Tongue Color: Everything You Need to Know about Tongue Health

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tongue color and overall tongue healthYour tongue color and overall tongue health can reveal a lot about you.

According to traditional Chinese and Indian medicine, the tongue is basically seen as a map of the body, and it’s thought to reflect your current state of health, and can show indicate any imbalances in the body.

A Chinese medicine doctor or Ayurvedic doctor will use the tongue as an important diagnostic tool to help determine certain deficiencies or health conditions in the body.

Stick out your tongue in the mirror. What can your tongue tell you about your health? The size, shape, thickness, dryness or moistness and color are among the tongue health indicators that the doctor will use to help determine health or disease.

A healthy tongue will be pink or light red with small nodules and a thin white coating, which may be more pronounced in the morning. Unfortunately, not everyone has that tongue.

What is the Relationship between Tongue Color and Health?

There are various signs that can help determine your tongue health problems. Certain areas of the tongue correspond to certain organs. For instance, discoloration at the center of the back of the tongue indicates a colon imbalance in Ayurvedic medicine. The following is an example of a tongue color chart with key symptoms and the meaning of tongue colors.

Tongue Color Chinese Syndrome Symptoms
Pink or light red with a thin white coating Normal None
Red tongue Heat There will be a red tongue with a thin yellow coating. Other symptoms include constipation and skin problems, and feeling hot, sweaty, thirsty, and irritable.
White coating Qi stagnation There will be a thin white coating with a red tip. The person will be stressed, depressed, upset, and in an unstable and emotional state of mind.
Thick white coating (cottage-cheese tongue) Yang deficiency Pale complexion, back pain, cold sensitivity, and a tendency toward panic, infertility, and impotence.
White, greasy, and swollen tongue Damp retention Fullness in abdomen and chest, bloating, and a lethargic and heavy feeling.
White or red spots on tongue Qi deficiency Teeth marks with a few spots. There is also a poor appetite, fatigue, shortness of breath, worrying, and overthinking.
Yellow tongue Damp heat There is a red tongue with a greasy yellow coating in the middle of it. Other symptoms include urinary infections, skin problems, clammy skin, anger, and discomfort.
Brown or black hairy tongue Qi and blood stagnation Often there are also cracks, and the person may be taking antibiotics, receiving chemotherapy treatment, or have diabetes.
Cracked tongue Yin deficiency Sweating at night, hot flashes, irritability, insomnia, menopause, ringing in the ears.
Pale tongue Blood deficiency Fatigue, palpitations, dizziness, poor concentration and memory, insomnia.
Purple or bluish-tinged tongue Blood stasis Varicose veins, headaches, cold limbs, liver spots, chest pain, and painful legs.


Red Tongue

With this condition, it almost looks as though you’ve been sucking on a strawberry Popsicle. What does a bright red or strawberry-colored tongue mean? When the body of the tongue is red, it’s often an indication that yin and stomach qi are severely damaged. Here are a few things that may cause your bright red tongue:

  • Vitamin deficiencies: Vitamin B12, folic acid, and iron deficiencies may cause a red tongue.
  • Kawasaki syndrome: Kawasaki syndrome affects the blood vessels and is usually seen in children under five years old. If severe, children will also get a very high fever and swelling and redness of the feet and hands.
  • Scarlet fever: A strawberry tongue is also common in children with scarlet fever. It’s often caused by strep throat and usually begins with a sunburned look and an itchy rash on the face and neck, which then spreads to the back, chest, and the rest of the body.
  • Geographic tongue: Also called benign migratory glossitis, geographic tongue looks like a map with red spots. Sometimes the red patches will develop a white border around them. A geographic tongue is usually not a concern but check with your dentist if the red patches last more than two weeks.

White Coating on the Tongue

Have you noticed a white coating on your tongue? This can indicate one of a few things:

  • Oral thrush or candida: Oral thrush is a yeast infection in the mouth, and is a sign that the person has Candida, which leads to a white colored tongue. Oral thrush is common in people with lung disease, asthma, diabetes, allergies, and poor digestion.
  • Leukoplakia: Leukoplakia will cause the cells in the mouth to grow excessively, leading to white patches. The condition may be a precursor to cancer, and it can develop from tongue irritation and in tobacco smokers.
  • Oral lichen planus: This is a condition in which there are raised white lines or patches on the tongue. There will also be red and swollen lesions that may burn or cause pain and discomfort.

White or Red Spots on the Tongue

A combination of red or white spots will often appear on a person with a geographic tongue, and it’s often a life-long issue. Scientific research indicates a link between geographic tongue and celiac disease, including a study published in the journal Gastroenterology Research and Practice in 2014. People with scarlet fever may also have a white tongue with red spots.

Cottage-Cheese White Tongue

A thick white coating on the tongue is a clear sign that Candida has gotten out of control. It will look as if cottage cheese is stuck on your tongue. According to traditional Chinese medicine, a thick white coating is a sign of yang deficiency and damp-cold.

Other symptoms will include back pain, a pale complexion, a cold feeling, and a tendency toward panic, impotence, and infertility. Also, taking antibiotics may cause an oral yeast infection. The antibiotics will kill all bacteria, including the good guys.

Taking probiotics will help replenish the good bacteria lost by the antibiotics. It’s also a good idea to treat Candida with herbal supplements such as oregano oil, garlic, grapefruit seed extract, wormwood, pau d’arco, gentian root, and ginger.

