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What Causes Altered Sense Of Smell And Metallic Taste In Mouth?

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Posted on Tue, 16 Dec 2014
Question: I have a funny smell in my nose....it is stronger at home, but I smell it other times too....it is worse in my bedroom, sometimes in my bathroom and/or laundry room, but randomly here and there throughout the day.....sometimes it is an unexplainable smell, sometimes it smells like bleach.....sometimes it is mild, sometimes VERY strong....sometimes just a smell, sometimes a metallic taste in my mouth also......
doctor
Answered by Dr. Dr. Naveen Kumar Nanjasetty (1 hour later)
Brief Answer:
Please consult a good internist/neurologist/ENT specialist...

Detailed Answer:
Hi

Thanks for posting the query

I do understand your concern. I will try my best to help you with this problem.

Dysosmia or the altered sense of smell in the age of yours could be due to various reasons which needs to be evaluated thoroughly. The taste defect is truly a primary defect in olfaction resulting in an alteration of flavor.

The probable theories/causes are:
1. The loss of functioning olfactory neurons results in the inability to form a complete picture of the odorant.
2. The integrative or interpretive centers in the brain form a distorted odor.
3. Chronic rhinosinusitis - which causes damage to the olfactory neurons.
4. Endocrine disturbances leading to hormonal changes such as hypothyroidism, diabetes mellitus may affect olfactory function.
5. Degenerative processes of the central nervous system such as Parkinson disease, Alzheimer disease, etc.
6. Subarachnoid hemorrhage.

I doubt it could be something related to the environment. Hence, I would suggest you to consult your internist/neurologist/ENT specialist for a complete examination of the nose and the neurological system.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Dr. Naveen Kumar Nanjasetty (24 minutes later)
OK...thanks
I do have another question....

Hopefully it is not the more concerning possibilities that you mentioned (I doubt there is a brain tumor or subarachnoid hemorrhage....Parkinsons and Alzheimers I suppose are possibilities but not likely since I don't have any other related symptoms..)..
But the two things that "jump out at me" from what you write are chronic rhinosinusitis and hypothyroidism
A blood test approx. 2years ago noted a borderline thyroid, so I will have that checked again
But the thing that I am assuming is the rhinosinusitis....I have had sinus problems for many years
When I first started noticing the odd smells, I was caring for my aging parents in their nearly 100 year old home, that is mold infested; during those few years, I developed not only the funny odor, but also a chronic cough and other allergy symptoms.....
Once I moved away from there, the cough went away, the allergy symptoms decreased, but the nasal smell actually got worse
My QUESTION now is: aside from having a complete check up (which I will schedule next week, but will probably take me several weeks to get in to the clinic) is there anything you can suggest I try in the meantime?
doctor
Answered by Dr. Dr. Naveen Kumar Nanjasetty (1 hour later)
Brief Answer:
Saline nasal spray and steroid nasal spray...

Detailed Answer:
Hi

Thanks for writing back.

In the best interest of your good health, an MRI of the brain would be very helpful to rule out any intracranial lesions.

Meanwhile, you try using saline nasal spray and steroid nasal spray such as momentasone or fluticasone. Drink plenty of warm water; avoid coffee/smoking.

Wish you good health

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Dr. Naveen Kumar Nanjasetty (1 hour later)
OK.... a few more questions:

First of all
I do not smoke (never have)
do not drink coffee (never have)
I eat well, am not overweight, exercise, etc...
I drink water, but have never tried warm water (?)...will try that
I have never tried the nasal sprays -- will consider them, although steroid sprays make me nervous

My medications:
estrogen daily
low dose aspirin daily
Vitamin D daily
Multivitamin/mineral daily
Flexeril prn (I have scoliosis which causes neck/back pain and occasional fibromyalgia flare ups)
Maxaalt prn migraine
OTC NSAID prn various aches and pains

QUESTIONS:
1) I have chronic migraines (several severe episodes a month, for 42 years)
The only thing that works are such things as Maxaalt or Imitrix....
Could the migraines and/or those particular meds damage the sinuses and/or cause the dysosmia?

