What Does Your Tongue Say About Your Digestion?

Sometimes our bodies are really weird. And sometimes they’re super cool.

Today let’s chat about how they’re cool. Did you know our bodies have all sorts of ways to indicate and reflect externally, what is going on internally?

One of these ways is by looking at your tongue. Let’s take a look at what we can learn from assessing our tongues today!

But first, if you’re a regular reader in this space, yes, I changed my website and business name. But, it’s the same old mostly serious, sometimes goofy me (Rebecca). I’ll continue to share recipes here interspersed with more just-plain-nutrition-topics. Thanks for continuing to read and follow. Now let’s get to learning about your tongue!

When you look at your tongue, you can see clues about internal moisture (or lack thereof), heat and cold, tissue integrity and health, and overall vitality. All of this begins in the digestive tract, since the food you eat literally becomes the cells and tissues of your body within the following days and weeks. 

There are several aspects of the tongue that clue us into what is going on, including: 
Color
Shape, including width and vertical thickness
Cracks
Marks (spots, swollen papillae)
Coat (its presence, thickness, color, and how rooted it is)
Tension
Under tongue vein conditions and/or teeth indentations

For instance: The color of a healthy tongue is generally a moderate shade of pink. If yours is darker or paler, that indicates there may be something going on with the blood and/or blood circulation, such as excess heat and internal inflammation, or anemia (which at its most basic definition means lack of blood). A tongue that is purple or bluish, or has spots of those colors tells us the blood isn’t moving. You might really be suffering from a lack of circulation and feel particularly cold compared to others. Adding warmer spices to your foods and circulation-promoting herbs can particularly help cold, stagnant blood circulation. 

The tongue size and shape indicates the state of fluids and hydration within the body, as well as overall tissue nourishment and balance. A swollen, wide tongue usually indicates there’s excess moisture, mucus, or edema, and a dry, thin, tongue is often the opposite. A tongue that’s thick vertically often indicates excess heat and internal inflammation. 

Likewise, lack of vertical or horizontal cracks indicate there is adequate bodily moisture. Are you routinely dehydrated? Do you have cracks on your tongue? 

The tongue’s coat and the color of the coat in particular are tell-tale signs of how digestion has become imbalanced and can be improved. If there is no coat at all or it’s present in patches, this tells us your digestive capacity is a bit insufficient. We need to work on helping the digestive system assimilate and absorb those nutrients from your foods!

And a particularly thick coating tells us there’s some sort of excess going on, in the way of imbalanced gut bacteria, excess moisture which often presents as bloating after meals, or stagnant digestion, where you feel like your food just sits in your gut. 

One of the most common indications of imbalance I see is tooth marks or indentations or ripples on the sides of the tongue. This means the digestive fire is low, and you’re not assimilating the foods you’ve eaten, leading to poor tissue quality and all sorts of bodily presentations of feeling not optimal.

Take a look at your tongue. What do you see? 

Here’s mine. What can you determine about my digestion by looking at it?

My tongue assessment:
Shape: A little wide, indicating possible lymphatic stagnation or mucus.

Color: Somewhat pale (not shown super well in this photo); indicating possible anemia and/or malnourishment.
I tend to float back and forth on the line between clinical anemia and low-normal red blood cells, have fairly chronic low digestive ability, and need for a ton of supplements to stay in “health” despite consistent focus on optimizing digestion and food first. This clue checks out with my actual lab data and long-term health tendencies.

Thickness and Color of the Tongue Coat: Spotty. Mostly absent from the front; thicker than ideal in the back, indicating poor digestive capacity in the middle and lower GI (stomach and small intestine), and excess mucus or stagnation in the lower GI (colon), probably as a result of the under functioning section above. The color is a transparent white which is ideal!

Tongue Moisture: Moist – which is ideal.

Cracks on the Tongue Body: none – ideal.

Lastly, I tend to have mild indentations or tooth marks on the sides of my tongue in the middle to front; particularly in the morning when I wake up. This indicates I’m likely not digesting the last meal of the day well and could use simpler to digest evening meals – and a little more help in getting digestive functioning to optimal: as reflected in the above areas.

Overall, my tongue indicates fairly exactly what I tend to find with my digestion, and what long-term lab data has shown: Sub-optimal digestion with a tendency to not digest and assimilate nutrients well.

I will say with consistent work at it, my digestion has improved substantially from what it used to be, and I’m less super-obviously symptomatic. I rarely experience bloating, sharp or low-grade GI pain, etc.

Here’s another illustration with notes about what the presentation is indicating in terms of digestion and health: 

Tongue Types – Digestive Health

Does your tongue suggest your digestion is functioning optimally? Or do you find indications that reflect exactly what you’ve had going on in there? If you’d like to learn more about how you can fix it, I’d love to speak with you in a quick phone consultation! Or learn more about your digestion in my other articles on the topic of optimal digestion and gut health

References:
Bunce, L. (2017). Tongue Assessment for Western Herbalists: A Primer.
Coatzee, O. (2017). NUTR 663: Sports Nutrition; Eastern Medicine Tongues. [Lecture]. Maryland University of Integrative Health. Retrieved from: https://learn.muih.edu

What is Leaky Gut and What Does it Have to Do with Your GI Symptoms, Athletic Performance and Long-Term Food Intolerances?

