Advice for Treating and Understanding Loss of Smell
My husband lost his sense of smell about two years ago, and we are certain it is not due to Covid. We have tried smell training without any success. Can you provide any advice on potential treatments or causes?
Loss of sense of smell, or anosmia, gained attention as a Covid symptom. It was more prevalent during the early stages of the pandemic, and experts suggest it was less common with later variants of the virus. However, anosmia can be caused by various viruses and infections of the upper airways, including the common cold. These conditions can damage the nerves responsible for transmitting smell signals to the brain.
Anosmia can also be a result of nerve degeneration or brain injury following events such as head trauma or stroke. Short-term anosmia can occur when the nose is blocked by a cold, while long-term anosmia may be caused by nasal polyps (fleshy growths inside the nasal cavity) or chronic nasal congestion related to allergies or smoking.
If you or your husband are experiencing persistent loss of smell, it would be advisable to consult with a GP and potentially seek a referral to an ear, nose, and throat (ENT) doctor for further examination, particularly to check for polyps. If polyps are found, they can be treated surgically or with nasal sprays.
Loss of smell is a serious condition as it can pose risks by preventing the detection of dangerous substances like gas or fire. Additionally, it takes away the enjoyment of eating and drinking, which can significantly impact quality of life. While smell training kits can be helpful, persistently seeking treatment and assistance is crucial.
There are two charities, AbScent (abscent.org) and Fifth Sense (fifthsense.org.uk), that offer excellent advice and support for individuals with loss of smell.
Seeking Help for Gilbert Syndrome
Our 16-year-old grandson is currently experiencing severe symptoms such as nausea, fatigue, frequent bathroom visits, intense anxiety, and severe cramping under the ribs. He also appears jaundiced. He has been diagnosed with Gilbert syndrome, and we have been told there is no treatment available. However, he is struggling to cope, and we are desperate for any suggestions. Where can we turn for help? He has missed a significant amount of school this year, and you are our last hope.
Gilbert syndrome is generally considered harmless and not typically referred to as a disease. Most individuals are unaware they have it, as it is often discovered incidentally during liver function tests. Gilbert syndrome does not cause symptoms like anxiety, cramps, nausea, tiredness, and stomach pains. If these symptoms are occurring in a teenager, other potential causes should be investigated.
You may want to write to Dr. Ellie to discuss these concerns.
About four percent of the population is thought to be affected by Gilbert syndrome, and it often has a familial pattern. The syndrome results in elevated levels of bilirubin, a waste product of red blood cells, which can cause a jaundiced appearance. This may occur in stressed, ill, or dehydrated individuals.
The British Liver Trust (britishlivertrust.org.uk) offers valuable advice and information regarding Gilbert syndrome. Given the significant problems your grandson is experiencing, it would be advisable to explore other potential causes such as inflammatory bowel diseases like Crohn’s disease or colitis, coeliac disease, or irritable bowel syndrome (IBS). Additional tests may be necessary, including repeated blood tests, screenings for infections, and specific stool analysis to detect inflammation.
It might also be beneficial for your grandson to have an opportunity to speak with his doctor privately, in case there are concerns he is unable to discuss openly with the family. Furthermore, this age group is prone to developing mental health problems that may initially present as physical symptoms.
Treatment Options for Benign Paroxysmal Positional Vertigo (BPPV)
My husband has been diagnosed with BPPV and has been experiencing weeks of dizziness, nausea, and increasing unsteadiness. No treatments have been suggested other than something called the Epley maneuver, which his osteopath attempted but with no improvement. Is there any medication available for this condition?
Benign paroxysmal positional vertigo (BPPV) is an ear-related problem that leads to dizziness, particularly when the individual assumes certain positions, turns their head, or rolls over in bed. The inner ear’s delicate components are responsible for maintaining balance, making issues within it a common cause of these symptoms.
BPPV is surprisingly common, especially among individuals aged 50 and above, and it can be distressing. In older individuals, it can lead to falls and significantly affect daily life. Fortunately, spontaneous recovery often occurs over several weeks without treatment. Being aware of the movements that trigger symptoms can help in managing the condition.
The Epley maneuver is designed to reposition the head slowly, aiming to shift fluid and debris within the inner ear. This procedure may be accompanied by Brandt-Daroff exercises, which are similar and can be performed at home. If the Epley maneuver did not yield positive results, it can be attempted again.
It is most likely that vertigo is caused by issues originating from the ear rather than the brain. However, if symptoms do not improve or worsen over time (BPPV can be intermittent), it would be advisable to discuss alternative diagnoses with a doctor.
The Importance of Smoking Bans
Can anyone reasonably argue against implementing smoking bans? In my youth, smoking was permitted in restaurants, on public transport, and even on planes. When I shared this fact with my teenagers, they found it unbelievable, considering how different the current norms are. Personally, I find this progress in preventing smoking in our society commendable, but I believe there is more we can do.
I support the government’s plan to gradually increase the legal smoking age by one year annually, effectively making it impossible for younger teenagers to purchase cigarettes. For instance, raising the smoking age from 16 to 18 in 2007 resulted in a 30% decrease in teen smoking rates, proving the effectiveness of such measures.
I am genuinely perplexed as to why anyone would argue against these measures, although I have seen some attempting to do so on social media. Allowing children to purchase cigarettes only benefits tobacco companies financially, with no value for the child. Let us continue to prioritize public health and further reduce smoking rates in our society.
Recognizing Male Menopause
Is there such a thing as male menopause? I am skeptical. Furthermore, I find it difficult to believe that middle-aged men require time off work to cope with symptoms like hot flushes and emotional changes, which some claim are similar to those experienced by menopausal women. It appears that some NHS Trusts have implemented this policy, but I have never come across it personally.
The fight for women to have menopause recognized has been hard-fought, with justifiable reasons considering menopause is a physiologically proven condition resulting from a significant decline in natural production of female hormones. The same cannot be said for so-called male menopause or “man-opause”. Through my medical practice, I often test men’s testosterone levels, primarily when they have erectile dysfunction, and very few have abnormal results.
Symptoms labeled as male menopause are more likely attributable to other factors, such as lack of exercise, weight gain, depression, or strained relationships. Let us refrain from classifying these symptoms as something they are not.
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