Have you ever heard of Geographic Tongue?
It certainly sounds strange, but bear with me because it's actually got some interesting connections to psoriasis and psoriatic arthritis.
Some believe that Geographic Tongue (GT) is a sign of psoriasis in the mouth.
In today's episode, I wanted to share with you what GT is, what it means if you have psoriasis, and why it's important NOT to ignore it!
Part of the reason I say you shouldn't ignore it is that I believe your body communicates with you through signs and symptoms. If you've got an issue like this, your body is trying to say something.
Here's why I think Geographic Tongue is an important clue and how to find out if you have it!
Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android
In this episode:
- What is Geographic Tongue + its connection to Psoriasis
- Does everyone with psoriasis get GT?
- Triggers, medication + conditions associated with GT
- Can GT be a sign of nutrient deficiencies?
- Why it would be good to get an oral exam if you’ve got psoriasis
Quotes:
Some sites call Geographic Tongue “psoriasis of the tongue”, but that might not be the case! Not everyone with psoriasis has GT though there is a high association between the two.
The potential for GT to be a sign of nutrient deficiencies underscores why this isn’t something to just blow off.
111: What is Geographic Tongue? (Is It a Sign of Psoriasis?) (FULL TRANSCRIPT)
Welcome back to episode #111 of the Healthy Skin Show!
In today’s episode, I want to share about a potential sign of psoriasis that can show up in your mouth.
This particular issue is called Geographic Tongue.
Honestly, I never heard about it until a number of people wrote to me to ask about it. Not everyone with psoriasis has Geographic Tongue, but like psoriatic lesions, it can make you feel incredibly embarrassed about the look of your tongue.
This is a reminder that signs and symptoms of a condition can show up in very unexpected ways and in areas of the body that you wouldn’t expect. That’s why I constantly tell you to consider ALL SYMPTOMS so that you can get a much clearer picture of what’s going on.
Since I believe that everything is typically connected, it makes sense that GT could have implications for other areas of your body.
If you’ve noticed a funny pattern on your tongue, here’s what could be going on!
What Is Geographic Tongue?
If you’ve ever seen a funny swirling pattern on someone’s tongue, it probably caught your eye.
Patterns that appear on the surface of the tongue are typically referred to as Geographic Tongue (GT).
It’s a painless condition affecting the top of your tongue. Patterns form that resembles a strange design or even a map (which is where the term comes from).
Though it’s possible for the patterns to go away, it can end up reappearing elsewhere on the tongue.
Typically diagnosed by your doctor or even a dentist, it’s not fully understood what causes Geographic Tongue.
I even found some conflicting information on who exactly GT affects. Some sources say it tends to affect older adults in midlife while other sources found it’s more common in children (especially females).(1,2)
Either way, GT is not contagious.(3)
A lot of people don’t notice anything funny except for the way their tongue looks.
While others find that certain substances bother or irritate their tongue. Triggers can include hot food, spicy food, acidic food, and even your toothpaste and mouthwash.(1) Some symptoms can
include tongue pain and even burning.(2)
How Is Geographic Tongue Connected To Psoriasis?
On some websites, I’ve seen geographic tongue referred to as “psoriasis of the tongue”.
But that might not be the case! Not everyone who has geographic tongue also has psoriasis though it does tend to have the highest association.(2)
Other circumstances where Geographic Tongue is seen include “diabetes mellitus, Reiter's syndrome, Down syndrome, pregnancy, psychological factors, family history and consumption of some medications, such as oral contraceptive pills and lithium carbonate.”(2)
Allergies and nutritional deficiencies could be triggers.
Hormonal imbalances can also play a role in women who develop GT.(3)
There could be a potential shared genetic component here due to “the presence of a common genetic marker, the human leukocyte antigen (HLA) HLA-Cw6.”(2)
One interesting study looked at the incidence of Geographic Tongue and those with Psoriasis. What the researchers found is that there appeared to be an interesting connection between those who had both issues and lifestyle choices such as alcohol use.(4)
It’s not uncommon for those with psoriasis or psoriatic arthritis to even end up with permanent fissures on your tongue. One paper that reviewed several different studies found the “prevalence of fissured tongue ranging from 9.8% to 47.5% and of Geographic Tongue between 5.6% and 18.1%.”(2)
Either way, studies seem to show that an oral examination by your doctor or dentist to check the health of your tongue is warranted.
