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Phantosmia: The Smells in Your Head

Updated on November 2, 2017
People with phantosmia hallucinate smells.
People with phantosmia hallucinate smells. | Source

Olfactory Hallucinations

Earlier, I wrote about anosmia or losing your sense of smell. For as long as I can remember, I have rarely been able to smell fragrances and odors.

Some people are sensitive to certain smells, and their sensitivity makes them physically ill. Others have an illusory sense of smell—they smell things that simply are not there.

The medical term for this condition is phantosmia, from the Greek words "phantasm" (illusion) and "osme" (smell). People with phantosmia smell things that are not derived from physical stimuli. In other words, the odors are "in the mind."

Phantosmia is a real problem, though the smells are not real. Olfactory hallucinations can vary from person to person. Sometimes phantom smells are pleasant scents; but more often, they are foul smelling odors that are hard to live with.

Those with this unusual condition say the smells can occur in one nostril or both. Unfortunately, other (real) fragrances usually cannot mask the phantom odors.

What Causes Phantosmia?

According to Dr. Jerry Swanson, a Mayo Clinic neurologist, phantosmia sometimes occurs after a head injury, brain tumor or stroke. Epileptic seizures may also cause the condition.

Phantosmia is often related to upper respiratory infections, sinusitis and migraine headaches. In some cases, it is linked to neurological disorders such as depression, schizophrenia, Alzheimer's disease, and Parkinson's disease.

While phantosmia may indicate an underlying medical condition, the problem is not always related to serious illness. It generally arises from some loss in the ability to smell.

Dr. Donald Leopold practices otolaryngology in Omaha, Nebraska. He says the brain has "a propensity to make smell." the When olfactory ability is impaired, the brain may overcompensate by creating odors that once existed but are now suppressed.

Phantosmia Treatments

Fortunately, some cases of phantosmia can be treated. If you experience any type of smell distortion, see your doctor or an ear, nose and throat specialist.

Nasal saline drops, antidepressants, sedatives and anti-seizure medicines are common treatments for smell disorders.

For severe olfactory hallucinations, especially foul smells that are hard to live with, surgery may be an option. A surgeon can severe certain olfactory connections to resolve the problem.

Interestingly, phantosmia sometimes disappears on its own. Most people just learn to live with the disorder. Have you?

Reference Sources

© 2012 Annette R. Smith

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      Annette R. Smith 14 months ago from Grand Island, Florida

      Hi, Karyn. Thank you for expressing your thoughts about / experience with phantosmia. I hope the doctor has an answer for you -- about the exhaust smells AND your chronic cough. All the best, and thank you again for your comment.

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      Karyn 14 months ago

      I'm like Steve, it is exhaust fumes for me and it will come on suddenly and last two or three weeks and then go away. but I have a chronic cough (all the time day or night) and the smell of exhaust fumes, real or imagined, makes me go into a coughing fit. I have a doctors appt coming up and plan on asking him about it. Who knows, maybe this is tied into my chronic cough somehow.

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      Annette R. Smith 2 years ago from Grand Island, Florida

      Thanks for the update, Anele. My thoughts and prayers are with you!

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      Anele 2 years ago

      Thanks very much Anette, I've got a referral to an ENT specialised in 10 days so hopefully they can help.

      Will let you know if they find anything or can offer any help.

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      Annette R. Smith 2 years ago from Grand Island, Florida

      Hello, Anele. I'm sorry to hear about your recent experience with phantom odors. That constant cigarette/smoke smell sounds miserable. I hope your doctor can pinpoint the problem and offer some relief. Please keep us posted!

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      Anele 2 years ago

      Hi there, I've just started experiencing Phamtosmia and I smell a really strong smell of smoke and my eyes sting with it also. It's so strong it's like someone is standing right next to me with a cigarette and I hate it. I've never smoked so have no idea why I'm smelling this now. I just wish it would go away as it's constant. I'm going to see my doctor next week so hopefully they can provide some relief.

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      Annette R. Smith 2 years ago from Grand Island, Florida

      Hi, Anabelle. I'm so glad you joined the discussion. Our smell disorders can really get us down, can't they? I hope your doctor can help you discover the cause of those new phantom smells, and maybe offer some relief for you. Keep us posted. And again, thank you for stopping by!

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      Anabelle 2 years ago

      I've had anosmia for the past ten years, and now I seem to have developed phantosmia. I've had two episodes this year triggered by eating a kebab where that was a recurring smell for several days, but now I'm smelling almond essence. Its *only* been one week but its already getting me down. Every time I breathe I get a nose full of that artificial almond essence. Its so strong it's constantly distracting. I had assumed it was a development of my anosmia and my sinuses playing up and that it might settle down, but after reading this and other articles I'll go see the doctor and get checked out.

