Taste Loss: A Possible Sign Of Stroke?

A stroke is a life-threatening medical condition that occurs when the blood supply to the brain is cut off, resulting in brain cell death due to oxygen deprivation. It can lead to permanent brain damage or even death if not treated promptly. A stroke can affect an individual's ability to taste and smell, with up to a third of stroke survivors experiencing changes in these senses. This can manifest as a distorted sense of taste (dysgeusia), reduced ability to taste (hypogeusia), or a complete loss of taste (ageusia). These changes can be upsetting and impact the enjoyment of food and drink, which is closely linked to our feelings and memories. Additionally, they can make it challenging to maintain a healthy diet and increase the risk of further strokes.

Loss of taste after a stroke can lead to malnutrition and depression, impeding recovery and adversely affecting quality of life

Loss of Taste After a Stroke: Malnutrition, Depression, and Quality of Life

A stroke occurs when the blood supply to the brain is cut off, resulting in the death of brain cells. This can affect various parts of the brain, including those responsible for interpreting taste and smell. As a result, many people experience changes in their senses of taste and smell following a stroke. Indeed, up to a third of people who have had a stroke report changes in their sense of taste or smell.

Malnutrition and Weight Loss

People who have had a stroke may experience a loss of taste or a distorted sense of taste (dysgeusia). This can lead to a reduced appetite and subsequent weight loss. In a cohort of stroke survivors, 24% experienced weight loss of more than 3 kg. Those with eating difficulties were more likely to experience significant weight loss. Weight loss often coincides with malnutrition, which can increase the risk of post-stroke complications such as gastrointestinal bleeding, pneumonia, and other infections. Malnutrition in acute stroke patients is also associated with poorer outcomes, continued undernourishment during hospitalization, and a higher risk of requiring institutionalized care following discharge.

Depression

Loss of taste or changes in taste perception can induce and exacerbate depressive symptoms, which can further hamper recovery. Depression is common after a stroke and can cause a loss of appetite, sadness, anxiety, and trouble sleeping. Additionally, impaired olfaction (sense of smell) is associated with major depression and higher scores on depression inventories. As taste and smell are closely linked, it is plausible that those with taste disorders following a stroke are at risk for depression.

Social Isolation and Quality of Life

Changes in taste can reduce a person's enjoyment of food and drink, which can be upsetting as these are often closely connected to our feelings and memories. It can also lead to social isolation as people may avoid sharing meals or going out to restaurants due to their altered sense of taste. This can further impact a person's quality of life and recovery.

A stroke can damage the parts of the brain that interpret information about taste and smell from your nose and tongue

A stroke occurs when the blood supply to the brain is cut off, resulting in the death of brain cells. When a stroke damages the parts of the brain that interpret information about taste and smell from the nose and tongue, it can lead to changes in these senses. This includes food tasting different or bad (dysgeusia), a reduced ability to taste flavours (hypogeusia), or a complete loss of taste (ageusia). Some people may also experience a complete loss of smell (anosmia) or heightened sensitivity to smells (hyperosmia).

The senses of taste and smell are closely interconnected, with flavour being dependent on both. When something gives off a smell, molecules rise and hit the smell receptor cells at the back of the nose. Taste works in a similar way, with molecules from food and drink hitting the taste receptors on the tongue. The receptors then send information through nerves to the brain, which interprets the information as smells and tastes.

Damage to the brain caused by a stroke can disrupt this process, leading to changes in taste and smell. This can have a significant impact on a person's quality of life, affecting their enjoyment of food and drink, as well as their social activities and emotional well-being. It can also make it challenging to maintain a healthy diet and reduce the risk of further strokes. Additionally, it may lead to malnutrition, depression, and weight loss, which can impede recovery and adversely affect overall health.

It is important for clinicians and rehabilitation specialists to monitor stroke patients for altered taste perception and provide support to help manage these changes. This may include dietary modifications, nutritional supplementation, and addressing any underlying conditions or medications that may be contributing to the issue.

