Bad, Metallic, Bitter Taste in Mouth and Tongue (Including Pregnancy)

A metallic taste can result from dry mouth, medications, regular or spoiled foods, a mild health condition, such as common cold, or a serious condition, such as poisoning or cancer.

Some people describe a metallic taste as a bitter or salty or the taste of dirty copper pennies. Other people describe a sour, acidic taste as metallic.

Dysgeusia is a synonym for any weird taste, for example, unusually salty or sweet or fishy taste.

Symptoms Checker

After reading this article, you might be able to narrow down possible causes of metallic taste from a combination of symptoms in various conditions.

Metallic Taste Causes

1. Foods
2. Physiological conditions
3. Early pregnancy
4. Health disorders (mouth, respiratory and gastrointestinal tract, neurological)
5. Cancer and chemotherapy
6. Psychological disorders
7. Causes of a phantom metallic taste
8. Medications
9. Poisoning
Metallic smell
Bitter, sour, salty, soapy and garlicky taste
Diagnosis
Treatment

1. Foods

Regular Foods and Foodstuffs with Metallic Taste

Potassium chloride – a salt substitute
Foods stored in aluminum foil, beverages stored in stainless steel or plastic bottles or using cheap silverware
Baked goods prepared using baking powder that contains aluminum
Mineral waters high in magnesium
Certain wines with added sulfites, fruits or glycerine can cause a “tinny” or “chemical” aftertaste. Eggs, artichokes, soy sauce or tomatoes eaten along wine can make wine to taste metallic.
Certain beers – due to high iron in water or poorly processed grains ⁽⁴³⁾
Artificial sweeteners–saccharin, aspartame, acesulfame-K, and cyclamate ⁽³⁰⁾ and sucralose–, but not sugar alcohols (polyols), such as erythritol, maltitol, mannitol, sorbitol and xylitol
Oysters
Brazil nuts, which are high in selenium

Rancid oils, butter and other dairy products and nuts and spoiled cereals can have a metallic taste ⁽¹¹⁾.

Using toothpaste that contain fluoride, a whitener, sodium laureth sulfate (SLS), or potassium nitrate (“sensitivity toothpaste”) can give a metallic taste to foods; the taste can persist for several weeks after stopping using the toothpaste.

When a metallic taste is caused solely by food, it usually lasts only for several minutes and can be rinsed out with water, but when it is caused by toothpaste, poisons or health disorders, it is usually more persistent ⁽⁴³⁾.

Metallic Taste After Eating or Drinking

Lingering metallic taste after eating or drinking can be caused by:

High caffeine intake from cola, coffee, tea or energy drinks
Alcoholic beverages
Acid reflux or bile reflux (heartburn–pain behind the breastbone and distinct acidic taste in the throat and mouth, especially when lying down, at night and in the morning, coated tongue, hoarseness;
- Silent GERD, which is gastroesophageal reflux disease without heartburn can cause a sour taste in mouth in the morning due to acid reflux at night; silent GERD may cause dental erosion ^[1].
- Laryngopharyngeal reflux (LPR) often does not cause heartburn but only symptoms in the throat and mouth, such as coughing and a sour taste ^[36])
Food intolerances: lactose intolerance, fructose malabsorption and celiac disease (abdominal bloating, belching, diarrhea within few hours after eating)
Allergic reaction to food (sudden mouth and skin itch and pink rash–hives–within minutes after eating)
Oral allergy syndrome in individuals with hay fever (itch in the mouth and throat within minutes after eating raw fruits and vegetables) ⁽⁴⁹⁾
Scombroid or histamine fish poisoning: facial flushing, itch, sweating, throbbing headache 15-60 minutes after eating improperly stored fish, such as tuna, mackerel, skipjack, bonito; symptoms can last from few hours to few days ^(3,27)
Ciguatera poisoning: tingling in the mouth, tooth pain, strange sensations in the limbs 6-12 hours (15 minutes to 24 hours) after eating big tropical fish, such as barracuda, grouper or tuna; symptoms may last for several days or weeks ⁽²⁸⁾
Clupeotoxin poisoning: a headache, sweating, dizziness 30-60 minutes after eating anchovies, herring, sardines or tarpon ^(12,38)

Pine Nuts Mouth Syndrome

Some people experience a strong metallic taste in mouth 2 days after eating Chinese pine nuts; the taste can persist for 10-14 days ⁽²³⁾. The cause is not known; it is probably not related to pesticides and molds.

