- 27 April 2023
6:30 pm - 9:00 pm
Fifth Sense – Festive Wine Tasting
Thursday 27th April from 6:30pm – 9pm
Tuckers Hall, 140 Fore Street, Exeter, Devon, EX4 3AN
Tickets: £45 per person
Fifth Sense – Festive Wine Tasting
Thursday 27th April from 6:30pm – 9pm
Tuckers Hall, 140 Fore Street, Exeter, Devon, EX4 3AN
Tickets: £45 per person
Fifth Sense recently heard about an interesting research project that investigated the role our tongues play in taste perception.
Scientists from the Monell Chemical Senses Center in Philadelphia report that functional olfactory receptors – the sensors that detect odours in the nose – are also present in taste cells found on the human tongue. By studying cultures of these taste cells, the scientists discovered that they responded to odour molecules in a manner similar to olfactory receptors in the nose.
With regards to eating, it has long been known that the brain processes information received independently from the tongue (taste) and retro-nasally via the nose (smell). In combination, this information contributes to our assessment of the food in our mouths – including what we know as flavour. Monell’s research suggests that something more may be going on, that interactions between the senses of smell and taste are also happening on the tongue.
Fifth Sense member and Communications Advisor, Max Law, was keen to learn more. What exactly do these findings mean? Might Fifth Sense members be the beneficiaries of this and future research into the tongue? Max caught up with the leading scientist on the Monell team, Dr Mehmet Hakan Ozdener, to find out.
Max Law: The majority of our members lack a properly functioning sense of smell which of course impacts their ability to enjoy flavour in food. What words of encouragement can you offer them with regard to your findings?
Dr Ozdener: My data demonstrate that olfactory receptors are present in taste cells. However, I do not know how these olfactory receptors are wired to the brain. Olfactory receptors are located on taste cells and when taste cells are stimulated, they activate areas of the brain that give us the sensations of taste: i.e. bitter, sour, sweet, savoury and salty. So, I believe that olfactory receptors in taste cells may have a modulatory role on taste perception in the mouth. That is, odour molecules may enhance/reduce/eliminate certain tastes of food. For example, it is well known that the odour of vanilla can enhance the sweetness of a food or beverage.
Max Law: It would be wonderful if Fifth Sense members might one day be pointed towards foods or drinks known to be richest in the molecules that activate odour receptors on the tongue. Might it be possible for research to identify such molecules and if so, are there any plans to do so?
Dr Ozdener: My work on the function of olfactory receptors located in taste cells is new and ongoing. There are many challenging questions to address, including the ones you raise. At this time, we understand very little about which odours stimulate the olfactory receptors on the tongue and how these ‘tongue odours’ may affect our sensory perception and enjoyment of food.
Max Law: We often hear from members concerned about the impact their anosmia is having on dietary choices. A fair number seem to gravitate towards foods high in sugar and salt. It’s only anecdotal, yet one wonders if such people are at higher risk than the general population. With this in mind, might they one day be able to satisfy their cravings in other, healthier ways?
Dr Ozdener: As you and the members of Fifth Sense are well aware, the odour of foods is very important to overall food perception and acceptance. Food odour and taste combine to produce food flavours. There is much interaction between taste and smell. We know that certain odours can enhance the perceived sweetness and saltiness of foods and reduce perceived bitterness. Without the sensory enhancement of taste from food odours, it may be the case that anosmics are more inclined to choose foods higher in salt and sugar. However, it is too early to predict whether we will be able to harness information from odours detected by the tongue to redirect flavour perception or preferences.
Max Law: We were fascinated to learn that your study was based on human taste cells grown in cultured environments. Fifth Sense partners with an organisation called FlavorActiV, the world leader in the training and monitoring of professional tasting panels. We are presently working with FlavorActiv on a taste training project aimed at helping people affected by olfactory loss make the best use of any remaining sense of taste. It prompts us to wonder whether there any plans, or is there any value, in using human subjects in future, tongue-related research? Could people with anosmia be helpful in this regard? Our experience suggests that many of us with no noses are very in tune with our tongues!
