A bitter taste in the mouth is often caused by poor oral hygiene, taking multivitamins, pregnancy or having a dry mouth. However, it can also be a sign of a more serious health condition, like thrush, acid reflux or sinusitis. Bitterness caused by more serious health condition may present with other symptoms, like heartburn, stomach pain, or tongue swelling.

Smoking cigarettes can also cause a bitter taste in the mouth, which can persist for a few minutes to a few hours. This typically improves after eating other foods, drinking water, or brushing your teeth.

If you notice that you have a bitter taste in your mouth frequently, or if it persists and does not resolve with regular tooth brushing, you should consult a general practitioner or a gastroenterologist to assess whether the symptom is related to another medical condition.

Why do I have a bitter taste in my mouth?

The most common causes of a bitter taste in the mouth are:

1. Poor oral hygiene

This is the most common cause for a bitter taste in the mouth, especially if it occurs after waking up. A build-up of saliva and bacteria on the tongue, teeth, and gums can lead to bad breath and changes in taste perception.

How to treat: Brush your teeth at least twice a day, once after waking-up and again before going to sleep. It is also very important to brush the tongue to prevent coated tongue, which is a build-up of bacteria and dead cells that can also contribute to foul breath.

2. Antibiotics or antidepressants

There are some drugs that, when ingested, are absorbed in the body and then released in the saliva, causing a bitter taste in the mouth. Some examples include antibiotics (e.g. tetracyclines), gout medication (e.g. allopurinol), and lithium. Some drugs used to treat heart disease can also cause a bitter taste.

People who use antidepressants may experience a dry mouth, which can also alter taste perception.

How to treat: The bitter taste usually resolves within a few days of taking a new medication. However, if it is constant and unpleasant, notify your prescriber, who may suggest an alternative medication for you.

3. Pregnancy

Dysgeusia, a change to taste perception, is a very common symptom for many women during the first trimester of pregnancy. It arises due to hormonal changes and usually resolves within a few days.

Some pregnant women may report a taste similar to having a coin in their mouth or drinking water from a metal cup, for example. Learn more about other pregnancy symptoms that can emerge early on.

How to treat: An effective way of getting rid of the bitter taste in the mouth is to drink lemonade or suck on a lemon popsicle.

4. Vitamin supplements

Some vitamin supplements that contain high amounts of metallic substances, such as zinc, copper, iron, or chromium, can cause a metallic and bitter taste in the mouth. This side effect is very common and usually appears once the supplement is completely absorbed in the body.

How to treat: It is recommended to wait a few minutes to allow the body to fully absorb the supplement. If the bitter taste is very intense or persists, you should discuss the possibility of changing your dose or using an alternative supplement with your prescriber.

5. Gastroesophageal reflux disease (GERD)

GERD happens when stomach content backs-up into the esophagus during digestion. The acid can flow back up to the mouth, leaving a bitter taste.

How to treat: Avoid eating foods that are very fatty or difficult to digest, as they increase the acidic content in the stomach. It’s also important to avoid eating very large meals, as they make it difficult for the stomach to digest efficiently. Read more about the GERD diet and how to start incorporating it into your lifestyle.

6. Hepatitis, fatty liver or cirrhosis

When the liver is not working properly, the body begins to accumulate high amounts of ammonia, which is a toxic substance normally transformed into urea by the liver and eliminated in the urine. Increased levels of ammonia cause a change in taste, similar to fish or onion.

If you suspect your bitter taste is related to a liver problem, report your symptoms in our liver disease symptom checker and assess your risk.

How to treat: Liver problems usually present with other symptoms, like fatigue or general malaise. Therefore, if liver disease is suspected, it is recommended you seek the medical opinion of a gastroenterologist, who can confirm a diagnosis and start treatment if necessary.

7. Cold or flu

A cold or flu virus are viral infections that can cause a dry throat and a bitter taste in the mouth. Viruses like influenza or rhinovirus, for example, can enter through the nose, and cause inflammation and irritation in the throat or nasal mucosa.

The cold or flu virus can also cause other symptoms, such as a dry nose, cough, fever, sneezing, headache and body aches.

How to treat: To recover from these infections, you should rest and maintain adequate hydration by drinking plenty of fluids. In addition, your ENT or general practitioner may prescribe the use of medications to relieve symptoms, such as painkillers, anti-inflammatories or antihistamines, for example.

8. Sinusitis

Sinusitis is the inflammation of the lining of the paranasal sinuses and facial cavities. This swelling can be caused by bacteria, viruses, fungi or allergies, and can lead to symptoms such as a bitter mouth, runny or blocked nose, facial pain or headache.

How to treat: To relieve the bitter taste in the mouth, the doctor may advise interventions like nasal irrigation with saline solution, nebulizing 3 times a day or taking sinus medication. Check-out the sinusitis medication your doctor can prescribe to help relieve symptoms and speed-up recovery.

9. Allergic rhinitis

Allergic rhinitis is the inflammation of the nasal mucosa that is triggered by certain allergenic substances, such as dust, pollen or animal hair.

Contact with these substances causes a reaction and results in symptoms such as sneezing, runny nose, phlegm, itchy nose and a bitter taste in the mouth.

How to treat: it is important to avoid contact with triggering substances substances. However, the doctor may prescribe medications for allergic rhinitis to help manage symptoms, such as desloratadine or cetirizine.

10. Strep throat

A bitter mouth can also be caused by strep throat, which is a characterized by inflammation of the tonsils. This infection is mainly caused by bacteria like Streptococcus pyogenes.

Other symptoms that can also occur include increased phlegm production, an intensely sore throat, difficulty swallowing, high-grade fever or the presence of pus in the throat.

