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Salty Taste in Mouth, Lips – Causes, Symptoms, Diagnosis, Treatment



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This article describes salty taste in mouth not caused by dietary salt.

Salty Taste in Mouth – Symptoms

  • Saltiness in mouth may be accompanied with metallic, soapy or bitter taste and can be extremely unpleasant.
  • Salty taste more pronounced on the back of the mouth and in the throat may speak for postnasal drip, GERD, respiratory infection, throat cancer.
  • Salty taste on the tongue tip and lips may speak for gingivitis or teeth problems.
  • Salty taste limited to or more pronounced on one side may be due to parotid gland disorder, teeth problem, ear infection, Bell’s palsy, trigeminal neuralgia, herpes zoster (rash on the same side).

Salty taste in mouth can be accompanied by:

  • Dry mouth may be from dehydration, medications side effects, Sjögren’s syndrome.
  • Burning mouth may occur in vitamin B12 deficiency, herpes zoster, Sjögren’s syndrome.
  • White coating on the tongue may occur in GERD.
  • White spots in the mouth are usually from oral thrush (yeast overgrowth).
  • Bad breath may be due to poor mouth hygiene, gingivitis, postnasal drip, respiratory infection, chronic tonsillitis, throat cancer.
  • Throat pain may occur in flu, strep throat, infectious mononucleosis, throat cancer.

Additional symptoms related to specific causes are described below.

Salty Taste in Mouth – Causes

1. Sweating

Sweat is salty and can pour over your face to your lips.

2. Dehydration

Dehydration makes saliva more salty. Common causes of dehydration: insufficient drinking, excessive sweating, regular drinking of alcohol, coffee and caffeinated drinks (energy drinks, soda, tea), overuse of diuretics, laxatives, diabetes type 1, kidney disease.

3. Tears, Eye Drops

Tears are more or less salty. Tears are normally drained through the lacrimal ducts, which start as pinpoint-sized openings in the inner eye corners and end in the nasal cavity. From there tears may drain into the throat and from there into the mouth. Causes of increased tear production:

  • Crying
  • Eyes, irritated by hay fever or other allergy, eye inflammation or infection, contact lenses, eye surgery
  • Eye drops (may take six weeks after stopping using them for salty taste in mouth to disappear)
  • Tearing eye on one side may be due to blocked lacrimal canal (tears pour over the face toward the lips)

4. Postnasal Drip

Mucus from the nose can drain into the throat and mouth.

  • Swimming, diving in the sea
  • Infectious sinusitis
  • Sinus rinses
  • Allergic sinusitis may be triggered by pollens, dust mites, molds, tea tree oil (in shampoos, cosmetics, cleansers)
  • Nasal polyps
  • Nosebleeds

5. Toothpastes and Mouth Washes

Taste buds can be damaged by:

  • Toothpaste with mint or whitening, or sodium lauryl sulfate (SLS)
  • Swallowing fluoridated toothpaste
  • Mouth washes with alcohol, mint, whitening
  • Breathing mints (impaired taste buds for 3-6 months)

6. Dental Causes

  • Tooth cavity
  • Broken tooth
  • Dental work: tooth (especially wisdom tooth) extraction, tooth filling or crown, teeth cleaning

7. Mouth Conditions

  • Poor mouth hygiene
  • Inflamed gums (gingivitis). Symptoms may include salty taste over the gums, reddened, swollen, tender, detached or easily bleeding gums.
  • Stones in salivary gland ducts (sialolithiasis). Symptom: pressing upon the parotid gland (in front and below the ear) may push salty saliva on the affected side.
  • Salivary gland infection (sialadenitis)
  • Oral thrush due to yeast overgrowth after therapy with antibiotics, steroids, chemotherapeutics or immunossuppresants, or in HIV/AIDS or other immunodeficiency. Symptom: whitish, removable spots (with underneath redness) in the mouth
  • Sjögren’s syndrome. Symptoms may include constant salty taste and dry mouth, itchy throat, difficulty swallowing, dry itchy eyes, dry skin, constipation, joint pains. Diagnosis: blood test.
  • Dry mouth syndrome
  • Burning mouth syndrome
  • Oral allergy syndrome
  • Chemical burn of the mouth. Symptoms: ulcers (acute burn), scars (chronic burn).

