Skip to main content

Advertisement

SpringerLink
Log in

Relationship between the severity of olfactory dysfunction and serum zinc levels

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Although the association between zinc deficiency and olfactory dysfunction is inconclusive, zinc deficiency causes apoptosis of the olfactory ensheathing cells which is involved in olfactory nerve turnover and axon regeneration, thereby suggesting a possible relationship. We investigated the relationship between serum zinc levels and olfactory function in patients with olfactory dysfunction.

Methods

Ninety patients who had been diagnosed with post-infectious, posttraumatic, drug-induced, neurological and idiopathic olfactory dysfunction were included. Patients were divided into zinc normal group and zinc deficiency groups according to three reference values for serum zinc levels (60, 65, 70 µg/dL). The results of olfactory tests and patient backgrounds were used to compare the differences between the two groups.

Results

There were significantly worse detection and recognition thresholds in the T&T olfactometer and Open Essence (odor identification test) results in the zinc deficiency group (< 60 µg/dL). In addition, significant correlations between olfactory tests (detection/recognition thresholds in the T&T olfactometer and Open Essence results) and serum zinc levels < 65 µg/dL were observed. The zinc deficiency group < 70 µg/dL with idiopathic olfactory dysfunction had significantly worse olfactory tests (detection/recognition thresholds in the T&T olfactometer and Open Essence). In addition, there was a significant correlation between the detection/recognition thresholds in the T&T olfactometer and serum zinc levels in idiopathic olfactory dysfunction.

Conclusions

Our findings suggest that zinc deficiency may exacerbate the severity of olfactory dysfunction. Furthermore, idiopathic olfactory dysfunction may be partly caused by zinc deficiency.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Raw data were generated at the Jikei university school of medicine. Derived data supporting the findings of this study are available from the corresponding author on request.

References

  1. Kumbargere Nagraj S, George RP, Shetty N, Levenson D, Ferraiolo DM, Shrestha A (2017) Interventions for managing taste disturbances. Cochrane Database Syst Rev 12:CD010470. https://doi.org/10.1002/14651858.CD010470.pub3

    Article  PubMed  Google Scholar 

  2. Kodama H, Itakura H, Omori H et al (2018) Practice guideline for zinc deficiency. Nihon Rinshō eiyō gakkai zasshi. J Jpn Soc Clin Nutr 40:120–167

    Google Scholar 

  3. Russell RM, Suter PM (2015) Vitamin and trace mineral deficiency and excess. In: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J (eds) Harrison’s principles of internal medicine, 19th edn. McGraw-Hill, New York, pp 96e-9–96e-10

    Google Scholar 

  4. Yoshida A, Shino M, Uchida J, Yokomori E, Suzuki E, Suzaki H (2005) The evaluation of serum zinc levels in patients with olfactory disturbance. Nihon aji To Nioi Gakkaishi. J Jpn Soc Taste Smell Res 12:511–514

    Google Scholar 

  5. Aiba T, Sugiura M, Mori J, Matsumoto K, Tomiyama K, Okuda F, Nakai Y (1998) Effect of zinc sulfate on sensorineural olfactory disorder. Acta Otolaryngol Suppl 538:202–204. https://doi.org/10.1080/00016489850182936

    Article  CAS  PubMed  Google Scholar 

  6. Quint C, Temmel AF, Hummel T, Ehrenberger K (2002) The quinoxaline derivative caroverine in the treatment of sensorineural smell disorders: a proof-of-concept study. Acta Otolaryngol 122:877–881

    Article  CAS  PubMed  Google Scholar 

  7. Patel ZM, Holbrook EH, Turner JH et al (2022) International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 12:327–680. https://doi.org/10.1002/alr.22929

    Article  PubMed  Google Scholar 

  8. Jiang Y, Gu L, Zhang Z, Zhao J, Wan C (2021) Severe zinc deficiency causes the loss and apoptosis of olfactory ensheathing cells (OECs) and olfactory deficit. J Mol Neurosci 71:869–878. https://doi.org/10.1007/s12031-020-01709-2

    Article  CAS  PubMed  Google Scholar 

  9. Su Z, Chen J, Qiu Y, Yuan Y, Zhu F, Zhu Y, Liu X, Pu Y, He C (2013) Olfactory ensheathing cells: the primary innate immunocytes in the olfactory pathway to engulf apoptotic olfactory nerve debris. Glia 61:490–503. https://doi.org/10.1002/glia.22450