What can cause tap water to have a metallic taste?

High levels of copper, iron, manganese or zinc, or low pH ^(14,29)
Corrosive plumbing, copper pipes ⁽²⁹⁾
Water fluoridation (anecdotal reports)

2. Physiological Conditions

Certain normal physiological conditions can be associated with metallic taste:

Women can experience metallic taste few days after ovulation (anecdotal reports), before periods as part of premenstrual syndrome ^(23,43) and in menopause.
Old age ^(22,32,43)
Intense exercise, like running–possibly due to fluid in the lungs or leak of red blood cells into the lungs ⁽³⁹⁾.

3. Early Pregnancy

The metallic taste is a commonly reported sign of early pregnancy; other taste disturbances may include increased bitter and decreased salt sensitivity ⁽²⁶⁾. Commonly reported foods that taste weird to pregnant women are sweet foods and coffee.

Some pregnant women experience disgusting odors, which may trigger nausea and vomiting (morning sickness) ^(17,26).

It is not known if increased sense of taste or smell is related to fluctuating (increased or decreased) levels of estrogen ⁽⁴⁾.

4. Health Conditions

Dry Mouth Syndrome (Xerostomia)

Metallic taste can occur in the dry mouth of any cause:

Anxiety, panic attack, stress or lack of sleep, which all can increase adrenaline release
Moderate to severe dehydration (dry mouth and lips, thirst, dizziness)
Smoking, tobacco chewing, nicotine patch
Mouthwashes containing alcohol or whitening
Autoimmune disorders: systemic lupus erythematosus (SLE), rheumatoid arthritis, Sjögren’s syndrome, systemic sclerosis (dry mouth and eyes, joint pain, skin rash)
Side effect of medications

Mouth and Lips Conditions

Mouth:
- Poor mouth hygiene
- Oral thrush caused by the yeast Candida (small white spots in mouth; in cancer, chemotherapy, steroid therapy or HIV/AIDS)
- Canker sores (shallow ulcers in mouth, usually between 10 and 20 years of age)
- Lichen planus (white rash in mouth and, sometimes, red bumps on the skin) ⁽²⁾
Lips:
- Cracked lips from dehydration; cracked corners of the mouth in vitamin B or iron deficiency
- Cold sore (Herpes simplex virus)
Teeth:
- Tooth filling or crown, dental caries, broken tooth, tooth abscess, tooth extraction, root canal procedure
- Teeth grinding resulting in jaw pain
- Denture use
Tongue:
- Burning mouth syndrome, most often in menopausal women (symptoms: pain, numbness, tingling and hot sensation on the tongue or other parts of mouth, not in the morning, worsening through the day, relieved by eating or drinking; the tongue appears normal) ⁽⁵⁰⁾
Gums:
- Periodontal disease (detached gums)
- Inflammation of the gums: gingivitis, trench mouth (symptoms: red, swollen gums with ulcers, bad breath) ⁽⁶⁾
Salivary gland infection–mumps–or inflammation–sialadenitis (swelling and tenderness below the ears)

Blood in the mouth can have a salty taste or a taste of dirty copper pennies.

Blood in the mouth can originate from rough tooth brushing, nasal bleeding, mouth ulcers or injuries, throat, esophagus (esophageal varices in alcoholics), stomach (ulcer, cancer), bronchi (chronic bronchitis) or lungs (pneumonia, tuberculosis, cancer).

Sore Throat, Coughing and Metallic Taste

Causes of sore throat, dry cough, difficulty swallowing, hoarseness and metallic taste include common cold, flu, acid reflux, foreign object in the throat, thermal burn, viral or bacterial pharyngitis (strep throat), laryngitis, infectious mononucleosis, tonsillitis, epiglottitis, impaired mobility of the esophagus (achalasia), and throat, lung or thyroid cancer ⁽¹⁹⁾.

