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Why do Acupuncturists Always Look at My Tongue?

Written by Sang Nguyen, L.Ac, DTCM

Daily Tongue Observation

Why do Acupuncturists Always Look at My Tongue?Tongue examination is a common method of diagnosis in Traditional Chinese Medicine (TCM), Ayurveda, and Esogetic Holistic Medicine (EHM). It is said to represent the whole body!

The tongue, is an essential tool to analyze the status of your health patterns.

A diagnostic tool in Chinese medicine, the tongue nearly always shows the true condition of the patient. It is particularly useful in complex, chronic conditions manifesting with contradicting symptoms and signs. Its strength relies in the fact that it is nearly always reliable and objective.

The tongue is the only external organ that can reflect the internal organs and their meridian channels’ balance and imbalance.  TCM practitioners focus on the shape, color, and coating of the tongue.

A short take on tongue diagnosis:


Round, swollen, thin, short, contracted, cracked, deviated, rigid, flaccid, teeth-marks

It reflects the constitution, aging, qi and blood, excess, and deficiency.


Red, deep red, crimson, purple, pink, pale, red dots, white

Reflects the status of qi, blood, and the yin organs: liver, heart, spleen, lungs and kidneys


Moist/dry, thin/thick, sticky/powdery, peeled, turbid
Reflects the stomach and the yang organs: stomach, gall bladder, large intestine, small intestine, bladder, and san jiao (triple burner).

Coating color: white, yellow, grey, black, brown: reflects on pathogenic factors: heat, cold, and damp

Often times, the tongue examination can be a misdiagnosis due to certain intake of food, drink, and pharmaceutical drugs. The long term effect of the medication can change the tongue significantly.

Food and drink have a shorter effect on tongue color and coating:

Coffee and Tea:   Yellow dry coating

Blueberries:   Blue tongue color

Diary and Cheese:   Whitish yellow sticky coating

Sugary Food:   Thick white, or yellow sticky coating

Medication, long term:   Significant effect on the tongue color and coating

Antibiotics:   Black and hairy tongue coating

Anti-Neoplastics:  Thick brownish to black tongue coating

Anti-Inflammatory:   Red dots, and peeled coating

In some systems (Ayurvedic), to keep the tongue healthy, it is recommended that the tongue be scrape daily with a metal tongue scraper, either copper or stainless steel; followed by brushing and flossing the teeth. This process is to remove the overnight bacteria and toxin build-up. It is your choice to do daily tongue cleaning, or not.  However, make sure to observe it first before doing so.   *In addition, keeping the tongue in its original coating when visiting a TCM Practitioner is appreciated. *

Although you may not be able to examine your tongue right away, it is still a good idea to take care of it.

It is a process of paying attention to your tongue daily, especially early in the morning when waking up, before brushing your teeth. A healthy tongue has pinkish-red color, a thin white coat, with the least amount of cracks.

If there is a thick tongue coating, we may want to look into our diet, emotional conflicts, stress level, and lifestyle.

You are invited to visit us and have our practitioners share more about your tongue diagnosis!

Come see Sang for a thorough tongue diagnosis at your acupuncture appointment. We always include a tongue check – ask us about it!

Sang Nguyen, L.Ac, DTCM
Many Lives Chinese Medicine
Acupuncturist Redwood City
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