Metallic Taste in the Mouth During Pregnancy: Main Causes & How to Relieve

Created by: Jillian Kinton-Vieira Registered Nurse
Key points
  • Metallic taste in the mouth during pregnancy is often most noticeable in the first trimester and is commonly tied to normal hormone shifts; small fixes like sugar-free gum, lemon, and brushing more often may help.
  • It can also be triggered by reflux, gingivitis, certain medications, infections, liver disease, or poorly controlled diabetes, so persistent symptoms are worth discussing with an OB/GYN or midwife.
  • Seek medical care right away if metallic taste comes with signs of diabetic ketoacidosis (fruity/“rotten apple” breath, severe thirst, confusion, extreme weakness) or severe symptoms like trouble breathing, high fever, or chest/upper abdominal pain.

A metallic taste in the mouth during pregnancy is most often caused by normal hormone shifts, especially changes in estrogen, which can affect how things taste. In some cases, it can also be linked to side effects from folic acid supplements.

Other common triggers include gum inflammation (gingivitis), gastroesophageal reflux, and poorly controlled diabetes. Certain medications, liver conditions, and infections like sinusitis or tonsillitis can also cause a bitter or metallic taste.

This metallic taste can sometimes improve with simple steps, such as chewing sugar-free gum or sucking on a lemon popsicle. Still, it’s important to check in with your OB/GYN or midwife to confirm the cause and decide whether any treatment is needed.

nauseated pregnant woman covering her mouth

Main causes

The main causes of a bitter or metallic taste during pregnancy are:

1. Hormonal changes

The most common reason for a metallic taste in the mouth during pregnancy is a shift in hormone levels, especially estrogen. Because taste and smell are closely connected, changes in one can affect the other.

This symptom is very common during the 1st trimester. It often improves as pregnancy progresses.

How to relieve: Hormonal changes are a normal part of pregnancy and usually aren’t cause for concern. To help lessen a metallic taste in your mouth, try sucking on a lemon popsicle, eating saltine crackers during the day, drinking citrus juices, and brushing your teeth more frequently.

2. Gingivitis

Gingivitis is inflammation of the gums that can happen during pregnancy due to hormone changes and increased blood volume. It may cause a metallic taste, gum tenderness, and bleeding when brushing or flossing.

How to relieve: Use a soft-bristled toothbrush and keep brushing and flossing regularly.

It’s also a good idea to see a dentist to check your teeth and gum health. Untreated gingivitis can progress to periodontitis, which can lead to inflammation, infection, or damage to the tissues that support the teeth and may be linked to complications like preterm birth.

3. Folic acid supplements

Folic acid in pregnancy is recommended to help lower the risk of certain birth defects. According to the CDC, getting 400 micrograms (mcg) of folic acid daily can help prevent neural tube defects (NTDs). Examples include spina bifida, myelomeningocele, anencephaly, and cleft palate.

However, some people may notice a metallic taste in the mouth as a side effect of folic acid supplementation.

How to relieve: Chewing gum or sucking on hard candy (preferably sugar-free) can help, and citrus fruit juice may also make the taste less noticeable.

Do not stop taking folic acid unless your OB/GYN or midwife tells you to. Keep taking it as prescribed and continue regular prenatal visits.

4. Gastroesophageal reflux

Gastroesophageal reflux is more likely to show up after about the 24th week of pregnancy. As the uterus grows, it can push the stomach upward, making it easier for stomach acid to move up into the esophagus and cause a metallic taste in the mouth.

Other reflux symptoms can include stomach pain, heartburn, a burning feeling in the stomach, excess gas, and sometimes throat itching or a scratchy throat.

How to relieve: Eat smaller portions more often (about every 2 to 3 hours), avoid fried foods and spicy or heavily seasoned foods, and avoid large meals.

In some cases, your OB provider may recommend antacids, such as milk of magnesia. Only use medications during pregnancy if your provider recommends them.

5. Medications

Some medications, such as certain antibiotics, gout medications, or heart medications, can cause a bitter or metallic taste during pregnancy. This can happen because the medication is absorbed into the bloodstream and can be released into saliva, changing your sense of taste.

How to relieve: Do not stop any medications without talking to your OB provider. The bitter or metallic taste often fades within minutes after taking the medicine, but if it’s constant, your OB/GYN or midwife can reassess and may switch you to an alternative that doesn’t cause this side effect.

6. Poorly controlled diabetes

Poorly controlled diabetes can cause a metallic taste in the mouth or breath that smells similar to rotten apples. This can happen due to diabetic ketoacidosis.

Other symptoms can include intense thirst and dry mouth, severe tiredness and weakness, or mental confusion.

According to the CDC, high blood sugar during pregnancy increases the risk of pregnancy complications, including preterm birth. Uncontrolled diabetes during pregnancy can affect fetal development and raise the risk of miscarriage, preeclampsia, eclampsia, or preterm birth. 

How to relieve: Follow your OB provider's treatment plan to control blood sugar and help prevent diabetic ketoacidosis. If symptoms suggest ketoacidosis, go to the hospital or emergency room right away to avoid complications.

7. Liver disease

Some liver conditions, such as hepatitis, cirrhosis, or fatty liver disease, can cause a bitter or metallic taste in the mouth that some people describe as fish- or onion-like. This can be related to higher levels of ammonia in the blood, which the liver normally converts into urea so it can be removed in urine.

How to relieve: Liver problems often cause additional symptoms, such as nausea or ongoing, unexplained fatigue. If your provider suspects liver disease, they’ll likely consult a hepatologist (liver specialist) to order blood tests, confirm the diagnosis, and begin treatment if necessary.

8. Infections

Some bacterial infections, such as tonsillitis or sinusitis, can cause a metallic taste due to substances produced by bacteria or from pus in the throat or sinuses. Viral infections like the flu or a common cold can also leave a metallic taste in the mouth.

How to relieve: Gargling with warm salt water can help clear pus from the throat in bacterial infections. Nasal rinses with saline solution can help thin and remove nasal mucus and may be helpful for sinusitis, the flu, and colds.

In all cases, it’s important to talk with your OB/GYN or midwife, who may prescribe antibiotics for a bacterial infection depending on the type of infection.

Update History
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References
  • Centers for Disease Control and Prevention. Folic Acid and Neural Tube Defects Resources. Centers for Disease Control and Prevention. Updated 23 May 2025. Accessed 13 Feb 2026 https://www.cdc.gov/folic-acid/communication-resources/index.html
  • Centers for Disease Control and Prevention. Diabetes During Pregnancy. Centers for Disease Control and Prevention. Updated 15 May 2024. Accessed 13 Feb 2026 https://www.cdc.gov/maternal-infant-health/pregnancy-diabetes/index.html
  • United States Preventive Services Task Force. Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication. United States Preventive Services Task Force. Updated 01 Aug 2023. Accessed 13 Feb 2026 https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/folic-acid-for-the-prevention-of-neural-tube-defects-preventive-medication
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