Our ability to taste is often something we don’t think about—until a taste disorder compromises it. One of these disorders is dysgeusia, which happens when your sense of taste becomes distorted, and everything tastes bitter, sour, or metallic. While taste disorders are common, they can be troubling. Luckily, there are ways to treat this condition. Here, we’ll look into symptoms, causes, and what you can do.
Dysgeusia is a disorder that distorts your sense of taste. People with this condition describe all foods as tasting sweet, sour, bitter or metallic. While dysgeusia refers to a distorted sense of taste, ageusia refers to total loss of taste. Anosmia is characterized by partial or total loss of smell. All of these conditions are possible symptoms of COVID-19, but they can also occur due to a number of other health problems.
Most of the time, dysgeusia is a side effect of certain treatments or medications, or it could be due to vitamin or mineral deficiencies. People who are pregnant can also develop altered taste. In rare cases, however, dysgeusia could be a symptom of liver disease, hypothyroidism or other health conditions.
In addition to making foods taste sweet, sour, bitter or metallic, dysgeusia can also cause you to have a bad taste in your mouth, even if you’re not eating anything. In many cases, people report enjoying foods they typically dislike and hating foods they normally love.
SYMPTOMS AND CAUSES
What are the symptoms of dysgeusia?
Dysgeusia symptoms can vary significantly from person to person. Here are some hallmark signs:
- Foods that used to taste good now taste bad, and sometimes rotten.
- Foods that are characteristically sweet or salty no longer taste sweet or salty.
- All foods taste metallic or bitter.
- There’s a taste in your mouth even though you haven’t eaten anything.
What causes dysgeusia?
It’s important to mention that the most common cause by and large is loss of sense of smell. This is particularly seen with COVID-19 infections. There are other different factors that can lead to the development of dysgeusia:
People who develop a bacterial, viral or fungal infection of the gums, mouth or throat may experience swelling. This swelling can lead to reduced blood flow to the taste buds, altering your sense of taste. Loss of taste or altered sense of taste is also a key symptom of COVID-19.
Medications and treatments
Several medications can affect your sense of taste. Some of the most common include amoxicillin, metronidazole, diuretics, calcium channel blockers and some blood pressure medications such as captopril. Altered taste is also a major side effect of chemotherapy and radiation therapy, particularly when treating head and neck cancers.
A number of health conditions can result in dysgeusia, including:
- Dry mouth: There are many factors that can cause dry mouth, including some medications, Sjogren’s disease or radiation therapy for cancer. Without enough saliva production, your taste receptors may not be stimulated.
- Vitamin or mineral deficiencies: People who have zinc or vitamin B deficiencies are especially prone to loss of taste.
- Inflammation: Any condition that results in inflammation of the tongue can affect your taste receptors.
- Nerve damage: Some nerves are responsible for taste sensations. When these nerves are damaged, it can lead to dysgeusia. Other dysgeusia causes related to nerve damage include ear surgery, neck surgery and Bell’s palsy.
- Acid reflux: When stomach acid enters the mouth, it can affect your taste function. For this reason, some people with GERD develop dysgeusia.
- Neurologic disorders: Alzheimer’s disease, Parkinson’s disease and multiple sclerosis (MS) have been associated with dysgeusia.
- Metabolic disorders: Diabetes, hypothyroidism, kidney disease and other metabolic conditions can cause dysgeusia.
- Dental prosthesis: In the elderly the prosthesis can cover the soft palate and inhibit the activity of taste receptors.
Dysgeusia during pregnancy is common, usually due to a surge of hormones. Symptoms typically go away on their own after the first trimester.
Chemicals found in tobacco products can cause changes in your taste function. The surfaces of the tongue and throat also undergo changes as a result of tobacco use, altering your perception of taste.
Aging can also lead to changes in your sense of taste. However, anosmia (loss of smell) is more common than dysgeusia as we grow older.
DIAGNOSIS AND TESTS
How is dysgeusia diagnosed?
Your healthcare provider will examine you and ask about your symptoms. If they determine that you have dysgeusia, then the next step will be identifying the underlying cause. In many cases, treating the root cause can ease your symptoms and help your sense of taste return to normal.
What tests will be done to diagnose dysgeusia?
You may need to undergo diagnostic tests to further evaluate your altered sense of taste. Your provider may first start with a smell identification test to see if your dysgeusia is linked to anosmia (loss of sense of smell). Your provider may also proceed with taste threshold or flavor discrimination assessments.
If your provider suspects that nutritional deficiencies are causing your dysgeusia, then they may recommend blood tests, such as a complete blood count (CBC). They can also run tests to measure your potassium, calcium, iron and vitamin B12 levels.
If your provider is concerned that a growth or structural abnormality could be causing your altered sense of taste, then they may perform imaging tests, such as X-rays, CT (computed tomography) scans or magnetic resonance imaging (MRI).
MANAGEMENT AND TREATMENT
What can be done for dysgeusia?
