Differential Diagnosis for Metallic Taste in the Mouth
The differential diagnosis for a metallic taste in the mouth can be organized into the following categories:
Single Most Likely Diagnosis
- Medication side effects: Many medications, including antibiotics, antihistamines, and decongestants, can cause a metallic taste as a side effect. This is often the most common and likely cause due to the widespread use of these medications.
Other Likely Diagnoses
- Gingivitis or periodontal disease: Inflammation of the gums can lead to changes in taste, including a metallic taste.
- Dental problems: Issues such as abscesses, tooth decay, or dental work can cause metallic tastes.
- Sinus infections: Sinusitis can lead to changes in taste and smell, including a metallic taste.
- Pregnancy: Hormonal changes during pregnancy can affect taste, leading to a metallic taste in some women.
- Nutritional deficiencies: Deficiencies in vitamins like zinc or vitamin B12 can affect taste.
Do Not Miss Diagnoses
- Heavy metal poisoning: Exposure to heavy metals like lead, mercury, or arsenic can cause a metallic taste and is potentially life-threatening.
- Neurological disorders: Conditions such as multiple sclerosis, Bell's palsy, or stroke can affect the nerves responsible for taste, leading to a metallic taste.
- Certain cancers: Head and neck cancers, in particular, can cause changes in taste, including a metallic taste.
- Sjögren's syndrome: An autoimmune disorder that can cause dry mouth and changes in taste.
Rare Diagnoses
- Wilson's disease: A genetic disorder that leads to copper accumulation in the body, which can cause a metallic taste among other symptoms.
- Acute intermittent porphyria: A rare genetic disorder that can cause a variety of symptoms, including changes in taste.
- Certain infections: Rare infections such as diphtheria can cause a metallic taste, although this is exceedingly uncommon in areas with widespread vaccination.