Is a bitter taste in your mouth due to "excessive liver fire"? Medical warning: Not only hepatitis, but also related to "7 diseases"
They often feel a bitter taste in their mouth, or even have a change in their sense of taste. Many people believe that this condition is related to “excessive liver fire”. Dr. Qian Zhenghong, director of the Liver Disease Prevention and Treatment Center of Keelung Chang Gung Memorial Hospital, explained in a social post that there are actually many reasons for bitter mouth and taste changes; chronic hepatitis or cirrhosis is indeed one of the possible causes, and specific diseases or nutrient deficiencies , may be related to the occurrence of abnormal taste.
I feel like vomiting when I smell a strange smell, and my food tastes tasteless! A 40-year-old man’s blood test showed “acute hepatitis A”
Dr. Qian Zhenghong gave an example of a male patient in his 40s half a year ago: The patient came to the clinic for treatment due to persistent nausea and vomiting. He originally thought it was food poisoning or norovirus infection. After taking gastrointestinal medicine for 3-4 days, the symptoms were still not relieved, so I was referred to Dr. Qian Zhenghong’s outpatient clinic for examination.
After consultation, it was discovered that the patient’s two major symptoms were similar to those of acute hepatitis: one was “nothing tastes good” and the other was “smelling an odor (such as fried food) makes you want to vomit.”; The results of the blood draw proved that it was indeed acute hepatitis A virus infection, and the ALT value was as high as 1,700. The patient continued to be unable to distinguish the taste of food for 3 weeks. His sense of taste and appetite did not return until his liver function became normal.
Your mouth is bitter and your sense of taste is abnormal? 7 major medical warning signs: not only related to confirmed diagnosis
However, hepatitis is not the only cause of abnormal taste. Dr. Qian Zhenghong explained that the basic human tastes include sour, sweet, bitter, umami and salty, and the perception of taste is formed through the interaction between taste buds on the tongue and chemical substances. Clinically, some patients will experience changes or loss of taste, such as “the mouth is very bitter, has a salty or even metallic taste”, “sweet food tastes like salty”, or “the mouth has a slightly sweet taste”.
Dr. Qian Zhenghong pointed out that there are many reasons for abnormal taste, which can be roughly divided into three major reasons: “specific diseases”, “medication” and “lack of nutrition”. Diseases or symptoms that may cause abnormal taste include:
Oral diseases. For example, periodontal disease, tooth decay, gingivitis, etc. will affect the sense of taste. The solution is to see a dentist as early as possible and brush your teeth frequently.
Dry mouth problem. For example, the immune disease “Sjögren’s disease” can easily affect the function of salivary glands, leading to insufficient saliva secretion. The countermeasure is to see a rheumatology and immunology department to check whether the amount of saliva is sufficient, or to eat plums in moderation to increase saliva secretion.
Gastroesophageal reflux. Acid reflux can easily cause a sour or bitter taste in the mouth because bile refluxes into the mouth. The countermeasure is to seek medical advice from a gastroenterologist as soon as possible to avoid acid reflux; and follow the doctor’s advice to prevent bile reflux through medication and diet.
Oral fungal infection. White coating on the tongue is caused by fungal infection which changes the sense of taste. The countermeasure is to seek help from an otolaryngologist and follow the doctor’s advice to treat and sterilize the disease by taking antibiotics.
COVID-19 infection. Changes in taste are one of the sequelae of infection with the new coronavirus. People suffering from sinusitis and otitis media may also experience a metallic taste in the mouth. For testing, seek help from an otolaryngologist, thoracic surgeon, or Chinese medicine practitioner.
Hormonal changes. Women may experience changes in their sense of taste and smell early in pregnancy, which gradually return to normal over time. In addition, hormonal changes in women after menopause may cause dryness of the mouth and changes in taste. The solution is to seek help from an obstetrician and gynecologist.
Hepatitis. Chronic hepatitis or cirrhosis can easily cause taste disorders and nausea. Patients with acute hepatitis may also experience the symptom of “tasteless food”. The countermeasure is to seek diagnosis and treatment from a gastrointestinal, hepatobiliary and biliary doctor and test liver function.
In addition, the side effects of many drugs can cause changes in taste, including antibiotics (such as those used to treat Helicobacter pylori), angiotensin-converting enzyme inhibitors ACEI (a type of blood pressure lowering drug), oral contraceptives, rheumatoid arthritis drugs, and immunomodulatory drugs. , antidepressants, antiepileptic drugs, antipsychotics, duck tablets and antihistamines. Among them, many cold medicines or allergy medicines contain antihistamines, which can cause changes in taste in addition to dry mouth.
Malnutrition leads to “tasteless food”. Medical advice: Eat more 7 kinds of vitamins and zinc ions
In addition to specific diseases and drug use, “micronutrient deficiencies” may also cause changes in oral taste. Dr. Qian Zhenghong explained that an article published in “Human Nutrition & Metabolism” analyzed how the deficiency of different vitamins and minerals affects taste perception. The following are the highlights of the article:
Zinc deficiency: It is related to taste disorders, especially bitter and salty tastes. People with chronic liver disease and those receiving chemotherapy are prone to zinc deficiency. Zinc supplementation has a certain effect on improving taste.
Vitamin B12 deficiency: can cause tongue pain, redness and swelling and increased taste threshold. B12 is mainly found in animal foods and is easily deficient in vegetarian diets. In addition, chronic gastritis can also cause insufficient absorption of B12.
Vitamin C deficiency: Linked to periodontal disease and may affect taste perception. Vitamin C supplementation can help restore taste changes caused by the new coronavirus.
Vitamin D deficiency: In the elderly, dysgeusia is particularly related to vitamin D deficiency, which may also affect the sense of smell.
Vitamin E deficiency: Supplementing vitamin E can help improve gum inflammation.
Folic acid (vitamin B9) deficiency: Smokers are prone to folic acid deficiency, which increases the risk of periodontal disease.
Lack of vitamin B3 and B6: Lack of vitamin B3 can easily lead to “blackening” of the tongue. Comprehensive B complex treatment can be supplemented.
Dr. Qian Zhenghong pointed out that cases of “zinc ion” and “vitamin B12” deficiency are more commonly encountered in clinical practice. In particular, B12 deficiency often causes “atrophic glossitis” (smooth tongue). Atrophic glossitis causes the small protrusions (taste buds) on the tongue to atrophy, causing the surface of the tongue to become smooth and shiny, or causing swelling, pain, redness, etc., making the patient’s taste insensitive or even loss of taste.
Insufficient vitamin B12 causes loss of taste? Pay attention to “2 abnormalities” in the tongue
Dr. Qian Zhenghong said that he had previously treated an elderly patient in his 90s who was unable to taste the food, resulting in a significant loss of appetite within a month and even refusing to eat. After an oral examination, it was found that the area around his tongue was red and the surface was unusually smooth, and a blood test showed that he was deficient in vitamin B12. After a month of vitamin B12 supplementation, the patient’s symptoms of loss of taste improved significantly and he got rid of the nightmare of “tasteless” meals.
Regarding the situation of insufficient trace vitamins, Dr. Qian Zhenghong said that zinc or vitamin B12 deficiency can be detected through reliable blood tests. Those who are deficient can try to take supplements first, such as eating more fruits and nuts. If there is a serious lack of specific nutrients, it may be caused by a picky diet or digestive tract disease. It is more important to find out the cause, and additional nutritional supplements may be needed. As for how to supplement, you should ask your doctor, pharmacist and nutritionist to avoid making mistakes or overdoing it.
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