Dr Ozdener: It certainly is of interest to contrast the olfactory function of taste receptors on the tongue in anosmic vs. non-anosmic populations. One might expect that the olfactory receptors on the tongue would function normally in anosmics who lost their sense of smell from conditions affecting the nasal cavity, for example from a viral infection. On the other hand, it may be that those who were born without a sense of smell may also not have functional olfactory receptors on the tongue. We simply don’t know the answers to these questions at this time.
So, what are we to make of all this?
With an impaired sense of smell, we’ve learnt to treasure our tongues as the gateway to what we have left. We’re never going to smell by sticking out our tongues, but it’s encouraging that they appear to be doing more than we knew.
Odours we pick up from our tongues seem to affect how we perceive the likes of saltiness, sweetness etc. This could be why some of us can still differentiate between certain foods or drinks, even when flavour is absent. For example, why some can evaluate the different ‘bitternesses’ of coffee or real ale.
Yet the senses of smell and taste operate in highly complex and multi-variate ways. Their precise workings are hard to pin down. Fifth Sense trustee and ENT consultant, Professor Carl Philpott summed it up:
“At this stage it’s too early to draw any significant conclusions from this research. We don’t know how olfactory receptors work on the tongue, and although the research does suggest a possible mechanism, we would need a further study to prove this.”
By revealing new things about smell and taste, Dr Ozdener’s work shows how much there is that we still don’t know. Nevertheless, Monell and Dr Ozdener should be applauded for a project that signposts where the world of science might look next for answers. Fifth Sense will follow such developments with interest.
Julie Wilson and James Martin from Fifth Sense, Scotland, attended the British Rhinological Society Conference on the 17th May, at Glasgow’s Science Centre. The conference revealed encouraging signs regarding Fifth Sense’s growing influence within the healthcare community.
The Fifth Sense stand was in the general exhibition area, and a well-attended conference meant that they were busy when lunchtime came. A number of healthcare professionals asked to be signed up for the Fifth Sense newsletter. Many said they were very pleased that Fifth Sense is such a strong presence now, as they signpost patients to the website and have gained lots of useful information themselves.
There was talk too about the prospects for member contact in two regions: one for a local support group to be set up, the other for Fifth Sense members to agree to present their experiences of anosmia and/or taste disorders at local health professional training days. Needless to say, these expressions of interest were carefully noted by James and Julie and will be subject to further discussion in the days and weeks ahead.
The Food Chain is a BBC radio show which “examines the business, science and cultural significance of food, and what it takes to put food on your plate.” A recent programme, entitled “I Can’t Taste!” looked at the impact that smell and taste disorders can have on people.
The programme looked at what people eat if they can’t appreciate the taste and flavour of their food. Featured on the show was cookery writer Marlena Spieler, who temporarily lost her sense of smell in a car accident, but found she became a more experimental cook as a result of her experiences. Also interviewed was Fifth Sense member Adrian Wellock, who discusses how his taste loss changed his social life, but he still manages to enjoy his food.
The presenter also met Prof Barry Smith, Director of the Centre for the Study of the Senses, who explained how the senses of smell and taste work together to create flavour, and some of the causes of smell and taste disorders.
You can listen to the show here.
We are delighted to announce that Fifth Sense has been awarded registered charity status. Our board of trustees put together a detailed and thorough application to the Charities Commission, which was approved the day before our conference, and our charity number is 1175553.
Fifth Sense has been a charity since we formed our board of trustees, ratified our first constitution and set out our charitable objects in January 2014. Becoming a registered charity is an important step forwards and can give an organisation greater legitimacy in the eyes of the public and potential funders. It will enable us to move forwards with our strategic vision and do more to support more people with smell and taste disorders.
We’d like to say a huge thanks to all our members, supporters and donors for helping us reach this important milestone and we look forward to exploring the opportunities this presents in 2018 and beyond.
Fifth Sense Members may be aware of a recent article in the Daily Mail highlighting a possible new treatment for loss of the sense of smell, involving an injection of blood up the nose.
