Etiology of subjective taste loss

Background Taste complaints are commonly encountered in clinical practice. Although changes in taste function may arise from varied etiologies, numerous other factors may impact patients’ taste perceptions, the most common of which is olfactory dysfunction. Thus, patients with taste complaints may or may not have measurable deficits in taste function. This poses a challenge to providers faced with evaluation of patients with taste disorders, and may delay diagnosis and management. Methods We retrospectively examined records of 1108 patients evaluated at the Virginia Commonwealth University Health System Smell and Taste Clinic and compared patients’ subjective taste complaints with results of objective testing of the senses of taste and smell. Results A total of 358 patients had a subjective taste complaint and results from both gustatory and olfactory function tests. Patients were grouped by subjective complaint as “taste only” (n = 63) or “taste and smell” (n = 295). Of patients reporting a “taste‐only” complaint, 25.4% had abnormal gustatory function, whereas 44.4% had abnormal olfactory function. For those reporting taste‐and‐smell complaints, only 9.5% had abnormal gustatory function, whereas 86.8% had abnormal olfactory function. Conclusion This study supports the hypothesis that patients who present with a taste complaint are more likely to have an underlying olfactory than gustatory impairment. However, those with a taste‐only complaint are more likely to have objective gustatory deficits than those with a taste‐and‐smell complaint. These findings may prove useful to healthcare providers who evaluate patients presenting with complaints of taste loss.