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      Annette R. Smith 3 years ago from Grand Island, Florida

      Hello, geri07 - Thank you for writing about your experiences with this smell disorder. I'm glad to hear that your phantom smells are seldom harsh ones. I wonder if the ketogenic diet has something to do with it, after all? I have a very weak sense of smell, but scents come more often now that I cut back on the carbs (modified Atkins).

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      geri07 3 years ago

      I was diagnosed with phantosmia 2.5 years ago. I appreciate the frustration. The smells all seem to be triggers that inspire panic or a flight response. I would wake up thinking the house was on fire, there was a gas leak, or there was a dead body somewhere. I was lucky to get in to see a neurologist within a week of my referral (Ontario, Canada). My neurologist sent me for CT scans and an MRI as well as a sleep deprivation EEG. He also put me on Kepra (anti-seizure) and told me that I needed to make sure I slept enough. By the time I went back to see him (six weeks later), the symptoms had subsided. Nothing showed on any of the tests (no brain injury, no tumour, no worrisome brainwave patterns) but he determined that it was epilepsy as this kind of seizure is mild and difficult to detect. Occasionally I don't sleep enough and the 'smells' return. Interestingly, they are seldom the harsh smells anymore - now they tend to be of the most recent thing I baked or something I smelled at a restaurant or store. I don't know if this is because of the meds or because I am on a ketogenic diet (my choice but doctor-approved).

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      Annette R. Smith 3 years ago from Grand Island, Florida

      Thanks for dropping by, Peg. I appreciate your visit and comment.

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      Peg Cole 3 years ago from Dallas, Texas

      It's reassuring that this is an actual medical condition and to read other accounts of people who have this same issue.

    • Annette R. Smith profile image
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      Annette R. Smith 3 years ago from Grand Island, Florida

      Nice to meet you too, Nancy! As someone with anosmia, I can't smell most scents, odors, and fragrances. My odd experience with phantosmia is that I "smell" coffee when I see something coffee-colored! Thank you for sharing about YOUR experiences with this unusual smell disorder.

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      Nancy A. 3 years ago

      My weird smells started shortly after I had a concussion in 2011. At first it wasn't bad . On some days I would smell popcorn all day. Then I started smelling cigarette smoke (no one in my house smokes) . Now it is just a general burning smell somewhere between burned toast and cigarettes. It is not pleasant, especially when it lasts for weeks on end. I have heard of people who smell garbage, so I guess I should feel lucky. Nice to meet you Annette.

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      Annette R. Smith 4 years ago from Grand Island, Florida

      Hello, Sandy. It is interesting to hear of all the things that can affect our olfactory systems. Thank you for joining the conversation.

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      Sandy 4 years ago

      Joan, interestingly enough I too have recently had dental implants and minor bone graft and I am feeling a bit like I might be catching the cold going around the office. I think I will follow what you do and get some extra rest. I hate the intense smoke smell but I have no time for a brain tumor or worse-Parkinson's.

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      Annette R. Smith 4 years ago from Grand Island, Florida

      Hello, Dustin. Thank you for reading, "Phantosmia: The Smells in Your Head." I appreciate your detailed comment and questions. Anosmia (the inability to smell things) is my smell disorder, so I can only imagine what you are going through with phantom odors. Other readers may have thoughts or suggestions for you, based on their own experiences. For medical questions or concerns, please talk to a doctor.

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      Dustin R. O'Hara 4 years ago

      When I was 16 I started smelling a rotten smell for a few hours at a time daily for several weeks. I'm 28 now and for the past 6 months the same odor has haunted me daily for hours or even days at a time. The smell is more pronounced when i exhale through my nose. I would consider my symptoms to be severe although I don't really have much basis for comparison. I would describe the odor as a foul burning hair....or stinky flower smell...the same odor that some carnivorous flowers use to attract insects. I have no recollection of brain or nasal injury. I do have a history of mental illness, muscle twitching (days at a time in singular locations that some times switch locations), and insomnia. I've read that if my olfactory hallucinations last long and are frequent, I should see a neurologist asap. Any thoughts, opinions, or advice??? thanks!

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      Annette R. Smith 4 years ago from Grand Island, Florida

      Hello, Brain Damaged Metal Head. I appreciate your thoughtful comment. It's great to read some fresh insights into the possible causes of phantosmia. I hope that the phantom odors you experience before a migraine do not bother you too much, and that you're able to find a way to cope until they subside.

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      Brain Damaged Metal Head 4 years ago

      I'm surprised that no one who has posted on here has had an EEG. Perhaps because the MRIs were clean, the doctors ruled out epilepsy, but epilepsy can occur without any visible MRI abnormalities.