Upon review of the article and the study it cites, Fifth Sense trustee Mr Carl Philpott (Consultant ENT Surgeon and Director of the Smell and Taste Clinic at James Paget Hospital) urges members to exercise strong scepticism when interpreting the article.
Mr Philpott points out that the study: “Looked at only five patients and did not use robust scientific methods to demonstrate the validity of any effect. Additional work, including a much more rigorous study, is needed to claim any potentially positive outcome.”
We fully understand that this might be disappointing news for people who saw the original article, which was part of a round-up of several research papers in a non-specialist publication, but hope that our statement provides some clarity on the matter.
You can read the research paper, which outlines the study findings, here.
On Friday 26th May over 120 Fifth Sense members, their partners and family members came together with medical professionals at an event at the Royal Society of Medicine (RSM) in London. Living Without Smell and Taste was part of the RSM’s Medicine and Me series, which provides patients and their families with an opportunity to gain insight from the medical profession and relevant patient bodies around a medical condition which affects them.
The event was proposed by RSM Dean Emeritus John Scadding after Consultant ENT Surgeon and Fifth Sense trustee Mr Carl Philpott deliver a lecture at the RSM in November 2016. Mr Philpott and fellow trustee Duncan Boak met with John and RSM colleagues and co-designed a programme that incorporated Fifth Sense members talking about their experiences of living with a smell/taste disorder alongside a number of ENT Consultants who explained what is known about these conditions and challenges involved in treating them.
Fragrance writer Louise Woollam opened proceedings by talking movingly about her experience of losing her sense of smell as the result of a virus, a situation that became much worse after she then began to experience severe parosmia. ENT Consultant Miss Lisha McClelland of the smell and taste clinic at Birmingham’s Queen Elizabeth Hospital then spoke about post-viral olfactory loss, phantosmia and parosmia.
Alahree McDonell then spoke about how she has been affected by Chronic Rhinosinusitis for many years, and the various dietary changes she has made as part of efforts to self-manage her condition, which was improved by a visit to the rhinology clinic at Guy’s Hospital in London, run by Miss Claire Hopkins. Claire herself followed Alahree and spoke about various ways in which CRS can be treated and managed, as well as the MACRO project that aims to improve the way this condition is managed across the NHS.
After a break, Ian Rickson spoke about losing his sense of smell following a head injury, and how this experience has affected his life in different ways. Iordanis Konstantinidis, an ENT Surgeon who runs a smell and taste clinic in Greece, followed Ian by explaining how olfactory loss can be caused by head trauma. Iordanis also spoke about the work he is doing to try to encourage early referrals from A&E to his clinic so patients can be investigated sooner for olfactory impairment.
BBC R4 presenter Kathy Clugston then gave a very engaging talk about having never had a sense of smell, mentioning her dad’s favourite joke: My daughter’s got no nose (we’ll refrain from including the ‘punchline’). John Scadding and Duncan Boak then summed up proceedings and thanked the speakers for their contributions to what was a really informative, rewarding and, at times, emotional experience.
It is the first time that such a high-profile UK medical organisation has hosted an event on smell and taste disorders, and the support of the RSM is something that will help us in our goals around engaging with and educating the medical profession on these conditions. Mr Sean Carrie, who runs a rhinology clinic at Freeman Hospital in Newcastle, made a great point when he talked about the partnership between Fifth Sense and the clinicians with whom we have links being a means through which we can educate other healthcare professionals. We look forward to developing our relationship with the RSM and we’d like to thank them for their support of our cause.
If you’re affected by a smell/taste disorder and would like to seek a referral to one of the clinicians mentioned in the article then visit the ‘Clinics’ page of our website for more information.
Louise Woollam writes a blog called the Parosmia Diaries which is a valuable resource for anyone affected by this condition.
A recent research study has shown that sodium citrate (in the form of a nasal spray) could potentially offer temporary improvement in the ability to smell for people affected by post-viral olfactory loss or other non-obstructive causes. The research was undertaken by the University of East Anglia (UEA) and the Smell and Taste Clinic at James Paget Hospital and involved Consultant ENT Surgeon and Fifth Sense trustee Mr Carl Philpott.
