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However, in those patients for whom the cause is only suspected or is unknown, blood tests might be useful (table 1 and table 2).

For such patients, we obtain a complete blood count, sedimentation rate (or C-reactive protein), tests of kidney and liver function, antinuclear antibodies, and a thyroid profile as part of the initial evaluation.

For those with symptoms suggestive of Sjögren's syndrome, detection of antibodies to Ro/SSA and LA/SSB may be helpful in identifying the cause.

Measurement of lead, arsenic, and other heavy metal concentrations may be warranted in selected patients with dysgeusia, depending upon risk factors for exposure (eg, occupation, region of residence, well water use).

For patients with glossitis or other features of B12 deficiency, a vitamin B12 level should be checked.

Zinc levels should be measured in patients with suspected malnutrition.