How To Treat Geographic Tongue
The ways people go about dealing with Geographic Tongue vary.
If you believe that you have GT, it’s best to make an appointment with your dentist or doctor to get an official diagnosis (especially because fissures can actually end up being permanent).
From what I could find, the following seems to be the conventional route for treating geographic tongue — special mouth rinses that could be antihistamine or antiseptic, pain relief used orally, mouth rinse that contains corticosteroids, and even vitamin B or zinc supplementation.(1)
In most of the articles I read online, nothing is typically done if there are no other symptoms present.
But the reality is that as a clinical nutritionist, the potential for GT to be a sign of nutrient deficiencies underscores why this isn’t something to just blow off.
Increasingly lower levels of critical nutrients can have a profound effect on your health, with or without psoriasis.
The Cleveland Clinic notes that nutritional deficiencies play a potential role. They list the following deficiencies as potential triggers for Geographic Tongue:(5)
- Zinc
- Iron
- Folate
- Vitamin B6
- Vitamin B12
Since a history of birth control pill use is a risk factor, it further underscores why looking at nutritional stores is important. Birth control pills are known to deplete B vitamins like folate, B6, B12, and riboflavin as well as Zinc.(6)
I’ve also found that many of my psoriasis clients tend to have lower or deficient levels of some of these nutrients. That’s why getting certain labs run (which are often covered by insurance) can be really helpful.
And of course, this highlights why looking at symptoms outside of your skin, as well as a complete history, is so critical to getting answers!
I hope you’ve found this helpful and if you’ve got Geographic Tongue, I’d love to hear how you found out about it. Leave your experience and how you care for your tongue in the comments!
And of course, don’t forget to share this episode with someone you know who either has Geographic Tongue or psoriasis! Knowing that the two are connected could help them realize the importance of looking at nutrient levels.
Thank you so much for tuning in and I’ll see you in the next episode!
REFERENCES
1. https://www.medicalnewstoday.com/articles/319342.php
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4999097/
3. https://www.aaom.com/geographic-tongue
4. https://www.ncbi.nlm.nih.gov/pubmed/25073550
5. https://my.clevelandclinic.org/health/diseases/21177-geographic-tongue
6. https://www.ncbi.nlm.nih.gov/pubmed/23852908
I haven’t listened to the podcast yet, but I was told years ago by a dentist that I had a geographic tongue. I think he said it was nothing to worry about it just explained why my tongue had an irregular surface. I’ve never had fissures though.
Flash forward 20 or so years and I was diagnosed with seronegative spondylarthritis- rheumy said she thought It would either develop into ankylosing spondylitis or psoriatic arthritis.
I was on birth control in my 20s when the dentist noted the look of tongue. I’m 50 now, I’m currently seeing an integrative physician who has me taking iron, zinc and b vitamins based on my autoimmune symptoms. No real change with my tongue but I do notice when I feeling well autoimmune-wise my tongue looks pretty normal, but not normal when I flare.
On a side note, I found your website because of chronic skin issues that dermatologists and my rheumatologist can’t figure out. Thanks for all the awesome information!
I was first told I had Geographic Tongue in my late 20’s by a supervising dentist at our local dental school in Portland, OR, but it had been present since at least middle school. I have never been overweight and never took medication of any kind, but I was raised vegetarian and may have had vitamin or mineral deficiencies. I’ve supplemented with B vitamins and minerals for a very long time, but had never seen any improvement in the fissures or the island toward the back of my tongue, which inflames with both spicy and acidic foods. However, I recently saw a huge improvement in both my GT and itchy psoriatic patches on my feet and scalp after doing a 5-day water fast. Although it started to get worse about a month after eating again, I have done a 5-day water fast every other month for the past 6 months and the GT is so much better. I see no sign of the fissures. The island is about 75 percent smaller and it doesn’t hurt as it doesn’t seem to be flaring up. The itchy spots of psoriasis are not completely gone, but they’re definitely smaller and they aren’t itching any longer. I did an organic, plant heavy, keto-diet for 6-weeks leading up to my first fast, so I became keto-adapted and fat-adapted and didn’t feel too many cravings while fasting. However, I may use supplements while fasting in the future as I am reading that a fasting-mimicking diet has nearly the same benefits as water fasting.