Dysgeusia treatment depends on the underlying cause of your condition. For example, if your dysgeusia is caused by a nutritional deficiency, then supplements can usually correct the issue. If you’re taking medication that could potentially affect your taste receptors, then your provider will likely change your prescriptions.
People who smoke may experience dysgeusia. Kicking the habit can dramatically improve sense of taste.
What should I eat if I have dysgeusia?
Some experts recommend eating foods that contain only a few ingredients. When foods have several ingredients, tastes can become mixed together and cause an unpleasant effect. Many people find that dysgeusia symptoms are reduced when they avoid spicy, preservative-filled and extremely sweet foods.
How can I reduce my risk for dysgeusia?
You can reduce your risk for dysgeusia by avoiding smoking, staying hydrated, practicing good oral hygiene and avoiding contracting COVID-19. If you notice a change in your sense of taste, try to identify anything new in your daily regimen, such as unfamiliar foods or new medications.
OUTLOOK / PROGNOSIS
What can I expect if I have dysgeusia?
In most cases, dysgeusia goes away on its own once the underlying cause is treated. However, some conditions — such as Alzheimer’s disease — can’t be treated, only managed. In these instances, dysgeusia treatment must be focused on improving nutrition and appetite.
Can dysgeusia be cured?
Yes, in most cases. Dysgeusia usually goes away once the root cause is treated.
When should I see my healthcare provider?
If you’ve experienced dysgeusia symptoms for more than a couple of weeks, it’s a good idea to schedule a visit with your healthcare provider. They can help determine what’s causing your altered sense of taste and design a personalized treatment plan to address the problem.
The main symptoms of dysgeusia have to do with how you perceive taste. You may find that foods have lost their sweetness or saltiness, and food might taste sour, rotten, or metallic. People with this condition also might have it in tandem with burning mouth syndrome, where your mouth has a burning sensation that causes pain.
Dysgeusia isn’t an anomaly—in fact, several causes can help you identify why you might be experiencing this condition.
- Medication. A metallic sensation is a common taste quality attributed to medication use. According to an article in Toxicological Sciences, more than 200 medications are known to cause taste disorders, yet drug developers often overlook this side effect. Further, specific medications are known to have this side effect, including angiotensin-converting-enzyme (ACE) inhibitors, antibiotics, and diuretics.
- Cancer treatment. Dysgeusia occurs as a side effect of chemotherapy and radiation. It is more common in treating head and neck cancers, though it can appear with the treatment of any cancer. Cancer treatment interferes with our ability to taste or smell food temporarily or permanently. If you are undergoing chemotherapy or other cancer treatments, talk with your doctors about these side effects to prevent malnutrition and weight loss.
- Diabetes. Another reason for tongue dysfunction is in people with undiagnosed diabetes, especially in type 2 diabetes mellitus. Often referred to as “diabetic tongue” by an article in the Journal of Family Medicine and Primary Care, dysgeusia can be an early disease symptom. Researchers found altered taste was not constant throughout the day, which could be attributed to fluctuations in blood sugar levels and identified as an early clinical sign for diabetes.
- Infection and Inflammation. If you’re undergoing a bacterial, viral, or fungal infection in your mouth, teeth, gums, or throat, this can cause swelling, which in turn reduces blood flow to taste buds and can create chemicals that alter your sense of taste.
- Vitamin Deficiencies. If you have a deficiency in B vitamins like B12 or zinc, you might experience this condition.
- Other Causes. Dry mouth, tobacco use, autoimmune diseases, aging, and physiological changes, such as pregnancy and menopause, can also cause this condition. Also, head injuries and certain surgeries of the ear, nose, and throat can cause taste disorders. Dental issues like poor oral hygiene and the extraction of a wisdom tooth can also lead to dysgeusia.
Treatment for taste dysfunctions like dysgeusia often includes addressing the underlying problem when possible. In some cases, the condition may be self-limiting and resolve on its own. In other instances, you might be able to address symptoms due to smoking or vitamin deficiencies by quitting smoking or taking supplements. However, when it occurs due to systemic issues or medications, you can manage a taste disturbance through nutritional, dietary, and palliative treatment. Lastly, management of your existing disorders, like diabetes, may help relieve symptoms. If you think you’re experiencing symptoms, reach out to your dental professional or doctor, and they can help you figure out the best treatment plan.
To avoid inadequate nutrition and unhealthy ingredients to enhance taste, talk to a registered dietician about flavoring agents and spices is also essential. Furthered counseling explains the importance of avoiding additional salts and sugars, which are linked to increase the risks of cavities and contribute to high blood pressure.
Finally, it is crucial to seek regular dental visits for preventive oral health care and maintain excellent oral care on your own. That means brushing twice daily with fluoride toothpaste and soft bristle toothbrush and cleaning between the teeth daily with floss, water flossers, or another interdental cleaning device.
Along with routine home care, a healthy lifestyle, and managing any other conditions, these tactics may reduce or diminish dysgeusia and make you more excited about sitting around the dinner table and enjoying your meals.