Imagine biting into your favorite dish, only to find the flavors bland, metallic-tasting or even completely gone. For people living with lupus, this surprising symptom can do more than just turn everyday eating into a blah experience; it can significantly affect your health and quality of life. How?  Check out this week’s blog article to discover the fascinating science behind the causes, symptoms, and treatment options for lupus taste disorders.

• The Science of Taste and Its Disorders
• How Lupus Can Causes Taste Disorders and Quality of Life
• How to Diagnose and Manage Lupus Taste Disorders
• Research and the Future
• In Conclusion

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The Science of Taste and Its Disorders

The sense of taste is an incredibly complex and emotional experience! Like all our senses, it is part of a complicated process involving three key steps: taste buds, sensory nerves, and the brain. Disruptions caused by lupus at any part of this pathway can lead to taste disorders.

1. The Taste Buds: This is where it all begins! When we eat or drink, tiny sensory cells in our taste buds detect chemicals in the food and medications that we consume. These taste buds are found not only on the tongue but also on the soft palate, throat, and even the top of the esophagus.

   These sensory cells respond to five basic tastes: sweet, sour, salty, bitter, and umami (savory). However, things like lupus inflammation or certain medications can affect how well these cells work.

2. The Sensory Nerves: After the taste buds pick up signals, they send them to the brain via special nerves. Two important cranial nerves play a role here:

• • The facial nerve, which carries taste signals from the front of the tongue, soft palate, and throat.
  • The glossopharyngeal nerve, which handles signals from the back of the tongue.

3. The Brain: This is where the magic happens. Once the brain receives the signals, it combines them with memories and emotions to interpret the taste. That’s why certain foods can remind us of happy moments or make us feel nostalgic. The brain also blends taste with smell and texture, creating the full experience we call flavor. This combination can stir up a wide range of feelings, from absolute delight to strong dislike.

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The most common medical conditions that describe taste disorders include:

• Ageusia: Complete loss of taste.
• Hypogeusia: Reduced ability to taste certain flavors.
• Dysgeusia: Distorted taste perception, often described as metallic or unpleasant.

So, how does lupus affect or lead to these conditions?  Read on …

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How Lupus Can Causes Taste Disorders and Quality of Life

Recent research has highlighted several links between lupus and taste disorders, that include:

1. Inflammation and Neuropathy: Lupus-induced inflammation can damage cranial nerves, particularly the facial and glossopharyngeal nerves, which, as mentioned above, are critical for transmitting taste signals to the brain.
2. Medications: Many medications used to manage lupus have side effects that can change a person’s sense of taste, such as:
   • Immunosuppressants, like methotrexate, cyclosporine and azathioprine (Imuran);
   • Corticosteroids, like prednisone can cause a bitter or metallic taste in the mouth.
   • Supplements that many with lupus take, like fish oil, turmeric can also temporarily affect taste;
   • Medications for other conditions like antibiotics, diabetes, antidepressants, and blood pressure medications.
3. Oral Health Issues: Lupus can cause oral ulcers, dry mouth (xerostomia), and gum disease, all of which can interfere with taste perception.
4. Nutritional Deficiencies: Chronic inflammation and the side effects of some medications can lead to deficiencies in zinc and vitamin B12, which are two nutrients that are essential for maintaining taste function.
5. Lupus Nephritis: Late stage kidney disease may cause waste products to build up in the blood and can create a metallic taste.
6. Other Medical Conditions: Hypothyroidism, acid reflux, and most significantly, the common overlapping condition of Sjögren’s disease, which attacks the salivary glands causing dry mouth, can seriously affect the sense of taste.

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The Impact on Quality of Life

Taste is closely tied to how we enjoy food, nutrition, and even our social interactions. When taste perception is changed, it can lead to unintended consequences such as weight loss, malnutrition, and depression. For lupus patients already dealing with a complex array of symptoms, taste disorders add another layer of difficulty.

Moreover, a distorted or diminished sense of taste can affect medication adherence. If oral medications taste unpleasant (even more unpleasant than usual), patients may avoid taking them, possibly worsening their lupus symptoms.

The possible social impacts of taste disorders can add more emotional stress and can exacerbate the feeling of social isolation that itself can be a devastating consequence of living with lupus.

