7 Health Conditions That Can Affect Your Tongue

Sure, your tongue helps you chew, swallow, and taste food. But your tongue can also do much more. In fact, your tongue can provide a snapshot of your overall health.

Symptoms of many chronic and acute illnesses can appear on your tongue. Sometimes, tongue changes are some of the first signs that something is amiss. So, what's normal for a tongue? 

"Pinkish-red—not bright red—with bumps and waves," said Sally Cram, DDS, Washington-based dentist and member of the American Association of Periodontology.

So, here's what you need to know about what your tongue might be trying to tell you if you notice any changes to its color or texture.

Tongue Health: What's Normal?

Your tongue may be able to tell you a lot about your overall health. So, what does your tongue normally look like?

A healthy tongue is a pinkish-red color, according to Dr. Cram. A moist layer of tissue, called mucosa, lines the surface of your tongue.

If you stick your tongue out in front of the mirror, you'll also notice small bumps on the back of your tongue, called papillae. Among the papillae are your taste buds, which help you taste the salty, sweet, or sour flavors of your food.

Diabetes

Oral thrush is a fungal infection caused by Candida albicans. Dr. Cram explained that oral thrush looks like a heavy, white coating on your tongue. Some people compare the consistency to that of cottage cheese.

Oral thrush is common among people with diabetes, especially if their blood pressure is not within a healthy range. Also, oral thrush commonly occurs due to a weak immune system. A weak immune system due to diabetes makes it hard for your body to fight off organisms. In those cases, some organisms, like the fungus that causes oral thrush, overgrow.

Typically, you can treat oral thrush with antifungal medicines prescribed by your healthcare provider.

People with diabetes are also more likely to have dry mouths, according to Ryan Kauffman, MD, an otolaryngologist at Northwest ENT and Allergy Center in Marietta, Ga. 

“Most folks with diabetes are somewhat dehydrated,” said Dr. Kauffman. “The tongue can be kind of shriveled up and lose some of its normal appearance.”

If you have diabetes, you may also notice that your tongue is sore or a bad taste in your mouth.

Human Immunodeficiency Virus (HIV)

Oral thrush is also one of the first signs of the human immunodeficiency virus (HIV). Like with diabetes, a weak immune system due to HIV may cause oral thrush.

If you're HIV-positive, you may also notice red sores on your tongue or inside your mouth. Red sores could mean herpes, a viral infection, or canker sores. Canker sores are often painful, but you can treat them with over-the-counter (OTC) medicines. On the other hand, prescription medicines treat herpes.

Hairy-looking growths may appear on the sides of your tongue. Those growths are also called hairy leukoplakia. Hairy leukoplakia normally goes away on its own. But, if the growths are severe or cause pain, your healthcare provider may prescribe medicines to treat them.

Celiac Disease

With celiac disease, gluten triggers the immune system to attack the small intestine. Constipation, diarrhea, bloating, and pain are the hallmark symptoms of celiac disease. But celiac disease can also cause you to lose the little hairs that dot the surface of your tongue.

According to Dr. Cram, atrophic glossitis, also known as "bald tongue" or "smooth tongue," can cause taste changes and be painful. Your healthcare provider may treat atrophic glossitis with intramuscular injections of vitamin B12.

"When you lose [those] hairs, it can be very, very sore," said Dr. Cram. "Anything acidic or spicy or containing alcohol can really burn."

Celiac disease can make your tongue burn or feel dry if your small intestine doesn't properly absorb vitamins and minerals. You may also notice frequent ulcerations on your tongue or other parts of your mouth.

Sjogren’s Syndrome

Sjögren’s syndrome is an autoimmune disease that attacks many parts of the body. It also often affects the salivary glands and the tear ducts. Sjögren’s syndrome may result in dry eyes and mouth, which can lead to oral thrush.

“When you don’t have saliva with its protective enzymes, that fungus living at low levels starts to proliferate,” explained Dr. Cram. 

According to Dr. Cram, the signature white spots of thrush may appear. Or, your tongue may become red and smooth if the little hairs disappear.

Some people with Sjögren’s syndrome also have a burning sensation and cracking of the tongue.

Cancer

Your dentist may be one of the first to detect head, neck, and oral cancers, based on how your tongue looks. 

Your dentist may want to check out any bump or sore on your tongue (or elsewhere in your mouth) that lingers longer than two weeks. Oral cancers typically grow on the base, lateral, and ventral surfaces of the tongue.

Also, leukoplakia is a condition that may produce white patches on your tongue. An uncontrolled growth of cells in your mouth causes those white patches. Leukoplakia can be harmless. But it may also lead to certain types of cancer. So, your healthcare provider may opt to surgically remove the affected area.

According to Dr. Kauffman, human papillomavirus (HPV)-related squamous cell carcinoma may also form on the base portion, especially in children and adolescents.

"Kids [should be] vaccinated because we've seen this huge uptick that's related to HPV," added Dr. Kauffman. 

The Centers for Disease Control and Prevention (CDC) recommends the HPV vaccine for children around 11 or 12. The CDC also recommends for adults up to 26 who did not receive the HPV vaccine during childhood.

Vitamin Deficiencies

Typically, your tongue is pinkish-red in color. If your tongue is bright red, you may have folic acid, vitamin B12, or iron deficiency. You can often correct those vitamin deficiencies with supplements or tweaks to your diet.

But don’t automatically freak out if your tongue blares red in the mirror. It could just as easily be from that strawberry smoothie or some too-hot soup that burned your mouth. 

It's also important to note that vitamin deficiencies aren't simply made by looking at the tongue. Other symptoms of vitamin deficiencies include:

• Changes in mental state
• Skin color changes (like hyperpigmentation)
• Vision impairement

Stress

Not to be confused with cold sores, canker sores can be a sign of stress. Canker sores can appear on your tongue or other parts of your mouth.

Try gargling with warm salt water if you have those small, shallow sores. You can also avoid greasy foods in favor of soft and cold foods, like yogurt. Also, you can ease stress with exercise, yoga, or meditation.

A Quick Review

Your tongue has a lot of useful functions. It helps you taste and eat your food and chitchat with your friends about the latest news. But it also can provide a snapshot of your overall health.

If you notice that your tongue isn't its normal pinkish color or develops thick, cottage-cheese-looking spots or ulcers, consult your healthcare provider.