Tongue Inspection: How’s Your Health?

By Maoshing Ni, L.Ac., D.O.M., Ph.D.

Wonder if you're coming down with a cold? Stick out your tongue and say "Ah!" Or at least give it a glance. Your tongue is one of the easiest ways to check in with your health status. I recently posted a blog about how to read your face to determine the condition of your health. The tongue is such an important diagnostic tool for Chinese medicine practitioners that it merits a full article.

How Chinese medicine uses the tongue to interpret your health The tongue is one of the most important diagnostic areas in ancient medical traditions. What makes the tongue such a great diagnostic tool? Your tongue, containing water, electrolytes, mucus, and enzymes, is a very sensitive organ and its appearance changes with many physical changes in the body. In Chinese medicine, the tongue is a "map" of the internal body. Like the face, the tongue is divided into five-element zones that correspond to your internal organ networks.

Get in front of the mirror and look at your tongue right now. The tip exhibits the fire element; behind the tongue tip is the metal element; both right and left sides the wood element; in the center towards the back is the earth element; and the very back of your tongue is the water element. Now that you know what element is where, how do you translate what your tongue is telling you?

Signs and symptoms
Here is what you want to see: A normal tongue should be pink, muscular without tooth marking or discoloration, and have a very thin clear coating that exhibits proper salivary secretions. Monitor your evolving health level by noticing color, shape, and coating changes in specific zones.

Tongue Color:
When the color becomes deeper -- going from pale to scarlet to purple -- it means that there is increasing heat in the body. Heat may mean inflammation, infection, or hyperactivity of the organ network. When the tongue's color becomes lighter -- from pink to pale to paper white -- it indicates cold, which can mean anemia, pathogenic cold factor, or low energy and function of the corresponding organ network. I treat patients with low immune system function, sometimes due to chemotherapy or chronic fatigue syndrome, and many of them exhibit a pale tongue indicating low energy.

Tongue Coating:
The thickness and color of the coating, or a lack of coating, can indicate different issues. When the coat of your tongue becomes thick, it is frequently a sign of imbalance in the digestive system. When the coat turns thick and cruddy, it generally points to decreased immune system with Candida (yeast infection). When the coat turns yellow, it often signals infection or inflammation in the body. A peeling coat is usually a sign of damage or weakening to certain systems of the body.

You can further diagnose underlying problems by analyzing the regions of your tongue; these show you which organ network is affected.

1. Tongue tip
The fire element zone, which corresponds to the heart-small intestine network, is located at the tip of the tongue. This includes matters of the heart, both emotions and the physical health. In Chinese medicine, the spirit is said to reside in the heart network. Stress and Anxiety will show up as red color and red dots on the tip of the tongue. Increasing heat signs means hyperactivity in the heart network due to stress and tension.

2. Sides of your tongue
The sides of your tongue display the wood element. Teeth markings on the sides of the tongue usually mean stagnant energy in the liver network. You may also notice a bluish-green or purplish hue or spots in this zone. Dark spots may indicate more serious problems. On several occasions, I've noticed purple spots in the wood zone in patients that suffer from low energy, discomfort, distension around the lower ribs, and swelling in the abdomen. I immediately sent each of them to see a hepatologis -- a liver specialist -- who, unfortunately, confirmed either liver cancer or cirrhosis in seven out of ten cases.

3. Behind the tongue tip
The band-like area across the tongue and just behind the tip is the metal element zone, which corresponds to the respiratory and the immune systems. When this area turns reddish, or when red pin-sized dots occur, it usually means a respiratory infection is on its way or is settling into the body. Paleness in the metal zone may reflect a weakened immune system. In rare fungal infections of the lungs, there may appear a brownish black coating over this zone, which was the case with several of my patients who suffer from lesions in their lungs.

4. Center of the tongue
This area is the earth element zone, and it is related to the stomach-spleen-pancreas network. Problems of the digestive system most often show up here in the center of the tongue. G.E.R.D. -- stomach and esophagus acid reflux that keeps many people awake at night -- may be seen with redness and a yellowish coating in the center of the tongue. Subtle changes in this area may indicate digestive problems that have not surfaced yet; observe this area and take prophylactic steps if necessary.

5. Back of your tongue
The back of the tongue reflects many of the body's functions, but is mainly the domain of the water element, or kidney-bladder network, which includes the hormonal system and sexual glands. The two large, elevated papilla on the back of the tongue are a normal part of the taste buds. What you should look for is color and coating. For example, when I see a thick yellow coating at the back-center of the tongue in my female patients, I know that they are very likely to get a bladder infection. I tell them to immediately start drinking 8 to 12 glasses of filtered water a day, take 5,000 mg of vitamin C, and to drink cranberry juice or take its extract -- this regimen will typically help prevent a bladder infection. More often than not, those who didn't follow this preventive treatment will call me a few days later with an infection.

Your body alerts you to imbalances in many more ways than just your tongue. Ideally, you should confirm your findings from your tongue with observations from others, such as the eyes, face, and nails. I hope this article helps you translate your tongue!