How is the spray thought to work?
Calcium is thought to have a role in ‘turning down’ the sense of smell, a bit like a volume control. Sodium citrate is known to ‘bind’ with calcium molecules, and stop them from acting in this way. In the study, a group of people with anosmia or hyposmia were treated with a sodium citrate nasal spray, alongside a control group whose spray contained water. Around one third of the study participants who were treated with the sodium citrate spray experienced some improvement in their ability to smell, which lasted up to two hours, with the effect peaking at 15-30 minutes.
Who could this potentially help?
The study showed that the spray seemed to be most effective in people affected by post-viral olfactory loss, although some people with idiopathic (no known cause) and post-traumatic olfactory loss (PTOL) also showed some improvement. It’s difficult to say why this is, but sometimes there can be more than one factor involved in anosmia or hyposmia. Some cases of idiopathic olfactory loss could have been caused by an undiagnosed virus, which would help explain why the citrate spray results in an improvement. The location and degree of damage caused in PTOL is likely to vary between people, and it is possible that the citrate boosts the function of any olfactory neurones and nerves that are still intact.
Further studies are needed to establish the effectiveness of sodium citrate in daily use as a longer-term treatment.
I want to try this myself, is it possible to purchase sodium citrate spray?
This was a research trial and sodium citrate spray is not available to purchase, although sodium citrate itself is safe to use and already licensed as a medicine for some stomach and bladder conditions.
For more information on the results of the study visit the UEA website.
For a link to the abstract of the research paper, published in Clinical Otolaryngology, visit the Wylie Online Library
During a chat at the recent MACRO launch (see earlier post for details), Fifth Sense founder Duncan Boak learned about a book from 1961, which featured a write-up of a patient’s perspective on post-traumatic olfactory loss in one of the appendices.
Martin Burton, Joint Coordinating Editor of the Cochrane ENT Disorder Group, had come across the book and shared the details with Duncan. Cochrane are responsible for Cochrane Reviews, which are systematic reviews of primary research in human health care and health policy. These are internationally recognised as the highest standard in evidence-based health care resources. The group investigates the effects of interventions for prevention, treatment, and rehabilitation.
Martin found that the information in the appendix was part of a script from a story broadcast by BBC World Service in October 1959, featured in the programme “Two of a Kind” in an episode called “Fragrant Memories.”
There were two contributions to the episode: ‘Lost Bouquets’ by Brian Elliott and ‘Nose to the Ground’ by Raymond Legge, and it’s Brian Elliott’s story which appears in the first edition of the book written by consultant neurosurgeon, John M. Potter: The Practical Management of Head Injuries. (London: Lloyd-Luke (Medical Books) Ltd.; 1961).
Martin has also learned that John Potter worked as Consultant Neurosurgeon to the Manchester Royal Infirmary and later became the Director of Postgraduate Medical Education and Training, University of Oxford as well as a lecturer and Fellow.
In the preface to the fourth edition (published in 1984), he stated: “In case readers may not sufficiently appreciate the loss that traumatic anosmia may inflict on nose-sensitive people, I have again included, as Appendix I, Brian Elliott’s moving account, with his permission and that of the BBC.”
Cochrane have done some investigating on behalf of Fifth Sense, and discovered that the copyright has expired. This means we’re able to publish a scanned copy of the script to our website. We think this will be of interest not only to those with PTOL, but anyone with anosmia or who would like to understand it a bit more.
Click here to download a scanned copy of the relevant sections of the book.
Let us know if you’ve read it and what you think – is it reflective of having PTOL today? Email us at email@example.com and tell us what you think.
Consultant ENT Surgeon Mr. Carl Philpott (who was instrumental in the setting up of Fifth Sense and sits on our board of trustees) was asked to deliver the prestigious annual Ellison-Cliffe lecture for the Royal Society of Medicine.
Mr. Philpott’s lecture covered the role and function of the senses of smell and taste and the impact that smell and taste disorders have on the lives of those affected. He also talked about his work in treating patients.
We are delighted to be able to share with you a video from the day, showing Mr. Philpott’s talk in full.