Why do I have a Metallic Taste in my Mouth during Strenuous Exercise?

389629_3393061061506_1618359499_nYesterday I had a nice run with a couple of friends of mine.  Actually, calling it a nice run is somewhat misleading since the run was both completely horrible and awesome at the same time.  I guess that averages out to nice right.

My friends and I went out and ran the Badger Mountain trails in Richland, WA starting from Trailhead Park up to the top then down the Skyline Trail to the parking lot off of N. Dallas Road before turning around and doing it in reverse.

The Badger Mountain trails are not extremely steep but if you are not used to running hills they can certainly put you in a position to overexert yourself.

Yesterday when we ran Badger I think it had been like 6 months since that last time I purposefully ran hills of any kind.  I probably should have spent more time on Badger this year than I have and perhaps the Boston Marathon’s Newton hills might not have kicked my butt as bad as they did.

Anyway, one of the guys I ran with obviously had done more hill training and took off like a rabbit up the side of the mountain headed to the top.  I tucked in behind but I tell you what, it was a rough 1.75 miles to the top.  There was some major league sucking wind going on from my end.

When we all three made it to the top I swear my heart was going to burst out of my chest and flop around on the ground before expiring.  The interesting thing was it totally tasted like I had been sucking on the bumper of a Buick or something because I had a metallic taste in my mouth as I stood in the breeze catching my breath.

Have you ever had that experience before where you have a metallic taste in your mouth after a strenuous run?  I know I have at times in the past when I was not in good of shape and tried to do too much.  I was curious what that was all about so I decided to do a little research yesterday.

I asked a couple of people I knew if they had ever “tasted metal” before during a hard workout.  Some said yes others said no.  Turns out that those who said no often clarified they had “tasted blood” during a hard workout.  Interesting…

I did a little research and you know what it is?  It is actually a mild form of heart failure.  That sounds super scary but it is actually not that uncommon and is really just a sign that you are exerting yourself beyond what you heart was able to keep up with.

How the Heart Works

So how does the human heart work anyway?  We all know that the human heat is nothing more than a pump to keep the blood circulating through the body to keep us going.  It is actually pretty interesting how it works.

Heart_diagram-en.svgHeart_diagram_blood_flow_en.svg

Blood flows through the heart in one direction, from the atria to the ventricles, and out of the great arteries, or the aorta for example.  Blood is prevented from flowing backwards by the tricuspid, bicuspid, aortic, and pulmonary valves.

The heart acts as a double pump.  The function of the right side of the heart is to collect de-oxygenated blood, in the right atrium, from the body (via superior and inferior vena cavae) and pump it, via the right ventricle, into the lungs (pulmonary circulation) so that carbon dioxide can be dropped off and oxygen picked up (gas exchange).  This happens through the process of diffusion.

The left side collects oxygenated blood from the lungs into the left atrium.  From the left atrium the blood moves to the left ventricle which pumps it out to the body (via the aorta) to bring oxygen to the body.

Heart Underperformance

Typically when you are resting or exercising you are at an equilibrium in that your heart is normally pumping out exactly as  much as it is pumping in.  This system usually runs very smoothly, resulting in the proper flow of blood.  Nonetheless, if one element of the pump is not performing at full capacity, fluid can accumulate in unwanted places.  If your left ventricle is not able to pump blood out of the heart to the body at the rate the right ventricle pumps it into the lungs, fluid accumulation in the lungs can result.  This is sometimes referred to as a pulmonary edema.

So Why Do I Taste Metal?

Our red blood cells contain hemoglobin, a highly efficient molecule whose purpose is to collect and transport oxygen.  Hemoglobin is carried around in groups connected by a central iron ion (Fe).

When you are overexerting yourself, fluid can accumulate in the lungs where some of the excess red blood cells can accumulate in and be transported to the mouth via phlegm (nasty I know…).  Our tongues carry receptors that respond to iron (Fe) by sending a signal to our brains that we sense as a “metallic taste.”  Whether you taste blood or “metal” it is basically the same mechanism at play.

This Sounds Bad – Is it?

In short, you have a metallic taste in your mouth during strenuous exercise because your heart is unable to keep up with the physical demands you are placing on it.  Is this a sign of really bad things?  Not necessarily.  Particularly is there are no other symptoms of concern.

Our bodies are capable of dealing with this mild form of cardiac underperformance.  You will typically experience relief from the symptoms when you stop exercising and resting for a bit.  By resting a bit you are decreasing the demand on the system and the left ventricle is able to catch up to the demands of the right ventricle.  The fluid is thereby cleared out and red blood cells are no longer accumulating in the lungs.

According to the experts, actual heart failure produces additional symptoms including shortness of breath.  This is accounted for by an even more extreme accumulation of fluid in the lungs than is expected during strenuous exercise.  One could also expect persistent coughing or wheezing, buildup of excess fluids in body tissues (i.e., swelling of feet, ankles, legs, etc.), fatigue, nausea, confusion, impaired thinking and increased heart rate.