Causes of coughing up phlegm and metallic or salty taste without sore throat include allergies (hay fever), chronic bronchitis (in smokers), asthma (wheezing, only minimal mucus), bacterial pneumonia (high fever, difficulty breathing), congestive heart failure (weakness, leg swelling), bronchiectasis (foul breath), cystic fibrosis (salty skin), tuberculosis (coughing up blood, low-grade fever) and croup.

Causes of Nausea, Vomiting and Metallic Taste

Constipation, motion sickness, jet lag
Intestinal parasites, such as worms or Giardia
Bile reflux after gallbladder removal (occasional vomiting of green-yellow fluid) ⁽⁴²⁾
Stomach flu (a viral infection), chronic gastritis caused by the bacterium H. pylori (upset stomach, bloating), peptic ulcer or cancer (upper abdominal pain)
Liver inflammation (hepatitis A, B or C), alcoholic liver disease ⁽³²⁾
Obstruction of the small or large intestine due to a tumor, Crohn’s disease or ulcerative colitis
Kidney failure resulting in uremia–a buildup of urea in the blood (symptoms: nausea, ammonia breath odor, skin itch and rash)
Cirrhosis with liver failure resulting in hyperammonemia–a buildup of ammonia in the blood (symptoms: lethargy, jaundice) ⁽³¹⁾
Infection of the inner ear (labyrinthitis)

Headache and Metallic Taste

Sinusitis (symptoms: blocked nose, pain around the nose, eyes and in the forehead)
A migraine (symptoms: throbbing headache on one or both sides and sensitivity to lights (photophobia) and sounds preceded by “aura:” flashing lights, tingling, metallic taste) ⁽²⁵⁾
A hangover (nausea and headache several hours after excessive alcohol drinking, lasting for several hours)
Brain infection or tumor

Hormonal and Metabolic Conditions

Ketosis–a harmless buildup of ketones in the blood–due to a low-carbohydrate (ketogenic) diet, fasting for more than 1 day (symptoms: chalky taste, acetone-like odor of the breath and urine)
In diabetes mellitus, metallic taste can be caused by hypoglycemia due to insulin overdose or a skipped meal), ketoacidosis–a buildup of ketones in the blood (acetone or fruity breath) or due to damage of the nerves ^(10,32).
Other hormonal disorders with metallic taste: hyperparathyroidism with hypercalcemia, hypothyroidism (feeling cold) ⁽¹⁰⁾, adrenal insufficiency (fatigue, muscle weakness) ⁽³²⁾, hypogonadism (Turner’s syndrome), primary amenorrhea (absent menstruation) ⁽³²⁾.

Neurological Conditions

Head injury ⁽³²⁾
Epilepsy (seizures) ^(2,25)
Shingles–a reactivation of a Herpes zoster infection in one of the nerves in the head area (burning rash on one side of the face)
Stroke (symptoms: a sudden weakness and lost of sensation on one side of the body)
Neurological diseases ^(23,25), such as Alzheimer’s disease (dementia), brain tumor, familial dysautonomia ⁽⁴³⁾, Guillain-Barré syndrome (progressing muscle weakness), Lyme disease, multiple sclerosis (tingling, numbness and weakness in various parts of the body) and Parkinson’s disease (tremor)
Bell’s palsy (symptoms: a sudden weakness and numbness on one side of the face)

Vitamin and Mineral Deficiencies

Individuals with chronic intestinal diseases, such as Crohn’s disease and small intestinal bacterial overgrowth, and chronic alcoholics are at higher risk to develop vitamin or mineral deficiencies.

Iron deficiency (anemia with fatigue and paleness)
Zinc deficiency (anorexia, fatigue, diarrhea) ⁽¹⁰⁾
Copper deficiency (fatigue, paleness) ⁽³²⁾
Vitamin B2, B3, B6 or B12 deficiencies (bright red tongue, cracked lips in the corners of the mouth, scaly skin, pernicious anemia, weakness) ^(10,32)
Vitamin C deficiency or scurvy (bleeding gums)

5. Cancer, Chemotherapy and Radiation

Cancers in the mouth, nose, throat and stomach, pancreatic cancer, brain tumors and possibly other cancers can cause constant metallic taste in mouth and a strong dislike of certain foods, like meat. A common cancer symptom is weight loss.