How to treat: treatment for strep throat should be guided by an otolaryngologist, who may prescribe antibiotics like amoxicillin, azithromycin, clindamycin or cephalosporin. Check-out other home remedies for a sore throat that you can prepare to help manage symptoms.

11. Dry mouth

Dry mouth, medically referred to as xerostomia, is characterized by a decrease or interruption in the production of saliva or a change in the composition of saliva. It causes the mouth to become very dry, which leads to the appearance of a bitter taste in the mouth.

It can also cause symptoms by other symptoms like bad breath, thick saliva or difficulty chewing, and is usually caused by smoking, stress, anxiety or other chronic diseases, such as anemia, lupus or multiple sclerosis.

How to treat: it is important to drink plenty of water throughout the day to hydrate the mucous membranes of the mouth and to reduce the discomfort associated with a dry mouth. Smoking cessation is also another important factor in reducing discomfort. I more severe cases, the doctor may prescribe the use of artificial saliva, or enhance the treatment for the disease that could be contributing to the xerostomia.

12. Coating of the tongue

Coating of the tongue is associated with the accumulation of bacteria on the tongue that leaves the surface with a whitish, yellowish, brown or gray color. It can also cause a bitter taste in the mouth or bad breath.

A coating on the tongue can be caused by poor oral hygiene, smoking and drinking alcohol, or it may related to another health condition, like diabetes or liver disease.

How to treat: you should ensure adequate oral hygiene, by using a tongue cleaner after brushing your teath. Smoking cessation and reducing alcohol intake can also help to relieve symptoms.

In the case of diseases, treatment should be provided by a doctor, according to their cause.

13. Gingivitis

Gingivitis is an inflammation of the gums caused by the accumulation of plaque or tartar between the teeth and the gums. It can cause symptoms such as a bitter mouth, increased sensitivity of the gums, and bleeding gyms when brushing your teeth or flossing.

How to treat: To treat gingivitis and a bitter taste in the mouth, you should use a soft toothbrush and brush your teeth properly and floss regularly.

In addition, you should see a dentist to assess the health of your mouth and teeth, as untreated gingivitis can develop into periodontitis. This condition can lead to inflammation, infection or destruction of the tissue that supports the tooth, and cause tooth loss.

14. Diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is a complication of diabetes that is characterized by a high level of sugar in the blood with a low level of sugar within the cells. The body tries to compensate this by producing more ketones to ensure there it has enough energy for regular functioning.

Due to a high amount of ketones circulating in the blood, pH levels decrease. This cause symptoms like a bitter taste, bad breath, dry mouth and confusion.

How to treat: Blood sugars should be regularly assessed by diabetics, and levels that are 3 times above normal should be urgently assessed, as this may be a sign of DKA.

Treatment in the hospital includes continuous monitoring and IV insulin to maintain hydration and reduce blood sugar.

15. Burning mouth syndrome

Burning mouth syndrome is a chronic condition caused by constant pain and burning in the oral cavity. It is associated with symptoms like a bitter or metallic taste, dry mouth and reduced saliva.

This syndrome commonly affects menopausal or post-menopausal women, but it may also emerge as a result of other health conditions, such as am infection (fungal, viral or bacterial), salivary gland problem, mouth sores, diabetes, hormonal disorders and nutritional deficiencies.

How to treat: If you suspect burning mouth syndrome, you should consult a doctor for a full evaluation and to identify the underlying cause. If related to another health condition, the burning mouth and bitter taste will usually resolve once the causative illness is corrected.

Treatment for burning mouth syndrome that is unrelated to another health condition is usually aimed at relieving active symptoms. The doctor may prescribe benzodiazepines (like clonazepam), lipoic acid supplements, capsaicin, anticonvulsants or tricyclic antidepressants.

16. Chemotherapy or radiation therapy

Some medications used for chemotherapy can damage taste buds and cause changes to taste. Many chemo patients report a bitter or metallic taste in their mouth.

Radiation therapy used to treat head and neck cancers can also damage taste buds, as these are sensitive to radiation. Other related symptoms include dry mouth, sore mouth, and sore throat, all which can worsen the bitter taste in the mouth.

How to treat: A bitter taste in the mouth generally improves 3 to 4 weeks after the last treatment. However, you can consider measures to prevent worsening, like chewing gum, sucking on hard candy, avoiding canned foods, seasoning foods with natural herbs, keeping your mouth clean and eating food at room temperature.

You can also perform a sodium bicarbonate, salt and water gargle to help improve the taste of food. Mix one teaspoon of salt and one teaspoon of sodium bicarbonate in 4 cups of water.

17. Pine mouth

Pine mouth is a condition that some people may experience after eating pine nuts. It is characterized by a bitter taste in the mouth and discomfort, which can appear 1 to 3 days (and up to 2 weeks) after eating pine nuts. The cause of this condition is unknown.

How to treat: Treatment is not necessary for pine mouth, as the bitter taste usually resolves on its own within a few days.

18. Oral thrush

Oral thrush is a yeast infection in the mouth caused by the excessive growth of Candida albicans fungus. It can cause the appearance of white plaques in the mouth, burning and a bitter taste in the mouth, all which may be a sign of reduced immunity.

How to treat: In cases of oral candidiasis, treatment should be carried out using mouthwash, antifungals, such as nystatin, and thorough oral hygiene. This treatment should be directed by a doctor or dentist.

19. Menopause

During menopause, several hormonal changes occur that cause systemic changes in the woman's body. Some of these changes may lead to symptoms such as hot flashes, mood changes and a bitter taste in the mouth.

How to treat: if menopause is confirmed, the gynecologist may recommend hormone replacement therapy and lifestyle changes to alleviate symptoms and improve the woman's quality of life. Check-out some natural remedies for menopause that can be used to complement your doctor's medical treatment.