What Your Tongue Tells You About Your Thyroid

What Your Tongue Tells You About Your Thyroid

When Dr. Wiggy appeared on The Doctors TV Show, here is what he had to say about the tongue that caught my attention, “Sometimes the tongue gets too big for the mouth and actually pushes up against the sides of the teeth and that can suggest the tongue is too large because there are too many toxins. A lot of times that is from having low thyroid.” 

I immediately went to the mirror and for the first time in my life looked at my tongue, not just looked at it but really examined it closely. I discovered that my tongue was in fact enlarged. I had 2 out of the 4 tongue issues (enlarged/scalloped tongue & fissure/cracked tongue) Dr. Wiggy describes below. I had no idea my tongue was so unhealthy looking.

How about you? Have you taken a good look at your tongue?

Written by Dr. Wiggy

Do you know that you can learn a great deal about your health, including your thyroid health, by examining your tongue?

Now, you may be asking yourself, “How much can you really learn by looking at your tongue?” The truth is you can learn a lot by looking at the tongue and to me, it’s one of the most useful physical exam focuses. The reason why it is so important, is because it is a glimpse into the inner workings of our digestive tract. It is the only part of our body that is directly connected to the stomach, unless you count the other end, but that’s not as easy to examine. 🙂

Not only is it directly connected to our digestive system but the tongue is often the “canary in the coalmine”. That is, many deficiencies and imbalances will show up in the tongue before those problems manifest in other parts of the body and sometimes even before symptoms are present.

So, before I tell you what you can learn by looking at your tongue. I want you to participate, so take a selfie and share what your tongue looks like with all of your friends…….just kidding, that could be a little embarrassing, not to mention a little weird.

But in all seriousness, I really do want you to look at your tongue, so go grab a mirror and take a good, close look at your tongue.  Then I want you to ask yourself these questions.

  • What is the color of my tongue, is it pink? If not what color is it?
  • Is my tongue smooth?
  • Does my tongue look similar throughout?
  • Does my tongue look like it is too big for my mouth, does it have indentations on the sides?
  • Are there any cracks, fissures, or crevices?
  • Is there a coating on the tongue?

All of these different features give us clues as to what may be going on with your thyroid and may have given you more information than your last set of labs.

So, hopefully this is what you see in the mirror. A healthy tongue should look pink, smooth, similar though out, without any cracks/fissures and without a coating on it like the picture below. If your tongue is healthy, then most often your thyroid will also be healthy.

What Your Tongue Tells You About Your Thyroid

Most people that come into my office do not have healthy tongues. Actually quite the contrary, very few people with hypothyroidism have healthy tongues. And if your tongue is unhealthy, then it is much more likely for your thyroid to be unhealthy. Here are examples of what unhealthy tongues look like and what it might mean for your thyroid health.

What Your Tongue Tells You About Your Thyroid

If the tongue is red or beefy that generally suggests a vitamin deficiency, especially the B-vitamins and folic acid.  Not only are the B vitamins especially B12 important for proper thyroid utilization but having low levels of these micronutrients also suggests a problem with absorption. If you are not able to absorb micronutrients from your food and supplements then your thyroid will have a tough time doing its job.

Most people with tongues like this are not only deficient in B12 but also low in zinc, selenium, and iron, which are all important for thyroid conversion. If you notice this you should probably have those micronutrient levels checked and supplemented while starting to fix your absorption. Fixing your absorption starts by healing the gut.

What Your Tongue Tells You About Your Thyroid

If the tongue is fissured, cracked, or something called geographic (different all over, looks like a map) then that generally indicates that there are some underlying food sensitivities.  These food sensitivities often develop after many years of damage to the gut. You see, when the gut is damaged it becomes “leaky”. This “leaky gut” sets you up for the development of food sensitivities. When I see a tongue like this, almost without fail food sensitivities will be part of the problem.

