Did you know that your tongue can serve as a window to your health?

Tongue Diagnosis is one of the four pillars of examination in Traditional Chinese Medicine, and reveals to the practitioner a basic guide of where disharmony is present. This may sound strange to those of us who were raised in a Western society that only looks at blood work, but you’d be surprised at all your tongue can tell you.

Here’s how it works…

– First, you look at the overall “material” of the tongue: is it a healthy pink signaling proper blood flow? Is it pale, suggesting there may be an iron/B12 deficiency? Is it deep red or even purple, signaling trapped heat and stagnation?

– Then, you want to look at the coating: is there a healthy thin coating – just enough to moisten the tongue? Or is there a thick white or yellow moss?

– Next, we move onto the nature of the tongue: examining whether it’s swollen (with teeth imprints on the sides), cracked (hinting at a dry tissue state in the body), or shaking (this is something known as “wind”).

– Lastly, we would tie this all together by focusing on where these different characteristics are seen. Since we know cracks represent a lack of moisture, if they’re in the “stomach/spleen” area we would focus on nourishing and rehydrating the gut with mucilaginous herbs like marshmallow root. We know redness represents trapped heat, so if it’s in the “heart” area we would focus on relaxation techniques and bitter herbs that clear heat to “cool” us down physically & emotionally.

Want to know more about what that means for your tongue? Here’s a more in depth explanation of some of the most common observations practitioners see:


Although the sides of the tongue mirror the liver/gallbladder meridian, teeth marks on the edges are actually a result of a ‘swollen’ tongue that is pressing into the teeth which leaves imprints over time.

  • In TCM, a swollen or puffy tongue indicates there is a deficiency in Qi (energy) – especially “spleen”/digestive Qi which helps you to metabolize and distribute fluids and nutrients from food & drinks.
  • You may experience symptoms such as fatigue/lack of energy, puffy or heavy limbs, bloating, sluggish bowel movements, and alternating constipation/diarrhea.
  • In Western terms, when I see “Qi deficiency” I immediately think of a B-vitamin deficiency and/or low thyroid hormone. If the tongue is pale, I would suggest an iron panel as well. A high quality methylated B-complex can be therapeutic here to improve energy and digestion.
  • HERBAL INDICATIONS: Warming herbs such as fennel, orange peel and mugwort can be blended into a warming “digestive bitter” tincture. Take 15 minutes before meals to stimulate gastric juices and support digestion, nutrient assimilation, and spleen Qi.
  • EAT MORE: sweet potato, soup, lightly cooked vegetables and easily digestible protein such as legumes and wild fish. Do noteat in front of the TV or while looking at your phone! Eat regular meals at the same time every day and don’t skip breakfast.
  • AVOID: raw, cold foods and iced beverages until digestion improves. Try cutting out wheat & dairy. No sugar is key because the intense sweetness damages the spleen Qi further.


The back of the tongue represents the kidney and bladder, but also includes the large and small intestines.

  • A yellow coating here signals ‘damp heat’ in either the bladder or intestines. When we think of the words ‘damp’ and ‘hot’ we picture an environment where pathogens such as fungi and bacteria can thrive & multiply. Thus, a person with this coating may have an overgrowth of pathogenic bacteria in the gut, may experience a ‘full’ feeling in the abdomen, and/or may experience frequent urinary infections. If you’re experiencing bloating and severe digestive symptoms, ask your doctor for a SIBO (small intestinal bacterial overgrowth) breath test.
  • This can also signal stressed adrenals that are overworked and have become too ‘hot.’ It’s important to avoid stimulants like coffee here because it’s such a concentrated ‘yang’ substance that can burn up your kidney/adrenal essence over time.
  • HERBAL INDICATIONS: Oregon Grape Root, a cooling bitter can be taken with meals to clear damp heat in the intestines and support digestion. Neutral to cooling adaptogens such as schizandra can be helpful to strengthen the adrenals.
  • EAT MORE: onion, cinnamon, basil, oregano, sage, adzuki beans, celery, lettuce
  • AVOID DAMP FOODS: milk products, SUGAR(!), alcohol, fatty & fried foods.


Cracks on the tongue always remind me of dry soil cracking in the dessert. This indicates a dry tissue state and ‘yin deficiency’ in the stomach/gut.

  • In this case, the gut needs nourishment and moisture through mucilaginous & hydrating foods. Replace cold water with warm to hot water throughout the day to rehydrate the intestines.
  • HERBAL INDICATIONS: Prepare a ‘cold infusion’ of marshmallow root and drink 1-2x daily to lubricate the gut and aid in nutrient absorption.
  • EAT MORE: oats for breakfast, brown rice, millet, barley & barley water, mushrooms, flaxseed.
  • AVOID: packaged foods, large meals and overeating, cigarettes (drying to the stomach & lungs).


This can manifest as irritability, restlessness, racing thoughts, insomnia, and anxiety.

  • Caused by lack of sleep, repressed emotions and anger not being released, too much working/thinking, holding everything in as to not inconvenience others.
  • Take walks in the woods each week to clear heat from both the liver and heart
  • TALK ABOUT YOUR EMOTIONS to get the heat “off your chest”
  • HERBAL INDICATIONS: hawthorn berry tea or linden tea
  • EAT MORE: bitter/sour foods such as celery, spinach, cucumber, green apple
  • AVOID: stimulants, stressful television shows, fried foods, excess meats, cheese, eggs, peanuts & alcohol

Leave a Comment


  • Mia says:

    Great post!!! It’s amazing all that you can learn just by looking at it. I looked at my tongue while I was reading this and was able to realize I have 2 of these conditions at the moment. Going to pay more attention now. Thanks so much!! You make being healthy easier ☺️

  • TERRY says:


  • Daisy says:

    I’ve recently started studying TCM and just wanted to say that your blog has been so so helpful in putting all this knowledge together. I always refer to this post when I notice my tongue isn’t looking healthy.

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