When you see your physician for a physical exam, chances are he/she doesn’t look at your tongue.

But doing so can offer valuable insight into conditions ranging from heart and digestive health to vitamin and mineral deficiencies, according to Traditional Chinese Medicine (TCM).

What most people don’t realize: Because the muscular organ that helps you chew, taste, swallow and speak also can serve as a finely tuned barometer of your overall well-being, it may provide signs of health issues that might not have been picked up by standard medical tests.

The Art of Tongue Diagnosis

A practitioner trained in TCM (or a holistic physician or dentist) is best qualified to examine a person’s tongue for signs of possible illness. However, you can potentially spot a serious medical concern early on by looking at your own tongue and reporting any of the key elements described in this article to a TCM practitioner or a holistic physician or dentist.*

Self-examination: When you first wake up, stand in front of a mirror close to a window with plenty of natural light shining into your mouth. Make certain that your tongue is flat and relaxed when extended. Do not brush your teeth or tongue first—doing so might remove important evidence. Be sure to examine your tongue in the morning—the color and other features of your tongue may change somewhat throughout the day. What to check…


A bright pink or pale red tongue is ideal. White, purple or bright red shades are often signs of possible health problems. For example…

• Pale or white tongue may signify circulatory problems, such as anemia, resulting in a reduction in red blood cells and oxygen, or adrenal difficulties (often accompanied by fatigue). It may also be a warning sign of chronic weakness of the digestive tract and circulatory system, or of hypothyroidism (low thyroid function).

• Redder-than-usual tongue is often a sign of excess acid in the body, dehydration, inflammation or bacterial infection. This condition can also be caused by stimulants or poor eating habits. The more severe the problem, the redder the tongue.

• Red-tipped tongue, with the rest of the tongue pink, may signal thyroid or cardiac problems. If the sides of your tongue are the reddest, this might be an indication of liver and/or gallbladder problems. If only the center of the tongue seems unusually red, this suggests stomach problems. Canker sores on the sides of the tongue often occur with intestinal distress, such as celiac disease, or mouth breathing, which dries the tongue and may allow these sores to develop.

• Purple tongue is an indication of blood stasis, a slowing or pooling of blood. It could signal a cardiac, liver or kidney condition.

Texture and Coatings

A healthy tongue is relatively smooth, with a thin, white see-through “fur” or “moss” covering the upper surface, indicating proper digestive functioning.

But thicker, patchy or colored coatings, along with irregular shapes and surfaces, can signify health issues. For example…

• White coating often happens during a cold or the flu. This opaque coating represents toxins exiting your system. In addition to a cold or the flu, this white coating may result when a person undergoes a dietary detoxification program for a few weeks.

• Patchy coating, which appears as white-bordered blotches, may indicate a stomach issue (the coating seems to be a bacterial response to stomach problems), or signal an autoimmune condition, such as rheumatoid arthritis or allergies.

• Yellowish coating suggests a stomach, liver or gallbladder condition.

• Gray or grayish-black coating suggests long-term stomach or intestinal problems. Candida (yeast), also known as thrush, or other fungal infections produce hydrogen sulfide, which can turn the tongue white, yellow and then gray.

• Dry surface may signal overall dehydration, poor kidney or heart function, or iron-deficiency anemia.

• Cracked surface can occur as a result of a general vitamin deficiency or poorly balanced diet. A long deep midline crack reaching the tip may suggest a cardiac condition, while short horizontal cracks are linked to kidney problems.

• Excessively shiny coating, in which you aren’t able to see your taste buds, suggests a vitamin B-12 deficiency.

Hidden Culprits

A variety of medications can sometimes cause changes in the color, texture and/or coating of the tongue. For example…

• Antibiotics may cause the tongue to peel in patches.

• Corticosteroids may cause a red and swollen tongue after taking them for 30 days.

• Bronchodilators may cause the tip of the tongue to turn red after prolonged use.

• Diuretics may cause the tongue coating to peel over time.

• Anti-inflammatory medications (both prescription and over-the-counter) may cause red spots.

Note: If a drug affects the color or other features of your tongue, and you are bothered by this side effect, talk to your doctor about possibly changing the medication.

*To find a practitioner near you, visit the Web site of the International Academy of Biologic Dentistry & Medicine, iabdm.org.