If you do not have these sort of symptoms, you probably just over did it a bit on your run so the next time you try to chase someone up the side of a mountain, well just let them go…

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Comments

  1. Over the years, I experienced this phenomenon on numerous occasions. In all instances, it happened when my fitness level was in question and I’d over exerted myself. Cold air temps also seemed to precipitate the event.

    • Stephen Mazurkiewicz says:

      I just experienced again recently myself when I was doing hill interval repeats. I have to admit that can second your observation that cold weather certainly does not help and well when I have experienced that metallic taste in my mouth it has been when my fitness did not match the load I was putting on my body. I have also noticed that when I jump straight into strenuous exercise with little to no warm up it is pretty much a guarantee. Here is to continue happy, smart running for both of us!

  2. Lauren Nielsen says:

    Thank you for posting this. I’ve had this issue since childhood. We used to run the 600 (I assume 600 meters) during our physical fitness tests. I always came in last and had the taste of blood in my mouth and coughed for about 45 minutes. It still happens if I try to run. I wonder if it is related to my Mitral Valve Prolapse.

    • Stephen Mazurkiewicz says:

      That is a great question Lauren. I am sorry that you have to deal with mitral valve prolapse and while I am not a doctor I can certainly see the logic behind a correlation there. I hate that you have adverse experiences when you run. I hope that you are able to still get out there and be active within the constraints you have.

    • Chris says:

      Lauren,

      I know this is really late, but I hope you see this somehow:

      http://www.hindawi.com/journals/pm/2011/361931/

      It is a medical study that mentions the link between mitral valve prolapse & exercise-induced pulmonary edema.

      “In a single case report, an apparently healthy man developed pulmonary edema after exercise [16]. Interestingly, a clinical examination revealed mitral valve prolapsed, and the authors suggest that this structural abnormality likely contributed to the edema formation. There may be a role for unrecognized valve dysfunction in other cases. Indeed, in patients with left ventricular systolic dysfunction, mitral valve dysfunction is associated with increased pulmonary vascular pressure, capillary barrier disruption, and exercise-induced pulmonary edema [17].”

      Best of luck!

  3. Hannah Craven says:

    This was so helpful to me. I am 17 years old and have ran two half marathons and ran cross country and track for the past three years. This blood taste happens to me usually when I’m out of season. I ran today for the first time during my holiday break and it happened. Thank you so much because it had honestly scared me.

  4. Andrea says:

    While I’m a very active person and eat well, I am 24 years old, and the alarming thing is that my mother passed away from congestive heart failure at 43 years old, just 2 years ago. We were/are very both stressed individuals and I’m sure her smoking contributed to her death too.

    I just don’t want this to be any more serious than it already looks to me.

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  6. San says:

    Thank you so much for this: I regularly have this happen when I run outside. Being an athlete and having played sports all my life, I wonder though if it only relates to your level of fitness, because the mysterious thing for me is: I don’t have any symptoms like this when I run indoors (on the treadmill) and have much longer stamina.
    Have you ever heard of this?

  7. Julia says:

    Thanks for the post! I’ve always had trouble with cardio workouts. I can push myself to do them, but the consequences usually suck. Depending on workout intensity I’ll start wheezing, build up phlegm in my throat, taste that metallic taste and become nauseous. I’ve been told most of this is because I’m not breathing enough/deep enough. My fingers and toes are always cold and sometimes i’ll experience heart palpitations or random high blood pressure (especially if I drink caffeine.. *shudder*).
    Yes, I’ve seen a cardiologist and got a heart ultrasound, tilt table test and some other test but they couldn’t find anything. All the women on my mom’s side have experienced this (acutely during the teen years). I’m 17 now and seem to be continuing the tradition.. My mom thinks we have something called POTS (Postural Orthostatic Tachycardia Symptoms). Postural Orthostatic Tachycardia Symptoms. Apparently it’s extremely hard to diagnose though, but that might explain why my first heart tests came back negative.
    Any advice?

  8. James says:

    Nice post. I just got back from a run after being out of training and I’d thought I’d look up the mechanism for the blood in mouth taste.
    Thing is- I’m a cardiologist. Whilst I admire your thought process I don’t think you are quite correct. Yes when you are pushing hard your heart is at its maximum capacity. BUT you’d have to work pretty hard and likely have a structural abnormality such as mitral valve prolapse, to get pulmonary oedema. When I see that it my patients they have pink, frothy sputum.
    So what are you describing? My explanation is simply that with max cardiac output the BP is elevated and there is maximum vasodilatation to help with heat dissipation. In the mouth, the small capillaries dilate up and you can taste blood but there isn’t actually any bleeding. It’s a similar mechanism where some people night get nose bleeds if they have fragile capillaries whilst exercising.
    Time for a glass of water.

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