If you have unexplained crop circles on your tongue, you suffer from a condition known as glossitis or geographic tongue. Most doctors and dentists will tell you the condition is nothing to worry about, but the truth is, those annoying circles on your tongue may be the sign of a serious gluten disorder, including celiac disease. This article is for informational purposes only. Please discuss any health conditions with your doctor. Please read my disclosures and disclaimers.
Geographic tongue is defined as a benign or “harmless” condition where a person experiences painless but annoying patches that look like red crop circles or lesions on the top and sides of the tongue.
These circles come and go and present differently each time they reappear. The circles change shape and location, albeit they are always located on the top and sides of the tongue. Geographic tongue is said to affect 1-3 percent of the population.
Geographic tongue is not contagious, even though it looks like sores on your tongue, and the best treatment is “reassurance” to the patient that the condition is harmless.
According to the American Academy of Oral Medicine (AAOM), the cause of geographic tongue is unknown, although AAOM says the condition has been linked to “emotional stress, psychological factors, habits, allergies, diabetes and hormonal disturbances” and it also is found frequently in patients with psoriasis.
An associated condition, fissured tongue, is similar to geographic tongue, however, it looks more like deep grooves (fissures) plotted along the surface and sides of the tongue. Many patients with geographic tongue also present fissured tongue and vice versa.
The Gluten Connection
There have been many connections between geographic tongue and gluten disorders, some of which I’ll present below.
Geographic tongue may be the sign of celiac disease
A 2016 study published in the Journal of Oral & Pathology Medicine found a strong connection between patients with celiac disease and geographic tongue.
Researchers assessed 60 geographic tongue patients and 60 healthy control subjects for celiac disease. They found that nine (15 percent) of geographic tongue patients tested positive for celiac disease both via bloodwork and duodenal biopsy (biopsy of the upper part of the small intestine).
Of the nine that tested positive for celiac disease, only two of them had gastrointestinal symptoms. This means the majority of the patients had asymptomatic or silent celiac, which means they presented non-gastrointestinal symptoms, which are the typical symptoms displayed by celiac patients.
Researchers concluded that patients with celiac disease exhibit an increased prevalence of geographic tongue, and a “clinical oral examination should be considered a diagnostic tool, especially in atypical or silent forms of celiac disease, since it may contribute to provide an early diagnosis.”
Geographic tongue may be the sign of a nutritional deficiency
Many researchers suspect that geographic tongue is a sign of a nutritional deficiency, particular deficiencies in iron, vitamin B6 and B12, folic acid and zinc.
Celiac disease is an autoimmune disease that impairs the body’s ability to properly absorb nutrients. When a person with celiac disease eats gluten, the body’s immune system gets confused and mistakenly attacks the lining of the small intestine.
A properly functioning small intestine is essential for absorption and distribution of nutrients from food. Without a fully functioning small intestine, people with celiac disease experience malnourishment, and they experience other negative health consequences resulting from a lack of proper nutrition.
This is why celiac disease symptoms often present themselves in non-classical disorders (non-digestive disorders) such as migraines, skin conditions, and joint pain.
It appears, then, that unmanaged celiac disease (or people not fully treating celiac disease via a strict gluten-free diet) leads to nutritional deficiencies, and nutritional deficiency thereby leads to geographic tongue.
Once again, all roads lead back to gluten.
I “healed” geographic tongue with a gluten-free diet
I would like to present my own story as a case study to the connection between gluten and geographic tongue.
Since I was a young adult, I recall having bouts of geographic tongue. The “outbreaks” would come here and there, and I asked every doctor and dentist I knew what was “wrong” with my tongue.
Each doctor and dentist reassured me nothing was “wrong” and that this was a benign condition with an unknown cause. I took this information at face value my whole life!
Here is what my tongue looks like when I have a geographic tongue visit:
While geographic tongue is not painful, it is annoying. You feel like there are sores on your tongue. I avoid citrus when I have an outbreak as it exacerbates the lesions.
Geographic tongue is unsightly. How do you explain to someone that you have these benign lesions on your tongue and not have them worry they will “catch” it? It definitely made dating a little trickier.
However, after I was diagnosed with celiac disease in 2012, and I implemented a strict gluten-free diet, my annoying geographic tongue “outbreaks” began to dissipate.