Just after an incredibly warm, humid and ROUGH marathon in which my gastrointestinal system barely held on to the end, and then subsequently fell completely apart at the finish line. In a prelude to what’s below, I was also stressed out for weeks before that race.

Leaky Gut, also called increased intestinal permeability or gut permeability is when the tight junctions, which are the space between each of the cells that line the small intestine where nutrient absorption occurs, loosen a little and allow larger food particles and bacterial fragments into the bloodstream, potentially setting off an immune response and inflammatory reactions (1).  

If you have a digestive disorder or gut health problems, it’s generally safe to assume you have a leaky gut. Likewise, leaky gut symptoms can present in a wide variety of ways across multiple body systems – not just in the digestive system.  

Leaky Gut is associated with Irritable Bowel Disease (IBD), Crohn’s Disease (CD), multiple sclerosis (MS), rheutamoid arthritis (RA), type 1 diabetes (T1D), asthma, necrotizing enterocolitis, and autism spectrum disorder (2), as well as celiac disease, non-celiac gluten sensitivity, various skin disorders (if your skin has problems–then you have digestive problems), and more (3). However, we haven’t yet determined whether leaky gut is a cause or consequence of these disorders.

The Athlete Component

What is not as well known to a lot of the run long and run harder crowd is that sustained endurance activities, particularly the jostling and pounding that we do as runners, can and will cause a fair bit of leaky gut symptoms. If you consider the anatomy and physiology of this region of the digestive system, it’s easier to see why. Picture a person running a three (or four, or nine) hour marathon or ultra endurance race, or a series of training runs day after day and throughout weeks and months. The race and many of the runs leading up to the race is going to be a hard and a long effort (sometimes both), which we also will sometimes begin without feeling as recovered from the last effort as we’d prefer. Then, while running, we down any number of foods and food-like substances to provide fuel to sustain the effort and to “train the gut.” This fueling on the go is something the digestive and nervous systems are arguably not designed for. We’re “supposed to” be in rest and digest mode while we’re processing those calories. So utilizing them on the go is a stress to the system.

Then there’s the gut itself. At the small intestine, the cells between it and the bloodstream are approximately one cell thick. This is because this is the site where broken down nutrients move through to be transported to the liver and other regions of the body for use. It’s super thin so nutrients can get where they’re supposed to go. But one cell, and the space between it and the next one, is pretty easy to damage with jostling and stress. So even with a perfect diet, a hard long run (or even a hard shorter run) can cause some damage down there. This is why many people have digestive complaints for three to five days after a race or hard effort. That’s exactly how long it takes for the epithelial lining to turnover into completely new cells!

But what makes leaky gut become chronic, thus inviting long-term digestive (or widespread) symptoms?

There are several lifestyle factors that can also lead to and sustain a leaky gut including stress (a BIG one!), lack of sleep, eating inflammatory foods, alcohol, antibiotics, oral contraceptives, prescription medications, exposure to environmental toxins, and frequent use of NSAIDS such as ibuprofen. Likewise, nutrient deficiencies, poor digestion due to digestive enzyme deficiency, overeating in general, wrong ratio of dietary fats, gut microbe dysbiosis and (sometimes hidden) other food allergies can also contribute. Oofda! That’s a lot of factors that can be working against us.

That Villain Gluten and the Bacterial Connection

Dr. Alessio Fasano, a leading scientist who studies celiac disease and related pathologies, discovered an enterotoxin called zonulin a few years ago. Zonulin disassembles the tight junctions in the intestinal lining, allowing pathogens through and thus causing more intestinal permeability. Dr. Fasano’s research team found that zonulin release is primarily triggered by both bacteria and gliadin. Gliadin is part of the gluten protein complex (2.) Hence the reason many of us are either mildly or definitively reactive to gluten-containing foods, at least some of the time.

Before developing increased intestinal permeability, changes in the gut microbiota have also been shown to occur, which, given that zonulin release is often triggered by bacteria, suggests that the bacterial change occurs first, and then zonulin release assists the epithelial tight junctions to disassemble, leading the way for subsequent disorders or diseases to develop after sustained leaky gut-inflammatory reactions. It has been suggested that an environmental stimulus, (that list above including stress, gluten, a virus, inflammatory diet, etc.) first causes the change in the gut microbiota (2).

How to Heal

Healing chronic leaky gut often takes a many-pronged approach. We have to remove as many of the things that are causing it as it’s appropriate to. For those of us who aren’t willing to give up endurance athlete lifestyles, that means eating a diet appropriate for the individual, repletion of nutrient deficiencies, and lifestyle tactics (that stress relief component!) become particularly important.

Want to Know More?

