Meal Ideas When Food Tastes Metallic

People describe it as sucking on a coin, or as if every plate has been rinsed in old bathwater. Steak turns to metal. Coffee turns to ash. Water itself can taste wrong, which is the part that unsettles people most.

The medical word is dysgeusia, meaning a distorted sense of taste. Two related words come up: hypogeusia, when taste is dulled, and ageusia, when it goes altogether. Metallic taste is a form of dysgeusia, and it is one of the more common complaints during chemotherapy.

The National Cancer Institute's summary on oral complications points to several causes at once. Taste buds themselves can be damaged. Dry mouth reduces taste, because saliva is what carries flavor molecules to the taste receptors. Infection and dental problems add to it. Some chemotherapy drugs also produce an unpleasant taste directly.

Radiation to the head and neck works differently. NCI notes it can alter how you perceive sweet, sour, bitter and salty tastes, and that these changes may be permanent for many people.

Timing matters for what you should expect. After chemotherapy, NCI says taste returns to normal for most people a few months after treatment ends. After radiation, taste buds may begin recovering six to eight weeks or more after treatment finishes, but not everyone gets full recovery.

This is the tip everyone passes on, and it has a plain reason behind it. Metal utensils put metal in your mouth. When your taste system is already misfiring toward metallic, a stainless steel fork adds to the signal.

The American Cancer Society recommends plastic or bamboo utensils and glass dishes instead. It extends the same logic to cooking: use glass cookware rather than metal where you can. Canned food eaten straight from the can is worth avoiding too.

Cold food is the second reliable trick. Much of what we call taste is really smell, and heat drives aroma into the air. Serving food cold or at room temperature keeps the smell down. That helps twice over if nausea is also in play.

These are starting points, not a prescription. Metallic taste is stubbornly individual, and what works one cycle may fail the next.

Cold protein plates. Chicken salad, egg salad, cold poached salmon, hummus with soft pita bread, cottage cheese with canned peaches. Red meat is the food most often reported as tasting wrong. ACS suggests swapping to chicken, fish, peanut butter, beans, peas, tofu, nuts, seeds, eggs or cheese.

Tart and sharp, if your mouth is intact. Lemon on fish, vinegar in a dressing, pickles, a squeeze of lime in water. NCI's Eating Hints booklet suggests recipes with orange, lime, lemon or vinegar. The caveat is important: if you have mouth sores or a sore throat, skip all of it. Acid on broken tissue is agony.

Marinated meats. Eating Hints recommends soaking meat, chicken or fish in a marinade to improve the flavor. Soy sauce, fruit juice, wine, Italian dressing and sweet-and-sour mixtures all work.

Strong non-metallic flavors. Herbs, spices, sugar, sauces, mint, basil, ginger, maple. Sweet often survives when savory does not.

Frozen things. Frozen grapes, frozen melon, ice pops, chilled fruit. Cold blunts the metal and adds fluid.

Between-meal resets. ACS suggests sugar-free gum or hard candy in mint, lemon, or orange flavors to clear the taste between meals.

A dry, coated or infected mouth makes metallic taste worse. Two habits are worth building.

Rinse before you eat. ACS suggests a mouthwash made from baking soda, salt and water. Ask your nurse or dietitian for the exact recipe your unit uses, because the proportions vary and a rinse that is too salty stings.

Brush regularly and see a dentist. NCI links taste changes to dental problems and infection, both of which are treatable. If you see white patches in your mouth, tell the team. That can be thrush, a yeast infection, and it responds to medicine.

Deal with dry mouth directly. NCI's nutrition guidance suggests drinking eight or more cups of water a day for dry mouth and rinsing the mouth three or four times daily.

There is no reliable cure, and you should be suspicious of anyone who says otherwise.

The NCI oral complications summary notes that zinc sulfate supplements may help some patients recover their sense of taste. That is a carefully hedged sentence and worth reading as such. The evidence is mixed and zinc is not a routine recommendation. Do not start it without asking your oncologist, because supplements can interact with treatment.

Everything else on this page is trial and error. The realistic aim is not to make food taste right. It is to find three or four things you can reliably get down while your taste recovers, and to keep enough calories and protein going in that you do not lose weight.

Taste changes themselves are not an emergency. What sometimes travels with them can be.

• Get emergency help the moment a reading on the thermometer hits 100.4°F (38°C) or higher while you are on chemotherapy. CDC calls that a medical emergency, since a fever can be the only warning of a dangerous infection. Head for the emergency department and phone your team on the way.
• Call your care team the same day if sores in your mouth have shut down eating and drinking altogether, or swallowing has become painful enough that fluids are going down badly.
• Call your care team within a day or two if white patches or a thick coating appear on your tongue or cheeks, since NCI links taste changes to infections such as thrush that respond to treatment. The same applies if the weight is drifting down, if several days have passed on almost no food, or if the metal taste arrived abruptly just as a new medicine started.

• Which of my drugs is most likely causing this?
• Roughly how long should I expect it to last with my treatment?
• Is my dry mouth treatable, and would that improve the taste?
• Should I see the dentist before or during treatment?
• Can I see a dietitian about keeping my weight steady?
• Is zinc worth trying in my case, or would it interfere?

See Eating When Food Tastes Different, Managing a Dry Mouth During Cancer Treatment, Eating With Mouth Sores, and High-Protein Snacks During Cancer Treatment.

• https://www.cancer.gov/about-cancer/treatment/side-effects/mouth-throat/oral-complications-pdq
• https://www.cancer.gov/about-cancer/treatment/side-effects/appetite-loss/nutrition-pdq
• https://www.cancer.gov/about-cancer/treatment/side-effects/infection
• https://www.cdc.gov/cancer-preventing-infections/patients/fever.html
• https://www.cancer.gov/publications/patient-education/eatinghints.pdf
• https://www.cancer.org/cancer/side-effects/eating-problems/taste-smell-changes.html