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Metallic Taste When I Cough: Why Do I Taste Blood When I Cough?

Dr. Michelle Frank

|

May 3, 2023
CoughPro is not a medical product. It is a wellness app intended only for users to obtain a better understanding of their cough. It is not intended to diagnose, monitor, or treat any illness.

We at Hyfe, Inc., are a company devoted to working on tools to better understand the importance of cough. It is Hyfe’s intention in the future to seek regulatory approval for medical products that analyze cough in order that they may be used to diagnose, monitor, and facilitate better treatment of respiratory illnesses.

A woman coughing in a tissue

Tasting blood when you cough can certainly be alarming. If this is noticed while you have a respiratory infection it is possible to link it to a likely culprit. However, among chronic coughers having the metallic taste during a coughing bout can indicate severe underlying respiratory consequences.

This article will explore these causes and also guide you through possible treatments which can help in dealing with the metallic taste when you cough.

What Causes Metallic Taste While Coughing?

Respiratory Infection

One of the first likely suspects of the metallic taste while coughing is an underlying infection. You may taste blood when you have a respiratory infection because of irritation and inflammation in your pulmonary system leading to minute amounts of blood leaking into your mucus from damaged tissue. 

In addition to coughing, with an infection you will observe symptoms such as high fever, runny nose, shortness of breath, and chest discomfort. An infection can be seated anywhere along the respiratory tract, in the sinuses, respiratory pathways, or even deep in the lungs. Sometimes these alterations in taste along with a cough can be noted after significant progress of the infection. In some cases, such as those observed with COVID-19, changes in taste can be noted before or along with symptoms such as a cough((Melley, L. E., Bress, E., & Polan, E. (2020). Hypogeusia as the initial presenting symptom of COVID-19. BMJ case reports, 13(5), e236080. https://doi.org/10.1136/bcr-2020-236080)).

Gastroesophageal Reflux Disease

While it can seem unlikely, your gastrointestinal tract can be a cause for the metallic taste while you cough. GERD has been linked to approximately 10–59% of cases of chronic cough((Wu, J., Ma, Y., & Chen, Y. (2022). GERD-related chronic cough: Possible mechanism, diagnosis, and treatment. Frontiers in physiology, 13, 1005404. https://doi.org/10.3389/fphys.2022.1005404)). Frequent reflux of stomach acid can cause a lingering metallic aftertaste, due to it damaging the throat lining. This taste can be present with or without the presence of a cough. Signs such as stomach pain, bloating, and heartburn can be initial signs of underlying GERD.

Pregnancy

Pregnancy can result in a lot of changes in the body, which can cause quite a few discomforts for its nine months. A metallic taste in the mouth and coughing can be some of those present either together or as isolated incidents during pregnancy. 

During the first trimester, frequent nausea and vomiting could be reasons for tasting blood while you cough. Later in pregnancy, hormones and a growing pregnancy bump can bring back feelings of discomfort. Since taste is subjective, studies cannot test objective changes in taste during pregnancy. However, both physiological changes in tastebuds and evidence of signs such as increased GERD or lowered immunity((Choo, E., & Dando, R. (2017). The Impact of Pregnancy on Taste Function. Chemical senses, 42(4), 279–286. https://doi.org/10.1093/chemse/bjx005)) have been linked to alterations in taste. 

Young pregnant woman coughing with tissues in hand

Situations That Provoke a Sudden Onset of Respiratory Symptoms 

Asthma, anaphylaxis, and even exercise alone((Gotshall, R. W. (2002). Exercise-Induced Bronchoconstriction. Drugs, 62(12), 1725–1739). https://doi.org/10.2165/00003495-200262120-00003)) can cause the narrowing of the respiratory pathways leading to wheezing, chest tightness, and coughing. The onset of symptoms is immediately following exposure. Sometimes a metallic taste can be present either before the coughing starts or during the bout of coughing. In rare cases, prolonged exposure to intense exercise can present with coughing with a metallic taste. This has been observed to be due to underlying exercise-induced pulmonary edema, a situation where fluid accumulates in the lungs((Aoun, J., Dgayli, K., Abou Zeid, C., Wong, G., & LaCamera, P. (2019). Pulmonary edema during the Boston Marathon. Respiratory medicine case reports 27, 100845. https://doi.org/10.1016/j.rmcr.2019.100845 )).

Medications or Treatments You Are Taking

Some medications can leave a metallic taste in your mouth right after you take them or after taking them over a persistent duration. Coughing can also be noted either due to the illness being treated or side effects of the medication. Lithium, allopurinol, ACE inhibitors such as captopril, antibiotics, and metformin are possible causes for this change in taste when you cough. For cancer patients, both the disease as well as its therapies such as radiation therapy or chemotherapy can cause changes in taste((Murtaza, B., Hichami, A., Khan, A. S., Ghiringhelli, F., & Khan, N. A. (2017). Alteration in Taste Perception in Cancer: Causes and Strategies of Treatment. Frontiers in physiology, 8, 134. https://doi.org/10.3389/fphys.2017.00134)) along with other effects such as a cough, loss of weight, and changes in appetite.

