What Your Tongue Says About Your Health | Western vs. Chinese Medicine

Did you know that your tongue is one of the strongest muscles in your body and that it can tell a lot about your health? According to both Western and Chinese medicines your tongue can indicate deficiencies and diseases. Here is a brief guide to what your tongue can tell you about your health.

What Western Medicine Says About Your Tongue

A normal healthy tongue is pale red/pink with a thin white layer on top and small nodules/bumps covering the upper surface.

A change in tongue colour can indicate disease

  • A thick white coating can indicate an oral yeast infection commonly caused by candida (thrush).
  • A lattice-like white network could indicate a chronic inflammatory disease.
  • Firmly attached white patches could be a symptom of a more severe underlying disease.
  • A bright red tongue could indicate a vitamin B deficiency or rare diseases such as scarlet fever and Kawasaki’s disease.

Bumps that don’t get better or get worse should be checked

Tongues come in all shapes and formats but generally they have a slightly bumpy topography. These bumps are your papillae that make tasting food possible.
  • If you suddenly notice your tongue appears smoother, it can be a sign of a nutrient deficiency and possibly a sign of an underlying condition such as celiac disease.
  • A tongue that has lesions, deep grooves or fissures can also indicate diseases such as psoriasis and Sjörgen’s syndrome, but deep grooves can also just be an age-related change. While these grooves are generally harmless, they are a perfect breeding ground for bacteria – and maintaining good oral hygiene is a must.
  • Sores or mouth ulcers may be painful and red, often located on the edges of your tongue. These bumps are the result of an irritated tongue or perhaps a viral infection. If they do not go away within two weeks it is best to see your dentist or doctor.

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Your lifestyle habits can make your tongue feel funky

The “feel” of your tongue is also an indicator of your health and/or lifestyle, especially since your tongue has many nerve endings. Soreness or a burning feeling can be caused by several factors such as eating too many citrus fruits, certain medication, smoking, or accidentally biting your tongue. If you cannot figure out what the cause of the soreness is or the feeling persists, it is advised to see your doctor or dentist to get to the root of the problem.

Your tongue can also stain and become blue or black in color due to the food or supplements you ate or took.

What Traditional Chinese Medicine Says About Your Tongue

The holistic philosophy of Traditional Chinese Medicine (TCM) sees the whole body as an interconnected energetic system in which proper flow of energy or qi (氣), brings harmony to the body (health). However, when the flow of qi is disrupted, disharmony can occur and can subsequently result in diseases and pain.

There are six pathogenic influences in Chinese Medicine and when these influences exceed the body’s ability to tolerate them, there can be an imbalance in the flow of qi. The six pathogenic influences are: cold (寒), heat (火), dampness (濕), dryness (燥), summer heat (暑) and wind (風).

We asked Chinese medicine practitioner William Lo from the Hong Kong Atlas Chinese Medicine & Physiotherapy Centre (Acupuncture) to give us the lowdown on TCM tongue examination.

How important is the tongue to a TCM practitioner when treating a patient?

Tongue examination is very important to TCM practitioners. We start by asking what the problem is and patients give us subjective information regarding their symptoms. With this information, a potential diagnosis can be confirmed with an objective (physical) examination including inspecting the patient’s tongue.

Tongue examination is usually divided into two parts. We start by examining the quality of the tongue in order to understand the patient’s body state. For example, the color and size of the tongue can indicate the level of qi and xue (血), the latter relating to blood perfusion levels. After establishing the body’s constitution we inspect the quality of the tongue’s coating which is believed to be related to stomach conditions and excessive dampness within the body.

In short, the tongue can reflect the body’s constitution and elucidate the nature/cause of the symptoms in relation to the six pathogenic influences.

What are some examples of what the appearance of the tongue can indicate in TCM?

A good balance of qi and xue is reflected in a normal healthy tongue that is pale red/pink, of normal size and a thin tongue coating.

An enlarged tongue can be recognized by several factors, including teeth marks on the side. From a TCM perspective, this condition indicates a weak functioning of the stomach and spleen.

A white-yellowish tongue coating that is irregular in shape, has ill-defined borders and varies in thickness can indicate a chronic illness.

What are some common changes of the tongue and what do they mean in TCM? What can you do to “return back to normal?”

We commonly see a change in the thickness of the tongue coating and as mentioned, this coating is believed to be related to stomach conditions. Most tongue conditions can be alleviated with proper treatment that is related to eliminating one or more of the pathogenic influences causing the disease. However, as with every treatment plan, it takes time before your tongue is back to normal.

Is there anything a patient should not to before a TCM consultation?

To facilitate observation and diagnosis, the tongue coating should be intact. Thus, it is best to avoid brushing your tongue before a TCM consultation.
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William Man Kin Lo 盧文健中醫師 is a registered Traditional Chinese Medicine Practitioner and Physiotherapist in Hong Kong. He has worked as a clinician since 2001 and has experience in treating pain conditions with acupuncture. After graduating from the Hong Kong Polytechnic University, he studied Chinese Medicine at Chinese University of Hong Kong. He is now the director of the Hong Kong Atlas Chinese Medicine and Physiotherapy Centre, a journal columnist for a local newspaper and faculty member of the Hong Kong St John Ambulance Sports First Aid.
This article was independently written by Healthy Matters and is not sponsored. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.

This article was reviewed and updated on June 6, 2019.