• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

B12 deficiency shown on tongue

Messages
6
Hi All,

Wonder how many of you have deficiency signs on your tongue. Since my health has declined so has my tongue health, large cracks sides and center and somewhat Geographic Tongue.

Interesting case reports and reversed with b12 & folate;

https://cda-adc.ca/jcda/vol-75/issue-7/533.pdf

"Megaloblastic anemias are a subgroup of macrocytic anemias, in which distinctive morphologic abnormalities occur in red cell precursors in bone marrow, namely megalo-blastic erythropoiesis. Of the many causes of megaloblastic anemia, the most common are disorders resulting from cobalamin or folate deficiency. The clinical symptoms are weakness, fatigue, shortness of breath and neurologic abnormalities. The presence of oral signs and symptoms, including glossitis, angular cheilitis, recurrent oral ulcer, oral candidiasis, diffuse erythematous mucositis and pale oral mucosa offer the dentist an opportunity to participate in the diagnosis of this condition. Early diagnosis is important to prevent neurologic signs, which could be irreversible. The aim of this paper is to describe the oral changes in a patient with megaloblastic anemia caused by a dietary deficiency of cobalamin."

Another study.;

https://www.dovepress.com/diagnosti...eficiency-peer-reviewed-fulltext-article-TCRM

"Results: Of 136 patients, 70 had B12 deficiency. Among these patients, the oral “beefy red” patch was observed in 61, abnormal mean corpuscular volume (MCV) was noted in 30, and serum cobalamin levels <200 and <350 pg/mL were seen in 59 and 67 cases, respectively. The “beefy red” patch demonstrated the highest diagnostic validity (Youden index 0.84) and reliability (consistency 91.9% [95% CI: 87.3%–96.5%]), followed by the serum cobalamin levels and MCV. The combination of “beefy red” patch with cobalamin <350 pg/mL exhibited better diagnostic value than the combination of “beefy red” patch with cobalamin <200 pg/mL, with accuracy of 0.81 vs 0.74 and reliability of 90.4% (95% CI: 85.5%–95.4%) vs 86.8% (95% CI: 81.1%–92.5%). "

id-159889-figure-2-revised-submission-90.jpg



Reversed case with b12;

Bob
 
Last edited:

YippeeKi YOW !!

Senior Member
Messages
16,047
Location
Second star to the right ...
Wonder how many of you have deficiency signs on your tongue.
Thank you for this thread, and particularly for your pics of various kinds of tongue indicators. I'm a little queasy today so will give them closer attention later.

And thank you, too, for the video ...
Since my health has declined so has my tongue health, large cracks sides and center and somewhat Geographic Tongue.
Are you trialing any of the various forms of B-12 and folate? Are they helping you at all? Have you browsed any of Freddd's work on SNPs, methylation issues, B12 etc? It might be helpful... I'll see if I can find a thread link for you, but if I wander off, you can hit 'Search', and Freddd should pop up immediately He's practically legend around these parts ....
 

wabi-sabi

Senior Member
Messages
1,458
Location
small town midwest
How about a blood test for b12 and folate levels? That's got to be more accurate than tongue diagnosis. Throw in a MTHFR and a CBC test too for good measure.

Looking at tongues is fun, but sometimes low tech isn't the best diagnostic test. Especially when there's such easy lab testing for B vitamin status.
 

Mary

Moderator Resource
Messages
17,335
Location
Southern California
How about a blood test for b12 and folate levels?
I don't know about folate, but standard blood tests for B12 are not that helpful. One can have high serum B12 but low intracellular levels. The blood level can be high because it's not getting into the cells. My former doctor (who unfortunately died) did a hair analysis each year and my B12 levels were always just about undetectable. Injections 3 x a week were not enough. I ended up taking 5000 mcg. of liquid methylcobalamin sublingually, 2 x a day, before I felt a difference with it.

There is a test called methylmalonic acid test (MMA) which may be more helpful than standard blood work (though I haven't had it done). If MMA is high, it can indicate low B12 https://medlineplus.gov/lab-tests/methylmalonic-acid-mma-test/

MCV (mean corpuscular volume) can also be helpful in determining a B12 or folate deficiency. A high-normal level can indicate low B12 and/or folate - mine was always near the top of the normal range. My doctor told me that if one is deficient in B12 or folate, it can cause blood cells to get larger in an attempt to compensate for the deficiency.

I think the tongue can provide clues of nutritional deficiencies. At the least it can indicate a need for more sophisticated testing than what is usually done.
 

Hip

Senior Member
Messages
17,824
Wonder how many of you have deficiency signs on your tongue. Since my health has declined so has my tongue health, large cracks sides and center and somewhat Geographic Tongue.

There are 4 main conditions which can cause a white tongue coating, detailed in this post.

Geographic tongue is more common in people who have psoriasis.