Chemotherapy medications, such as cisplatin and methotrexate, can cause metallic taste (“chemo mouth”) because they affects the taste buds. Radiation of the head and neck area can affect the salivary glands and mouth lining (radiation stomatitis) and thus cause metallic taste ^(5,6).

6. Psychological Disorders

In psychological disorders, metallic taste can be caused by dry mouth, medications or altered perception of taste. Causes include anxiety, panic attack (tingly lips and mouth, dizziness), depression ⁽⁴³⁾, anorexia nervosa, bulimia, schizophrenia and psychosis ^(23,24).

7. Other Health Conditions

Other health conditions that can be associated with metallic taste include fibromyalgia, hypothermia, low blood pressure, blood disorders (hemophilia and other blood clotting disorders, sickle cell disease, leukemia, thrombocytopenia), heart attack (anecdotal reports), aortic aneurysm or dissection Eaton-Lambert syndrome, HIV/AIDS ^(10,23) and porphyria ⁽²⁵⁾.

Severe allergic reaction (anaphylactic reaction) to insects bites and stings (wasps, bees, ants) can include redness at the site of the bite or sting, body swelling and metallic taste in mouth ⁽¹²⁾. Rattlesnake bite can cause metallic taste and tingling lips ⁽³⁵⁾.

In one small study, altered sense of taste in men with benign prostate hyperplasia was improved in all men after surgical resection of the prostate ⁽⁴¹⁾.

Phantom Metallic Taste

Phantom metallic taste is an unpleasant taste that persists for several months or years after the treatment of the original cause:

Head and neck cancer ⁽⁹⁾
Damaged nerves responsible for taste (chorda tympani) ⁽⁴³⁾

Idiopathic Dysgeusia

Idiopathic dysgeusia is an abnormal sense of taste from an unknown reason. In one small study, alpha-lipoic acid was more effective than placebo in relieving the unpleasant taste ⁽⁴⁰⁾.

8. Medications

Acne medications (tretinoin)
Analgesics (aspirin), for migraine (sumatriptan, topiramate), narcotics (codeine, morphine)
Antibiotics (ampicillin, azithromycin, doxycycline, ethambutol, gentamicin, metronidazole, rifampin, tetracycline)
Antidepressants (bupropion, citalopram, doxepin, nortryptiline)
Antidiarrheals (loperamide)
Antiepileptics (carbamazipine, phenytoin)
Antifungals (amphotericin B, griseofulvin, terbinafine)
Antihistamines (chlorpheniramine, diphenhydramine)
Antispasmodics (baclofen, chlormezanone)
Antiparasitics (levamisole)
Antipsychotics (lithium, trifluoperazine)
Anxiolytics (buspirone)
Asthma medications (albuterol, bamifylline)
Atropine, scopolamine
Diabetes medications (glipizide, metformin)
Disulfiram ⁽¹²⁾
Glaucoma medications (acetazolamide, methazolamide)
Gout medications (allopurinol, colchicine)
Heart and high blood pressure medications (adenosine, amiodarone, amiloride, amlodipine, atenolol, bisoprolol, captopril, digitalis, diltiazem, losartan, nitroglycerin patch, propranolol)
Osteoporosis medications (etidronate)
Rheumatoid arthritis medications (gold)
Sleeping pills and sedatives (eszopiclone, zolpidem, zopiclone)
Steroids (dexamethasone, hydrocortisone)
Stimulants (amphetamine, metamphetamine)
Thyroid medications (carbimazole, methimazole, potassium iodide)
Other: botulinum injection, clofibrate, dipyridamole, levodopa
References: ^{(5,6,8,13,15,23)}

Medical procedures, such as heart, brain or ear surgery, or hemodialysis can be followed by a metallic taste.

Birth control pills can also cause metallic taste.