      Phantosmia can also be related to migraines. This sometimes happens to me a day or two before a migraine, but sometimes it just occurs spontaneously. The latter could be what my neurologist calls a "migraine equivalent symptom", or it could be a tiny seizure, but it hasn't bothered me enough to go in for a video EEG.

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      Annette R. Smith 4 years ago from Grand Island, Florida

      Hello, Octavia. So glad you found this article. I wonder, too, if we share something in common that causes our smell disorders. You're in my prayers as you go through the testing. Please stop back, and let us know what you find out.

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      Octavia 4 years ago

      For about two years off and on I have been experiencing cigarette smoke. When I first experienced it I goggle it but could not find anything bc I did not goggle the correct key words. Finally three days ago I goggled smelling problems and stumbled across a lot of information some of it very worrisome, but I am going to stay on the positive. I do get comfort in knowing that this smell came back after a bad cold. I literally could not smell a thing at all and as soon as I could smell something the cigarette smoke came along with it. It is very annoying. My doctor said that I have to get blood work first in order to get a MRI etc, so tomorrow that is what I am doing. Or maybe I should get hooked up with an ENT specialist first. I do not know. I am praying though that it is not a big underlying issue. I do not have any side effects for tumors etc. But I do get headaches but I strongly belief it is from stress. I am very relieved that most of you all have no major issues. I wonder if we all have something in common to help us link where this disorder is coming.

    • Annette R. Smith profile image
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      Annette R. Smith 4 years ago from Grand Island, Florida

      Hi, Debs. It's good to hear from you again. May we both find a way to cope with our unusual smell disorders!

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      Annette R. Smith 4 years ago from Grand Island, Florida

      Hello, Yramb. Thank you for giving us an update on your condition. I'm so glad that the visit to your ENT specialist has given you some peace of mind. You continue to have my prayers.

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      debs 4 years ago

      thank you for taking some time to reply.I hope you can get your own problems sorted soon too hun.

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      Yramb 4 years ago

      Hi Annette, Thanks for your comments. I feel much better now that I've been to my ENT specialist and found out that I don't have cancer or a brain tumor. I feel very Blessed in that area because some people do. The specialist suggests trying saline solution, antidepressants and a seizure medication. He said sometimes the smells go away on its own, and sometimes they never go away, we just have to find a way to live with it. For me, Prayer is my answer. I pray that others can find a way to cope with it as well.

    • Annette R. Smith profile image
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      Annette R. Smith 4 years ago from Grand Island, Florida

      Hello, Debs. Thank you for your comments and your question. I'm sorry to hear that you're experiencing phantom smells. As a writer, I cannot give you medical advice, but your doctor may be able to provide some answers.

      My problem is anosmia, or the inability to smell, so I can only imagine your suffering. I hope you take comfort in the fact that you're not alone; from the comments above, it seems that other people also experience what you're going through. I hope you discover the cause of your problem and also a way to treat it. You're in my prayers today.

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      debs 4 years ago

      hello i have recently started experiencing smells out of the blue over the last few weeks.I have had beer,poo,rotten flesh.perm solution and other strange chemical smells. I havnt been ill or depressed and just happened to come across your video. Im quite spiritual and so i associated it with this but now feel a bit freaked after finding out its medical. What should i do?

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      Annette R. Smith 4 years ago from Grand Island, Florida

      Hello, Yramb. Thank you not only for reading my hub, but also for sharing about your experiences with phantosmia. I suffer from anosmia or a lack of smell sensation, so I can only imagine the misery that your smell disorder causes for you. I hope you can find something to help you cope with the condition. You're in my thoughts and prayers tonight.

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      Yramb 4 years ago

      How I would love to smell roses. I just got my diagnoses today. The smells started in September of 2011, started as some smelly rotten grass from deep down in the earth, then went to smoke. I was going through the house looking for smoke, asking my sons if they smelled smoke, they,said mom it's in your head. Little did I know that it was in my head. My neurologist was treating me for migraines, then after I had my neck surgery, the migraines stopped, then my neurologist decides to send me to ENT specialist for chronic sinusitis. My MRI showed nothing wrong with my brain and I had never even heard of anything called phantosmia. The smell gets so bad at times, it come and go as it please, it's worse at night, I lay in my bed, stuff tissue up my nose, bury my head in my pillow and just want to cry. It depresses me more then anything else in the world. I had a free day until right now, it just popped out., so guys, you are not alone. I know what you are going through, and we are not crazy.

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      Annette R. Smith 5 years ago from Grand Island, Florida

      Hello, Tess. How wonderful to smell roses, even when they are not around! I wish I could smell all the lovely things in life. However, I'm blessed that I can't smell the unpleasant things, either! Thanks so much for stopping by and sharing a word here.