8. Throat Conditions

  • Common cold, influenza
  • Strep throat
  • Spread of ear infection into the throat
  • Infectious mononucleosis. Symptoms: fever, enlarged lymph nodes in the groin, armpits, neck, sore throat.
  • Chronic tonsillitis (tonsil inflammation), tonsil stones. Symptoms: enlarged tonsils, bad breath, white excretions.
  • Tonsil removal (tonsillectomy)
  • Throat cancer. Common cause: smoking. Symptoms: bad breath, hoarseness, throat pain.

9. Coughing Up Mucus from the Bronchi or Lungs

  • Acute bronchitis. Symptoms: chest pain during (dry or wet) coughing, sometimes following common cold or influenza, lasting few weeks.
  • Chronic bronchitis. Typical symptoms: a smoker coughs up yellow/green mucus, especially in the morning, no fever.
  • Bacterial pneumonia. Symptoms: high fever, difficulty breathing, coughing up mucus.
  • Tuberculosis. Symptoms: low-grade fever, feeling unwell, coughing up bloody mucus. Ethambutol and rifampin used in treatment can add to salty taste.
  • Asthma. Symptoms: difficulty breathing and wheezing after stress or exertion.
  • Cystic fibrosis, a genetic disease with frequent respiratory infections, thick salty mucus, salty skin, diarrhea.

10. GERD (Gastroesophageal Reflux Disease)

Anything what increases gastric acid secretion, increases alkaline (and therefore neutralizing) pancreatic juice secretion, which is high in salt. During reflux, both acid and salt may flow toward the mouth and cause heartburn (burning behind the breastbone), acidic and/or salty taste, white tongue. Common causes and triggers of gastric reflux:

  • Foods, like chocolate, citruses, vinegar, mints, caffeine, spices, alcohol, sugary foods, tomatoes, cucumbers, onions, berries
  • High protein diet
  • Smoking
  • Stress
  • Fish oil and cod liver oil supplements, conjugated linolenic acid (CLA) in supplement form or in Burn Fat “recovery drinks”
  • Helicobacter pylori infection. Symptoms may include excessive burping and bloating. Diagnosis is made by a breath or blood test or histological examination of a sample of gastric mucosa obtained during endoscopy. Treatment is with antibiotics.
  • Pancreatitis.

Therapy includes removing the cause, antacids or acid lowering drugs, eradicating H. pylori, surgery. Note: an acid lowering drug containing omeprazol/sodium bicarbonate may cause salty taste.

11. Bile Reflux

Gallbladder issues may result in bile reflux – flow of the bile from the duodenum through the stomach and esophagus toward the mouth, resulting in a bitter and/or salty taste, hoarseness, nausea, vomiting bile. Causes:

  • Peptic ulcer. Symptoms: upper middle abdominal pain aggravated by eating.
  • Gastric surgery
  • Gallbladder removal (cholecystectomy)

12. Dietary Causes

  • Ammonium chloride or “sal amoniac” as a food additive E510 in salty liquorice and other foods, and as a diuretic
  • Magnesium sulfate in low-sodium salt, food additives (magnesium diglutamate or E625)
  • Monosodium glutamate or MSG (E621)
  • Potassium chloride in low-sodium salt
  • Fluoridated water or water naturally high in fluoride

13. Nutrient Deficiencies

  • Zinc deficiency. Causes include inadequate zinc intake (foods high in zinc are meat, seafood, eggs, legumes), zinc malabsorption (celiac and Crohn’s disease, chronic diarrhea), main symptoms are anorexia, fatigue and diarrhea. Diagnosis is by a blood test. Zinc supplements should help within a week time.
  • Vitamin B12 deficiency (pernicious anemia). Causes: autoimmune disease, vegetarian diet. Symptoms: paleness, fatigue, a smooth, red tongue. Vitamin B12 supplements should help in few weeks.

