Pernicious Anemia Tongue: Causes, Symptoms & Treatment Options

Pernicious anemia is a condition that occurs when the human body can’t make enough healthy blood red cells. In most cases, pernicious anemia is linked to an individual’s inability to absorb B12 properly.

However, pernicious anemia may also be linked to how a person processes B12. This is particularly true when certain medications, recent surgeries or infections prevent the body from absorbing B12.

Pernicious anemia often presents itself by altering the appearance of your tongue.

What is Pernicious Anemia Tongue?

Pernicious anemia doesn’t always impact the tongue. However, tongue-related symptoms are often one of the first things people notice when they have the condition, and it is the signal that leads people to visit their doctor in a search for answers.

What Causes Pernicious Anemia Tongue?

Pernicious anemia that leads to tongue symptoms is often caused by a deficiency in vitamin B12, or a problem with the absorption of B12. This may be caused by a number of issues, including these:

• Stomach, intestinal, or gastric bypass surgery 

• A bacteria problem in your small intestine, possibly small intestine bacterial overgrowth (SIBO)

• Tapeworm or parasites

• Certain medications

• A diet lacking in B12 (more common in vegan and vegetarians)

• Digestive, endocrine, and autoimmune disorders

Other conditions can result in tongue problems that look like pernicious anemia tongue. These include the following:

• Allergic reactions or food sensitivities

• Dry mouth

• Oral herpes 

• Sores

• Injuries and burns

Symptoms

The primary symptom related to pernicious anemia and your oral health is typically a red, smooth-looking tongue. This is often referred to as glossitis by medical professionals. In some cases, it can be painful or uncomfortable.

There are different types of glossitis.

• Acute glossitis: This is a sudden tongue reaction with serious symptoms, usually caused by an allergic reaction or food sensitivity. 

• Chronic glossitis: Recurring tongue problems are likely caused by a chronic health problem like diabetes or anemia. 

• Idiopathic glossitis: This is tongue inflammation that is commonly linked to a gluten sensitivity or celiac disease.

• Atrophic glossitis: The tongue loses its color and some of its papillae (the little bumps that help hold food for chewing and contain taste buds).

Other symptoms can include a cracked or swollen-looking tongue. Individuals who are dealing with certain blood disorders may notice ulcers or other types of irritation within the mouth. A swollen-looking tongue that appears thicker than normal can also be a sign of pernicious anemia. Some patients describe the tongue as “beefy” when this occurs.

Specific autoimmune disorders can trigger pernicious anemia, such as type 1 diabetes.

Treatment Options

Pernicious anemia can occur because of unchecked health problems. Autoimmune disorders like diabetes are common factors in the onset of the condition.

When something like diabetes is involved, treating the more serious condition allows the doctor to also alleviate pernicious anemia. Stopping certain medicines or transitioning from one medicine to another can help with the treatment of pernicious anemia.

For individuals who don’t have existing health issues, replacement therapy with vitamin B12 is often effective. You may need to work with your doctor to determine the correct amount of vitamin B12 to take.

Changing your diet to include more B12-rich foods (like eggs, milk, poultry, and shellfish) may be recommended for those who prefer not to take supplements. Regular evaluations may be required over time as well, particularly if you start to see signs and symptoms of pernicious anemia returning.

When you’re dealing with tongue-related symptoms of pernicious anemia, it’s particularly important to stay on top of your dental and oral health hygiene routine. That means brushing and flossing at least twice per day or as recommended by your dentist.

You may also want to add an antibacterial mouthwash to your oral care routine.

Prevention

Preventing pernicious anemia and symptoms like glossitis, mouth ulcers, and a swollen, beefy tongue is highly dependent on your personal case. Working with your doctor is usually your best bet.  Here are a few common prevention methods you can use going forward once you and your doctor have treated the initial symptoms:

• Improve your diet and add B12-rich foods to your pantry and refrigerator. Foods like yogurt, chicken, beef, lentils, soy beans, and spinach can help.

• Add a multivitamin to your diet. You may also want to consider a B12 supplement going forward if you don’t have much B12 in your diet or you have trouble processing it.

• Consider vitamin B12 shots if your doctor thinks they may be helpful for you. Many people find that getting B12 shots is a little more convenient than taking supplements or altering their diet dramatically, particularly if they have a problem absorbing normal amounts of B12.

Pernicious anemia can seem scary. After all, it has a rather formal-sounding medical name. Pair that with unusual tongue-related symptoms, and it’s easy to feel overwhelmed. The good news is that pernicious anemia can usually be treated by handling underlying medical issues like diabetes or other autoimmune diseases if they’re present. For individuals without these autoimmune issues, supplements or simply changing your diet can make a big difference. With a little effort on your part, you can leave pernicious anemia behind for good.