What is hyperosmia?
Hyperosmia is a heightened sense of smell. People with hyperosmia have an extremely sensitive sense of smell, where certain odors that most people don’t notice can be overpowering. This can make daily life very difficult, as smells from foods, perfumes, cleaning products, or other scents in the environment can cause discomfort or nausea.
Some key signs of hyperosmia include:
- Being easily overwhelmed by smells that don’t bother other people
- Getting headaches, feeling sick, or losing your appetite from certain smells
- Having to avoid going places like supermarkets, restaurants, or friends’ houses due to the smells
- Needing to use unscented personal care and cleaning products
- Having trouble tolerating perfumes, colognes, and scented body products on other people
If you experience these types of reactions to smells on a regular basis, you may have hyperosmia. The severity can range from mild to debilitating.
What causes hyperosmia?
There are a few possible causes of hyperosmia:
Pregnancy
Many women experience heightened smell sensitivity during pregnancy, especially in the first trimester. This is thought to be related to hormonal changes. The hyperosmia usually goes away after giving birth.
Medications
Certain medications like antibiotics, anti-inflammatories, antidepressants, and Parkinson’s drugs can cause temporary hyperosmia in some people. The mechanism behind this side effect is not always clear. The hyperosmia typically resolves when the medication is stopped.
Head injury
Injuries to the head, especially the nasal region, can damage the olfactory nerves and cause smell distortions like hyperosmia. This may improve over time as the nerves heal.
Neurological conditions
Disorders like Alzheimer’s, Parkinson’s, multiple sclerosis, and schizophrenia have been associated with hyperosmia. Research suggests the disease processes in the brain may impact olfactory functioning.
Infections
Sinus infections, colds, flu, and other respiratory infections can inflame the nasal passages and potentially make smells seem stronger. This is usually temporary and resolves with treatment of the infection.
Chemical exposure
Exposure to certain chemicals like insecticides, solvents, or metals can damage the olfactory nerves and trigger hyperosmia. Avoiding further exposure may help improve the sense of smell.
Unknown causes
In some people, the cause of hyperosmia is unknown. There are a number of theories about factors that may contribute, like genetic predispositions, hormones, or variations in olfactory nerve pathways. More research is needed.
When to see a doctor
You should make an appointment with your doctor if:
- Your hyperosmia is severe and impacting your daily functioning
- The heightened smell sensitivity does not have an apparent cause like pregnancy or a respiratory infection
- It occurs along with other unusual neurological symptoms
- It persists for more than a few weeks
Your doctor can perform exams and tests to try to pinpoint the cause, which will guide the treatment approach.
Tests may include:
- Medical history and physical exam
- Nasal endoscopy – examination of the nasal cavities with a tiny camera
- Smell testing – identifying different odors
- Imaging tests – CT scan or MRI of the nasal area
- Neurological evaluation – assessment of the nerves and brain
Based on the results, your doctor may refer you to an otolaryngologist (ear, nose, and throat doctor), neurologist, or other specialists for further assessment and care.
How is hyperosmia treated?
The treatment for hyperosmia depends on the underlying cause:
Pregnancy
No specific treatment needed. It typically resolves after giving birth. Avoiding triggers can help manage symptoms.
Medications
Switching to a different medication may stop the hyperosmia.
Infections
Treating the infection with rest, fluids, antiviral/antibacterial medications can help resolve associated hyperosmia.
Head injuries
Smell retraining therapy may help regenerate damaged olfactory nerves. Medications like steroids might also aid recovery.
Neurological disorders
Treatment is aimed at the underlying condition. Smell training and medications may provide some relief.
Chemical exposures
Avoiding further exposure is critical. Smell retraining therapy can help re-establish normal olfactory functioning.
Idiopathic hyperosmia
When no cause is found, management focuses on coping strategies:
- Avoiding triggers like perfume counters, candle shops, etc.
- Using unscented products
- Wearing a mask in triggering environments
- Using air purifiers and filters
- Trying acupuncture or acupressure for symptom relief
- Prescription nasal sprays or oral medications in severe cases
If hyperosmia is severely impacting quality of life, surgery on the olfactory nerves may be an option in rare cases.
Outlook for hyperosmia
The long-term outlook depends on the cause:
- Pregnancy-related hyperosmia completely resolves after delivery
- Medication side effects go away when the drug is stopped
- Post-viral and post-traumatic hyperosmia often improve over weeks to months as nerves heal
- Neurological and idiopathic hyperosmia tend to persist and require ongoing management
While hyperosmia can be challenging to live with, trying to identify triggers, using coping strategies, and working with your doctor can help prevent odors from overwhelming your life. Support groups and smell training therapy may also help you better tolerate and adapt to a sensitive sniffer.
Frequently Asked Questions
What is phantosmia?
Phantosmia refers to smelling odors that aren’t actually present. Having phantom smells along with hyperosmia can make it even more difficult to tolerate scents. Phantosmia may be caused by similar factors as hyperosmia. Treatments focus on coping strategies and underlying medical conditions.
Can zinc supplements help hyperosmia?
Some research indicates zinc supplements may modestly improve hyperosmia symptoms in certain cases. Zinc appears to support regeneration of olfactory nerve cells. However, outcomes are mixed and more studies are needed. Talk to your doctor before trying zinc.
Is hyperosmia a sign of COVID-19?
Loss of smell (anosmia) is a well-known COVID-19 symptom. However, developing hyperosmia appears very rare with COVID infections. Most published cases of COVID-related hyperosmia improved after recovery from the acute illness.
Can anxiety cause hyperosmia?
While not a direct cause, anxiety can make hyperosmia worse. Stress and anxiety appear to increase odor sensitivity. Practicing relaxation techniques, getting counseling, and treating other underlying causes may help minimize anxiety’s impact.
Does hyperosmia go away with age?
Hyperosmia often improves or resolves with advanced age, typically due to gradual decline in olfactory function. However, experimental therapies are being tested to try to restore smell in elderly patients with chronic smell disorders.
| Cause | Onset | Duration | Treatment |
|---|---|---|---|
| Pregnancy | First trimester | Resolves after delivery | Avoidance of triggers |
| Medications | Soon after starting drug | Resolves with drug cessation | Changing medications |
| Infections | During active illness | Usually resolves with treatment | Treating underlying infection |
| Head injury | After sustaining injury | Often improves over weeks to months | Smell training, steroids |
| Neurologic disorders | Variable | Usually lifelong | Treatment of underlying disorder |
| Chemical exposure | After exposure | May be long-lasting | Avoidance, smell training |
| Idiopathic | Gradual or sudden onset | Often lifelong | Trigger avoidance, medications |
This table summarizes the common causes of hyperosmia, when it starts, how long it lasts, and how it is treated.
Conclusion
Hyperosmia is a condition affecting the sense of smell that is not well understood, but can significantly impact quality of life for those who experience it. If smell sensitivities are disrupting your daily activities or causing distress, consult your doctor for an evaluation. Identifying potential triggers and underlying causes is key in developing an effective treatment approach. While hyperosmia may not be curable in all cases, a combination of medications, nasal therapies, lifestyle modifications, and coping techniques can help prevent smells from overwhelming you. Support groups and smell training therapy can also help you better manage and adjust to a sensitive sniffer. Work closely with your doctor to find the strategies that provide the most relief.