Omg! I have been combating this since 2015. I went to an ENT who told me that it was my fault for having lost teeth!! I didn’t know what was wrong but I knew it wasn’t that. The fissures have gotten deeper so that it feels like they will go all the way through. Spicy-hot is my enemy. Cold, hot, sweet are ok. More pain to the touch whenever I eat spicy or fissure is new or deeper. And I already know that due to the MTHFR Gene I have that I am unable to utilize any of the B vitamins unless they are methylated. The pictures really threw me because my tongue looks exactly the same even the white coating. Sometimes I even get an orange coating at the back of my tongue. Thank you.
Thank you for finally talking about this issue! I am in my 40s now, and I have had GT all my life, or at least ever since I remember as a kid. My mom thinks it may have surfaced after I got hepatitis A at school, around 5 yo, which is why I do believe it is nutrient deficiency related, and at some point, damage to my digestive system. At around 8 yo I started having epileptic seizures, but I was told I didn’t have epilepsia, so I believe it was also a nutrient deficiency. I also do agree that it is hormone related because I got my period at the early age of 9 yo. In my very many attempts to find out why I had that tongue and what could be done about it, all doctors and dentists would tell me it was no big deal and nothing to worry about and that it was very common. Boys would ask me what was wrong with my tongue, luckily it never became a major embarrassment for me until I picked up acting and I was embarrassed to get close-ups. Coincidentally, in my teenage years I finally got diagnosed with psoriasis, which I probably already had earlier in life since I remember the entire skin of the bottom of my feet peeling like a snake as a kid. I also went to several chiropractors and other bone doctors because I had horrible joint pain beginning in my teenage years. They told me it was because I played tennis and I was stressing my joints because they couldn’t see anything too strange in the x-rays. At 42 I got diagnosed with Hashimoto’s Thyroiditis, at 44 Bronchiecstasis of the lungs. I had had an 11cm fibroid removed in my 30s, now I have another big fibroid growing, not being helped by the IVF treatments that I have unsuccessfully undergone. Every conventional doctor I ever went to did not collaborate in helping me figure out why all these things were happening to me. They had the patch mentality and had no interest in digging deeper. I wanted permanent and lasting solutions, not band aids and pills. Around 42, I had gone to the Endocrynologist that diagnosed me with hypothyroid, because I thought I had arthritis and Alzheimer’s. I couldn’t sleep from joint pain, and I couldn’t remember even basic words, I couldn’t have conversations with people, because my words would get tangled, my memory could not even think of basic everyday words, or remember names of even people I knew well. She put me on thyroid meds. It helped with joint pain a bit, and hair loss a bit, but gave me muscle pain instead, to which I got used to, but I wasn’t convinced that was solving the root issue. I went to a throat ear doctor who put me on antacids, but after a month of taking them I decided they were too unhealthy for me and they were not solving my issues either, so I stopped taking them. I went to a neurologist because apart from thinking I had Alzheimer’s, my hands would fall sleep constantly. I couldn’t have conversations with people, I would trip on my words, and I thought it was because I spoke three languages so my brain was confusing all of them, I also obviously thought I was getting old and that was the end of my brain. Whenever I had to introduce myself, I had to pause for a few seconds before saying my own name. So I finally started reading obsessively and listening to great podcast like yours and many other functional medicine practitioners, I bought every book on the immune system, children with autism, nutritional healing, etc etc. Contacted my favorite doctors from the best books I read, until finally one of them took me as a client. When I started working with a functional nutritionist, I had already quit gluten, which reduced my joint pain from 80% to about 10% almost immediately. While taking functional tests after that, I discovered I had the Celiac gene DQ2. I guess I had weakened my inmune system, and thrown my hormones out of whack, by having exposed myself to non-welcomed substances all my life. I had mayor sensitivity to wheat, to the point it was affecting my brain, my gluteomorphin and prodynorphin levels where at high risk, crossing my blood brain barrier and causing a lot of neurodegeneration. Furthermore I don’t digest