Metallic Mouth Medical Mystery

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‘Tis the season and pine trees are everywhere. I watch the lights on my tree while eating an apple and find that the apple tastes bitter. In fact, everything I have eaten over the past few days has tasted bitter and the bitterness lasts for about 30 minutes after I have finished eating.    I am scanning my brain for a diagnosis. I’m pretty sure if I had a toxic level of metals in my body I wouldn’t be leisurely watching my Christmas tree. I don’t have any indigestion either. Some people with acid reflux will describe a “water brash” taste in their mouth, which is basically the taste of stomach contents rising up into the throat. I have had many interesting medical complaints thrown my way from people, but nothing about a metallic taste in the mouth. None of my textbooks have an answer, so I do some further investigation on the internet (via reliable sources of course).

It turns out some people who eat pine nuts may experience the symptoms I described above. I happened to have eaten pine nuts in a salad last week, but have never experienced this before, despite having eaten pine nuts in the past. According to the article I read, it’s called “Pine Mouth”, or Pine Nut related Cacogeusia in medical terms. I had never learned about or heard about it until today. What’s interesting is that it was discovered by a physician a few years ago. Dr. Marc-David Munk of the University of New Mexico published a paper in the  Journal of Medical Toxicology about his experience with pine mouth after eating pine nuts on a salad. Scientists are still stumped as to what causes it but think it may be related to a species imported from China. Thankfully it’s not dangerous and the taste disappears after a week or two.

While most of what I learned in medical school has not changed, medicine is still ever evolving. Doctors are always learning (and apparently have issues related to pine nuts). I do seriously advise against self- diagnosis especially via the internet, even as a physician, which is why I am going to run it by a colleague. I could do without the metallic tasting holiday treats this week, but I won’t be giving up pesto anytime soon. I hope you all have a wonderful, happy, healthy and safe Holiday. -Dr. A

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