Episode 109 - Metallic Taste

The Pharmacist Answers Podcast

Glossary

Aguesia: no taste

Hypoguesia: reduced ability to taste (no the same as when taste changes due to changes in ability to smell)

Dysgeusia: dysfunctional taste - bad, salty, rotten, or metallic taste (metallic is the most common).

Causes for Change

Chemotherapy and radiation for cancer causes taste changes because the taste buds are rapid-cycling cells and the goal of chemo and radiation is to kill fast-growing cells (cancer cells are definitely fast-growing).

Head trauma or brain damage may damage the path of taste from the mouth to the brain.

Conditions like GERD, diabetes, urinary retention, and dry mouth can cause dysgeusia. Zinc deficiencies can too (in case you can't tell, zinc plays a big role in many processes in your mouth).

Over 250 medications can causes changes in taste. These include blood pressure medications, antibiotics, chemotherapy, asthma medications, and lithium. Some of them are secreted in the saliva, so the change in taste is because you actually taste the medicine. Other changes are because the medication disrupts or alters receptor or signal transport (i.e. ion transport - sodium, calcium, potassium, or chloride).

My Own Metallic Taste

I was taking generic Biaxin, AKA clarithromycin, for a sinus infection. Clarithromycin is in a class of medication called macrolides. Macrolides work on infections by disrupting the DNA-copying proteins in the bacteria. They are known as bacteriostatic antibiotics, which means they stop the bacteria from growing and dividing, but do not kill them. This allows your own immune system to get rid of the bacteria itself.

Clarithromycin is excreted in your saliva at ~2.72 mg/L. To get an idea of how small this amount is, it takes you 12-24 hours to produce 1 liter of saliva. Only 3-7% of adults report metallic taste with clarithromycin.

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