Healthy Living

Tongue Diagnosis: The Basics

The tongue is a very interesting organ that is often overlooked in Western Medicine. But in TCM, the tongue plays an important role in assessment and diagnosis. The tongue is the only organ that can really give us an idea of our internal health and displays a lot more than just oral hygiene. Have you ever noticed that no matter how much you brush your tongue, there is still a coating? This coating can tell you so much about your lifestyle and can even be linked with certain symptoms!

The way this works is that in TCM, parts of the tongue are associated with different internal organs. The colour, coating and size of the tongue are all taken in mind when doing a tongue diagnosis.

This map of the tongue is generally used when doing an assessment. It’s important to notice if there’s a difference between each section or organ. In some patients, there are purple spots or cracks on certain areas. This is all normal, and can be changed with the proper lifestyle and diet.

Here are four key descriptors when looking at your tongue:

  • Body Colour: Pale, Red, Crimson, Purplish Blue.
  • Body Shape: Enlarged (Swollen), Thin, Deviated,
  • Coating: White, Yellow, Thick/Thin
  • Texture: Moist, Cracked, Rough, Peeling, Slimy/Greasy

In this blog, I will go into depth about what each tongue colour signifies, associated symptoms, and small lifestyle changes that you can make. A healthy tongue should be a fleshy pink with a bit of a coating. The sides should not have teeth marks, and it should not look swollen or thinned out.


A Pale tongue is associated with deficiency in TCM. It’s linked to fatigue, poor appetite, pale complexion, spontaneous sweating, feeling cold and tired. It’s generally seen on those who eat foods that are colder in nature such as raw foods, fruits, salads and vegetables. These foods are amazing for you, but in moderation! If your tongue is pale, it’s because you are eating too much cold foods. Try cooking a bit of apple with cinnamon or adding ginger to your diet. These foods will warm your interior and help ease some of the mentioned symptoms. Another useful tip is to soak your feet in a warm bath when you feel cold.

A Red tongue is linked to many heat symptoms such as constipation, skin irregularities, feeling hot/thirsty and having trouble sleeping. A red tongue is generally seen when someone indulges in spicy foods and is a result of too much heat in the body. To cool your interior, try eating more foods that are colder in nature such as fruits, salads, vegetables and fruit juices. You can also try meditating because heat is also linked to irritation and a bad temper. Mint is great for cooling the body!

A Purplish Blue tongue is linked to blood stasis. Blood stasis is when the blood circulation in the body is not optimal. This can manifest as headaches, pain, cold limbs, varicose veins and digestive issues. A purple/blue tongue is generally seen in older patients, smokers and those with less nutritionally rich diets. A purple tongue signifies that both diet and lifestyle need to be improved. The best thing to do if you notice your tongue is purple or has purple spots, is to start exercising daily and go for a massage. Also, incorporate nutrient rich foods into your diet such as black beans, lentils and avocados. This will improve your circulation and therefore ease pain and the above mentioned symptoms.


Aside from the appearance of your tongue, please make sure that you are properly nourishing your mind and body. This means doing what makes you happy, eating nutrient dense foods and practicing self-care. Never forget how important you really are!

If you want to learn more about how TCM theory works, click here.

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