Mineral ad Vitamin Supplements

Mineral and vitamin supplements that can cause metallic taste include calcium, chromium, copper, fluoride, iron, magnesium, manganese, potassium, selenium, zinc, prenatal vitamins for pregnant women, vitamin B12 (overdose) and vitamin D (intoxication) ^(5,11,12).

Illegal Drugs

Illegal drugs that can cause metallic taste include cocaine ⁽³²⁾, ecstasy (MDMA), LSD, marijuana and phencyclidine.

Drug withdrawal can be also associated with metallic taste.

9. Poisoning

Heavy metals: arsenic ⁽³⁴⁾, lead (grey gums, eating dirty things – pica) ⁽²¹⁾, organic mercury (methylmercury) ⁽³⁴⁾, solder ⁽¹²⁾, stannous salts (tin chloride), thallium, vanadium ⁽¹²⁾
Metal fume fever after inhalation of aluminum, antimony, cadmium, chromium, copper, gold, iron, magnesium, manganese, nickel, selenium, silver or zinc fumes (symptoms: fever, muscle weakness and aches) ⁽¹²⁾
The mushrooms common ink cap, which contains coprine, when consumed along with alcohol, causes hot flashes and throbbing headache 30-60 minutes after ingestion ⁽³³⁾
Other: nitrogen dioxide ⁽³⁷⁾, pepper or tear gas ⁽¹⁰⁾, pesticides (trifluralin) ⁽¹⁰⁾

If everything what you eat and drink tastes like metal, the cause is probably an underlying disease, medication, anxiety, using a toothpaste, pregnancy, heavy exercise, vitamin or mineral deficiency or poisoning rather than normal food.

Metallic Smell

Disorders that affect the sense of smell usually also cause metallic taste. Causes include:

Common cold ^(5,6), allergic rhinitis (hay fever), sinusitis ⁽⁶⁾
Foreign body in the nose
Smoking, exposure to mold, dust, ashes, chalk, chemical air pollutants (benzene, chlorine, formaldehyde, paint solvents, sulfuric acid) ⁽²³⁾
Nasal polyps, tumors and anatomical abnormalities that block the flow of the air ⁽²³⁾
Brain tumors
Brain, nasal or gastric bypass surgery ⁽²³⁾
Hereditary disorders: Kallman syndrome ⁽²³⁾
Tracheostomy ⁽²³⁾
Cocaine abuse ⁽²³⁾
Cyanide poisoning (bitter almonds smell)

Zinc nasal sprays used in treatment of common cold (but not zinc tablets) can result in a permanent loss of smell (anosmia) after a single use ^(44,45).

Other Types of Unusual Bad Taste

Bitter Taste

Some people describe metallic taste, especially when caused by medications, as a bitter taste. Other causes of a bitter taste include:

Tonic water
Plant foods naturally high in phenols, flavonoids, isoflavones or terpenes, such as unripe fruits, grapefruits, tea, coffee, beer, dark chocolate, red wine, yams, beans, soy protein, cabbage, Brussels sprouts, cucumbers, zucchini and other squashes, turnips, spinach and kale are almost always bitter, acrid or astringent ⁽⁴²⁾.
Drugs containing alkaloids (quinine, ephedrine, morphine, piperine, cocaine, caffeine, nicotine) and herbal extracts (cinchona); other drugs: antihistamines (cetirizine, fexofenadine), drugs for glaucoma, and Parkinson’s disease (levodopa)
Supplements (biotin, hydrolyzed proteins, lysine)
A tumor in front of the brain (meningioma of the frontal olfactory groove)

Sour (Acidic) Taste

Acidic foods, such as vinegar and citrus fruits
Acid reflux or GERD
Drugs: nonsteroid anti-inflammatory drugs (NSAIDs): aspirin, ibuprofen, naproxen, tramadol
Supplements: vitamin C

Salty Taste

Some people describe metallic taste as a salty taste. Other causes of salty taste:

