As the name suggests, this section is devoted to questions that

readers have sent me that I though may interest people

Wine, Pills and Illness (1 November)

I recently received the following email from Glen Green, a qualified winemaker and the creator of the Essential Wine Tasting Guide. As the subject is an interesting one, I decided to follow it though and share the findings and comments with you.

Glen: I was tasting wine with some people today when one of them mentioned their palate wasn't acting normally, because she was pregnant.

This got me to thinking.

I remember you saying a few wines at the dinner we had at the Victory Hotel were 'sour', and yes, the rubbish was rubbish, that's for sure, no argument there. However I didn't agree with some of the verdicts especially the sour one.

Hence, now thinking about it, do you think that having been under the weather for a while and having undergone surgery, this could impact on your palate? I remember once an anesthetist that I flatted with telling me that the anesthetic doesn't completely leave the body for months, and sometimes a couple of years.

This isn't bringing your palate under attack mind you, but I am just really interested in this sort of thing.

Did any of those wines, or wines before and since, taste thin, acidic or especially metallic (sour we know), especially wines that you may be familiar with from before your surgery/illness, and that you have tried since?

TORB: A very valid question mate. There are a huge number of things that can affect one's palate, especially sickness. However, I had that operation months before and was fully recovered, so I doubt that the operation would have any impact. As far as the anesthetic not leaving you for years, I have copied my sister Rosemarie on this e-mail, who is a Professor of Pharmacology to get her input. (Yes, there is a modern-day Professor Einstein.)

What is more likely is that it could have been a combination of the food and wine that caused our differences of opinion in relation to the sour wine. It could have been my palate effected, or it could have been your palate effected.

On that last trip I found a significant number of acidic wine, and I guess yes, I probably am fairly sensitive to a high level of acid in reds, but when done properly don't mind if the acid is a noticeable. If it was only my palate, Brian and John would have quickly told me they disagreed. In most cases, but obviously not all due to palate variation, we agreed.

I struck very few metallic wines on the trip, although some had acid that was tart or stuck out. Once again, in every case Brian and John agreed.

Rosemary: As far as being ill is concerned, my personal memory is of visiting the Capel Vale winery in WA while I was plagued with a horrible viral infection. After one sip of what tasted like kerosene, I gave up tasting!

We would be in serious trouble if drugs of any sort did not leave the body for years! The gaseous anesthetics go very quickly, and it would be highly unlikely for any anesthetic (including the injectable ones), to have any action for longer than 48 hours. Obviously the fact the person had surgery indicates there were other things wrong, and, as you have both agreed, the underlying disease could have all sorts of effects.

Glen: Thanks. That is good news, mind you she was only a student at the time, perhaps trying to scare me.

Sorry to bother you again with what probably seems like nonsense but can I also ask about the plethora of prescription medication that people take nowadays.

Is there any research that has been done, or perhaps recorded instances where the palate has been noticeably affected due to the this? ie: is there a common understanding with nurses that when they give somebody XY drug, don't feed them XZ food because they will hate it.

Rosemarie: There are a number of drugs which are known to affect taste - the most common side effect is that they leave a metallic taste in the mouth. It is also quite common for drugs to have a negative effect on saliva flow - which could no doubt affect the finer points of taste.

So much needs to be done when drugs are being developed and followed up for side effects, I am not sure if anyone has done a study directed to measuring the effects of drugs on taste. I'll check it out over the weekend and get back to you.

…… Well, I started having a look - and was quite overwhelmed. In the medical literature, it is difficult to search for all drugs - much easier if you are naming a particular drug or drug class. However, a general search identified captopril (sold as Capoten, Acenorm etc), the (older) ACE inhibitor which is used for high blood pressure, as a common one which changes taste. Then, other articles say things like:

“Drugs in every major pharmacological category can impair both taste and smell function and do so more commonly than presently appreciated. Impairment usually affects sensory function at a molecular level, causing 2 major behavioral changes--loss of acuity and/or distortion of function (i.e. dysgeusia and dysosmia).”

One of the problems is that taste is quite a difficult thing to measure and, for any drug, there is quite a bit of variability of side effects between patients. So, in answer to your question, there is no doubt that some drugs can affect the palate, but, to my knowledge, no-one takes too much notice of this until the patient complains!

Sorry I could not offer words of great wisdom on the topic!

Readers Comment: From Dr David G More

Saw the stuff on the site..Go to  What are the side effects of ARBs?

ARBs are well-tolerated by most individuals. The most common side effects are cough, elevated potassium levels, low blood pressure, dizziness, headache, drowsiness, diarrhea, abnormal taste sensation (metallic or salty taste), and rash. Compared to ACE inhibitors, cough occurs less often with ARBs. The most serious, but rare, side effects are kidney failure, liver failure, allergic reactions, a decrease in white blood cells, and swelling of tissues (angioedema). ARBs usually are not prescribed for pregnant patients because they may cause birth defects. Individuals with severe kidney problems and those who have had a severe reaction to ARBs probably should avoid them.

This little mother almost got me off the red wine totally.... A different ARB and I am fine and back on it again!  Any therapy can muck up palate in an unpredictable way I fear - most don't.

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