Dysgeusia: bitter, metallic taste, how to treat it?

Taste is one of our five senses. It stimulates our desire to eat and allows, thanks to the taste buds, to detect salty, sweet, bitter, acid, fatty and unamis flavors, to select the foods most suited to our needs. Certain dysfunctions or diseases can alter the taste and train a stray taste in the mouththat’s what we call dysgeusia. The main consequence of dysgeusia: loss of appetite which can lead to malnutrition.

What is the definition of dysgeusia?

Dysgeusia is a taste disorder that corresponds to a change in the taste sensation of food. In case of dysgeusia, the person has a parasitic taste in the mouth constantly or when eating food. This parasitic taste is unpleasant: it can be bitter, cardboard, metallic (iron taste)... This taste disorder can participate in the reduction of appetite and lead in the long term malnutrition.

What are the symptoms of dysgeusia?

• A parasitic taste in the mouth constantly or when eating. This parasitic taste can be bitter, cardboard, metallic…
• A feeling of dry mouth
• An itchy tongue sensation
• Lymph nodes or a fever if it is an infection
• Loss of appetite and therefore weight loss

What causes dysgeusia?

► A modification of the oral flora which can result from several things:

• Poor oral hygiene
• Gastroesophageal reflux disease (GERD)
• The presence of a large tumor of the throat or tongue
• Taking antibiotic treatments
• Taking anti-ulcer treatment

► Inflammation of the oral mucosa (mucositis):

• A viral infection : nasopharyngitis, sinusitis, strep throat, flu, pharyngitis, Covid…
• A fungal infection
• Tobacco use
• Vomiting regularly

► In the case of cancer, the destruction of the taste buds by certain chemotherapies (platinum salts and anthracyclines) and in the course of radiotherapy, a phenomenon which may persist for up to a year after the end of treatment. In a dossier on undernutrition and taste disorders, Gustave Roussy reports that nearly one in six people suffer from a taste disorder at the time of their cancer diagnosis. During treatment, this frequency increases since more than half of patients undergoing chemotherapy and more than 90% of patients receiving radiotherapy in the throat and mouth have taste disorders during treatment.

► Decreased sense of smell (in case of active smoking in particular or Covid)

What treatment to remove a bitter taste in the mouth?

Treatment for dysgeusia depends on the cause. And there is no “miracle” treatment for this taste disorder. However, certain measures can help reduce this unpleasant taste:

• Choose foods that are pleasant to eat. You have to try to listen to yourself, to identify the foods that “go down” well.
• Prefer wooden or glass utensils to metal utensils (such as cutlery, pots and dishes). Avoid consuming food sold in a metal container (aluminum, cans and cans).
• Avoid foods that promote bitterness in the mouth such as endive, broccoli, arugula, black radish, cabbage, grapefruit, tea, coffee, dark chocolate, beer and red meat.
• Drink acidic drinks (mint or citrus based), which can bring a pleasant feeling of freshness in the mouth.
• Try different methods of preparation, cooking, food temperature
• Add flavor enhancers (fleur de sel, aromatic herbs, etc.) and think about marinating your meat and fish
• Split your diet to make it less painful
• Modify the texture in case of swallowing difficulties.
• Maintain good oral hygiene by brushing your teeth regularly or even using mouthwashes according to the doctor’s recommendations and consulting a dentist and/or an ENT specialist.
• Promote smoking cessation
• Talk to your doctor about changing or stopping certain medications.
• Make sure you are well hydrated by drinking water regularly.

When to worry?

If the bitter taste persists for several days or several weeks, or is accompanied by other symptoms such as fever or pain, you should consult his attending physician, the dentist, the stomatologist, or the ENT specialist as soon as possible. In case of weight loss of more than 5% of your total weight, consultation with a dietitian or nutritionist is recommended. If needed, administration of an oral nutritional supplement (ONC) may be considered by the physician. It is a preparation rich in energy, nutrients, vitamins, minerals intended to compensate for an insufficient or incomplete diet to cover the recommended daily needs in energy and nutrients. It is a ready-to-use, sterilized product, available in pharmacies, intended to be consumed in addition to and away from usual meals.