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posted: 1/13/2014 6:00 AM

Advancing age, blocked nasal passages affect sense of taste

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Q: I've lost my sense of taste within the past few months. I take medicine for high blood pressure -- could that be the reason?

A: It could be, but there are other possibilities.

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What we call "taste" is actually a combination of the sensations from the taste buds on our tongue and the smell centers in our nose. Taste also involves nerves in the tongue that sense the texture of food we are eating.

The taste receptors on our tongue pick up five different types of taste. They identify what is salty, sweet, sour or bitter. There's also a fifth taste, called "umami," which is best described as a "meaty" taste.

As we get older, most of us lose some sense of smell and taste. This usually starts after about age 60. I don't know your age, but perhaps that's a part of what's happening to you.

People with high blood pressure are more likely to lose their sense of taste and smell. It's not clear whether this is related to high blood pressure itself or to the drugs used to treat it. That said, certain types of high blood pressure drugs have been reported to cause loss of taste.

These include diuretics, which help the kidneys eliminate sodium and water from the body. ACE inhibitors may also cause loss of taste.

If your loss of taste is related to one of your blood pressure pills, it's probably reversible. But don't stop taking any medications until you talk with your doctor. He or she might suggest switching to a different class of drugs or taking other steps.

If your mouth is dry from diuretics, for example, you might try sipping water between bites. Sometimes the moisture can help make food more flavorful.

However, rather than assume your loss of taste is due to age or blood pressure, let's consider some other possible explanations.

Since your sense of smell also affects taste, it's not surprising that conditions that affect your nose could reduce your sense of taste.

Perhaps your nasal passages are blocked by: allergies; secondhand smoke or other irritants; a persistent sinus infection; or polyps in the nose.

Sometimes people temporarily lose their sense of smell after an upper respiratory tract infection.

Based on personal experience, I suspect there are certain kinds of viral infections that can directly affect the nose and sense of smell. When I was a teenager, I was very sick for about a week with what the doctor called a viral infection. I recovered completely -- except that my sense of smell and taste has not been as good since.

I've seen patients with a similar experience. One benefit I've found from having a reduced sense of taste and smell is that I cannot appreciate the pleasures of fancy meals and wines that delight many of my friends.

That's one less thing to spend money on!

• Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com.

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