Monday, April 7, 2014

Pine Nut Syndrome / Pine Mouth - Facts, Remedy and Cure

What is Pine Nut Syndrome (PNS) or Pine Mouth
Pine nuts can cause taste disturbances, lasting from a few days to a few weeks after consumption. A bitter, metallic taste is described. Though unpleasant, there are no known lasting effects, with the FDA reporting that there are "no apparent adverse clinical side effects."[1] This phenomenon was first described in a scientific paper in 2001.[2] Publications have made reference to this phenomenon as "pine nut syndrome" or as "pine mouth".[3] The NestlĂ© Research Centre has hypothesized that nuts from a particular species of pine occurring mostly in China, Pinus armandii, is the cause of the problem. The suspect species of pine nuts are smaller, duller, and more rounded than typical pine nuts.[4] 


  1. [1] "Pine Mouth" and Consumption of Pine Nuts
  2. Jump up[2] ^ Mostin, M. (2001). "Taste disturbances after pine nut ingestion". European Journal of Emergency Medicine 8: 76.doi:10.1097/00063110-200103000-00036.
  3.  [3] Christopher Middleton (May 2009). "Pine mouth puzzle: Why do these nuts leave you with a bitter taste?"Daily Mail. Retrieved 2009-09-01.
  4. Jump up[4] ^ "The Great Pine Nut Mystery".


Other PNS references

  • R. Hampton1, C. Scully1 & S. Ellison1    Pine mouth British Dental Journal 210, 151 (2011)   Published online: 26 February 2011 | doi:10.1038/sj.bdj.2011.102 
    • http://www.nature.com/bdj/journal/v210/n4/full/sj.bdj.2011.102.html
  • Pine nuts and pine mouth   Emerging issues paper June 2012  Prepared by the NSW Food Authority on  behalf of the Coordinated Food Survey Plan
    • http://www.foodauthority.nsw.gov.au/_Documents/science/pine_nuts_pine_mouth_emerging_issues.pdf
  • 'Pine mouth syndrome' leaves a bitter taste.  http://bodyodd.nbcnews.com/_news/2010/06/03/4452626-pine-mouth-syndrome-leaves-a-bitter-taste


First reported case of pine mouth
The first documented case of pine mouth in the scientific literature dates back to 2001 when
Mostin (2001) published an article in the European Journal of Emergency Medicine. He noted
that a colleague at the Poisons Centre in Brussels had experienced several episodes of taste
disturbance a few days after consuming pine nuts. The phenomenon was described as a
bitter, metallic taste disturbance usually lasting a few days. Since that time, this taste
disturbance has become referred to as ‘pine mouth’ or ‘pine nut syndrome’, however
medically it is known as dysgeusia, metallogeusia or cacogeusia (Zonneveld, 2011).

Symptoms
Accounts from sufferers of pine mouth indicate there is nothing at the time of consumption to suggest a difference with the pine nuts, they do not taste any different to ‘normal’ pine nuts. However, between 1 to 3 days after consuming the pine nuts the symptoms of the taste disturbance become evident and are usually described as a bitter or metallic taste which is exacerbated by the consumption of food and drink. The symptoms can last from a few days to up 2 weeks, although there are several anecdotal reports of symptoms lasting longer (up to 6-9 weeks) (Hampton, 2011; Tan, 2011). Prolonged duration of symptoms may possibly be due to ongoing consumption of pine nuts, with people not realising the cause of the taste disturbance.
While pine nuts are potentially allergenic, for all of the reported cases of pine mouth, the
taste disturbance is not due to an allergy, and symptoms are self-limiting with no long-term adverse health effects observed (Ballin, 2012). As such, while pine mouth is not considered a food safety issue in the traditional sense, reports from consumers suggest that the taste disturbance is quite pronounced, significantly decreasing appetite and enjoyment of food and causing considerable discomfort to the sufferer. There are also anecdotal reports of sufferers undergoing unnecessary medical scans (e.g. MRI scans and endoscopy) or being prescribed medication (eg antibiotics) because there is insufficient knowledge of the condition among the population and the medical profession to realise the cause (Tan, 2011). The degree of susceptibility to pine mouth appears to vary among people, as there are reports that consumers who eat pine nuts from the same batch may or may not experience the taste disturbance. Flesch (2011) and Ballin (2012) reported that females may be more frequently affected by pine mouth than males. Zonneveld (2011) found that it was necessary to consume at least six nuts (seeds) to bring on the bitter aftertaste, while Tan (2011) found that 2-3 seeds were enough to bring on symptoms. Ballin (2012) fed 6-8 pine nuts to volunteers and found that four out of six people developed classical symptoms. The severity of the symptoms may be dependent on the sensitivity of the person and the amount of pine  nuts consumed. Roasting pine nuts, or processing as in pesto, does not appear to make a difference and may still trigger the symptoms. Tan (2011) found that approximately 35% of cases also experienced other non-taste symptoms such as headache, throat and stomach discomfort, nausea and bowel disturbance.


