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Have a strong smell of urine in nose. Have had citrus smell in past. On thyroid medication. Related?

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General & Family Physician
Practicing since : 2005
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I have a strong smell of urine in my nose all the time. Started about a month ago and I have also had citrus smells in the past but now this recent smell is unpleasent. I am 60 years old weigh 70 kilos and am 5ft 4in am on medication for over active thyroid problem the past 17 years. Can you help me please.
Posted Tue, 23 Jul 2013 in Ear, Nose and Throat Problems
Answered by Dr. Prasad 4 hours later

Thanks for writing here.

I went through the details with diligence. What is important at this point is

1. Whether you alone perceive the smell or if people around you are able to perceive the same smell.
2. If it is only felt by you, then do you find other substances as foul smelling or is it presence without a source.

I have had a few patients reporting with similar complaints that they perceive abnormal smell at my clinic. When I looked/examined them, they usually have an underlying infection in the nose - sinusitis / atrophied turbinates with infection and so on.
Generally people around these patients are also able to feel the foul smell while they breathe. So check with your close associates/family and friends whether they feel the smell while you breathe.

In the absence of an underlying source, the abnormal smell just could be a misinterpretation of perceive olfactory signals arising from the nose. This abnormality can be associated with few neuropsychiatric conditions. A detailed neuropsychological examination with or without radiological imaging (CT/MRI scans) of the brain can isolate the exact cause.

To conclude, I would say:
1. Over active thyroid or the medications for it is not related to your symptom.
2. Discuss with your close associates about the problem and learn if they do perceive the same.
3. If it is only you who perceive the smell, fix an appointment with an ENT surgeon. He can examine your nose and treat if any underlying infection is found.
4. If your nose is clear, then the next step is to visit a neurologist.

I hope this approach will get your problem solved. Let me know if you need clarifications.

Good luck!!
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