Ask Dr. H: Taste: It's more than the tongue

Question: Can you explain how taste buds work?

Answer: We all have taste buds, the "chemical receptors" that detect the four basic tastes: sweet, salty, bitter, and sour. The reason taste is so subjective is that the sense of taste involves much more than your tongue. Your brain interprets taste and texture through an important interaction between your nose and your mouth.

Try eating an orange with your nose pinched shut. It doesn't have much taste, does it? There are receptors in your nose leading to the brain that start to form an impression of taste even before food enters the mouth. Once the food enters the mouth and you chew it, the aroma of the food is carried from the back of the mouth through the nasal passages to those receptors for additional taste.

Some people have much more sensitivity to what they taste and smell than others. Some people are born with many more taste buds than the rest of us. A genetic "supertaster" may have more than 1,000 taste buds per square centimeter more than a "non-taster," who perceives many foods as tasteless due to having as few as 50 taste buds per square centimeter.

If you examine the surface of your tongue, you'll see many little oval-shaped bumps called "papillae." These are made of up to 200 taste buds in a cluster, with as many as 10,000 taste buds on your tongue! Each taste bud under a microscope looks like an onion with an opening at the top.

From an evolutionary standpoint, a keen sense of taste helps us to identify sources of calories, and to avoid poisonous foods or plants. Bitter plants found in nature often are poisonous. Of course, a keen sense also allows us to experience the immense pleasure of a good meal.

Q: For the first time in five years, I had a gout attack in my foot.My doctor gave me prescriptions for colchicine and indomethacin. When I took the prescriptions to the pharmacy, generic colchicine was no longer available. There was a branded colchicine called Colcrys at $6.50 per pill, so I passed on it. What's going on?

A: Generic colchicine has been around for many years in the United States for the treatment of acute gout. It worked well, even though none of the makers submitted data on safety and efficacy to the Food and Drug Administration.

In 2006, the FDA started the "Unapproved Drugs Initiative," requiring more rigorous testing of colchicine and other unapproved drugs on the market. URL Pharma was the only company that submitted data for a colchicine product. In exchange, the FDA granted the firm market exclusivity on colchicine for three years.

URL Pharma sued to block any competition and raised the price of its drug, called Colcrys, from 9 cents to $6.67 a pill ($199.99 for 30 pills at CVS Pharmacy).

I see this as price gouging and exploitation of the FDA's efforts to ensure drug quality and safety. The same generic colchicine approved for use in Canada sells for just 50 cents a pill.