What are the causes of dysgeusia (distortion of the sense of taste), specifically a metallic taste?

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From the Guidelines

A metallic taste can be caused by various factors, including certain medications, dental problems, medical conditions, hormonal changes, chemical exposures, and cancer treatments, with COVID-19 being a recently identified potential cause, as some patients have reported a metallic smell and taste as a symptom 1.

Common Causes of Metallic Taste

Some common causes of metallic taste include:

  • Certain medications such as antibiotics, antidepressants, blood pressure medications, and chemotherapy drugs
  • Dental problems like poor oral hygiene, gum disease, or dental appliances
  • Medical conditions such as upper respiratory infections, sinusitis, kidney or liver disease, diabetes, and certain vitamin deficiencies, particularly zinc and vitamin B12
  • Hormonal changes during pregnancy or menopause
  • Chemical exposures from industrial environments or everyday items like certain foods, supplements, or drinking water with high metal content
  • Cancer treatments, including radiation therapy to the head and neck

Recent Findings on Metallic Taste

Recent studies have also identified metal hypersensitivity as a potential cause of metallic taste, with approximately 10% to 15% of the population exhibiting an allergy to one or more metals commonly used in implantology 1.

COVID-19 and Metallic Taste

COVID-19 has been identified as a potential cause of metallic taste, with some patients reporting a metallic smell and taste as a symptom 1. This is often accompanied by anosmia, or loss of smell, which has been recognized as a symptom of COVID-19.

Importance of Medical Evaluation

If the metallic taste persists for more than a few days without an obvious cause, it is essential to consult a healthcare provider to identify and address the underlying issue, as it may be a symptom of an underlying medical condition that requires treatment 1.

From the Research

Causes of Metallic Taste

There are several potential causes of metallic taste, including:

  • Gastroesophageal reflux disease (GERD) 2
  • Certain medications, such as antibiotics 3
  • Rhinitis and sinusitis, which can cause postnasal drip and alter taste perception 4
  • Other factors, such as hormonal changes, vitamin deficiencies, and exposure to heavy metals

Medication-Related Causes

Some medications, including antibiotics, can cause a metallic taste as a side effect 3. For example, erythromycins/macrolides, which are commonly prescribed for acute sinusitis, can cause a metallic taste in some patients.

Gastrointestinal Causes

Gastroesophageal reflux disease (GERD) can also cause a metallic taste, possibly due to the reflux of stomach acid into the esophagus 2. This can lead to inflammation and irritation of the esophagus, which can affect taste perception.

Respiratory Causes

Rhinitis and sinusitis can cause a metallic taste by altering the sense of smell and taste 4. This can be due to postnasal drip, which can carry bacteria and other irritants into the throat and mouth, altering taste perception.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Current and Future Treatments of Rhinitis and Sinusitis.

The journal of allergy and clinical immunology. In practice, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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