A 55-year-old woman (recently postmenopausal) visited the clinic with an unusual presentation.
For about two to three years, she had been suffering from an intermittent burning and tingling sensation in her mouth. She had been to her doctor who had suggested medication, but she was wondering if there was any alternative. On investigation, she had no obvious mouth changes.
This condition appears to affect women more than men, affecting 20–30 per cent of menopausal women, in particular, in varying degrees of severity. According to research, it can last several years and there are no obvious causes in many cases (although thyroid conditions, autoimmune disease and pharmaceuticals can be implicated in some cases).
On questioning her further, she was not taking any pharmaceutical treatments as she generally tried to avoid these (there are some drugs that can cause this condition). She also complained of a very dry mouth, was always thirsty, couldn’t taste her food like she used to (can indicate a zinc deficiency) and was left with an unpleasant metallic taste in her mouth after eating and after cleaning her teeth. She had her own teeth (no dentures) but had some digestive problems (mainly reflux and heartburn), possibly related to food allergies or intolerances. The burning mouth sensation was intermittent but appeared to be getting worse and she was experiencing the symptoms more frequently. Her energy was very low.
Several blood tests were recommended from her GP, including a full blood count (FBC), iron stores, homocysteine, vitamin B12 and folic acid, vitamin D, zinc, copper and ceruloplasmin (for zinc: copper balance), thyroid function t