Causes for taste loss, male osteoporosis

By Howard LeWine, M.D.

Q: Everything I eat tastes bland. Could my loss of taste be related to one of my blood pressure pills?

A : Our ability to fully enjoy food requires stimulation of many nerve endings in the mouth and nose. Taste is the mouth’s ability to identify what is salty, sweet, sour or bitter. There’s also a fifth type of taste called umami, from the Japanese word for delicious. It’s triggered by monosodium glutamate (MSG).

But what we commonly refer to as the taste of food is actually its flavor. And flavor is determined more by the food’s aroma, which is more a function of our sense of smell than by pure taste.

Some loss of smell and taste almost always happens as we get older. This usually starts after about age 60. But before accepting older age as the cause, it’s worth considering reasons for losing the sense of smell or taste that aren’t related to getting older.

Sometimes people lose their sense of smell or taste during and after a viral respiratory tract infection. This is a common symptom of infection with the SARS CoV-1 virus that causes COVID-19.

Loss of smell also happens when nasal passages are blocked. This might be caused by:

• Allergies

• Secondhand smoke or other irritants

• A persistent sinus infection

• Polyps in the nose

People with high blood pressure seem to be more likely to lose the sense of taste and smell. It’s not clear whether this is related to high blood pressure itself or to the drugs used to treat it.

These types of high blood pressure drugs have been reported to cause taste loss: diuretics (water pills) such as hydrochlorothiazide, and ACE inhibitors such as enalapril (Vasotec) and lisinopril (Prinivil, Zestril).

If your taste loss is related to one of your blood pressure pills, it’s probably reversible. But don’t stop taking any of them until you talk with your doctor. He or she might suggest switching to a different class of drugs or taking other steps to regain some taste.

For example, if your mouth is dry from diuretics, you might try sipping water between bites. Sometimes, the moisture can help make food more flavorful.

Q: I have just been diagnosed with osteoporosis. I am a 57-year-old man. Why would a man get osteoporosis? Are the causes of this disease different in men than in women?

A: Men do get osteoporosis, but developing it at your age is unusual. You and your doctor should investigate to find an underlying cause.

Although osteoporosis is less frequent in men than in women, the causes of thin bones are similar in both groups.

Many things can affect the growth and loss of bone during a lifetime: genetic factors, diet, physical activity or hormones. And the risk of developing osteoporosis definitely increases with age.

It is not always possible to know why someone gets osteoporosis. However, doctors often look for “secondary” causes, particularly if the bone loss is out of the expected range for someone of that gender and age group. If appropriate, the specific cause should be searched for in order to treat the condition appropriately.

What are the common causes? Hormone levels are known to affect bone growth and bone loss. In men, both male hormones (testosterone) and female (estrogenic) hormones play a role in bone growth and loss.

Men produce less testosterone as they age. If your testosterone level is low at age 57, a cause other than just getting older needs to be considered.

Other hormones can be involved in the development of osteoporosis. Parathyroid hormone, for example, is involved in calcium metabolism in the body. Bone loss can occur if there is too much of this hormone. So, levels are often measured to make sure a person does not have hyperparathyroidism (an overactive parathyroid gland). atu d n n , a ulture , c s t r f a o rove e t sur ths reas s a t h i eac a B Virgini his f t l o l s a y eaut l b ura aptures y c ommunit o c N o c c ceni s s ’ y it e c h n t o deally , i y e Ba Chesapeak e a r e a ar f c m o continuu an amenities, fabulous org , g esidences s r Luxuriou y B 2-stor e 2 h h t it d w An nclus e i n r o nde ow u n more for 0188 717- 0) (80 e e a p chedul o s r t o s e u e r s . O oday r t tou b anter C ter- mins t Wes ui r q andeu r s g ’ area ower y T Ba e e fe siv vailable l a l full the d iews, s v geou tline oas ituated y s on y bur ike e l t bay w.wc w ps:///w t ht le ? P iving e l yl t s t- resor ore n m ear o l t t Wan ome o c e t mor there’s expansion, / / my.co nline:o sonal r mation infor all e c eas about e even y followed for only three years. However, it was a randomized, double-blind trial, which is considered the most powerful study design. Should you take a multivitamin?

Some medications are known to cause thin bones. The most commonly identified ones include prednisone and other corticosteroid medications, and some medicines used to treat seizures. Heavy alcohol use and smoking can also lead to thin bones.

Vitamin D is necessary for normal bone growth, so a deficiency of this vitamin can lead to thinning of bone.

Thin bones can be associated with inflammatory bowel disease, malabsorption syndromes like celiac disease, and having stomach surgery to treat obesity.

The development of osteoporosis might relate to decreased absorption of vitamin D or calcium. It also can be due to medications used to treat some of these diseases.

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, see health.harvard.edu.

© 2023 Harvard University. Distributed by Tribune Content Agency, LLC.

This study alone isn’t enough to suggest routine use of multivitamins for people of all ages. It may turn out that the benefits seen in this study were due to deficiencies in certain nutrients among some of the study participants. We don’t know if this is true because it wasn’t part of the study.

Or we might learn that the benefits reported here are too small to make much difference in real life, or wane over time, or have no effect on preventing common types of dementia.

And it’s hard to ignore an earlier randomized, placebo-controlled trial that was actually larger and longer-term: It found no improvement in brain function among male physicians ages 65 and older taking multivitamins.

But it does mean that more study is warranted. We need to understand who is most likely to benefit from multivitamin use, what dose is optimal, and what parts of the multivitamin are most important. We also need larger trials that last longer and include a diverse group of participants.

And certainly, there’s a difference between improving cognitive function and preventing dementia. We still need to know if conditions like Alzheimer’s disease can be prevented by multivitamins or other supplements.

The bottom line

Claims that certain supplements can improve brain health are everywhere you look. But sound scientific evidence backing up those claims is much rarer.

That’s one reason this new study is important: If confirmed, it means that a safe, widely available and inexpensive vitamin supplement could improve quality of life for many millions of aging people. Studies like this one should help science catch up and sort out which claims are valid.

Robert H. Shmerling, M.D., is a senior faculty editor and an editorial advisory board member for Harvard Health Publishing.

© 2023 Harvard University. Distributed by Tribune Content Agency LLC.