cow milk, or goat or sheep well at all. My breakfast all my life had been milk and cookies! Raw tomatoes always hurt my tongue, sometimes to the point of bleeding. My tongue is fully split in the middle with additional rips all over. I figured it must resemble the permeable intestine (leaky gut) I discovered I had with another functional test. It was only after going on a very strict AIP protocol that my tongue got better. My tongue cuts will probably never close up fully, but when I eat well, it looks so much better. I also recovered a big part of my brain functioning and my memory has improved. My joint pain was almost non-existent, until just a few days ago when I caught some form of flu, or viral lungh infection, I’m sure my bronchiecstasis doesn’t help, so now my tongue is really sick again. Again, coincidentally enough I had recently started reintroducing certain foods back into my diet, and maybe my gut and my immune system are not ready yet, definitely not fully healed after all the years of abuse without knowing. I get impatient about the re-introductory phase of the AIP diet, but frankly, when I was on that eating protocol, my tongue looked as close as ever to being “normal”. I’ll never touch gluten consciously ever again, as it turns me sore, and brain numb (basically dumb is what I wanted to say, because for a few years I thought I was loosing my intelligence and it was quite traumatic!) I have a bit of an addictive personality still, and my prodynorphin levels are still high, so I get a lot of my symptoms back when I don’t watch what I eat. Now that I got the flu and some kind of viral lung infection, my tongue is a disaster again. But I know I will master it at some point and figure out how to fully get rid of this broken tongue. I really do think it is a leaky tongue, and I will know when I no longer have a leaky gut because my tongue will be clear of sores, patches, white “continent” lines, red splotches, and reaps and cuts. I managed to undo my hypothyroidism and get off the medication through diet and supplements, so I will get to the heart of this tongue issue at some point, even if I’m an old lady by then!
I had a GT for a couple years, with no other symptoms other than the pattern on my tongue. Only when I went in for a Strep culture and a Dr commented, I didn’t know what it was. About a year later when I had the classic symptoms of a vaginal yeast infection and another Dr. prescribed a single dose of diflucan a common fungal Rx, did my GT go away, completely. A few years later I was diagnosed with Leukoplakia, a white swollen patch on the under-side of my tongue, which my dentist sent me to a ear/nose&throat specialist to biopsy and after watching it for almost a year, I again was prescribed diflucan, for another issue and amazingly it cleared up my swollen tongue. So I believe there can be a fungal component to GT.
Absolutely agree with you!
So happy to find this site!
I’ve had two bouts of GT in my life, ten years apart, but both started after months of birth control. This time, I can not seem to kick it. I truly believe gluten is to blame. I had years of infertility, then quit gluten this year and got pregnant twice! We have a baby due in January now 🙂
But my tongue still looks abnormal. It looks a little better since quitting gluten, but I am desperate for my normal pink tongue to return.
I can’t seem to figure out what foods it is reacting to. Citric acid?! Pea protein? Rice?! Dairy?!
It’s so frustrating.
Would love to learn more about how people truly recover from this!
Hi Jen, the thing that would be probably MOST important is to identify any potential nutrient deficiencies (which are mentioned in this article) as that would be really important for the health of your child. Nutrient deficiencies are a greater concern. I hope that helps you!
Thank you so much for your reply! I just now came across it. Pregnancy is going well, but I definitely agree that I want to know what deficiencies I might have. I take a high quality prenatal vitamin.
I want to know what tests you like best for finding deficiencies? I did a spectra blood draw years ago. That seemed thorough. Are there better tests though?
Thank you!
Hi! I am 27 weeks pregnant with GT. I’ve had it now for 3 months. At first I thought I had oral thrush and after 2 runs of the antibiotic mouthwash it didn’t go away I knew it was something else. Did my own research and figured it’s it GT. I’m finding that when I eat sweets my tongue gets inflamed. I go tomorrow for my glucose test and labs to see if I’m deficient in any vitamins. My OB doesn’t seem concerned. I’m hoping that pregnancy is the culprit and that it will go away after I have my baby since I’ve NEVER had this issue before and I’m 36. Thanks for your help!