Famous people believed to have had Asperger’s Syndrome
Aspergers traits in Sheldon Cooper.
Actually as well as being funny this is quite perceptive. What do you think?
Aspie Miss is a big fan – you can read her blog post on Big Bang Theory here.
Anosmia is the medical term for loss of the sense of smell. It’s usually caused by a nasal condition or brain injury, but some people are born without a sense of smell (congenital anosmia).
Losing your sense of smell can be very depressing and isolating. It means missing out on many experiences most of us take for granted, such as smelling fresh flowers, perfume or the scent of a loved one.
Smell also plays an important role in how you taste things. Many people with anosmia lose interest in food, because 80% of the flavour of food comes from its smell.
If you’ve suddenly lost your sense of smell and don’t know why, see your GP. They may be able to diagnose an underlying cause (see below) and offer treatment to restore your sense of smell.
Seeing your GP
Your GP will want to take your full medical history, examine the inside of your nose and take a blood sample for testing in a laboratory.
Your doctor may refer you to an ear, nose and throat (ENT) specialist in hospital. Further tests, such as a CT scan, MRI scan or nasal endoscopy (where a thin tube with a camera is inserted up your nose), can be used to investigate the cause.
What are the causes?
There are several medical conditions and medications associated with a loss of smell. The possible causes include:
a viral infection affecting the upper respiratory tract, such as a cold
a nose abnormality, such as a crooked nose or a nasal septum (wall dividing the nostrils) that isn’t straight
hay fever (rhinitis) that causes severe inflammation of the nasal passages
certain medication, including antibiotics such as metronidazole
recreational drug use such as cocaine or amphetamines
long-term alcohol misuse
Cushing’s syndrome (high levels of the hormone cortisol in the blood)
exposure to a chemical that burns the inside of the nose
radiotherapy to the head and neck
liver or kidney disease
granulomatosis with polyangiitis – an uncommon disorder of the blood vessels
sarcoidosis – a rare disease that causes body cells to form into clumps
In general, anosmia is usually caused by either a problem with odours getting to the top of the nose (because of swelling or a blockage in the nose) or a problem with nerve signals from the nose to the brain.
However, in around 20% of cases, the cause can’t be found. This is known as idiopathic anosmia.
An estimated 6,000 people in the UK are born without a sense of smell because of a genetic condition or faulty gene. This is known as congenital anosmia.
It can occur alone (isolated congenital anosmia) or it can be a symptom of another genetic condition, such as Kallmann syndrome or Klinefelter syndrome.
Can anosmia be cured?
Whether or not anosmia can be cured depends on the underlying cause.
People with congenital anosmia have a lifelong inability to smell and have no concept of what a smell even is. Currently, there’s no known cure or treatment for congenital anosmia.
However, other types of anosmia may be improved or cured when the underlying condition is treated. For example, if the cause is swelling in the nose or sinuses, steroids can usually clear this up and restore your sense of smell.
Treatments that may help, depending on your condition, are:
nasal washing (douching)
an operation to straighten the nasal septum
an operation to clear out the sinuses, called endoscopic sinus surgery (ESS) (see below)
These treatments may come with unpleasant side effects. Speak to your doctor about whether any of these treatments may be suitable for you and, if so, what side effects you may experience.
In bilateral endoscopic sinus surgery (ESS), the surgeon opens all your sinuses and clears them out to reduce inflammation and allow nasal rinses and sprays to reach them. In some centres, this may involve the use of an image guidance system (IGS) to map out your sinuses. ESS also involves removing any polyps present at the same time.
This treatment can bring back some sense of smell for many people with anosmia when medication alone has failed. However, if you don’t keep taking your nasal medications afterwards, the anosmia is likely to return.
If you’ve had surgery to remove nasal polyps, it’s quite common for these to grow back, and many people find they need another operation. However, ESS may reduce the need for further surgery.
A recent journal publication looked at how successful ESS with IGS was in treating patients with chronic frontal sinusitis, some of whom also had nasal polyps. Data from a five-year period showed that only four patients out of 141 (3%) needed to have further surgery after having ESS with IGS as their first operation. IGS is not available in all hospitals, but may be performed by specialist centres where possible.
If you have anosmia, you’ll need to take special precautions because you won’t be able to smell fires, poisonous fumes, leaking gas or food that has gone off.
It’s recommended that you:
install smoke alarms in all areas of the home, especially in the kitchen and near the fireplace
change from natural gas appliances to electric or consider installing a natural gas detector
clearly mark expiry dates on food and mark leftovers with dates, so you know when to throw them away
carefully read warning labels on products such as bathroom and kitchen cleaners, and insecticides, to be aware of potent chemicals
Some people with anosmia also experience a loss of appetite, but it’s important to maintain your nutrition levels. It may help to set reminders for mealtimes and weigh yourself regularly to ensure you stay healthy.
Weight loss surgery, also called bariatric or metabolic surgery, is sometimes used as a treatment for people who are very obese.
Weight loss surgery
Weight loss surgery is available on the NHS for people who meet certain criteria.
you have a body mass index (BMI) of 40 or more, or a BMI between 35 and 40 and an obesity-related condition that might improve if you lost weight (such as type 2 diabetes or high blood pressure)
you’ve tried all other weight loss methods, such as dieting and exercise, but have struggled to lose weight or keep it off
you agree to long-term follow-up after surgery – such as making healthy lifestyle changes and attending regular check-ups
Speak to your GP if you think weight loss surgery may be an option for you. If you qualify for NHS treatment, they can refer you for an assessment to check surgery is suitable.
You may can also pay for surgery privately, although this can be expensive.
Read more about NHS and private weight loss surgery.
Types of weight loss surgery
There are several types of weight loss surgery.
The most common types are:
gastric band – a band is placed around the stomach, so you don’t need to eat as much to feel full
gastric bypass – the top part of the stomach is joined to the small intestine, so you feel fuller sooner and don’t absorb as many calories from food
sleeve gastrectomy – some of the stomach is removed, so you can’t eat as much as you could before and you’ll feel full sooner
All these operations can lead to significant weight loss within a few years, but each has advantages and disadvantages.
If you’re considering weight loss surgery, speak to a surgeon about the different types available to help decide which is best for you.
Read more about the types of weight loss surgery.
Life after weight loss surgery
Weight loss surgery can achieve dramatic weight loss, but it’s not a cure for obesity on its own.
You’ll need to commit to making permanent lifestyle changes after surgery to avoid putting weight back on.
You’ll need to:
change your diet – you’ll be on a liquid or soft food diet in the weeks after surgery, but will gradually move onto a normal balanced diet that you need to stay on for life
exercise regularly – once you’ve recovered from surgery, you’ll be advised to start an exercise plan and continue it for life
attend regular follow-up appointments to check how things are going after surgery and get advice or support if you need it
Women who have weight loss surgery will also usually need to avoid becoming pregnant during the first 12 to 18 months after surgery.
Read more about life after weight loss surgery.
Risks of weight loss surgery
Weight loss surgery carries a small risk of complications.
being left with excess folds of skin – you may need further surgery to remove these
not getting enough vitamins and minerals from your diet – you’ll probably need to take supplements for the rest of your life after surgery
gallstones (small, hard stones that form in the gallbladder)
the gastric band slipping out of place, food leaking from the join between the stomach and small intestine, or the gut becoming blocked or narrowed
Before having surgery, speak to your surgeon about the possible benefits and risks of the procedure.
Read more about the risks of weight loss surgery.