14. Medications and Remedies Side Effects

An (incomplete) list of drugs that can cause salty/metallic taste (2,3,4,5):

  • ACE inhibitors (for high blood pressure): captopril, enalapril, lisinopril, etc.
  • Allopurinol
  • Antibiotics: ceftriaxone, clindamycin, ethambutol, lincomycin, metronidazole, penicillin, rifampin, tetracycline
  • Antidepressants: citalopram, desvenlafaxine
  • Antifungals: griseofulvin, terbinafine
  • Antihistamines: loratadine
  • Antimalarics: hydroxychloroquine
  • Anti-thyroid medications (strong iodine solution – potassium iodide). Raspberry syrup or orange juice can help reduce the taste.
  • Beta blockers: toprol, metoprolol
  • Bisphosphonates: ibandronate (for osteoporosis)
  • Calcitonin-salmon
  • Chemotherapy: vinblastin, vincristin, cisplatin, colchicine, methotrexate, procarbazine, etc.
  • Chondroitin
  • Dicyclomine (for IBS)
  • Diuretics: furosemide, spironolactone
  • Fluoride supplements
  • Gold
  • Hydralazine
  • Lithium
  • Lysine
  • Magnesium supplements, magnesium hydroxide or milk of magnesia in antacids and laxatives
  • Metyldopa
  • MSM (methyl sulfonyl methane or “MSM sulfur”)
  • NSAIDS: aspirin, tramadol, etc.
  • Omega 3 fish oil
  • Penicillamine
  • Phenindione (anticoagulant)
  • Phenytoin
  • Potassium supplements
  • Radiotherapy for cancers of the head and neck
  • Sodium phenylbutyrate
  • Statins (cholesterol-lowering drugs): lovastatin, simvastatin
  • Steroid nasal sprays
  • Synthroid (thyroid hormones for hypothyroidism – Hashimoto disease)
  • Vitamin D
  • Zoloft

You can discuss with your doctor about changing the drugs (do not stop taking any drug on your own). Many of above drugs affect zinc absorption or metabolism, so zinc supplements may sometimes help.

15. Other Substances

  • Contrast dye for CT scan
  • Magnesium citrate for colonoscopy prepare
  • Methamphetamine (meth, cold pill) abuse

16. Neurological Disorders

  • Bell’s palsy
  • Hemifacial spasm
  • Herpes zoster of trigeminal nerve. Symptom: tingling, rash on one side of the mouth or tongue.
  • Trigeminal neuralgia. Symptom: short intense pain on one side of the face or mouth.
  • Eardrum, nose, mouth or throat surgery. An infection or injury of the middle ear can damage chorda tympani (a branch of the facial nerve that enables the taste in the front part of the tongue).
  • Migraine
  • Seizures (epileptic attack)
  • Stroke
  • Brain tumor. Symptoms: headache, various neurological symptoms.
  • Cerebrospinal fluid (CFS) leak (after head injury)

17. Endocrine Disorders

  • Birth control pills
  • Pregnancy
  • Menopause
  • Hypothyroidism (Hashimoto disease)
  • Anorexia

Diagnosis of Salty Taste in Mouth

Diagnosis can be made either after disappearing of salty taste after removing/changing suspected triggers (medications, toothpaste, etc.), or by testing for diseases known to cause salty taste.

If you cannot identify the cause, you may visit a doctor for ears, nose and throat (ENT).

Treatment of Salty Taste in Mouth

Removing or treating the cause may treat salty taste. Some tips:

  • Lemonade without sugar or sugar-free gum may provide temporary relief.
  • Use non-whitening toothpaste and non-alcoholic mouthwash.
  • If you think you are dehydrated, drink sufficient amount of water and reduce amount of alcohol, tea, coffee in your diet.
  • If you have gastric reflux, avoid alcohol, smoking, caffeine, acidic foods and discuss with your doctor about the treatment possibilities.
  • In allergies, antihistamines may help. Loratadine may make salty taste worse, though.

References:

  1. Causes of salty taste (riversideonline.com)
  2. Causes of salty taste (doctorslounge.com)
  3. Medications that cause salty taste (drugs.com)
  4. Drugs that affect taste (books.google.com, Goldfrank’s toxicologic emergencies)
  5. Drugs that affect taste (books.google.com, Neurology and General Medicine, by Michael J. Aminoff)

 

 

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