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Why You Develop Unhealthy Thyroid Tongue And What To Do About It

Jun 19, 2023 | Health & Wellness Blog Updates | Advanced Integrated Health, Thyroid Health

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unhealthy thyroid tongue

When you’re dealing with thyroid issues, medical practitioners require a blood test to confirm what thyroid disorder you have. But besides taking blood tests, your body shows different signs of thyroid dysfunction, such as your tongue. Its appearance, like changes in color, texture, and shape, can indicate whether you’re experiencing a certain health condition, from nutritional deficiencies and dehydration to diseases affecting the thyroid, kidney, or liver.

This makes you wonder, do fluctuations in thyroid hormone levels affect what my tongue looks like? Yes, people with thyroid diseases, such as hypothyroidism, can develop a scalloped tongue. If you or a loved one is experiencing a scalloped tongue, it’s worth looking at the connection between your tongue and thyroid health, other symptoms that occur along with a scalloped tongue, and how you can treat it.

What Is A Thyroid Scalloped Tongue?

It’s a name for when your tongue develops waves or ridges on the sides because of a health condition. A scalloped tongue is also known as a wavy tongue, crenated tongue, or lingua indentata. Though it’s rarely a serious problem that causes pain, you should still get it checked by a doctor.

Ridges form on your tongue because it’s pressed against the teeth. However, it rarely causes pain, so any discomfort you feel is likely due to the underlying thyroid issue causing the ripples. You’ll also notice that the inside of your mouth feels sensitive and looks red, especially on the sides near your tongue.

How Thyroid Disorders Cause A Scalloped Tongue

A scalloped, swollen tongue isn’t a disease but a symptom linked to your underlying thyroid condition. It happens due to inflammation or swelling and is also called macroglossia, which means tongue swelling. Depending on what’s causing macroglossia, you could also be experiencing other symptoms. Knowing your accompanying symptoms can help you determine what’s causing your tongue issues.

One of the leading causes of macroglossia is hypothyroidism, so we’ll start with that. Low thyroid hormone levels can slow down various processes in the body. One of the many signs you’ll see is swelling, which doesn’t just affect your tongue, but your face, legs, and hands, too. The condition is called myxedema and occurs because of the accumulation of glycosaminoglycans in your tissues. Fluid retention can cause your tongue to enlarge and press against your teeth, giving it a scalloped appearance.

Congenital Hypothyroidism

Swelling and indentations on the tongue occur due to congenital hypothyroidism, which refers to hypothyroidism present at birth. Though it’s rare and affects one in 2000 to 4000 newborns, an enlarged, scalloped tongue is a common sign. It’s not present at birth and doesn’t manifest until hypothyroidism is left untreated after the baby develops teeth.

Fortunately, newborns in the US take a standard heel stick test within 48 hours after birth, which helps in diagnosing congenital conditions like hypothyroidism. Infants who are diagnosed with congenital hypothyroidism are immediately started on hormone replacement treatment to ensure age-appropriate cognitive, physical, and neurological development.

Other Causes of A Scalloped Tongue

Keep in mind that a swollen tongue isn’t always the result of a thyroid problem. It could be due to other conditions, such as:

  • Dehydration: Dehydration triggers the body to work extra hard, conserving the limited fluid it does have. One of the first major signs of dehydration is reduced saliva production, causing your tongue to become dry and swollen.
  • Anxiety: Several oral symptoms can occur as a result of high stress or anxiety levels. People experience teeth grinding and jaw pain and press their tongue against their teeth, which can leave indentations similar to a scalloped tongue.
  • Sleep Apnea: Your scalloped, swollen tongue could be a sign of sleep apnea. Patients with the condition unconsciously push their tongues towards their mandibular teeth because they have difficulty breathing while asleep. This leaves visible ridges on the sides of your tongue.
  • Nutritional Deficiencies: If you have a medical history of nutritional deficiencies, it can affect what your tongue looks like. A diet lacking in essential nutrients like folic acid, vitamin B12, and iron, can cause swelling in your tongue.
  • Periodontal disease: This refers to inflammation and infection of the tissues around your teeth. Other symptoms are loose teeth and bleeding gums, which can affect your tongue, as well.
  • Problematic Oral Habits: These include bruxism (teeth grinding), cheek and tongue biting, and tongue thrusting, which put pressure on the tongue and cause indentations. These are learned behaviors that can be treated with dental devices and help from an occupational therapist.

In some cases, thyroid problems can overlap with the above-mentioned issues. To know what’s causing the swelling in your tongue, it’s best to see a medical professional who can assess your symptoms and check your body’s TSH (thyroid stimulating hormone) levels to know what’s causing it.

thyroid gland dysfunction

Symptoms of Thyroid Gland Dysfunction That Accompany Scalloped Tongue

Besides giving your tongue its scalloped appearance, hypothyroidism can also contribute to other oral manifestations. For instance, oral health issues like a dry mouth, difficulty swallowing, or a sore throat. But that’s not all – you’ll also experience other symptoms that indicate unhealthy levels of thyroid hormones in your body:

  • Fatigue and weakness
  • Weight gain because of a slow metabolism
  • Dry skin due to reduced sweat production
  • Hair loss occurs due to a disrupted hair growth cycle
  • Increased sensitivity to cold
  • Secondary burning mouth syndrome refers to a recurring burning sensation in the mouth without an obvious cause.