This is particularly important when it comes to people with Hashimoto’s because there is some evidence to suggest that the development of food sensitivities can be a trigger to the development of Hashimoto’s. If you tongue looks like this you need to be sure to have your thyroid antibody levels checked (Anti-Thyroglobulin and Anti-Thyroid Peroxidase Antibodies) because a fissued/cracked tongue has been a good indicator. I would also recommend doing an IgG food allergy panel or, if you do not have access to that test, then simply try an elimination diet off of the two biggest offenders: wheat (gluten) and dairy (casein). Most people will notice a significant improvement just by cutting out those two foods.

What Your Tongue Tells You About Your Thyroid

If the tongue is too large and has indentations on the sides, this generally indicates that your body is full of toxins. The tongue can be a harbinger of toxins and when there are high levels of toxins in the body the tongue will start to swell and enlarge and will push against the sides of the teeth.  This results in the tongue having indentations on the sides or something we call “scalloping”.  Toxins can hamper the thyroid in a couple of different ways: 1) they can have a blocking effect on the cell receptors so the thyroid hormone has a tough time doing its job inside of the cells, 2) there is also some evidence that these toxins can actually damage the thyroid gland. This damage makes the thyroid less effective and more prone to disease and underactivity.

Whenever, I see a tongue that is scalloped, I first think about enhancing detoxification. One of the easiest things that almost everyone can do to enhance detoxification is to drink more water. This seems to be a neglected aspect of health and detoxification. Most people are looking for the special “Detox Diet or Pill” but optimizing detoxification often starts with making sure that the body is optimally hydrated. I generally recommend my patients work up to at least 80 ounces of water every day.

What Your Tongue Tells You About Your Thyroid

If there is a coating on the tongue that suggests that there is a yeast overgrowth. Yeast (Candida) is an opportunistic infection and when the healthy gut bacteria has been disrupted then yeast can overtake residence in the digestive system. This is not limited to just the intestines and can also present on the tongue. Yeast can disrupt the thyroid in a couple of different ways but one of the most important ways that yeast effects thyroid hormone, is that it decreases the conversion of T4 to T3. Many people are walking around with suboptimal T3 levels because of a yeast overgrowth.

If you notice this then you should probably do a test to see if a yeast overgrowth is present. There are blood and stool tests that can identify this. We look for elevated levels of antibodies to yeast in the blood as one of our diagnostic tests. If this is identified, treatment for yeast is indicated. This includes a yeast-killing diet (low carbs, no yeast) as well as certain supplements including a high potency probiotic. Sometimes a compounded medication formulated specifically to treat yeast is needed but this is often reserved for more advanced cases.

Hopefully, studying your tongue was enlightening and will help you identify possible underlying issues with your thyroid health. Trying to overcome hypothyroidism is an arduous process and something that will have its ups and downs. It can be frustrating and overwhelming at times but I do believe that most people can optimize their thyroid functioning and start to feel better. Of course it always helps to have an Integrative Thyroid doctor to help you along the way.

About Dr. Wiggy

Dr. Weston “Wiggy” Saunders is an integrative/functional medicine physician featured regularly on NBC, CBS, and FOX Television Stations. Dr. Wiggy is a sought after doctor seeing patients at Robinhood Integrative Health in Winston-Salem, North Carolina.

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About Dana Trentini

Dana Trentini M.A., Ed.M., founded Hypothyroid Mom October 2012 in memory of the unborn baby she lost to hypothyroidism. This is for informational purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. Hypothyroid Mom includes affiliate links including the Amazon Services LLC Associates Program.


  1. Rebecca McMillan says

    My tongue is huge. Its so big it overlaps my teeth on the sides. I can never fully shut my month. I still at times bite it accidentally when eating. I am married with 3 kids and I have no idea how to properly kiss which is depressing. I have a huge complex about something so odd. And so many unnecessary issues. I only found out this was not normal at 17. And it wasn’t fun to be made a spectacle of.

