Studies on olfactory thresholds in normal man and in patients with adrenal cortical insufficiency: the role of adrenal cortical steroids and of serum sodium concentration.

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Abstract
-Olfactory thresholds for NaCl, KC1, NaHCO3, sucrose and urea were determined in 11 patients with adrenal cortical insufficiency and compared to those in normal volunteers. Olfactory thresholds for pyridine, thiophene and nitrobenzene were determined in 4 patients with adrenal cortical insufficiency. In adrenal insufficiency the olfactory sensitivity was roughly 100,000 times (range 103 to l08) more acute than in normal subjects. Treatment with deoxycorticosterone acetate, 20 mg per day, returned serum Na and K concentrations to normal and produced gains in body weight, but did not alter olfactory threshold. Olfactory threshold for all modalities was unchanged in a variety of conditions in which alterations in the concentration of serum Na were produced or occurred naturally. Treatment with prednisolone, 20 mg per day, returned olfactory thresholds to normal in every patient within the 1st day, frequently before any change in serum electrolyte concentration or body weight. When treatment with prednisolone was stopped, increased olfactory sensitivity did not reappear for 5 to 7 days, 1 to 3 days after taste sensitivity became maximal. The effect of carbohydrate-active steroids on olfaction may be related to a generalized effect on nervous system function, particularly the sensory system.