An Overview of Dysgeusia

Altered Sense of Taste

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Table of Contents

Dysgeusia is an altered sense of taste. It has a variety of different triggers. Some of the causes—like the common cold—resolve on their own, while others—like dementia—are chronic illnesses. 

Taste distortion is typically very noticeable. Most people with this condition describe very specific and unusual tastes. In some cases, when it is not clear whether you have an impairment of taste or smell, you may need to have your sense of taste evaluated with a diagnostic test. 

It is also important to get a diagnosis for the cause of your symptoms, especially if the cause of your dysgeusia isn’t something obvious—like a cold sore or pregnancy. Most conditions that impair taste, such as vitamin deficiencies, can be treated. And often, your sense of taste will improve after treatment.

Symptoms

An altered sense of taste can affect you while you are eating or drinking and even when you are not consuming anything by mouth. Some people complain of a metallic taste, a bitter taste, a salty taste, or an unpleasantly sweet taste.

It can interfere with your enjoyment of all or some foods, but it rarely causes nausea. And dysgeusia often causes aversion to certain foods. 

Associated Symptoms

With dysgeusia, you may also experience other symptoms. These symptoms are typically related to the cause of your dysgeusia and are not caused by taste distortion. 

Associated symptoms include: 

  • Bad breath
  • Stuffy nose 
  • Sore throat
  • Nausea 
  • Stomach upset 
  • Head pain 
  • Fatigue 
  • Fevers 
  • A dry mouth
  • Pain or soreness inside your mouth

Complications

When you experience dysgeusia for a short time, you might develop a decreased appetite. You may lose weight—even if this problem lasts for only a few days. In fact, pregnant women who experience dysgeusia often lose several pounds. However, in a healthy person, appetite is restored once dysgeusia resolves, and most people gain their weight back again. 

When taste distortion is caused by a long-term condition, such as diabetes , gastrointestinal (GI) disease, or a stroke, it can result in malnutrition. Some people lose weight.

With dysgeusia you may not necessarily lose weight, but you can develop a preference for unhealthy foods, which results in malnutrition—even without weight loss.

Causes

There are numerous causes of dysgeusia. Some of these are related to changes in the mouth, such as a dry mouth, dental problems, or chemotherapy, while others are based on changes in the neurological aspects of taste sensation, such as pregnancy and migraines. 

Common temporary causes of dysgeusia include:

Medications

There are hundreds of medications that can cause dysgeusia. If you take a medicine that can cause taste distortion as a side effect, this does not necessarily mean that you will develop the dysgeusia. And you can develop dysgeusia with just a few doses, or it may come on suddenly after you have been taking the medication for years. 

Some of the medications that are associated with dysgeusia include: 

  • Antidepressants
  • Thyroid medications
  • Antibiotics
  • Antihypertensives
  • Muscle relaxants
  • Chemotherapeutic medicines

Chronic Illnesses

There are a number of medical conditions that result in an impaired sense of taste. Several of the medical conditions that interfere with taste sensation also interfere with the sense of smell, and it can be difficult to distinguish which of these senses is impaired. 

Common medical illnesses associated with impaired taste sensation include: 

Chemical Exposure

Chemical toxin exposure can impair your sense of taste. Chemicals in pesticides, cosmetics, detergents, and industrial environments can enter your system through your skin, mouth, or nasal passages. 

Your Sense of Taste 

Your sense of taste is activated all the time, but it is more sensitive while you are eating and within about an hour after eating.

Taste is mediated by taste receptors in your mouth. The receptors signal the facial nerve (cranial nerve seven), the glossopharyngeal nerve (cranial nerve nine), and the vagus nerve (cranial nerve 10). These nerves send signals to the sensory area of your brain, allowing you to recognize the taste. The taste sensation typically elicits a positive, negative, or neutral response. 

A disruption in your sense of taste can occur as a result of damage or impairment in any part of this pathway. 

Any traumatic injury affecting your mouth or the nerves that mediate your sense of taste can cause dysgeusia. This can happen due to an accidental injury, surgery, or after a severe infection.

Your sense of taste can also change with age.

Diagnosis

The diagnostic evaluation of dysgeusia is based on determining whether you have an altered sense of taste and identifying the cause.

There are several diagnostic tests that can be used to evaluate taste. Some of the examinations involve measuring your response upon your exposure to certain tastes. Other tests evaluate your nerve function. 