  2. 20 years ago I was told I a fissure tonge by my dentist. Since then it got cracked I sometimes got sores and it is sensitive to certain foods. 2 months ago I was diagnosed with papillary thyroid cancer. I underwent surgery where they found the my lymph nodes were already affected. I am currently waiting for my consultation with a second oncologist, and awaiting further treatment. I have struggled with do many symptoms for over 20 years never imagining this was the root of many of my health problems!!!

    • Oh Mari this is so upsetting what happened to you. Thank you for sharing your story. It reminds us all to listen to our bodies. Wishing you all the best with your consultation from Hypothyroid Mom.

  3. I don’t even know where to begin…swollen sore geographical tongue my stomach is a mess…but when I started having issues swallowing I did the castor oil packs on my neck with a heating pad everyday for 2o minutes I did it for a month…and i no longer have that issue ..for that I’m grateful..that was scary

  4. Shirley K Robbins says

    I have had swelling on both sides of my neck right above the clavicle at the base of my neck, they feel like gel packs. Saw my Docter and he is not sure as to what it is. They seem to get larger when I’m stressed.With rest they get smaller. Today I noticed some black looking spots on the sides of my tongue could this be due to thyroid problems?.

  5. I have scalloping on one side and cracked tongue, the latter only being recent. I have Hashi’s but the scalloping is fairly new. I’m overdue for testing to check my levels, but if I’ve had Hashimoto’s for 12 yrs, why these tongue issues now?

  6. Hi in my case, my geographic tongue acts up after having acidic foods (balsamic vinaigrette, walnuts, and overly ripe tomatoes) usually a rinse with water mellows it out. Just thought I’d share ! It’s such a weird thing to have. So many people comment about my tounge if they see it.

  7. Debbie Schwartz says

    I have geographic and sore tongue and sometimes ulcers that come and go on my tongue. My whole body feels itchy and my thyroid not number went from 5.6 to 3.5 in 3 months. I am seeing an endocrinologist in a few days, I think I have hyperthyroid.

    Any thoughts?

    • Nancy Schiebert says

      I started out the same way. Went hyperthyroid and because I was over 50 they had to nuke my thyroid and this sent me into major hypo. My life has gone down since then. I had a friend who went through the same thing as me at the same time but was lucky enough to find a MD that used UK drug that eventually brought her to normal levels. She will continue to be at risk to have a reoccurrence but for now her thyroid is normal. Wish I had known.

  8. Sharon Reed says

    I have been diagnosed with geographic tongue. This was before I was diagnosed with stage 3 papillary thyroid cancer and had my thyroid taken out. I am hypothroid and low b12. My tongue has become super sensitive to citric fruits and juices and soda drinks. I have GERD and my stomach is a mess. I’m miserable.

    • This sounds like me! My tongue used to hurt when I ate citrus but now it hurts all the time. Is your thyroid regulated now?

    • Frances Johnson says

      Don’t know if you have taken care of your gerd and have no idea where you live. I have had hypo for over 20yrs n had a nissen for gerd (my thyroid has been acting up a little and now using ancestral supplement thyroid and working better). I had 2 nissen fundoplications bc first one done incorrectly (great relief when done right), and UT Austin has GREAT SURGEON, Dr. Francis Paul “Tripp” Buckley n does them 100% correctly….”the go to dr” in that area….he has 1st hand experience with this disease and only wants to help and educate! There is a procedure called LYNX for 1st timers….if suffering….run, don’t walk to this dr. He is God Sent! Made my life worth living again! Use of portal best form of communication prost op! (FYI)
      Good luck!

  9. danilo danguilan says

    My brothers tongue gets really smaller. He has excessive saliva and difficulty swallowing. What may have caused it and is there a way to make his tongue turn to normal size. Thank you

  10. My tongue is moving continuously also stuck in front teeth. Plz help me its very irritating.

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