2) I also have a history of deviated septum, and nasal polyps (do not know if I have polyps at this point)....can either of those possibly result in the dysosmia or parosmia?

3) I have an allergy to mold (verified by intradermal allergy testing)...and as I said I was exposed to quite a bit of household mold daily for several years....do you know much about mold allergies? in your opinion can constant exposure to mold can cause the dysosmia or parosmia?

4) why drink "warm" water?


5) originally you said you doubted it was environmental....since I do smell this strange odor occasionally in other places than at home, I would have a tendency to agree with you....except for one thing....it is SO much stronger at home, and it is constant there....(and only occasionally and more mild elsewhere) .........SO my question is threefold:
A) could it be a combination?....AND there is a something in the home that triggers the problem.....and I encounter similar "something" elsewhere occasionally.
B) could it be that whatever is the trigger, when I am around something similar elsewhere my olfactory senses "remember" the problem at home and "remind" me?
C) could it be the problem is only at home, but it gets "stuck" in my sinus cavities and I carry it around with me, and because I have possibly some anosmia as well, I only experience the "stuck" smell off and on?

thanks for any opinions and/or insight you can give....
doctor
Answered by Dr. Dr. Naveen Kumar Nanjasetty (5 hours later)
Brief Answer:
Migraine does not cause dysosmia...

Detailed Answer:
Hi

Welcome back

1. Sumaripatan can cause taste disturbances. Migraine does not cause dysosmia.

2. Nasal polyps and crooked nose or a deviated septum, can prevent air from getting to the olfactory area of the nose where the smell receptors are found.

3. Hay fever or an allergy may cause one or more polyps to show up, followed by nasal block and anosmia.

4. Warm water, helps in improving the blood circulation in the oral cavity and the nose. Thus keeping the nasal mucosa moist and clear of dried up secretions, if any.

5. Drugs like estrogen taken for long periods can alter the sense of smell. The aging process also causes the olfactory sense to lessen. In most cases, there is no other obvious cause for the disorder. Approximately 1% of the population younger than 65 years has major difficulty smelling.

6. I would like to stick on to the comments I made in my previous response regarding the environmental condition. The reason is, in the previous house you stayed there were similar problems, and later on when you moved to the new house and took all the precautions and necessary steps, but you still continued to have the same symptoms. That implies it is something different which is bothering you. Secondly, you do not experience or seldom experience this problem in other places because of various distractions you come across. Hence, a thorough evaluation is required to identify the cause.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Dr. Naveen Kumar Nanjasetty

Otolaryngologist / ENT Specialist

Practicing since :2001

Answered : 2542 Questions

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What Causes Altered Sense Of Smell And Metallic Taste In Mouth?

Brief Answer: Please consult a good internist/neurologist/ENT specialist... Detailed Answer: Hi Thanks for posting the query I do understand your concern. I will try my best to help you with this problem. Dysosmia or the altered sense of smell in the age of yours could be due to various reasons which needs to be evaluated thoroughly. The taste defect is truly a primary defect in olfaction resulting in an alteration of flavor. The probable theories/causes are: 1. The loss of functioning olfactory neurons results in the inability to form a complete picture of the odorant. 2. The integrative or interpretive centers in the brain form a distorted odor. 3. Chronic rhinosinusitis - which causes damage to the olfactory neurons. 4. Endocrine disturbances leading to hormonal changes such as hypothyroidism, diabetes mellitus may affect olfactory function. 5. Degenerative processes of the central nervous system such as Parkinson disease, Alzheimer disease, etc. 6. Subarachnoid hemorrhage. I doubt it could be something related to the environment. Hence, I would suggest you to consult your internist/neurologist/ENT specialist for a complete examination of the nose and the neurological system. Hope I have answered your query; I will be available for the follow-up queries. Regards Dr. Naveen Kumar N. ENT and Head & Neck Surgeon