    Article  PubMed  Google Scholar 

  10. Ajmani GS, Suh HH, Wroblewski KE, Pinto JM (2017) Smoking and olfactory dysfunction: a systematic literature review and meta-analysis. Laryngoscope 127:1753–1761. https://doi.org/10.1002/lary.26558

    Article  PubMed  PubMed Central  Google Scholar 

  11. Fjaeldstad AW, Ovesen T, Hummel T (2021) The association between smoking on olfactory dysfunction in 3,900 patients with olfactory loss. Laryngoscope 131:E8–E13. https://doi.org/10.1002/lary.28552

    Article  PubMed  Google Scholar 

  12. Miwa T, Ikeda K, Ishibashi T et al (2019) Clinical practice guidelines for the management of olfactory dysfunction—secondary publication. Auris Nasus Larynx 46:653–662. https://doi.org/10.1016/j.anl.2019.04.002

    Article  PubMed  Google Scholar 

  13. Hummel T, Whitcroft KL, Andrews P et al (2017) Position paper on olfactory dysfunction. Rhin 54:1–30. https://doi.org/10.4193/Rhino16.248

    Article  CAS  Google Scholar 

  14. Takebayashi H, Tsuzuki K, Oka H, Fukazawa K, Daimon T, Sakagami M (2011) Clinical availability of a self-administered odor questionnaire for patients with olfactory disorders. Auris Nasus Larynx 38:65–72. https://doi.org/10.1016/j.anl.2010.05.013

    Article  PubMed  Google Scholar 

  15. Okutani F, Hirose K, Kobayashi T, Kaba H, Hyodo M (2013) Evaluation of “Open Essence” odor-identification test card by application to healthy volunteers. Auris Nasus Larynx 40:76–80. https://doi.org/10.1016/j.anl.2012.02.007

    Article  PubMed  Google Scholar 

  16. Fujio H, Doi K, Hasegawa S, Kobayakawa T, Nibu K (2012) Evaluation of card-type odor identification test for Japanese patients with olfactory disturbance. Ann Otol Rhinol Laryngol 121:413–418. https://doi.org/10.1177/000348941212100609

    Article  PubMed  Google Scholar 

  17. Laura JB, Paul QT (2017) Zinc as a neuromodulator in the central nervous system with a focus on the olfactory bulb. Front Cell Neurosci 11:1–20. https://doi.org/10.3389/fncel.2017.00297

    Article  CAS  Google Scholar 

  18. Abdelmaksoud AA, Ghweil AA, Hassan MH et al (2021) Olfactory disturbances as presenting manifestation among Egyptian patients with COVID-19: possible role of zinc. Biol Trace Elem Res 199:4101–4108. https://doi.org/10.1007/s12011-020-02546-5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Nomoto S, Yamauchi K, Nakabayashi T (2003) A propose to the examination system of zinc deficiency with serum zinc levels which has serious defect. Nihon Biryō Genso Gakkai [Biomed Res Trace Elem] 14:335–337

    CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-Ku, Tokyo, Japan

    Hirotaka Tanaka, Eri Mori, Nagomi Yonezawa, Masayoshi Tei & Nobuyoshi Otori

  2. Department of Otorhinolaryngology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan

    Hirotaka Tanaka

  3. Department of Otorhinolaryngology, The Jikei University Daisan Hospital, Tokyo, Japan

    Rumi Sekine

Authors
  1. Hirotaka Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eri Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rumi Sekine
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nagomi Yonezawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Masayoshi Tei
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nobuyoshi Otori
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

HT: conceptualization, data collection and analysis, funding acquisition, investigation, methodology, resources. EM: conceptualization, investigation, methodology, writing, review, and editing of the manuscript, and total project administration and supervision. RS and NY: data collection and carrying out the olfactory tests. MT: review and editing of the manuscript. NO: supervision, review, and editing of the final manuscript.

Corresponding author

Correspondence to Eri Mori.

Ethics declarations

Conflict of interest

None of the authors declare any conflict of interest.

Ethics approval

This study design was approved by the ethics committee of our university (Approval No. 33-156[10771]).

Informed consent

All study participants provided informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tanaka, H., Mori, E., Sekine, R. et al. Relationship between the severity of olfactory dysfunction and serum zinc levels. Eur Arch Otorhinolaryngol 280, 3229–3236 (2023). https://doi.org/10.1007/s00405-023-07828-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-023-07828-x

Keywords

Search

Navigation