Changes in Smell: COVID-19 or Lyme Disease?
LOSS OF SMELL—BUT IS IT COVID OR SOMETHING ELSE?
LYME DISEASE MAY ALSO AFFECT YOUR SENSE OF SMELL
“I lost my sense of smell—but my COVID test was negative.”
Changes in smell are widely recognized as a hallmark of COVID-19. However, disturbances in smell have also been reported in Lyme disease and other neurologic conditions.
Quick Answer: Both COVID-19 and Lyme disease can affect smell, but Lyme-related changes may include heightened sensitivity or distorted perception rather than complete loss.
Clinical Insight: When smell disturbances occur alongside neurologic or systemic symptoms, Lyme disease may need to be considered—especially in endemic areas.
According to Parma and colleagues, “A sudden loss of smell and taste is consistent with the now typical presentation of COVID-19 symptoms.” :contentReference[oaicite:0]{index=0}
However, patients with Lyme disease and other neurologic conditions also report disturbances in smell, including both decreased and heightened sensitivity.
For an overview of overlapping symptoms, see Long COVID and Lyme disease.
Smell changes in Lyme disease
Lyme disease has been associated with a range of sensory disturbances affecting smell, taste, and sensitivity to stimuli.
Studies have reported both:
- Hyposmia (reduced sense of smell)
- Hyperosmia (heightened sense of smell)
In one study, 50% of patients with Lyme disease experienced hyperosmia, compared with none of the control subjects. :contentReference[oaicite:1]{index=1}
Patients may describe smells as unusually intense, unpleasant, or distorted.
Other chemosensory disturbances
Smell is only one part of the chemosensory system, which also includes taste and chemical sensitivity.
COVID-19 research shows that these systems can be broadly affected—not just smell alone. :contentReference[oaicite:2]{index=2}
Disturbances may include:
- Anosmia: loss of smell
- Hyposmia: reduced smell sensitivity
- Parosmia: distorted smell
- Phantosmia: smelling odors that are not present
- Ageusia: loss of taste
- Dysgeusia: altered or unpleasant taste
In Lyme disease, these changes may occur alongside other neurologic symptoms such as brain fog, light sensitivity, or sound sensitivity.
Why smell changes can be confusing
Smell disturbances are not specific to a single condition.
They have been reported in:
- COVID-19
- Lyme disease
- Autoimmune disorders
- Neurodegenerative diseases
- Fibromyalgia
This overlap can make diagnosis challenging when symptoms are evaluated in isolation.
These patterns reflect broader diagnostic challenges described in why Lyme disease can be difficult to diagnose.
When to consider Lyme disease
Lyme disease may be considered when smell changes occur alongside:
- fatigue
- neurologic symptoms
- cognitive changes
- unexplained sensory sensitivity
- history of outdoor exposure
These symptoms often fluctuate and may not follow a typical pattern.
Clinical takeaway
Changes in smell are commonly associated with COVID-19 but are not exclusive to it.
Lyme disease may also affect smell, particularly as part of broader neurologic involvement.
When smell disturbances occur with other unexplained symptoms, clinicians should consider a wider differential diagnosis.
Frequently Asked Questions
Can Lyme disease affect your sense of smell?
Yes. Lyme disease may cause reduced, heightened, or distorted smell perception.
Is smell loss always COVID-19?
No. While common in COVID-19, smell changes can occur in other conditions, including Lyme disease.
What type of smell changes occur in Lyme disease?
Patients may experience hyperosmia, parosmia, or altered smell perception.
When should Lyme disease be considered?
When smell changes occur with neurologic or systemic symptoms, especially after outdoor exposure.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
Glad I saw this. I’ve been getting phantom smells of cigarette smoke starting from March 2022. I’ve never had COVID, but I was treated for Lyme Disease in Aug 2021 & then seemed to have a resurgence of Lyme symptoms after a Moderna booster in early December 2021 (muscle & nerve pain, spasms, increased brain fog, depression, etc.)
I hope you get an answer soon.
I was diagnosed with Parkinson’s disease four years ago. For over two years, I relied on Levodopa and several other medications, but unfortunately, the symptoms kept getting worse. The tremors became more noticeable, and my balance and mobility started to decline quickly. Last year, out of desperation and hope, I decided to try a herbal treatment program from NaturePath Herbal Clinic.
Honestly, I was skeptical at first, but within a few months of starting the treatment, I began to notice real changes. My movements became smoother, the tremors subsided, and I felt steadier on my feet. Incredibly, I also regained much of my energy and confidence. It’s been a life-changing experience I feel more like myself again, better than I’ve felt in years.If you or a loved one is struggling with Parkinson’s disease, I truly recommend looking into their natural approach. You can visit their website at www. naturepathherbalclinic .com