Tongue Will Tell

It is well known in traditional Chinese medicine that the state and colour of the tongue are indicators of one’s internal health. In naturopathic medicine, the tongue is considered a barometer for what is going on inside the body.

Canada-trained Shirley Mirpuri, of City Osteopathy & Physiotherapy, is a licensed naturopathic doctor, regulated by the College of Naturopaths of Ontario, Canada. She has been practising in Singapore since 2015, providing people with alternative solutions to health and healing. She uses clinical nutrition, botanical medicine and homeopathy to manage acute and chronic conditions by addressing the root causes of illness. She explains why the tongue is a good tool for diagnosis, and what different colours and textures mean.

Is it true that the colour and appearance of the tongue can reveal things about our state of health?

Dr Mirpuri (DM): Yes, absolutely. The state of a person’s tongue can tell you a great deal about his health. Your tongue is rich in blood vessels and nerves, so there is a lot of movement of nutrients, toxins and wastes, since it is so metabolically active. Observing the colour, texture, thickness and coating, for example, can tell us a great deal about the patient’s health. Combining what we see on a person’s tongue with his presenting symptoms can help narrow down the approach of treatment and further testing. In addition, your mouth is the initial part of the digestive system and is thus an amazing assessment tool to see the state of your gut and basic nutritional deficiencies. We all know at this point that a lot of health concerns stem from poor gut health and nutritional deficiencies. As Hippocrates, the father of medicine, once said, “All disease begins in the gut.”

What are some common examples of what the tongue can show about our health?

DM: A tongue that looks more pale than pink could indicate that you are anaemic, so checking your blood count via a blood test would confirm this. A person with low iron levels would experience frequent mouth sores as well.

DM: Having a thick, white coat on your tongue can indicate a lot of things. Saliva in our mouth constantly lubricates and washes the tongue. Dehydration, for example, results in a decreased production of saliva, so we see a dry tongue with a build-up of bacteria and food, resulting in a white coat. Another cause of a white coat is due to candida, which is yeast-like fungus, in the gut.

DM: A thick, yellow coating is usually a sign of poor digestive health and a build-up of dampness in the body. This can be due to factors such as stress, poor diet, nutritional imbalances, or a change in the bacterial population of your digestive system.

DM: A tongue that is swollen and looks almost beefy red could indicate a deficiency in vitamin B12 or folic acid. Some people may or may not experience mild soreness or burning of their tongue as well.

Observing a person’s tongue does provide us with a quick understanding of how a person’s body is functioning as it correlates quite well with their presenting concerns and symptoms.

What about the texture of the tongue? Can that reveal anything?

DM: Yes, the texture of the tongue also gives us information about our health. The normal texture of the tongue generally consists of tiny, pink bumps, which are called papillae. Changes in the texture of the tongue that can either lead it to look smooth or cracked with raised bumps can indicate hydration or nutrient status. A tongue that looks dry and has various lines and fissures on it can indicate dehydration, biotin deficiency or a high intake of hot or spicy foods. If the tongue is smooth without much of the normal little pink bumps, it is likely an indication of vitamin B12 and iron deficiencies.

In that case, what kind of tongue denotes good health?

DM: A normal tongue should be pink, moist and usually have a very thin coating. Keep in mind that if you are on any medication, it can change the consistency of how your tongue looks. The food you eat also has an impact on your tongue’s appearance. The best time to observe your tongue is upon waking and under natural light. I would go one step further and smell your saliva as well. Usually saliva is not supposed to have any odour to it, so the presence of an odour can indicate poor dental or gut health, or a build-up of toxins. It is also important to understand that - while observing your tongue can tell you a great deal about your health - it does not replace the use of medical tests to confirm and diagnose your health concerns. Observing a person’s tongue does, however, provide us with a quick understanding of how a person’s body is functioning as it correlates quite well with their presenting concerns and symptoms.


The tongue is known as the organ that senses taste. The organ does this via taste buds.

Most people think that the many tiny bumps on the tongue are the taste buds, but those are called the papillae, which help create friction between tongue and food. Taste buds are much smaller, and usually found between papillae, although they can sometimes be found on the papillae as well.

Each taste bud has about 50 gustatory receptor cells, which are the cells that respond to the different tastes food provides: sweet, salty, bitter, sour, umami and - some scientists claim - fat. When a gustatory receptor cell comes across food, it sends an electrical impulse to the brain, which interprets it as taste.

The tongue is full of muscles. Its extrinsic muscles hold it in place, with connections to the jawbone, the hyoid bone and the styloid processes, which is the only bone that is not connected to another. Its intrinsic muscles give it the ability to expand and contract. Because these muscles can be consciously controlled, the tongue possesses a great degree of articulation. This is why the tongue is important for moving food around the mouth, swallowing food, and for speaking.