How Your Swollen Tongue Could Be Signaling a Major Health Problem
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If you happen to notice you have a swollen tongue, a.k.a. glossitis, you might be a bit concerned. After all, your tongue plays an important role—eating is vital. And much like swollen feet or swollen tonsils, you’re likely to notice something is up right away.
It doesn’t take long to notice when your tongue is suddenly too large for your mouth. Your first instinct might be to freak out (and we don’t blame you!), but fear not: “Swelling of the tongue can be caused by a variety of different problems, most of which are self-limiting and not serious,” says Clare Morrison, M.D., general practitioner and medical advisor at MedExpress.
However, if the swelling happens quickly, or is severe and accompanied by throat tightness, difficulty breathing, dizziness or feeling faint, then you should seek medical attention right away, as it may indicate a life-threatening situation.
Likewise, if the swelling persists (say, 10 days or longer), gets worse, or you’re experiencing other concerning symptoms, such as fatigue, pain, or fever, then definitely check in with your doctor.
Symptoms of a swollen tongue
No matter the cause of your swollen tongue, you’re likely to experience a variety of related symptoms. According to Omid Mehdizadeh, M.D., otolaryngologist (ENT) and laryngologist at Providence Saint John’s Health Center in Santa Monica, California, here are the most common symptoms:
Speech changes
Difficulty breathing
Difficulty swallowing
Painful and/or burning sensation
Sleep apnea or snoring
As for what might be causing your tongue to puff up? Below, experts share 11 possible culprits.
What causes a swollen tongue?
1. Your tongue is recovering from an injury
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amazon.com“The tongue is vulnerable to trauma from the teeth, due to accidental or compulsive biting, sharp edges of broken teeth, and from dental work such as braces, false teeth, and rough fillings,” says Dr. Morrison.
The obvious solution is to nix the causative factor of your puffy tongue (in some cases, you may need an assist from your dentist, says Dr. Morrison), while soothing the injury by sucking on an ice cube, popping ibuprofen, and using a gentle mouthwash to prevent infections.
2. You’re experiencing irritation
Hot or sharp pieces of food can cause tongue irritation and swelling too, especially if those eats are acidic (like hard sour candies) or hot and spicy (chilies and curries), Dr. Morrsion cautions. Try eliminating some of these types of foods from your diet to see if your tongue swelling improves.
Additionally, “Some people tend to chew on their tongue during their sleep,” notes Dr. Mehdizadeh. “Especially if they experience something such as a TMJ disorder.”
3. Your mouthwash may be causing problems
Certain toothpaste and mouthwash ingredients can cause tongue swelling that won’t resolve until the inciting ingredient is discontinued, says Los Angeles-based board-certified dermatologist Tsippora Shainhouse, M.D. The most common culprits to cause oral contact dermatitis? Hydrogen peroxide (often found in teeth-whitening products), alcohol (found in mouthwashes), baking soda (in many toothpastes), and cinnamates (found in chewing gum).
If you’re not sure which ingredient is giving you ‘tude, your dermatologist can perform an allergy patch test to suss it out, adds Dr. Shainhouse.
4. It’s a sign of an allergic reaction
Allergic reactions are caused by the immune system overreacting to something it’s exposed to. Think: fruit, nuts, shellfish, milk, or even an insect bite. The allergic response involves the release of histamine, narrowing of small blood vessels, and the accumulation of fluid in the tissues, says Dr. Morrison. When an allergy causes swelling of the tongue, lips, and face, it’s known as angioedema.
Allergic reactions can be treated with antihistamines or oral steroids. Serious reactions can ultimately restrict breathing, which is why people who know they can react to specific foods or bites must carry an EpiPen and administer it immediately.
5. It’s a side effect of certain medications
The medications best known for causing allergic reactions—and associated tongue swelling—are blood pressure medications known as ACE-I inhibitors. “They can cause potentially life-threatening tongue swelling that can occur at any time during therapy,” says Dr. Mehdizadeh. “It doesn’t necessarily occur when first taken.”
Anti-inflammatories (like aspirin and ibuprofen) and antibiotics (penicillin, antivirals), can also trigger an allergic reaction. “If affected, it’s important to stop the offending medication,” says Dr. Morrison. Treatment must be sought right away, and depending on severity, can include antihistamines, steroids, and intramuscular adrenaline.