Should I Be Worried If I Taste Blood When I Cough?

It is reassuring to know that not all conditions which result in tasting blood while you cough require immediate medical attention. For one, a common cold respiratory infection usually runs its course in a week or so with plenty of rest and fluids. Often it is the onset of more alarming symptoms along with a metallic-tasting cough that requires medical attention. A few signs to look out for include:

  • Having a high, unrelenting fever
  • Persistent chest discomfort
  • Trouble with breathing
  • Wheezing
  • Coughing up blood
  • Unexplained loss of weight

A lot of these signs can indicate more serious health issues, such as bronchitis, tuberculosis, or lung cancer. Having symptoms such as coughing up blood, chest pain or wheezing requires immediate medical assistance, especially to rule out serious consequences of asthma, pulmonary embolism, or even a heart attack.

However, having a metallic taste with a chronic cough lasting longer than eight weeks, could also be a lingering indication of a previous infection, medications you have been taking, or GERD. While these are not medical emergencies, they do require checking in with your primary care physician to find out the root cause and manage it accordingly.

For health conditions such as lung cancer, chronic obstructive pulmonary disease, pulmonary edema, or chronic bronchitis, your doctor will work out a treatment plan with you to be able to decipher the best course of action to manage your symptoms.

Treatment For Metallic Taste While Coughing

Treating a metallic-tasting cough can be done by seeking out and fixing the possible causes for it.

Often, when a cold or an attack of asthma subsides, the lingering metallic taste also goes away along with the cough. For allergic coughs or symptoms of the common cold, nasal decongestants, fever-reducers such as acetaminophen (brand names include Tylenol, Bromo Seltzer, and Actamin), and cough medicines can be used. Most of these medications are available over the counter and help with symptom management. In cases of severe asthma symptoms or anaphylaxis, checking into the emergency room for life-saving treatment can help reduce symptoms.

Antibiotics

Antibiotics can be considered for bacterial respiratory infections resulting in a cough. Once the bacterial infection is treated, the cough should subside and with it the metallic taste. However, antibiotics only help in the cases of bacterial infection and not fungal or viral, and won’t relieve asthma symptoms.

A doctor holding a bottle of antibiotics

Proton Pump Inhibitors and Lifestyle Changes

Proton pump inhibitors and lifestyle changes are cornerstone management options for GERD((Kröner, P. T., Cortés, P., & Lukens, F. J. (2021). The Medical Management of Gastroesophageal Reflux Disease: A Narrative Review. Journal of Primary Care & Community Health, 12, 21501327211046736. https://doi.org/10.1177/21501327211046736)). Along with chest discomfort, the taste of blood when you cough will also subside, as the continuous reflux of stomach acid reduces. Similarly, in pregnancy, adopting routine lifestyle changes such as having smaller meals, adding pillows for a more upright position while sleeping, and increasing daily activity, can help reduce gastric reflux as well as the metallic taste coupled with your nagging cough.

Antitussives

Managing the cough with antitussives, while treating the underlying cause or while the underlying cause is being investigated, can be one avenue to manage the metallic taste. This is especially useful for the 10% of the global population who suffer from a chronic cough((Arinze, J. T., de Roos, E. W., Karimi, L., Verhamme, K. M. C., Stricker, B. H., & Brusselle, G. G. (2020). Prevalence and incidence of, and risk factors for chronic cough in the adult population: the Rotterdam Study. ERJ Open Research, 6(2), 00300-2019. https://doi.org/10.1183/23120541.00300-2019)). 

Cough Suppression Therapy

A vast majority of people with a chronic cough haver no known cause attributable to their cough. In such cases, physical cough suppression therapy has been found to have benefits to reduce the rate of coughing((Chamberlain Mitchell, S. A., Garrod, R., Clark, L., Douiri, A., Parker, S. M., Ellis, J., Fowler, S. J., Ludlow, S., Hull, J. H., Chung, K. F., Lee, K. K., Bellas, H., Pandyan, A., & Birring, S. S. (2017). Physiotherapy, and speech and language therapy intervention for patients with refractory chronic cough: a multicentre randomized control trial. Thorax, 72(2), 129–136. https://doi.org/10.1136/thoraxjnl-2016-208843)), which can also help assist with the metallic taste associated with frequent coughing. Behavioral cough therapy is also an option.

To Wrap Up

In most instances, tasting blood when you cough will not have any serious underlying consequences. It could occur as a lingering aftertaste of frequent coughing or due to underlying conditions such as GERD. However, if your cough has progressed and now includes a metallic taste, it would be best to check in with a doctor.

This becomes more crucial if you observe the persistence or the appearance of new symptoms such as coughing up blood, a high fever, chest pain or tightness, difficulty breathing, and wheezing. Check into the emergency room for life-saving treatment, especially if you feel it could be asthma or anaphylaxis. 

Tasting blood when you cough can seem alarming. But getting the right treatment for it is the best way to manage it. Never hesitate to check in with a healthcare professional for new symptoms, especially for symptoms that are worsening. Early treatment is the best way to reduce a nagging cough and improve your quality of life.

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