Question: I wake up in the morning with a horrible metallic taste in my mouth. My doctor prescribed pantoprazole and an antacid, and it has helped, but only a little. Any suggestions?

Dr. Hibberd's answer:
A metallic taste in the mouth is a form of dysgeusia, an abnormality of the sense of taste. It appears your doctor is treating you for GERD (gastro-esophageal reflux). Sometimes a split dose of pantoprazole will help further, and sometimes a dose adjustment is also helpful until your symptoms settle. There are many possible causes of having a metallic taste in your mouth. The side-effects of certain medications can cause a metallic taste. Sometimes a sinus infection, allergies, dental abscess, poor oral hygiene, or the nausea or acid brash occasionally experienced by those with gastro-esophageal reflux could lead to a metallic taste. Some systemic diseases can cause a metallic taste in the mouth including cancer, hyperparathyroidism, renal failure, diabetes, Sjögren's syndrome, sarcoidosis, amyloidosis, vitamin B-12 deficiency, and zinc deficiency. Sometimes the exact cause is just not determined, in which it is known as idiopathic dysgeusia. If the symptom persists, go back to your doctor for further evaluation, medication adjustments, and possible referral to a gastro-enterologist.