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Can a smoking like smell always around me be the result of some deficiency ?

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Practicing since : 1991
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Hi. I'm 43 year old female. I am 5 ft 1 in and am overweight at about 275 lbs. I have just recently begun treatment for low thyroid. I've had struggles in insulin resistance and polycystic ovarian disease for many years. I struggle some with low potassium levels for know known reason. I have some issues with fatigue as well but I have two toddlers - so somewhat explainable.

When I was pregnant with my now 3 1/2 year old I began to have this strange symptom develop. I would smell cigarett smoke when there was absolutely no smoking anywhere near me. I detest smoking and never allow it in my home or car so there is no chance it's a lingering real odor. It's now been over four years since this phantom smell thing began and it is still here. I went to see an Ear Nose and Throat doctor who did tests on my sinuses to see if there was any infection and he found nothing at all wrong. I even went through about 21 days of antibiotics during that time - just in case. But it hasn't helped. I'm wondering if you have ever heard of these phantom smells being associated with changes in hormones? Or could there be any connection with a deficiency in a mineral like Magnesium? Any ideas would be helpful. Thanks.
Posted Thu, 19 Apr 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Sumit Bhatti 3 hours later

Thank you for your query.

1. The most common cause for these symptoms will be a nasal / sinus infection. Stasis of nasal secretions causes infections. Sometimes fungal, and build up of waste products of inflammation, infection, immune system by-products and gases like nitric oxide and ammonia. This would explain the acrid, pungent, cigarette smoke like smell which you experience.

2. The sinuses may harbor silent infection. Fungal infections may exist only within the sinuses (as against invasive fungal infections) and yet cause allergic reactions. This constitutes Allergic Fungal Rhino Sinusitis (AFRS). Such fungal infections may be missed out on CT Scans and requires MRI Scans to detect. Antibiotics will not help in fungal infections.

3. Due to their unique design, airflow through our sinuses and their ventilation occurs gently and passively during expiration. This may explain why you get the smell occasionally.

4. Is it possible for any other person experience this from your breath? If yes, then there is a cause that can be found. If this smell is apparent to others, it is unlikely to be an olfactory hallucination or damage to the (olfactory) smell area of the nose. If not, then this is true parosmia / cacosmia / phantosmia. Viral infections such as influenza can cause this for years after the infection. A neurological reference will be required. Early Parkinson's Syndrome may present as phantosmia.

4. Hypothyroidism can rarely be associated with a decrease or loss of sense of smell (anosmia) though increased nasal infections are common. Menopause, Diabetes, PCOD are conditions that can also cause similar symptoms.

5. Deficiencies of Vitamin D, Vitamin B12, Magnesium can also cause similar symptoms. However, deficiencies are fairly easy to treat. A high protein diet may also cause these symptoms. Get your liver and renal function tests done.

6. Conditions like atrophic rhinitis, post nasal drip and acid reflux may also co-exist. Use a medicated gargle. Bile reflux following gall bladder removal may also be responsible for this strange smell.

7. Your hypokalemia (low potassium) is likely to be related to your low magnesium levels and a cause for your fatigue. Consult an Endocrinologist. Sometimes it is drug related.

8. You seem to have a multitude of problems. Many of these are interrelated. For example, Hypothyroidism causes weight gain which confuses the metabolism in our body. Insulin, hormones and fat have a common metabolic pathway. This causes insulin resistance and PCOD. Begin by checking your Thyroid Function Tests. After optimal control of hypothyroidism, weight loss will solve most of your problems.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

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