Can your tongue reveal a vitamin deficiency? All your tongue questions answered

Healthylife Pharmacy14 August 2018|3 min read

The appearance of your tongue can say a lot about your current health. Next time you’re looking in the mirror, stick out your tongue and have a close look. A healthy tongue should be pink and covered with tiny, pinkish-white bumps (papillae), which are short, fine, hairlike projections. Any deviation from this appearance may be cause for concern, and you should talk to your healthcare professional.

Common tongue signs

Healthcare professionals often use the tongue as part of a physical examination when taking a client’s medical history. Here’s a list of the most common tongue signs and what they mean.

Does a white tongue mean anything?

A white tongue may be the result of an overgrowth and swelling of the papillae on the surface of your tongue. The appearance of a white coating can be caused by debris, bacteria and dead cells getting stuck between the enlarged papillae.

Conditions that may be associated with a white coating or spots on the tongue include:

Oral thrush – if your tongue has a white coating, this may be a sign of a yeast infection such as oral thrush. It appears as white patches that are often the consistency of cottage cheese. This infection is commonly seen in the elderly, infants, denture wearers or in people with weakened immune systems. It may also be  a side-effect of antibiotics or inhaled steroids for asthma.

Leukoplakia is a condition where the cells in the mouth grow excessively, leading to white patches on the tongue and inside the mouth. Smoking is the most common cause, but other irritants may result in this condition as well.

Oral lichen planus – a chronic inflammatory condition that affects the mucous membranes in your mouth and tongue. Oral lichen planus often appears as white, lacy patches, red swollen tissues or open sores.

Black hairy tongue

Black hairy tongue is a temporary, harmless oral condition that gives the tongue a dark, furry look. It usually starts as a yellow coating, which then darkens over time. The distinct appearance usually results from an accumulation of dead skin cells on the many tiny papillae on the surface of the tongue. These papillae are longer than normal which easily trap bacteria, yeast, tobacco, food or other substances and become stained.

Although a black hairy tongue may look alarming, typically, it doesn't cause any health problems. Eliminating possible causes or contributing factors and practising good oral hygiene usually resolves black hairy tongue. If you are concerned, see a healthcare professional. 

If your tongue is red

A red tongue could be a sign of:

  • Vitamin deficiency: a lack of iron, folic acid and B12 may cause your tongue to have a reddish, shiny and swollen appearance (glossitis).
  • Geographic tongue: an inflammatory but harmless condition affecting the tongue's surface. It results in lesions that give the tongue a map-like or geographic appearance. The lesioned areas are a result of missing papillae and give a smooth, red appearance, often with slightly raised borders. Although it may cause increased sensitivity to certain foods, it isn’t usually associated with serious health issues.
  • Scarlet fever: If you have a high fever and a red tongue, seek out your healthcare professional. Scarlett fever is an infection that causes the tongue to have a red and bumpy strawberry-like appearance.
  • Kawasaki disease: a condition that may also cause the tongue to have a strawberry-like surface. Kawasaki disease is a serious disorder that is seen in children under the age of five and requires prompt medical assessment. 

Enlarged tongue

Macroglossia is the medical term for an enlarged tongue. It commonly leads to a scalloped tongue around the edges as the tongue pushes against the teeth, causing indentations. Macroglossia and tongue scalloping is a non-specific sign which may be associated with a variety of infiltrative or inflammatory conditions like Down syndrome, hypothyroidism, tuberculosis, sarcoidosis, amyloidosis, multiple myeloma, angioedema and certain infections. Tongue scalloping without enlargement may also be seen with obstructive sleep apnoea. While this might all sound alarming, some people may have a scalloped tongue for no known cause.

An acute allergic reaction to foods may result in an enlarged tongue and requires immediate medical attention.

Sore and bumpy

Painful bumps on your tongue may be due to:

Trauma: 

Accidentally biting your tongue or scalding it on something straight out of the oven may result in a sore tongue until the damage heals. Grinding or clenching your teeth may also irritate the sides of your tongue and cause it to become painful.

Smoking: 

Soreness may be a result of cigarette smoke irritating your tongue.

Mouth ulcers: 

Many people develop mouth ulcers on the tongue at one time or another. If they reoccur it could be a sign of nutritional deficiencies, stress or food sensitivities.

Tongue signs summarised

  • How your tongue looks may say something about your health.
  • An enlarged, coated or red tongue may be a sign of infection, underlying disease, nutritional deficiencies or an allergy.
  • Sometimes tongue signs are harmless, but if they are causing problems, you should seek out a healthcare professional for advice.

Related reads:

References:

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  13. Oyetola, E. (2018, December 1). GEOGRAPHIC TONGUE: PATTERN OF PRESENTATION IN a SOUTH WESTERN NIGERIAN TEACHING HOSPITAL. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6580408/#:~:text=Geographic%20tongue%20(GT)%20also%20known,the%20dorsum%20of%20the%20tongue.
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This article is for informational purposes only and does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice. If you have any concerns or questions about your health you should consult with a health professional.