Dysgeusia is a distorted sense of taste that can be caused by a stroke

Dysgeusia is a distortion of the sense of taste. It is often associated with ageusia, the complete lack of taste, and hypogeusia, a decrease in taste sensitivity. While dysgeusia can be caused by a wide range of factors, it can also be caused by a stroke.

Dysgeusia and Strokes

Stroke patients with altered taste perception are at risk of malnutrition and depression, which can impede their recovery and adversely affect their quality of life. Impaired taste perception can result from lesions in several locations, including the pons, insular cortices, and specific thalamic nuclei. Dysgeusia can occur following a stroke due to damage to the somatosensory pathways, independent of the gustatory pathways.

Diagnosis and Treatment

Diagnosis of dysgeusia involves questioning the patient about salivation, swallowing, chewing, oral pain, and stomach problems. A clinical examination is conducted, including an inspection of the tongue, oral cavity, and ear canal. Gustatory testing may also be performed to further classify the extent of dysgeusia and clinically measure the sense of taste.

While there is currently no standard pharmacological treatment for taste disorders, there are several effective interventions for managing dysgeusia. These include artificial saliva, pilocarpine, zinc supplementation, alterations in drug therapy, and alpha-lipoic acid.

A stroke can make it difficult to eat a healthy diet and reduce the risk of further strokes

A stroke can cause brain damage that makes it difficult to eat a healthy diet, which is necessary to reduce the risk of further strokes. Brain damage can make it harder to move muscles, cause choking or gagging while swallowing, and affect appetite and moods.

• Trouble swallowing: Stick to soft foods like cooked cereal, mashed potatoes, soup, cottage cheese, and applesauce. Cut tougher foods into small pieces or blend them to make them easier to chew. Thicken liquids with tapioca, matzo meal, cornstarch, or banana or potato flakes to avoid choking.
• Problems using utensils: Use flatware with larger and thicker handles, knives with curved blades for one-handed cutting, plate guards to help scoop food, and rubberized pads to keep plates and bowls from sliding. Invest in adaptive kitchen equipment like easy-grip scissors, battery-powered peelers, and specialised cutting boards.
• Loss of appetite: Choose foods with strong flavours, such as citrus fruits, herbs, and spices, and colourful foods like salmon, carrots, and dark green vegetables. These foods are not only more appetising but also full of heart-healthy nutrients that lower the risk of another stroke. Eat high-calorie foods first, and consider liquid supplements for added energy and nutrients. Light exercise, such as walking, can also help increase appetite.
• No energy: Make breakfast your biggest meal, as you'll likely have the most energy in the morning. Keep your last meal simple, or opt for six small meals a day instead of three large ones. Buy pre-cut, pre-washed fruits and vegetables, and ask friends and family to make freezable meals for days when cooking is too tiring. Check if you can sign up for a local Meals on Wheels program to get meals delivered.

In addition to these strategies, it's important to adopt a healthy diet that can help reduce the risk of another stroke. This includes:

• Eating whole, mostly plant-based foods and lots of vegetables
• Avoiding processed foods, salt, and sugar
• Consuming fish and poultry instead of red meat
• Avoiding saturated fat and snacking on seeds and nuts

Loss of taste can lead to a decreased appetite and unintentional weight loss

A loss of taste can be a symptom of a stroke. After a stroke, up to a third of people find that their sense of taste changes. This can be upsetting as enjoying food and drink is an important part of life, and taste and smell are closely connected to our feelings and memories.

When a person loses their sense of taste, food may become unappetising. This can lead to a decreased appetite and, as a result, unintended weight loss. This can be dangerous, as it may lead to malnutrition and associated complications that impede recovery and adversely affect quality of life.

In addition, a loss of taste can induce and exacerbate depressive symptomatology, which can further hamper recovery. This is because areas of the brain dealing with memory, learning and emotion are also involved in taste and smell. So, smells and tastes can be linked to feelings and memories.

Furthermore, a loss of taste can make it harder to eat a healthy diet and reduce the risk of further strokes. For example, a person may crave sweet or salty foods, or they may overeat to try to get more satisfaction from food.

Frequently asked questions