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      tessvowels 5 years ago from Missouri

      On occasion, I smell roses... different locations, no roses in the area! I like this one. But there's another I have, smells like something electrical is burning... this one is rather bothersome! I notice it more when I don't smell it!!

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      Annette R. Smith 5 years ago from Grand Island, Florida

      Hi, Colin. Thank you for telling us about your experiences with this smell disorder. Like you, I'm confused about the acid reflux / phantosmia connection. I'm sorry that you and so many others suffer those unpleasant phantom smells. It would be nice if doctors could find some answers soon. Again, many thanks for stopping by.

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      Colin 5 years ago

      I've suffered with this since May. I smelled cigarette smoke to the point of bringing tears to my eyes, but I don't smoke and neither does anyone else around me. I had antibiotics for sinusitis that reduced it, but didn't remove it. I recently had an MRI scan that ruled out a sinus blockage and a brain tumor. I've been discharged from ENT and the trail is going cold. They're now thinking acid reflux might have something to do with it, but I can't find anything to explain that connection. It worries me that the specialists aren't really aware of this problem and may never find the cause, or even be interested in finding it :(

    • Annette R. Smith profile image
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      Annette R. Smith 5 years ago from Grand Island, Florida

      Phantosmia really is quite the phenomenon, and an interesting topic to research too. I'm more familiar (and personally acquainted) with anosmia, which is the absence of smell sensation. Thank you, pinkhawk, for reading and commenting.

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      pinkhawk 5 years ago from Pearl of the Orient

      Never heard this before... but based from the information here, I realized that it's really possible to vomit because you imagine or remember unpleasant things... This is interesting, another word for my vocabulary..Thank you for sharing!

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      Annette R. Smith 5 years ago from Grand Island, Florida

      Hi, Joan. I love your comment, "At least if I cannot get rid of it I can put it to work." What a great attitude! I'm sorry that you have to cope with this unusual phenomenon, but I'm glad you've found a way to live with it so far. Thank you for reading my article and sharing your insights with us.

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      Joan 5 years ago

      I began experiencing phantosmia about 18 months ago. At first I could smell very strong cigarette smoke constantly but no one in our house smokes. I did not know why it was happening and did not tell anyone( I still have not told anyone I know) that this was happening for fear of being thought insane. I did an internet search a few months after the onset of my phantosmia and discovered I was not alone. The cigarette smell is intensely unpleasant but is not constant anymore. After about 6 months I could go days without smelling smoke. These days I mostly experience it when I am about to get a cold or become unwell. I now know if I smell smoke that is not there I am under the weather. I don't know if it a good thing or a bad thing but I use it as an early warning system for my health - if I smell smoke I try to get more sleep and look after my health better. At least if I cannot get rid of it I can put it to work. I am normally in good health and have never smoked, the only thing that comes to mind that occurred in the same year as my phantosmia began was that I underwent a dental implant for an upper lateral incisor with a minor bone graft. Maybe this had an effect on my olfactory system, or maybe I am just reaching. I am fortunate in that my life is not blighted by it but it is not pleasant and I no longer trust my sense of smell.

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      Annette R. Smith 5 years ago from Grand Island, Florida

      Hello, Steve. Thank you for sharing your comments with us. This frustrating condition is indeed real, and those who share your condition can take comfort in the fact that they are not alone. You have my prayers for recovery from phantosmia and the smells that are making you sick.

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      Steve 5 years ago

      I also have the same condition. For the last few weeks I have been smelling exhaust fumes and it gets to the point of making me very sick to my stomach. It is getting to a stage where I am getting very worried. This has been happening for about the last year on and off. I have also had brain surgery in the past and suffer from C.O.P.D.

      I just thought I would share to let others know this is real and we are not going crazy like it may seem.

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      Annette R. Smith 5 years ago from Grand Island, Florida

      Hello, Devin. Thank you for reading this article and telling us about your experiences with phantosmia. My problem is anosmia, so I rarely smell anything at all. How frustrating it must be to continually sense bad smells, even through hallucinations. I pray that you will eventually find a treatment for this condition that improves your quality of life.

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      Devin 5 years ago

      I have had phantosmiathis my entire life and has been getting preogressively worse over the past 4 years. I do not have pleasant smells, though. I am one of the ones who hallucinate basically the worst odor in the entire world. It is literally the worst thing ever. I can't eat when it happens. It happens almost every day. Sometimes if I put my head upside down and hold my breath, it goes away. I have talked to Dr. Leopold and read everything I can about this disease, but nothing really helps because this disease is so under-researched. Does anyone know why rare diseases are so under researched in America? After all, they are not so rare anymore, because if you put them all together, about ten percent of Americans have a rare disease and that is a lot of people! I hate not being able to smell normally. Phantosmia sucks, that's all I have to say! I wish the government would fund more research for this disease and others :/