Remedy / Cure for Pine Nut Syndrome or Pine Mouth
Cure for Pine Nut Syndrome 
Remedy for Pine Mouth
Treatment for Pine Nut Syndrome, Pine Mouth
Dr. Wang has researched this after he experienced PNS himself in 2014 and identified that the bitter after-taste is most likely due to some modified form of the fatty acid from affected pine nuts being deposit to the plaque on the tongue itself.   Thus when one eats or drinks, it activates the receptors, thus subjected them to over sensitization to such bitter-taste-causing chemicals. 
He identified that the bitter taste is most dominant in the back of the tongue, where there is the most plaque build-up. One would think the plaque and whatever in the plaque will be dislodged readily when one eats and drink, but in fact a dentist or good oral hygienist will tell you that tongue plaque is not readily removed without some manual effort.  
Dr. Wang recommends the use of a long and small spoon (e.g. those for ice-tea), or use the finger nail on your index or middle finger or a tooth brush or tooth brush fitted with a plaque removing ribbed rubber part. You would need to be patient - and while extending your tongue out  (flat) as much as possible, try to remove the plaque a bit at a time, and do it gently enough to avoid injuring your tongue or having a gag reflex.  You need to focus on the back of the tongue where you can see or feel the white plaque build- p and remove it a bit at a time and rinse it out with warm water. You need to repeat this till you get the majority of the plaque off. By now, you will notice that the spontaneous bitter taste is mostly gone. Now you can try to eat and drink something; and this time, you will find that the bitter after taste has largely subsided!!
A note of caution, the results might vary for different individuals depending on the severity and level of exposure to pin nut.   But I do believe that it will be effective in most cases in reliving the sensation.   If you tried it, I love to hear from you so I know if it works well for you or not. 
Remedy / cure provided by Kevin Wang, PhD.

Another new remedy for Pine mouth I have just developed is as follows:
(Update 9/25/16)
Buy fresh pineapple (whole, uncut  is best, or freshly cut up). 
Cut them into bite size, rinse them with water a bit, drain and store them in a food container with lid in the fridge.  
Between meals, rinse your mouth with water, then chew a couple of pineapple pieces at a time slowly for at least 60 sec. 
Trying to move the pineapple pieces around the mouth with your tongue as you chew them. You can then swallow them (or spit them out).   
Repeat that five- six time per session.  You can repeat this twice a day or daily - 
Try this routine for 5 days to a week. 
The principle behind this remedy is that pineapple has a enzyme - a protease that digests the protein receptors on the taste-buds - the same receptors that the pine nut chemical stuck to. So this way, hopefully the pine nut chemicals will be removed  and you will be symptom-free again!

Let me know if this new remedy works for you.  This will be very helpful to others.

Pine Mouth Remedy /Cure Update provided by Kevin Wang, PhD. on 9/25/2016