The research or lack there of dying prematurely?? Does Anosmia change the way people perceive memories and perhaps contribute to Affective disorders????
Michael says
Looking forward to that new tool, David!
Johanna says
I’ve never had any problem eating enough (just the opposite) but can see how it could become a real struggle if your food suddenly tasted like sewage! Just how serious this can get, especially for elderly people, was pointed out in an article I ran across by a GP in New Zealand:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2980431/
“Many medications affect taste, smell, or salivation, and lead patients to change their patterns of food or fluid intake. The elderly are particularly affected on account of higher rates of polypharmacy and underlying frailty. Some affected patients consume fewer calories, resulting in nutritional deficiencies and weight loss. Others try to compensate by masking symptoms with additional fluids or by using added salt or sugar. Predictably, these changes can lead to polyuria, incontinence, or exacerbation of pre-existing conditions such as hypertension. Less predictably, changes like these contribute to complex geriatric syndromes and can result in abrupt functional decline.”
In other words, a fairly healthy, active person in their eighties could start spiraling down towards the nursing home before they and their doctor realized what was going on. The author explains how she did not spot the problem until her patient took a nasty fall, and started explaining how it happened …
mary vaubel says
Used Flonase in Feb had flu cannot smell or taste since saw ent had CT scan normal it is awful
Keith Mc Clenaghan says
I have been taking champix for around 10 weeks (this time round). I have a terrible burning smell, which is made worse when my nose is completely empty, i.e the entire contents has been blown out. This is worsened by the smell of burning candles or any freshener. Reading around this seems to happen to a large portion of people. I find if i keep my nose bunged up, it seems to be fine. I know myself that NRT will not work and since I don’t want to keep smoking this seems to be the only way forward. Has anyone come across a method of combating this ?
Joe says
I have been taking Chantix (Champix in the US) for about five weeks and have the same thing. Mine is like an old burned food smell.
I have not discovered any way to mitigate it but am hopeful that it will go away when I am off of it.
Taylor hall says
I’m having a side affect from doxycycline and I’m sad to say it. I am now having very bad body Oder even after showering three times a day won’t go away. I’m a 24 year old woman with a six year old child who is very active in dance and Girl Scouts we are always on the move. I have no way to mask my smell I have even stopped sleeping in bed with her father and sleep on the sofa out of shame.
C.L. Hazzard says
Hi. I do hope you have returned to your marriage bed and the shame has dissipated. And even better yet your issue! But try and remember we are our own worst critics. And beauty comes from within. And if you don’t feel beautiful bc if how you feel you smell or a blemish, or what the scale says, then trick yourself into believing it. Fake it until you make it girl! I’m sure you have tried a multitude of things. But I know for me, when going thru chemo I smelled horrific. It was excreting thru my pores. Add my chemical cocktails for seizure medicines and radiation. Boom you have a gross smelling lady! Which is quite sad bc I was sort of known for my signature scent. I had a lover tell me I stain the atmosphere. Haha so with my grief and my Shame, I set off to try any and everything. What I found helped was regulating my pH. I took all of them. Tagament and alka seltzer seemed to do the trick. Just sort of added it to my medicinal wardrobe and it got better. I still can’t smell like I used too tho. I have found menopause is wreaking havoc on my nasal capabilities. I have worn the same perfume since 1996 and now it smells like Body Odor to me. So I’m on the hunt for my new signature scent.
And remember your partner loved you and pheromones are an incredible thing.
“You can’t say no to Hope,
You can’t say no to Happiness.”
Bjork
C.L.
Ed says
I smell a strong musty odor that makes my eyes tear up. It has an ammonia like hit to it.
I can not find the cause.
My wife and friends do not smell it at all.
I smell it on and off all day. Mostly at home. But occasionally away from home.
Vicki Morgab says
Recently finished 2 week course of keflex, now I am smelling a sweet, burning, chemical smell. It sort of causes a cough, and slight headache.
Could keflex have caused it?
Laura Ferris says
I had sinus surgery and had my turbinates trimmed when I was 29 or 30. I lost my senses of taste and smell (for the most part) shortly thereafter. My tastebuds seem to react to extremes like salty and sweet, other than that, everything tastes blah or bitter. Its put me off of many foods, and I tend to eat a lot of popcorn, lol. The salt on the popcorn keeps me satisfied. Smell is a real loss. Most things smell like wet dog or something rotting (cooking meat always smells like its off!). I also am very paranoid about possible body odor, and the possibility of having my home smell, and not being able to recognize it.
Laura Carry says
I lost my senses of smell and taste as I recovered from COVID-19. After several weeks they were both returning, and I thought all was well. Suddenly, I constantly smell a sweet, burning foul odor. It never goes away and gets worse when I’m confronted with other strong scents like coffee, fresh cut grass, etc. Even a breeze blowing on my face makes it worse. I only have a few foods I can tolerate. Everything else tastes just like the foul smell. I normally spend hours each day cooking and baking. Now I can hardly stand to be in my kitchen. This is taking a toll on my entire life. I’m currently waiting for an appointment with my primary physician, but after all I’ve read about this condition, I’m not feeling very hopeful.
mike says
Dear Laura,
My daughter is experiencing the exact same symptoms. Can you tell me what has happened since you last posted. She is very depressed.
Thanks
Jade says
My daughter and I are having the same issue as your experiencing after coated we lost our taste and smell as well. And when it returned it was different it has turned normal smells into a sweet, foul, metallic-like, if you will, smell to things. its things like brewed coffee, garlic, onion being cooked, hand sanitizer, rubbing alcohol any and all soaps, sprays-aerosol sprays, etc. It is extremely depressing because I love to cook with garlic and onion in my food.. My daughter cannot stand the taste of cooked onion anymore as well as the smell luckily for me I can still eat everything OK without disgust. Just praying this returns to normal.
Jade says
After having covid-19*
Shayna says
This happened to me too ! Saw an ENT whom said I now have polyps and need my terbinates grinded down bc they are swollen. I go next week to get a CT of my brain but this is what a CT of my sinuses read . This was all after covid and then losing smell fors weeks gaining it back a few days and then nothing but fowl odors ….horrible !
Anna says
Same. Lost taste and smell for 5-7 days with COVID. Taste returned 100%, smell about 75%. Just this week (after 6 weeks being healed) I started to smell cigarette smoke everywhere. I’ve never smoked and find the odor quite traumatizing. I’m putting STRONG essential oils like rosemary, clove, and peppermint right up to my nose and sometimes they mask the nasty cigarette smell, sometimes they don’t. It’s freaking me out a bit.
zain says
Intranasal zinc products, decongestant nose sprays, and certain oral drugs, such as nifedipine and phenothiazines, are examples of drugs that may cause permanent loss of smell.
Bryan says
Hi there. 🙂
Can someone please explain what the ‘PRR’ column in the tables is in reference to? (I’ve already scanned and scanned this article for that info, I promise.)
Grateful for this data and the stories; I have come off Pregabalin this summer (off of it for roughly 5 weeks now) and normal smells are amplified, distorted, repulsive and overwhelming (to the detriment of my family life, my appetite, overall quality of life, etc).
Also went off Sertraline two months ago, although I don’t recall this happening with going off that.)
Please tell me it gets better! Thanks and God bless. 🙏🏻