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Thursday, April 17, 2014
Ear, Nose, and Throat Disorders
For four months, I`ve had extremely salty saliva from the glands beneath my tongue. The salt crystallizes between my teeth and can be dislodged by flossing, which increases the briny taste. It`s definitely not a `phantom` taste my tongue is always tasting. Dental exam revealed no problems but I`m going for a followup to the university oral medicine department to measure the salinity of my saliva in a few weeks. Am drinking plenty of water and my urine is light, almost clear, not dark.
Early on, I thought it might be leaking cerebrospinal fluid because I`d been diagnosed with several benign skull-base lesions five years ago; but recent followup MRI of brain and CT of head showed no change in the lesions and the radiologist`s report noted no other problems. In case it was medication-induced, I stopped taking Lipitor (20mg/day) about three weeks ago, but have noticed no improvement.
My family doctor (who wants me back on Lipitor and dismissed the drug out of hand as a possible direct or indirect cause, although I`ve read that it is associated rarely with dysgeusia) suggested a post-nasal drip, but my sinuses are clear and postnasal drip would cause a pervasive faint salty taste, whereas my problem is very localized and intense saltiness--as though my lower incisors are made of salt. It parches my lips and makes the insides of my lips puffy.
I`ve made an appointment with an ear-nose-throat specialist and a kidney specialist (just guessing that the Lipitor might have thrown my body`s sodium/potassium processing out of whack) but these appointments are for 90 days from now, they`re both so booked up. Are there any simple blood tests I could have my family doctor take to identify the cause or eliminate some things?
It seems more likely that you are experiencing a salty dysgeusia, rather than a change in the composition of your saliva. Dysgeusia can sometimes be localized to the anterior tongue. There is not a simple blood test of which I am aware that will easily provide an answer. I would proceed with your workup as planned.
If it all proves to be negative, I would consult a taste and smell clinic (there is one at the University of Cincinnati), since there are ways to treat the symptom of dysgeusia.
Allen M Seiden, MD
Professor of Otolaryngology, Director of Division of Rhinology and Sinus Disorders, Director of University Taste and Smell Center, Director of University Sinus and Allergy
College of Medicine
University of Cincinnati