White, Greasy, and Swollen Tongue

A swollen tongue with a white-greasy coating in the middle and scalloped edges indicates dampness within the body, according to traditional Chinese medicine principles. A swollen tongue is also associated with symptoms such as fatigue, bloating, loose stools, and a tendency for the person to worry. The person will also experience coldness, heaviness, and lethargy.

To help prevent a swollen tongue, it’s a good idea to consume warming foods such as cinnamon, rosemary, ginger, nuts, leeks, beef, lamb, and soup. You should also avoid foods that enhance coldness in the body like creamy or fried foods, cold drinks, ice cream, bananas, or cucumbers.

Yellow Tongue

Your tongue color and health is particularly interesting when your tongue turns yellow. A yellow tongue may be temporary, but it can also be a sign of a condition called black hairy tongue. Other causes of a yellow tongue include post-nasal drip, urinary tract infections, excess bacteria growth, dehydration, dry mouth, scarlet fever, antibiotic use, and excessive use of tobacco or caffeine.

A yellow tongue can also be a sign of jaundice, which indicates gallbladder or liver problems. A yellow tongue may also be present in severe health conditions such as strep throat, HIV/AIDS, mononucleosis, and cancer.

Brown or Black Fuzz, or Hairy Tongue

What if the tongue color changes to black? In traditional Chinese medicine, a brown or black tongue color is a sign of qi and blood stagnation. When there is a little bit of brown or black fuzz on the tongue, it’s likely not a major concern, but when too much yeast and bacteria grow, it may lead to a black hairy tongue. Various lifestyle habits and other health conditions can also contribute, including excessive caffeine consumption, smoking tobacco, poor oral hygiene, dehydration, antibiotic use, medications such as Pepto-Bismol, regular mouthwash use with menthol, witch hazel or peroxide, and radiation or chemotherapy of the neck or head.

It’s also common for tongue cracks to be present in this situation. Black hairy tongue is also more prevalent in men, intravenous drug users, and people with HIV/AIDS. Other symptoms of black hairy tongue include nausea, gagging, bad breath, and a metallic taste in the mouth.

Tongue Wrinkles or Cracks

Does your tongue have several wrinkles or cracks in it? When it comes to tongue health, cracks are an indication of a yin deficiency. Cracks, fissures, or wrinkles in the tongue may also be a sign of aging. The tongue color may be red, and other symptoms include irritability, insomnia, sweating at night, hot flashes, and ringing in the ears.

Postmenopausal women will also develop painful bumps on the tongue, called burning tongue syndrome. Sometimes you can also get Candida or a fungal infection inside the wrinkles or cracks on the tongue, which will lead to pain, burning, or a foul smell. Dentures may also cause the tongue to crack or wrinkle.

Pale Tongue

A pale tongue is an indication that there isn’t enough blood in the body. In particular, the blood may be lacking hemoglobin, which is found in red blood cells. A pale and swollen tongue can also indicate yang deficiency, and a problem with the colon and lungs.

Common symptoms include an overall pale complexion, fatigue, lethargy, impotence, infertility, back pain, and a tendency toward anxiety and panicking. The person will be sensitive to cold. It’s a good idea to treat a pale tongue with a well-balanced diet with lean foods like liver, spinach, turmeric, basil, and romaine lettuce. Warming foods will also help such as ginger, cinnamon, and garlic.

Purple or Bluish-Tinged Tongue

Finally, what if the tongue turns purple or bluish with black spots? This can be a warning sign that fluids and blood are not circulating properly in the body—in other words, it’s an indication of blood stagnation. A lack of circulation can lead to depression or emotional stagnation.

Symptoms of a purple tongue include fatigue, tiredness, chest pain, liver spots, headaches, painful legs, cold limbs, and varicose veins. A purple tongue is also thought to be a sign of high cholesterol and chronic bronchitis. Warming herbs can help the tongue, such as ginger, garlic, and coriander.

It’s important to emphasize that Ayurvedic or Chinese medicine doesn’t rely solely on the tongue to diagnose diseases or health conditions; checking the tongue for health is merely a part of the diagnostic process. Your doctor will still want to do additional testing.

So, what can you do for your tongue health? Here are a few oral hygiene tips that can help improve tongue color and health:

  • Tongue scraper: A metal or copper tongue scrapper is essential for the removal of the yellow film and bacteria buildup.
  • Mouthwash: It’s a good idea to use an antibacterial herbal mouthwash. Essential oils in the mouthwash include lavender oil, gotu kola extract, peppermint oil, cinnamon oil, Echinacea extract, eucalyptus oil, and thyme oil.
  • Dietary restrictions: Avoid foods such as processed foods, alcohol, dairy products, gluten and wheat, and sugar products. These contribute to yeast and bacterial overgrowth. Instead, consume lots of steamed and fermented vegetables.

Also Read:

Sources for Today’s Article:
Bramanti, E., et al., “Clinical Evaluation of Specific Oral Manifestations in Pediatric Patients with Ascertained versus Potential Coeliac Disease: A Cross-Sectional Study,” Gastroenterology Research and Practice, 2014; doi:10.1155/2014/934159.
“Which Tongue Are You?” Emperors web site;, last accessed April 18, 2016.
“Black Hairy Tongue,” Web MD web site;, last accessed April 18, 2016.
Kloss, K., “9 Surprising Secrets Your Tongue Can Reveal about Your Health,” Reader’s Digest web site;, last accessed April 18, 2016.
Thompson, E., “Tongue Health,” Institute for Optimum Nutrition web site;, last accessed April 18, 2016.