Paule Joseph

Joseph recommends practicing everyday olfactory training, such as deliberately smelling spices while cooking.

“you can do this even when you're cooking at home, right? Just get something out of your cabinet when you're putting the spices in”

TED Radio Hour: Big mysteries explained through your senses (Sep 18, 2026) · Listen from 41:46

Joseph says treatment options are limited to olfactory training, which works for some people but not others, and virus-caused loss can regenerate if caught early.

“We don't have a lot of treatment when it comes to smell and taste. We primarily have, you know, olfactory training is one of the things that we tend to recommend to individuals”

TED Radio Hour: Big mysteries explained through your senses (Sep 18, 2026) · Listen from 37:18

Joseph says what matters clinically is not whether smell is perfect but whether it changed suddenly and failed to return.

“what matters is not whether your smell is perfect, it's whether it changed, especially if this change is suddenly and it has not come back”

TED Radio Hour: Big mysteries explained through your senses (Sep 18, 2026) · Listen from 31:06

Joseph argues that primary care physicians should at minimum screen for smell loss and refer patients, noting no specialty currently owns the test.

“if you ask me who should be doing this test, I would say at a minimum, primary care should be screening and then doing the proper referrals”

TED Radio Hour: Big mysteries explained through your senses (Sep 18, 2026) · Listen from 30:02

Joseph says smell decline appears years before other symptoms in Alzheimer's, Parkinson's and frontotemporal dementia.

“we see that in individuals with Alzheimer's and Parkinson's disease and even frontal temporal lobe dementia, the sense of smell is decreased early, like years before any other symptoms appear”

TED Radio Hour: Big mysteries explained through your senses (Sep 18, 2026) · Listen from 28:41

Joseph describes smell as an evolutionarily preserved survival system that detects airborne threats before they are seen or heard.

“it detects airborne threats like smoke, fire, toxic chemicals that are in the environment, including predators, before they can be seen or heard”

TED Radio Hour: Big mysteries explained through your senses (Sep 18, 2026) · Listen from 26:24

Joseph says her team is scanning parosmia patients with fMRI to understand what brain signals change during smell distortion.

“we're getting individuals with parosmia and putting them inside a scanner to understand through, you know, fMRI, just scanning their brain, what signals are changing?”

TED Radio Hour: Big mysteries explained through your senses (Sep 18, 2026) · Listen from 32:59

Joseph says a small group of COVID patients developed parosmia, in which familiar smells become distorted, which she considers harder to live with than total loss.

“some of them have developed parasmia, which is an absence of distortion. For example, your coffee smells like burning garbage”

TED Radio Hour: Big mysteries explained through your senses (Sep 18, 2026) · Listen from 31:49

Joseph reports a recent study finding smell unchanged in people taking GLP-1 medications, with differences appearing in detection thresholds and reduced food noise.

“everybody assumes that these medications make food taste bad or taste like nothing. And that's not what this group of investigators found. Smell was unchanged”

TED Radio Hour: Big mysteries explained through your senses (Sep 18, 2026) · Listen from 39:37

Joseph argues that persistent smell loss should be treated as an invisible disability, citing a firefighter who needed workplace accommodations.

“we really needed to start thinking about this as a disability. This is one of those things that we consider an invisible disability”

TED Radio Hour: Big mysteries explained through your senses (Sep 18, 2026) · Listen from 36:18

Joseph recounts that changes in her mother-in-law's cooking led her to test her smell with scratch-and-sniff stickers, ultimately yielding a frontotemporal dementia diagnosis.

“that kind of sort of led to a cascade of doctors' employment and a number of tests. And then we realized that she had frontal temporal lobe dementia”

TED Radio Hour: Big mysteries explained through your senses (Sep 18, 2026) · Listen from 28:10