An enlarged tongue can lead to mouth discomfort, like difficulty speaking or swallowing. Your doctor will examine these symptoms to determine whether the cause is an underactive thyroid.

If you’d like to know about other symptoms that accompany tongue swelling and are linked to thyroid dysfunction, consider speaking to one of our holistic medicine experts. At Advanced Integrated Health, we provide online functional medicine sessions to inform patients about underlying causes.

Diagnosing Scalloped Tongue Due To Thyroid Disease

Diagnosis usually starts with a physical examination of your tongue by a trained physician. To diagnose you with a scalloped tongue, your doctor needs to rule out other possible conditions, as well. For this, they’ll ask you to describe all your symptoms and give a detailed account of your medical history.

You may be required to undergo tests like a biopsy, CT scan, MRI, or blood test. And diagnostic processes frequently include evaluating your thyroid and assessing your lifestyle habits. If your doctor notices poor tooth alignment or other dental issues, they may refer you for a dental examination;

It’s important to remember that you can develop a scalloped tongue because of other thyroid conditions besides hypothyroidism. That’s why a complete diagnosis always includes thyroid function tests, a physical examination, and an extensive medical history.

Treating Scalloped Tongue

If your scalloped tongue has developed because of an underactive or overactive thyroid, treatment aims to address the underlying issue. A holistic approach to treatment includes lifestyle modifications, medication, and in some cases, surgery.

Either way, healing a swollen tongue starts with diagnosing and treating the underlying condition. Besides the comprehensive treatment process required for your autoimmune, neurological, or congenital condition, your treatment approach for a scalloped tongue depends on what’s causing it:

Thyroid Hormone Medication

If the underlying medical condition is hypothyroidism, treatment for scalloped tongue starts with thyroid hormone replacement medication. The medication restores your body’s thyroid hormone levels within a normal range. It can reverse the accumulation of glycosaminoglycans, which causes the swelling in your tongue, restoring its shape to normal.

Anti-Inflammatory Medication

Another common treatment approach includes prescribing anti-inflammatory medication to address the scalloped edges on your tongue. The medication can reduce inflammation and swelling in your tongue and the surrounding tissues. By reducing the swelling, anti-inflammatory medication alleviates some of the pressure against your teeth. This, in turn, reduces the scalloped appearance.

These medicines are typically prescribed for people with who experience tongue swelling due to chronic inflammation, autoimmune disorders, or allergies.

CPAP Machine

If you’ve developed swelling in the tongue because of sleep apnea, your doctor may recommend using a CPAP (Continuous Positive Airway Pressure) machine. In obstructive sleep apnea, your airway becomes blocked or partially collapses while sleeping, forcing your tongue to press against the teeth.

A CPAP machine will deliver a steady stream of air to ensure your airway stays open, allowing you to breathe easily while sleeping. This reduces the pressure on your tongue while preventing further scalloping.

Increasing Fluid Levels

When the cause of swelling is dehydration, one of the first things your doctor will prescribe is to increase your fluid levels. Dehydration causes your tongue to swell up and press against the teeth, causing indentations.

Rehydrating your body reduces swelling by restoring the body’s fluid balance. Drinking enough water throughout the day ensures adequate hydration in your body’s tissues, which reduces puffiness in the tongue and restores it to its natural shape.

anxiety treatment

Anxiety Treatment

Your anxiety can indirectly cause a scalloped dinge because of clenching your jaw or pushing the tongue against the teeth. If that’s the case, your doctor will recommend anxiety treatment to help. This includes a comprehensive mix of anti-anxiety medication, mindfulness practices, and relaxation techniques that reduce your tension levels.

Dental Devices

Besides medication, various dental devices can help in reducing tongue swelling. These devices are especially effective if your scalloped tongue occurs because of tongue thrusting or bruxism, also known as teeth grinding.

  • Mouth Guards: Getting a custom-fitted mouth guard will help protect your teeth and act as a cushion, preventing the teeth from grinding and taking pressure off your tongue. You can even wear them while sleeping, which is when you teeth clenching usually occurs.
  • Tongue Retainers: If you’re having a hard time positioning your tongue properly in the mouth, tongue retainers can help. This device is also useful for people with sleep apnea of tongue thrusting habits.
  • Orthodontic Devices: Though swelling in the tongue is rarely painful, it can be accompanied by orthodontic issues, like misalignment of the teeth or jaw. Your orthodontist may recommend devices like aligners or braces to align your teeth and improve your bite. This reduces the number of spaces in your oral cavity where your tongue may press against the teeth.

If you want to discuss the different treatment options available for swollen, scalloped tongue, consider speaking to our functional medicine specialists. Book an online functional medicine session with us to discuss causes, treatment, and diagnosis of inflammation and swelling in the tongue.

Get In Touch With Advanced Integrated Health For Expert Advice On Scalloped Tongue

If you’re dealing with a scalloped tongue, it’s important to find out what’s causing it by checking for other symptoms. It can occur due to an underactive thyroid gland, allergic reaction, dehydration, or other causes. If you have a thyroid disease like hypothyroidism, treatment will include hormone replacement therapy. Diagnosis for a scalloped tongue includes a physical assessment, blood tests, and comprehensive medical history.

To better understand the link between your thyroid and a scalloped tongue, we recommend talking to one of our functional medicine experts at Advanced Integrated Health. Contact us today to schedule virtual functional medicine consultation.

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