A leaky gut is one of the primary categories of digestive imbalances I look for when working with individuals clinically with digestion-related and sometimes widespread symptoms. Often when we’re experiencing chronic GI distress, fatigue, and malabsorption of foods and nutrients, there will be imbalances in several categories, and we begin working on the areas that appear most pertinent. I shared more about this topic in the nervous system’s role in part 1, the immune response and subsequent inflammation in part two, gut microbes and dysbiosis in part three and the importance of chewing our food in part four.

And If you’re tired of dealing with your wonky GI symptoms and fatigue, and would like to get back to feeling and training well, I invite you to reach out to me for more personalized support.

References:
1). Lipski, E. (2012). Digestive Wellness (4th ed). McGraw Hill: New York, NY.
2). Sturgeon, C. and Fasano, A. (2016). Zonulin, a regulator of epithelial and endothelial barrier functions, and its involvement in chronic inflammatory diseases. Tissue Barriers, 4(4). https://doi.org/10.1080/21688370.2016.1251384.
3) Kneessi, R. (2017). NUTR 635: Adverse Reactions to Food. [Lecture]. Maryland University of Integrative Health. Retrieved from: https://learn.muih.edu

An especially important, and often overlooked, key to better digestion

One of my mentors recently shared a phrase that’s stuck with me, and really helped in my day to day. She shared in an almost offhand way, Rushing is ego. It feeds self-importance. As someone that tends to perpetually feel rushed and scattered and multi-tasks far more than I should, her statement was like a gentle but stern hand on my shoulder. And a reminder that rushing never makes me feel better in any way.

One of the main areas I tend to rush, multi-task and be scattered is when eating. Alone and left to my own devices, I tend to rarely eat without distraction. And when William and I enjoy meals in the evenings together, catching up on our days and eating while talking (quickly) is more the norm. A couple years ago, recognizing a pattern in myself, I started an experiment of several days of eating with no distraction. What I realized from that experiment was that I’ve tended to avoid being alone with my thoughts at meals because it brought awareness to things I didn’t want to feel. A few months later, I reinstated the distraction free eating practice, having lunch every day outside on the patio without technology or (my weakness), things to read. Instead I simply enjoyed my meals, listened to the summer bugs and watched the hummingbird’s daily visit to the pink zinnia. It was lovely and stress-reducing. And a few weeks into that new habit, I noticed my digestion had really improved, and that I’d begun to feel a lot better in my autoimmune pain and other symptoms. And quite noticeably, I was running and recovering really well during that time.

Summer ended and the practice gradually fell away. I went back to distracted eating and well, I’d notice my digestion was off, stress ran higher, and I didn’t tend to enjoy my meals much because I wasn’t paying attention to actually eating them!

Today, I’ve got a short but incredibly substantial tip if you’re struggling with poor digestion, GI pain (whether it’s general or after a tough workout), bloating, excess gas, etc. And it also helps A LOT if you tend to be generally mentally scattered or anxious. It’s one that you don’t have to spend a ton of money on – actually it’s free! It doesn’t take special skills or preparation. And the process of eating your meals and the hours afterward (those poor digestion side effects), will be much more enjoyable.

Are you ready?

For the next few days, try really chewing your food.

And by that I mean, chewing every bite until it’s broken down into a mush. This means you might chew 20-35 times per bite. Yes, really.

That’s going to be tolerated better than it used to…

Before food ever gets to our stomach or small intestine where stomach acids and digestive enzymes contribute to the chemical process of digestion and then nutrient absorption, digestion actually begins in the brain (just thinking about and then smelling food) and in the mouth. Digestive juices, saliva, enzymes, and digestive hormones are released and begin flowing in anticipation of a meal. Then saliva contains enzymes that further initiate digestion. Likewise, mechanical breakdown of food with our teeth is incredibly important so the enzymes, gastric acids, and hormones can then take over further along in the process.

Some people like to count the number of chews per bite, so go ahead if this helps you to establish the practice. Focus on chewing every mouthful until it is liquid.

The father of modern medicine, Hippocrates, is often quoted as saying that all disease begins in the gut. Interestingly and unsurprisingly, most traditional (and much older) medical systems around the world believe the same. For all I know, some wise sage (or perhaps just my wise mentor) also came up with that phrase about rushing and feeding ego’s self-importance. Especially now in mid-December leading up to the holidays — especially now when Covid-rates are increasing stress (again), help your digestion out a little, and actually enjoy your food, by chewing it a little more.

Impaired digestion and subsequent absorption of food is one of the primary categories of digestive imbalances I look for when working with individuals clinically with impaired digestion. Often when we’re experiencing chronic GI distress, fatigue, or anxiety, there will be imbalances in several categories, and we begin working on the areas that appear most pertinent. I shared about the nervous system’s role in part 1 of this topic, the immune response and subsequent inflammation in part two, gut microbes and dysbiosis in part three and I’ll explain remaining categories in future articles.

And If you’re tired of dealing with your wonky GI and would like to get back to feeling and training well, I invite you to reach out to me for more personalized support.