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How to Diagnose and Manage Lupus Taste Disorders

Addressing taste disorders in lupus patients requires a comprehensive approach. While there is no specific treatment for generalized loss of taste, here are some strategies:

Diagnosing Taste Disorders: This can be surprisingly tricky.  It requires a detailed patient history and physical examination.  Additionally, there are tests such as taste strip evaluations or even a clinical procedure called electrogustometry.

Electrogustometry (EGM) uses a metal probe to pass weak electrical current though different parts of the tongue. Patients push a button when they feel a taste or similar sensation.  This measures the taste thresholds for the sensory receptors and the health of the cranial nerves that take these signals to the brain.

 

Manage the Underlying Lupus: Effective management of lupus through medications, lifestyle changes, and regular monitoring can reduce inflammation and its impact on taste.

Oral Health: Maintaining good oral hygiene is the first and most important thing a person can do to improve taste directly.

Saliva substitutes, gum or medicated lozenges can also help fight dry mouth – a common problem caused by lupus medications and Sjögren’s disease if present.

Medication-induced Taste Disorders: Talk to your healthcare provider about adjusting dosages or even switching medications, such as those listed above, if this becomes a quality of life issue.

Nutritional Deficiency: If you are low in zinc or vitamin B12, taking supplements of either can help improve taste and remove metallic tastes.  However, taking zinc supplements can reduce the effectiveness of NSAIDs, corticosteroids, immunosuppressants, and some antibiotics.

Dietary Adjustments: Patients may need to adapt their diets to enhance flavor perception. For example, using herbs and spices can compensate for diminished taste sensitivity.

Psychological Support: Taste disorders can lead to reduced appetite and social isolation. Counseling and attending support groups can effectively help patients cope with these challenges.

NOTE: Always check with your healthcare provider before making any significant changes to your diet, use of supplements or medications.

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Research and the Future

While the connection between lupus and taste disorders is becoming clearer, more research is needed to fully understand the underlying mechanisms and to develop targeted treatments. Studies investigating the role of cytokines, neural pathways, and the microbiome in taste perception may lead to better treatment options in the future.

Additionally, advancements in precision medicine could lead to personalized treatments that address both lupus and taste disorders more effectively.

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In Conclusion

Lupus is a multifaceted disease that presents numerous challenges for patients and healthcare providers alike. Taste disorders, while not as commonly discussed as other symptoms, can significantly impact quality of life and overall health. Understanding the connection between lupus and taste disorders can make a surprisingly effective way to develop better treatment strategies and improve quality of life. By addressing this often-overlooked aspect of lupus, we can take a more holistic approach to care and ensure that patients receive the comprehensive support they need.

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References

Ballok, D.A., Szechtman, H., & Sakic, B. (2003). Taste responsiveness and diet preference in autoimmune MRL mice. Behavioural Brain Research,140(1),119-130.  https://doi.org/10.1016/S0166-4328(02)00276-0.

Chen, Q., Qiu, F., Liu, H., Li, X., & Li, J. (2019). Altered olfactory function in patients with systemic lupus erythematosus. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 25, 5929–5933. https://doi.org/10.12659/MSM.915738

Leasure, C. (2023, July 10). Metallic taste in your mouth with lupus: 10 potential causes. My Lupus Team. https://www.mylupusteam.com/resources/metallic-taste-in-mouth-with-lupus-potential-causes

St. Luke’s Hospital (2025, January 8). Possible interactions with: Zinc. St. Luke’s Hospital. https://www.stlukes-stl.com/health-content/medicine/33/000999.htm#:~:text=Cisplatin%20(Platinol%2DAQ)%20%2D%2D,of%20zinc%20in%20your%20blood.

Wang, H., Zhou, M., Brand, J., & Huang, L. (2009). Inflammation and taste disorders: mechanisms in taste buds. Annals of the New York Academy of Sciences, 1170, 596–603. https://doi.org/10.1111/j.1749-6632.2009.04480.x

 

Author: Greg Dardis, MS      

Professor Dardis was formerly the Chair of the Science Department at Marylhurst University and is currently an Assistant Professor at Portland State University and the American College of Healthcare Sciences.  His focus has been human biology and physiology with an interest in  autoimmunity.  Professor Dardis is also a former President of the Board of Directors of Kaleidoscope Fighting Lupus.

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