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

Tongue colour can indicate health conditions

Your tongue's appearance changes with your body's health condition. For examples:

• 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 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 forms and shapes, there is a slightly bumpy topography generally. These bumps are papillae that make tasting possible.

• If a smoothen tongue sensation occurs suddenly, it can be a sign of nutrient deficiency and other underlying conditions such as celiac disease.
• A tongue with lesions, deep grooves or fissures, may indicate diseases such as psoriasis and Sjörgen’s syndrome, but deep grooves may just be an age-related change. While these grooves are generally harmless, they are a perfect breeding ground for bacteria – So maintaining good oral hygiene is a must.
• Sores or mouth ulcers can be red and painful, 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, one must visit a dentist or doctor.

Your lifestyle habits can make your tongue feel funky

The sensation 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 feel can be caused by several factors such as eating too many citrus fruits, certain medication, smoking, or biting your tongue accidentally. If you fail to figure out the cause of the soreness or the feeling persists, you should visit a 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 taken.

What Traditional Chinese Medicine Says About Your Tongue

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

There are six pathogenic influences in Chinese Medicine, which are cold (寒), heat (熱), dampness (濕), dryness (燥), summer heat (暑) and wind (風). When they exceed the body’s tolerance, the flow of Qi will be disrupted. 

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

Tongue Examination by TCM practitioners

Tongue examination is essential to TCM diagnosis. TCM practitioners begin with chief complaints, in which patients provide subjective information regarding their symptoms. With this information, diagnosis can be achieved with objective physical examination which includes tongue inspection. 

Tongue examination is usually divided into two parts. First of all, a practitioner would examine the quality of the tongue, to understand the patient's body status in general. 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, TCM inspects the quality of the tongue’s coating which is mainly related to stomach conditions and dampness inside the body. 

In short, the tongue can reflect the body's constitution and elucidate the cause of symptoms and signs concerning the six pathogenic influences and organs.

Examples of tongue's appearance and their TCM indication

• Normal healthy tongue looks pale red/pink in color, normal in size, with a thin coating: It implies a good balance of Qi and Xue.
• An enlarged tongue with teeth marks along the sides: It indicates a weak functioning of the stomach and spleen, as well as a high level of dampness.
• A white-yellowish tongue coating that is irregular in shape: It indicates potential chronic illnesses, and a high level of heat and dampness.

A change in thickness of tongue coating is common, 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.

What to do before a TCM tongue examination?

• To facilitate diagnosis, the tongue coating should be intact. Thus, it is best to avoid brushing your tongue before a TCM consultation.
• Avoid intaking any dyed foods or drinks before TCM consultation. Pigments may change the color of the tongue coating, resulting in misleading tongue information.
• Avoid drinking any liquid 30minutes before tongue examination.
• Tongue appearance reflects your body status most accurately when you wake up in the morning. You may take a picture of your tongue in the morning when you wake up, for your TCM practitioner's reference.

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.