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What causes a musty smell in the nose?

I have a musty smell in my nose and can't seem to get rid of it. I've experienced this problem for the last couple of months and it's really starting to affect my quality of life. Do you have any advice?

James, UK

Dr Sarah Jarvis says:

Changes in your sense of smell are rarely life-threatening, but they can have a significant impact on your quality of life. Your senses of smell and taste are closely linked, and many people who lose their sense of smell find that food loses much of its taste as well. You can recognise 'basic' tastes - bitter, sweet, salty, sour and umami (the taste of meaty/savoury substances) - without needing smell, but more complex flavours need both senses to appreciate them fully. In fact, most of the flavour of food is largely due to its smell.

Like taste, smell is a chemical sense. Receptors in your nose turn messages from smells received into electrical signals for the brain to interpret. You can smell food through your nose without tasting it but when you're eating, the smells also travel to the back of your nose from the back of your mouth.

One of the most common reasons for a distorted sense of smell is the common cold. The build-up of mucus blocks the delicate chemoreceptors that line the nose, affecting their ability to be stimulated and send those electrical signals. Hay fever, which can also lead to a build-up of mucus and a blocked - along with a runny, itchy - nose, can have the same effect. However, these conditions are unlikely to lead to abnormal smells - partial or complete loss of sense of smell is more likely.

A more common reason for a musty smell in the nose is a sinus infection. This can be acute (acute sinusitis is more commonly associated with pain over the front of your face, a blocked or runny nose, fever and/or an unpleasant-tasting drip down the back of your nose into your throat) or chronic (lasting for more than 12 weeks, pain is often less prominent but runny nose and reduced sense of smell are more common).

Mouth infections or problems with your teeth can also cause an unpleasant sense of smell. A much less common cause of problems with smelling is partial damage to the nerve involved in smell - the olfactory nerve. This can happen as a result of a head injury or a stroke.

Because smell and taste are closely linked, other problems which affect your mouth can also result in a change in your sense of smell. Tooth decay, inflamed gums and smoking are obvious culprits.

Reflux from your gullet (oesophagus) can cause a nasty taste in the back of your throat which can affect your sense of smell. If your symptoms are severe or persistent, see your GP. They may consider tests and possibly a referral to an ear, nose and throat (ENT) specialist who can examine the inside of your nose with a small flexible telescope (called an endoscope).

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