I rarely exhibit a geographic tongue episode anymore, after 8+ years of a strict gluten-free diet, and when I do, it’s typically in the week’s after an accidental glutening episode, in times of stress or when I’m not eating well and am “off” my normal routine. Just like cold sores, I rarely get geographic tongue any more.
I discussed geographic tongue with Dr. Tom O’Bryan when he interviewed me for his weekly Facebook Live segment. You can watch the full segment below (and see me stick out my healthy tongue when prompted to do so by Dr. Tom – so embarrassing!).
What To Do If You Have Geographic Tongue
If you suffer from geographic tongue, you should discuss several testing and treatment options with your doctor.
(1) Get tested for celiac disease
First, and most importantly, ask your doctor to test you for celiac disease, or take this at-home celiac disease test (which is the same test your doctor would give you) and discuss the results with your doctor. Use the code “JENNY10” for 10 percent off your at-home test.
Your doctor will look if there is tissue transglutaminase (tTG) antibodies (tTG-IgA and tTG-IgG) in your blood. tTG is an enzyme found in the intestine and is currently the gold standard screening test. When someone has celiac disease (and is consuming gluten), the immune system produces antibodies that attack tTG. Read more about how a celiac disease blood test works in this article.
Do not implement the gluten-free diet until you’ve been tested for celiac disease, as you must be eating gluten in order to get an accurate test result. Read this article to understand why it’s important to get tested for celiac disease before making dietary changes.
If you have celiac disease, you’ll need to implement a medically-prescribed, life-long gluten-free diet, which will aid in your small intestine’s recovery. As a result, your small intestine will heal and begin to properly absorb nutrients again. You may find it also clears up or lessons your geographic tongue outbreaks.
(2) Give yourself a nutrition boost
Because research indicates a connection between nutritional deficiencies and geographic tongue, you may want to consider boosting your vitamin intake both through food and supplementation.
Talk to your doctor or nutritionist about taking supplements to boost your iron, folic acid, vitamins B6 and B12 and zinc. Your doctor can test you for vitamin deficiencies, or you can take an at-home vitamin check test to check yourself. Many insurance companies no longer pay for vitamin checks, so consider the at-home testing options as a far more affordable and convenient way to get the job done.
A good multivitamin may do the trick, or you may need further nutritional therapy, which you can assess with your healthcare provider.
Additionally, you’ll want to take a hard look at your diet and see if you’re able to naturally boost your nutritional intake by eating more fruits, vegetables, beans, wild fish, lean meats and more.
I wrote about 10 naturally gluten-free foods every celiac should be eating in this article. I always believe you should strive to get the majority of your nutritional needs from food vs. supplements, although a few supplements can help fill in where food leaves off.
Eliminate gluten for awhile
If you have a negative celiac disease test, consider getting tested for gluten sensitivity (Wheat Zoomer is the most comprehensive gluten sensitivity test recommended by Dr. Tom O’Bryan, who wrote the forward to my book, Dear Gluten, It’s Not Me, It’s You.)
This test will give you insights into how gluten may be impacting your body in an adverse way.
Regardless, you may also want to simply eliminate gluten for several weeks or better, for several months (no cheating, not even a crumb!), to see if your geographic symptoms dissipate or disappear altogether.
You can work with a nutrition professional to help you implement the gluten-free diet with ease and/or sign up for my gluten-free meal planning program to get meal ideas and recipes emailed to you each week.
Listen to Your Body
While many doctors say they believe geographic tongue to be a harmless condition, which may very well be true, research suggests it could also be the sign of something more serious going on in your body, such as celiac disease, nutritional deficiencies, gluten sensitivity, or something else.
Talk to your doctor about getting tested for celiac disease, gluten sensitivity, and nutritional deficiencies, and assessing other symptoms you’re experiencing to help you connect the dots in your own health.
Overall, trust your intuition. You may figure out the root cause of your geographic tongue and/or other unexplained conditions in your life by trusting your gut and experimenting on yourself.
- Dear Gluten, It’s Not Me, It’s You book
- Gluten’s Effect on Cold Sores, Canker Sores and Geographic Tongue
- Autoimmune Disease and the Gluten Connection
- The Autoimmune Fix Book Review
- 10 Facts Your Doctor Doesn’t Know about Celiac Disease
- 10 Signs and Symptoms of Celiac Disease
- 60+ Symptoms of Non-Celiac Gluten Sensitivity