A stroke can sometimes cause changes to your taste and smell. Things can taste different or taste bad (dysgeusia) or you may not taste flavours (hypogeusia or ageusia). Some people lose the sense of smell (anosmia) or become more sensitive to smells (hyperosmia). These problems often improve over time, and our guide gives some practical tips about oral hygiene and enjoying your food.
Changes to the way you taste food and drink after a stroke can be due to damage to the parts of the brain that control your sense of smell and taste. Some medications can also cause taste changes.
Your GP or specialist stroke nurse can help you find out the causes of the changes. If you think medication may be causing your problems, speak to your GP or pharmacist. Don't stop taking any medications without speaking to your GP.
A new, sudden loss of taste and smell is also one of the signs of coronavirus (COVID-19). The NHS website has more information about COVID-19 including a symptom checker.
Taste changes after a stroke
Your sense of taste and smell are very closely linked (smell helps to define your sense of taste). Often when people lose their sense of taste and visit the doctor, they learn that what they are suffering from is actually a smell disorder.
Types of taste problem:
Hypogeusia – a reduced ability to taste. You will not be able to taste all flavours such as sweet, savoury or bitter as well as before.
Dysgeusia – a distortion of taste. If you are suffering from dysgeusia, it can leave you with a salty, foul or metallic sensation in your mouth. Along with distorted taste, people with dysgeusia can sometimes experience a painful burning sensation in the mouth.
Ageusia – a loss of taste. This means you cannot detect any tastes at all.
Smell changes after a stroke
Your ability to smell can be affected by damage to the area of the brain that controls your sense of smell. There are different types of smell problems:
- Hyposmia – a reduced ability to smell.
- Anosmia – loss of smell.
- Hyperosmia – oversensitivity to smell.
- Dysosmia – a distorted sense of smell.
Changes to your taste and smell often improve with time, but they can be very frustrating as you may not be able to enjoy eating and drinking as you did before your stroke. This can lead to weight loss or malnutrition, so it’s important to ask your GP for help if you are having trouble eating enough to stay a healthy weight. In addition, if you cannot smell properly, you may be unable to recognise warning smells such as harmful gases or smoke.
There are various tests you can have to find out whether you have smell or taste problems. Taste can be tested by using foods that are from different taste qualities, such as sugar, lemon juice and salt. Your doctor may check your mouth for dryness or infection.
To test your sense of smell, doctors may ask you to smell common fragrant substances such as coffee, cloves or soap, using one nostril at a time. You will then be asked to try and identify what the smell is.
Your GP may refer you to see an otolaryngologist (a specialist for problems with ears, nose and throat) or a dietitian for further advice and support with eating.
Tips for dealing with taste changes
If you are having changes to your sense of taste, there are some things you can try to make your food taste better. Some people add more salt or sugar to boost flavour, but it’s a good idea to avoid this as it can lead to high blood pressure or weight gain. Check with your pharmacist about any foods you should avoid with your medication.
Try eating food cold or at room temperature, rather than hot. Sometimes, cooling can reduce strong or sweet flavours.
Drink plenty of fluids.
Dilute sweet beverages or juice with water, soda or tonic water.
Chewing sweets such as mints or boiled sweets can help to refresh your mouth. Try sugar-free varieties.
Keep your mouth clean and brush your teeth regularly and thoroughly, including brushing your tongue.
Ideas to flavour food
Use aromatic herbs and spices, which will add more flavour. Try herbs like garlic, tarragon, rosemary and mint, or spices like cloves and cinnamon.
Prepare and make foods with a variety of textures and colours to add to visual appeal.
You could try adding toasted nuts or olive oil to vegetables to add flavour.
- Add chilli, spices or curry powder to savoury dishes.
Adding lemon and lime juices or Worcestershire sauce to cooking adds flavour.
Olives, garlic or pesto may add flavour to pasta dishes.
If food tastes too sweet
Choose sharp-tasting fruits such as gooseberries, blackcurrants, grapefruit or stewed rhubarb in pies or tarts.
Add spices to puddings, for example, nutmeg to rice pudding or custard, or ginger to stewed fruit or fresh melon.
If food tastes bitter
Sweet flavours such as sweet spices like cinnamon may hide bitter tastes. Artificial sweeteners may also help. If you have diabetes, check with your GP first.
If tea or coffee tastes bitter, try alternatives, such as lemon or herbal tea, hot chocolate or fruit juices.
Don’t use salt to enhance the flavour in food. Too much salt can raise your blood pressure, which is a major risk factor for stroke.
See more information about healthy eating and stroke.
Good oral hygiene can also help. It is important to look after your mouth, teeth and gums to make sure your mouth does not become dry or sore. Swallowing problems, as well as other effects of stroke such as paralysis or weakness, may make this difficult. Some types of medication can also add to these difficulties by giving you a dry mouth or affecting the control of your saliva. Saliva is essential for our sense of taste.
If you have swallowing problems, good oral health is really important. This includes brushing your teeth, cleaning your gums and cleaning any dentures. You may need to keep your mouth moist by using wet swabs and putting some petroleum jelly around your lips. Read more about swallowing problems including our practical tips about eating and oral hygiene.