You may need one or more of the following diagnostic tests for evaluation of your taste distortion:

  • Taste-threshold test 
  • Taste-suprathreshold test
  • Taste-quadrant test
  • Flavor discrimination test 
  • Electrogustometry
  • Gustatory event potentials 

If your taste distortion seems to be related to a problem related to your sense of smell, you might have one of the following diagnostic smell tests:

  • University Of Pennsylvania Smell Identification Test (UPSIT) or “Sniffin' Sticks”
  • The University of Connecticut Test Battery
  • The Pocket Smell Test
  • The Brief Smell Identification Test

Blood Tests 

You might need to have blood tests to identify nutritional deficits caused by dietary changes if your dysgeusia has caused you to avoid food. It is important that you are tested for nutritional deficiencies if you have dysgeusia for longer than a few months. Often, nutritional effects are not easily detected within the first few weeks.

Tests that are used to identify a nutritional deficit include a complete blood count (CBC) to assess your red blood cells (RBC) count. Specialized blood tests can measure your vitamin B12 level, iron level, calcium level, and potassium level. 

You may also need to have your lead or mercury level checked to identify a toxic exposure to either of these agents.

Imaging Tests 

If there is a concern that you could have a growth, infection, or a structural issue in your mouth, throat, or brain, you would need to have an imaging test, such as an X-ray, computerized tomography (CT) or magnetic resonance imaging (MRI) to assess the area of concern.

Treatment 

The treatment of dysgeusia can include a few approaches, and you may need a combination of these strategies. If you have a nutritional deficit, this has to be addressed and corrected. There are a few treatments that can help reduce your sense of taste distortion. And if a cause of your taste distortion identified, you would need treatment for the cause of your taste disorder as well. 

Nutrition

Typically, vitamin and mineral deficiencies can be corrected with supplements. If you have a major deficiency, you may need to take a prescription-strength supplement as directed by your doctor.

Taste Sensation

There are a few strategies that can be used to help diminish your altered sense of taste. Some doctors and dentists suggest using artificial saliva products. 

Sometimes, good oral hygiene, including flossing, brushing, and regular use of mouthwash, can alleviate the effects. In fact, if overgrowth of oral bacteria is the cause of your dysgeusia, taking care of your oral health can permanently resolve the problem.

Diet

Your doctor may recommend dietary modifications to help reduce the unpleasant taste in your mouth or to alleviate a GI condition.

For example, some experts suggest eating food with a few ingredients so that the tastes do not become mixed together, potentially causing an unpleasant effect. Sweetened food, preservatives, and heavily spiced food can leave an unpleasant residue in your mouth, so it is a good idea to avoid these products.

Dietary strategies can help alleviate some GI conditions. For example, fiber and raw fruit and vegetables can combat constipation. And if you have any food intolerance, the resulting bad breath can exacerbate your dysgeusia.

Treatment of the Underlying Problem 

Several of the causes of taste distortion, such as pregnancy and the common cold, resolve on their own. 

If your smoking habit is the cause of your dysgeusia, then smoking cessation can help. If you are taking medication that causes dysgeusia, your doctor might change your prescription.

You may need treatment to correct the cause of your taste distortion. For example, constipation can be managed with diet and stool softeners. Allergies can be managed with antihistamines or steroids.

Conditions such as Alzheimer’s dementia are not treatable, and the issues with altered taste need to be addressed as effectively as possible to help improve appetite and nutrition.

 A Word From Verywell

Dysgeusia is often mild, but it can be distressing . This condition can affect your enjoyment of food and it may bother you even when you aren’t eating. You should talk to your doctor if you experience a distorted sense of taste that lasts for longer than a few days.

Try to be observant about any other symptoms that you are experiencing. And carefully consider whether you might have been exposed to any new substances around the time that your dysgeusia developed—these observations can help you and your medical team as you work to identify the cause of your problem. Once you know the cause of your taste distortion, you and your doctor can begin to work on a treatment plan.

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Article Sources

  1. Matsunaga K, Yoshida Y, Takemaru M, Yamashiro K, Monden I, Inohara K et al. Multidisciplinary clinical approach by sharing oral examination information to treat a diabetes patient with dysgeusia. Clin Case Rep. 2019 Mar 22;7(5):877-880. doi: 10.1002/ccr3.2111. eCollection 2019 May.

  2. Carvalho BF, Alves MG, Dutra MT, Balducci I, Nicodemo D, Almeida JD. Persistent dysgeusia post-halitosis treatment: How does it impact the patients' quality of life? Med Oral Patol Oral Cir Bucal. 2019 May 1;24(3):e319-e325. doi: 10.4317/medoral.22370.

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