Medications: potassium iodide (for the thyroid), statins (to lower cholesterol), hydralazine (for high blood pressure), calcitonin-salmon (for osteoporosis) and medications containing sodium, eye drops
Supplements: potassium, fluoride, omega-3 fish oil (fishy aftertaste)
Bleeding in the mouth or throat, nosebleeds
Coughing up phlegm (in chronic bronchitis) or blood (in tuberculosis or lung cancer)
Postnasal drip (salty taste in the throat, itchy throat)
Head injury with a leak of the cerebrospinal fluid into the nose
Cystic fibrosis–a genetic disease (“salty kiss”, salty skin, coughing up thick mucus, frequent infections, diarrhea)

Soapy (Alkaline) Taste

Toothpaste containing sodium fluoride [NaF] (soapy, salty taste)
Fluoride supplements
Fluoridated water
Spices, like coriander or cilantro may taste soapy to some people ⁽⁵³⁾.

Garlic Taste

Poisoning: arsenic, dimetyl sulfoxide, organophosphate insecticides, phosphorus, selenious acid, thallium
Brazil nuts
Selenium supplements

Diagnosis

An examination performed by a dentist, an ear, nose and throat (ENT) specialist, gastroenterologist or neurologist may be needed to determine the cause of a metallic taste.

Investigations may include blood or stool tests, gastroscopy, CT scan of the head and neurological tests.

Treatment of Metallic Taste

When to call a doctor?

Call a doctor when you experience:

Sudden, unusual metallic taste after ingesting or inhaling something or when you can not explain it
Persisting metallic taste not caused by a known mild disease or medications

Metallic taste usually goes away when the original cause is removed.

How to get rid of metallic taste when you cannot treat the cause?

If you think, medications cause you bad taste, discuss with your doctor about changing them.

Sugar-free mint or eucalyptus chewing gum can help mask the metallic taste.

Artificial saliva and pilocarpine can help relieve metallic taste due to dry mouth.

Zinc supplements are widely recommended as a metallic taste relief but according to one 2014 systematic review of studies they may not be very efficient ⁽⁴⁶⁾. Zinc supplements may improve taste in individuals with zinc deficiency and in some individuals with idiopathic dysgeusia ⁽⁴⁶⁾. In some people, zinc supplements may even aggravate metallic taste ⁽⁴⁷⁾. Do NOT use zinc nasal sprays, since they may cause temporary or permanent loss of smell ^(44,45)!

A drug clonazepam can reduce pain and metallic taste in burning mouth syndrome ⁽⁴³⁾.

Alpha-lipoic acid may help improve taste in individuals with idiopathic dysgeusia and burning mouth syndrome, according to one small study ⁽⁴⁰⁾.

Diet changes and home remedies to improve taste during chemotherapy ^(7,39):

Do not eat 2 hours before and 3 hours after chemotherapy.
Keep your mouth clean and brush your teeth.
Use plastic flatware, glass cups and plates instead of metal ones.
Serve foods cold or at room temperature. Avoid hot foods and beverages.
Rinse your mouth with a baking soda, salt and water mouthwash before eating (1 tbsp soda and 1 tbsp salt in 1 liter of water).
Avoid sugary foods (candies, chewing gum), carbonated drinks and milk.
Instead of red meat, try chicken, fish, eggs or cheese.
Season foods with tart flavors (lemon, vinegar, pickled foods) or new tastes or spices (onion, garlic, chili powder, basil, oregano, rosemary, BBQ sauce, mustard, mint).
Try a “miracle fruit” that makes sour foods taste sweet (Synsepalum dulcificum).

Vitamin D supplements can improve taste during chemotherapy ⁽⁴⁸⁾, but probably not in others.

Frequently Asked Questions

1. How long does metallic taste last?

Metallic taste usually lasts until the cause persists, which can be, for example a couple of weeks in sinusitis, or more than a year in a moth rash called lichen planus. Metallic taste can persists after the cause is removed, for example for few minutes after a burp, few hours or several days after using a toothpaste, a couple of weeks after eating pine nuts, or several months after stopping chemotherapy.

2. What causes constant metallic taste in mouth, even between meals?

Anxiety, mouth conditions, ketosis, medications, neurological conditions, iron or zinc deficiency, kidney failure, chemotherapy and poisoning can cause constant metallic taste.

References

Metallic Taste in Mouth