Tongue Swelling: Causes of Swollen Tongue

Your tongue helps you taste, swallow, and talk. But it sometimes may get swollen for some reason.

Usually, a puffy tongue is more annoying or uncomfortable than dangerous. But it may be a sign of something serious. It can even be a medical emergency if your tongue swells so much that it’s hard for you to breathe.

Here are some common reasons for an enlarged tongue and how to handle them.

Allergic Reactions

When you eat or swallow something you are sensitive to, your immune system responds by flooding your bloodstream with histamines and other chemicals. That swells your tissue because fluid leaks from narrowed blood vessels.

That is called angioedema. It’s similar to hives, except that the welts caused by angioedema appear deeper under the skin. Insects bites also can cause this reaction. Most of the time, a puffy tongue or other symptoms may appear within a couple of hours. They usually go away within a few days. But a swollen tongue can affect your breathing, so see a doctor right away and get it checked.

Other possible signs of angioedema or other allergic reactions include:

Angioedema could lead to a life-threatening condition called anaphylaxis. Your tongue and throat can puff up so much that it closes up your airway. The same thing may happen if you have oral allergy syndrome. That’s when your body reacts to raw fruits, nuts, and vegetables that have proteins similar to those found in pollen.

Everyone is different, but common allergy triggers include:

A shot of epinephrine can help you breathe. You can get a prescription for an auto-injector to carry with you in case it happens again. Call 911 after you use it since the allergic reaction is likely to come roaring back. For less serious cases, your doctor may recommend an over-the-counter or prescription antihistamine.

There is also a condition called acquired angioedema. You may get it if you have cancer or an autoimmune disorder. It can cause swelling in your tongue, face, lips, and elsewhere. The swelling might come and go for no reason and it might be painful, but you won’t itch or have bumps.

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Injury

Piercing your tongue sometimes may cause it to get plumped up, especially if you have an allergy to the metal. Biting or cutting your tongue also can make it swell. Your tongue is a sensitive muscle that’s filled with blood vessels. So any injury may bleed or be very painful. But it should heal on its own within a few days. A deeper cut might take a few weeks to get better.

For minor tongue injuries, you may:

  • Rinse with warm salt water, especially after meals.
  • Suck on an ice cube or ice pop to ease swelling.
  • Take ibuprofen or another NSAID, if you’re not allergic.
  • Avoid alcohol, tobacco, and spicy foods that might burn.

Infections

This can happen in different ways. Bacteria might get into your tongue from a piercing or a cut. Or you might have an overgrowth of yeast, known as oral thrush. Sexually transmitted diseases like syphilis, gonorrhea, or oral HPV can also bother your tongue.

If your tongue swells because of an infection, you also might have a fever or chills. See your doctor or dentist if you:

  • Feel sick or have any signs of an infection
  • Have trouble eating
  • Have painful sores or white spots on your tongue

Irritants

Alcohol, tobacco, spicy food, mouthwash, some toothpaste, and additives like cinnamon and mint can cause an allergy-like reaction. If you think these things might be behind your puffy tongue, stay away next time.

Lack of Vitamins and Minerals

Magnesium, iron, B vitamins, and others help your nerves work right. But you may not get enough from foods or supplements, or you may lose them through heavy menstrual periods or other ways.

For example, a lack of vitamin B12 can cause a condition called glossitis. The name comes from the fact that your tongue may puff up so much that the little bumps on it, or papillae, look smooth.

Other symptoms may include:

Blood tests will show if you are low in certain vitamins. Your doctor can tell you if you need supplements and how much of them you may need to take.

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Health Conditions

Sometimes, a swollen tongue can result from an existing or undiagnosed medical problem.

Cancer. A lump in your tongue could be a sign of cancer. Smoking, using tobacco products, and alcohol can raise your chances for cancer in the mouth.

Sjogren’s syndrome. This autoimmune disease prevents your body from making enough tears or saliva. It also may make your tongue look red, white, or smooth.

Amyloidosis. When your body collects too much of a certain protein, called amyloid, it can affect how your organs work. Parts of the body, including the tongue, can swell. Amyloidosis also can leave you dizzy, numb in the fingers or toes, and make your heart beat out of sync. Your doctor can diagnose this with tests on different tissues on your body.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on April 29, 2019

Sources

SOURCES:

National Health Service (UK): “Angioedema,” “Sjogren’s Syndrome.”

University of Florida Health: “Angioedema,” “Oral Cancer.”

Cleveland Clinic: “Urticaria (Hives) and Angioedema,” “Mouth Jewelry, Oral Piercings, and Your Health: Risks / Benefits,” “Oropharyngeal Human Papilloma Virus (HPV) Infection.”

American Academy of Allergy, Asthma & Immunology: “Food Allergy,” “Allergic Skin Conditions.”

American College of Allergy, Asthma & Immunology: “Oral Allergy Syndrome.”

Harvard Health Publishing, Harvard Medical School: “Anaphylaxis: An overwhelming allergic reaction.”

UpToDate: “ACE inhibitor-induced angioedema.”

Cedars-Sinai: “Chemotherapy-Related Mouth Mucositis in Children,” “Amyloidosis.”

American Dental Association, Mouth Healthy: “Oral Piercings.”

Merck Manual: “Tongue Injury,” “Mouth Sores and Inflammation,” “Tongue Sores and Bumps,” “Hereditary and Acquired Angioedema.”

Michigan Medicine, University of Michigan: “Mouth and Dental Injuries.”

Johns Hopkins Medicine: “Iron-Deficiency Anemia.”

Canadian Medical Association Journal: Glossitis secondary to vitamin B12 deficiency anemia.”

Stanford Medicine: “Examination of the Tongue.”

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