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One of the most common complaints during and after chemotherapy is that things just don't smell and taste the same. What we perceive as taste is intimately linked with our sense of smell, and in most cases it's really disturbances in olfactory function that are the problem after chemo. However, our sense of smell isn't just something in our noses. It's also something in our brains.

A lot of the most often-recommended natural remedies for restoration of sense of smell after chemotherapy just don't work.

  • High-dose zinc therapy (50 mg twice a day, which is a dose large enough to cause copper deficiencies) has been recommended as a treatment for loss of olfaction for decades, but when it was finally tested in a clinical trial at the University of Virginia, zinc supplements were found to make sense of smell worse after chemo. A study of the nasal spray Zicam even found that some people lost their sense of smell permanently, without chemotherapy, due to overexposure to zinc.
  • Marijuana is frequently recommended to cancer patients to stabilize nausea and vomiting. It does, according the results of the only clinical trial of its use, hold any benefit for restoring sense of smell.
  • High-dose vitamin D therapy, 10 thousand IU per day, is also sometimes recommended for restoring sense of smell after chemotherapy. This may actually work if there is a vitamin D deficiency, and due to the disruption of lifestyle caused by cancer treatment, there often is. However, it usually only restores the ability to detect extremely strong smells.
There are ways to help bring back your sense of smell after chemotherapy that will be discussed in a moment, but first, what about the common problem of body odor after chemotherapy? Do you really smell bad, or is it all in your head, or all in your brain, to be more precise?
  • There really are kinds of chemotherapy that make patients smell bad not just to themselves but also to other people. Just about anything that contains a heavy metal (Platinol, for example), will change body odor to more metallic. The odor change lasts for several weeks after the end of treatment, but goes away when skin cells have a chance to renew themselves. This takes longer if you are on a second chemotherapy that inhibits cell division, such as methotrexate.
  • There are treatments often given with chemotherapy that make patients smell bad to themselves and other people. The antibiotic vancomycin, given to stop infections that arise when white blood cell counts fall, generates a putrid sulfurous smell in urine. Any spillage becomes highly odorous. Iron supplements given to counteract anemia don't just build up red blood cells, they also feed odor-causing bacteria on the skin. As long as you are taking iron, you will tend to have very healthy underarm bacteria.
  • Stinky foods can also have an unusually potent effect in people who are on chemotherapy. Ordinarily the liver quickly breaks down the sulfur compounds in onions, garlic, broccoli, cabbage, and stinky cheese. When the liver is busy detoxifying chemotherapy drugs, however, odors from food can accumulate and linger in sweat and urine. People who ordinarily don't get a garlicky smell may have a persistent food odor that lingers almost as long as they are taking chemotherapy.
Problem foods can be avoided, but medications cannot. You can drink more water so urine odor doesn't waft into the next room. You can take more showers (preferably in lukewarm water, not hot water, since hot water causes the accumulation of dry skin which can harbor odor-causing bacteria) to counteract the accumulation of odors on your skin. Avoiding the odors that you can smell and other people cannot, however, takes some planning.
Most of aren't aware of our "smell memories." Our brains record smell as well as words, events, and feelings, and sometimes just a scent can trigger a memory at an unconscious level. Our brains are particularly sensitive to a chemical called vannilin, the main scent in vanilla. Food manufacturers in Europe and North America are very aware of this. They add traces of vanilla to baby formula, and then rely on the fact that consumers remember that faint scent of vanilla when they were held in their mother's arms when they eat tiny traces of vanilla in unlikely foods such as pickles, soft drinks, ketchup, energy bars, and hamburger buns. A feeling of security can be encoded in vanilla scent. A feeling of distress can be encoded into vanilla scent, too.
For chemotherapy patients, it is important to remember that your brain will associate any unpleasant experience caused by cancer or cancer treatment with the food you smell that day. If your favorite food has always been hamburgers, French fries, and ketchup, and you just didn't know why, chances are it will cease to be your favorite food if that's what a friend smuggles in to you when you are in the hospital for chemotherapy. Any strong odor, such as onions, or cheese, or even apple pie, can become associated with unpleasant experiences. Then, you will later tend to smell these food odors whether or not they are physically present when you feel bad, and you will tend to feel bad when you smell the food odors.
It's important to avoid the foods you like on days you are sick from chemotherapy treatment. Those are the days to stick to bland, unseasoned foods. Save pleasant foods for after chemotherapy, and you will have fewer problems with phantom odors and unpleasant, subliminal memories of your cancer treatment.

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