6. A vitamin deficiency could be to blame
vitamin B12 deficiency and folate deficiency can cause a swollen, red, beefy-looking tongue. “You may also get tingling in the hands and feet, fatigue, and weakness,” says Dr. Morrison. Meanwhile, an iron deficiency can cause the tongue to become sore, smooth, and pale, and is likely to be accompanied by fatigue, shortness of breath, and super-pale skin.
Increasing your intake of these vitamins by eating foods like meat, fish, eggs, leafy greens, beans, and lentils, can relieve symptoms, but major vitamin and mineral deficiencies should ultimately be investigated by your doctor, says Dr. Morrison. They’ll want to look into how the deficiency arose, and replace the missing nutrients through specific supplements and dietary changes.
7. Acid reflux is irritating your tongue
Stomach acid that travels to the throat (laryngopharyngeal reflux, or LPR), may irritate the tongue and cause swelling. “You may notice an acidic or bitter taste in your mouth, throat burning, or the sensation of a lump in your throat,” says Dr. Mehdizadeh. Steering clear of acidic or spicy foods and drinks can help with keeping LPR in check—so can popping antacids, eating smaller, more frequent meals, and wearing loose-fitting clothes.
8. Your tongue is infected
Bacterial infections can arise from a cut—say, from teeth biting or rubbing on the tongue—that bacteria then use as an entry point. Your tongue might feel red and sore, says Dr. Morrison, and if the infection is deep, it can cause an abscess that results in painful swelling.
Occasionally, STDs, like syphilis and gonorrhea, can affect the tongue. Bacterial infections will require a round of antibiotics from your doctor—and in the case of a large abscess, hospital admission and surgical drainage.
Viral infections of the tongue include herpes (the cold sore virus). “The first infection is the worst, and may be associated with multiple painful blisters inside the mouth, including the surface of the tongue, as well as fever and malaise,” says Dr. Morrison.
HPV (human papillomavirus) and canker sores can also mess with your tongue. These usually clear up without treatment, but medical guidance should always be sought if you’re feeling particularly awful.
9. An underactive thyroid could be stirring up symptoms
When circulating levels of thyroid hormone are low (which is common in women, and often autoimmune-related, says Dr. Shainhouse), there are specific signs to watch out for, including fatigue, unexplained weight gain, constipation, cold intolerance, hair thinning, and (surprise!) tongue swelling.
Fortunately, hypothyroidism can be diagnosed with a blood test. “If confirmed, it’s treated by taking prescription medication to replace the thyroid hormone,” says Dr. Morrison. From there, regular blood tests will be required to check the dose, which will be adjusted on an as-needed basis.
10. Your pituitary gland is acting up
The pituitary gland is an itty bitty organ that’s located at the base of the brain. It makes and ships a variety of different hormones to the rest of the body, and tells other glands when to do the same. “If the pituitary gland produces too much growth hormone, there will be gradual swelling of several parts of the body, including the tongue, hands, feet, and face,” says Dr. Morrison.
Docs call this disorder acromegaly. Usually caused by a benign tumor in the pituitary gland, other symptoms can include headaches, deepening of the voice, irregular periods, skin tags, and enlarged facial features.
Because acromegaly develops slowly, you might not notice the changes to your appearance at first—but the second you suspect it to be a problem, it’s important to check in with your doctor for a blood test to confirm and subsequent treatment, as life-threatening complications can strike if left untreated, says Dr. Morrison.
11. It could be a sign of tongue cancer
Tongue cancer starts off superficially, typically with a white or red patch, or a small lump or ulcer on the tongue. “It usually arises at the site of a previous infection with HPV, which may have occurred many years earlier,” says Dr. Morrison, and is more common in people who smoke or drink alcohol.
“If removed at this stage, it’s completely curable,” says Dr. Morrison. That’s why it’s so important to seek medical attention if you have persistent tongue soreness or a lump that won’t quit—a biopsy can determine if it’s cancerous so you can be treated right away.
When to see your doctor
While some individuals with a swollen tongue may experience milder symptoms, if your symptoms are severe, you should see your doctor right away. Mainly, if you notice you are having trouble breathing or speaking, seek medical care urgently. And if you have a history of severe allergies and notice tongue swelling and/or throat-tightening, get to your doctor or call 911, stat.
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