22436 Geographic Tongue (Glossitis) and its Relationship with Celiac Disease - Celiac.com
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Geographic Tongue (Glossitis) and its Relationship with Celiac Disease

Celiac.com 01/27/2011 - In response to a post on the celiac listserv stating that both a pediatrician and a dermatologist dismissed the possibility of a connection between previously diagnosed celiac disease and geographic tongue, I wrote the following:

One of several early mentions of geographic tongue (glossitis) in association with celiac disease may be found in the medical textbook "Coeliac Disease" by Cooke and Holmes, Churchill Livingstone, 1984, on pages 84 and 85 under the heading "glossitis". They say that it occurs, to a greater or lesser extent, "in a majority of celiac patients" (1). 

Another very informative article on glossitis can be found at:

In this recent article from the New England Journal of Medicine (2007)  the authors also state that the connection between celiac disease and glossitis is very common. They go on to say: "Our report should alert physicians and dental practitioners to consider celiac disease in managing cases of idiopathic atrophic glossitis." In other words, they want physicians and dentists to be aware that there may be underlying celiac disease when they encounter glossitis. This information is neither controversial nor difficult to locate. Celiac disease is not the only cause of glossitis, or geographic tongue, but it is a common and long acknowledged symptom of celiac disease, with mention of this connection in the medical literature at least as early as 1974.  
My own experience with glossitis is that most of my problems went away when I began a GF diet. The remainder of my glossitis resolved after getting IgG food allergy testing from Immuno Labs in Ft. Lauderdale, and removing all identified allergenic foods from my diet. (I have since re-introduced some of these foods but I avoided them for about 5 years. ( 12 years later, I still have to avoid some of the foods identified by that testing.)

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My questions/concerns are:

  1. Is your daughter eating gluten? Is it possible that there is gluten contamination in her diet?
  2. Is she eating oats? A significant portion of celiac patients do react to oats, yet oat consumption is now widely advocated. 
  3. Has she had testing for common food allergies? If she is strictly GF and avoiding oats, then food allergy testing may provide her with the the information she needs to eliminate this source of her discomfort.  
I am distressed that neither the pediatrician nor the dermatologist took just a few minutes to run a Medline search that would have informed them about the connection between celiac disease and glossitis and some possible treatments for her problem.  Accidental or intentional gluten consumption, oats consumption, and food allergy testing are all relatively easy for either of these physicians to address. There may, of course, be some other explanation for your daughter's affliction, but these physicians' ignorance of the connection with celiac disease and their failure to run a quick Medline search does not inspire confidence in their opinions.  You might want to pursue a third opinion on this issue, especially since the topical drug she was prescribed falls well short of solving such autoimmune/allergic problems, which almost assuredly is the underlying cause of your daughter's difficulties with her tongue.


  1. Cooke WT, Holmes GKT. Coeliac Disease. Churchill Livingstone, NY, 1984
  2. Pastore L &  Lo Muzio L. Atrophic Glossitis Leading to the Diagnosis of Celiac DiseaseN Engl J Med 2007; 356:2547June 14, 2007
  3. Lampert F, Harms K, Bidlingmaier F, Kiefhaber P, Meister P.Pernicious anemia with dermatologic and neurologic involvement in a 10-year-old boy. Monatsschr Kinderheilkd. 1974 May;122(5):217-20.
  4. Barry RE, Baker P, Read AE.Coeliac disease. The clinical presentation. Clin Gastroenterol. 1974 Jan;3(1):55-69

I hope this helps.
Best Wishes,

Ron Hoggan, Ed. D.

Royal Roads University, Continuing Studies

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16 Responses:

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said this on
31 Jan 2011 10:39:03 AM PDT
I suffered from geographical tongue long before I was diagnosed with celiac disease. I visited my general physician, dentist and ENT specialist. Not one doctor suggested a test for celiac disease. Thank you for this valuable information.

Christine Toms
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said this on
31 Jan 2011 5:45:04 PM PDT
Thank you, this is very much appreciated. The glossitis problem has been with me for over 20 years. I thought it was part of my diagnosed coeliac disease-related difficulty, but you've now confirmed it.

Georgia Hartley
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said this on
04 Feb 2011 8:33:42 PM PDT
Glossitis is an indication of absorption of vitamin B12, which is very common with celiac disease. Taking liquid B12 is one of the best ways to counteract this and help with healing. It is a very inexpensive treatment.

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said this on
07 Feb 2011 5:09:07 PM PDT
As a child, my pediatrician diagnosed me with glossitis. However, I went YEARS without knowing I had celiac disease, suffering from various illnesses. It has only been in the last 2 years that I have been healthy. I attribute this to my Gluten-free lifestyle. This info you have provided is so helpful and appreciated. Thanks for sharing this valuable information!

Betty J. Owen
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said this on
10 Feb 2011 12:46:46 AM PDT
Note: This is the first article that I have seen on this subject. After much concern regarding this condition and the potential harmfulness of it I now learn that having celiac disease has fostered yet one more site of discomfort. Thank you sincerely for these published findings. It is a true blessing to us who struggle with celiac disease.

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said this on
10 Mar 2011 11:34:07 AM PDT
I have had geographic tongue as long as I can remember and have recently been diagnosed with fibromyalgia. This article was so helpful, I went to get tested for celiac today. It seems consistent with many of my symptoms. Thank you.

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said this on
10 Mar 2011 11:35:01 AM PDT
I have had geographic tongue as long as I can remember and have recently been diagnosed with fibromyalgia. This article was so helpful, I went to get tested for celiac today. It seems consistent with many of my symptoms. Thank you.

vivienne harris
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said this on
12 Sep 2011 6:53:10 PM PDT
I always wondered about my tongue. I just learned something new. Thank you.

Soeren Rasmussen
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said this on
26 Sep 2011 3:23:11 AM PDT
I've been diagnosed with multiple sclerosis some years ago and I've had geographic tongue for several years. My daughter has celiac disease but I've not checked her for geographic tongue. Wonder if there are a connection between autoimmune diseases as f.ex. multiple sclerosis, geographic tongue and celiac disease. It could be a very interesting research subject.

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said this on
29 Oct 2011 2:04:06 AM PDT
I liked the article its very interesting and informative. Keep up the great work.

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said this on
06 Dec 2011 7:26:53 AM PDT
Finally informative article! I've been looking for info for almost 2 years! thank you so much! I guess my next step should be getting my daughter tested for celiac..

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said this on
31 Dec 2011 2:18:21 AM PDT
This is the first I've ever heard of a name for this condition. I had the fissure type for decades, and recently tested high for tTG antibodies. Dad is a celiac so there's a good chance I am as well.

Very interesting stuff!

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said this on
12 Jul 2013 5:09:10 PM PDT
OMG. I have had a burning tongue for 4 horrible years. I went to 3 doctors about it. One was even an oral pathologist! All they did was give me a mouth rinse to numb my tongue. Now, my abdomen is hurting and I have an appointment with a gastroenterologist. I will ask him to test for celiac disease. My mom's sister developed celiac in her late 70s. I am 60. Hope I can get answers soon. Thanks for all your research.

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said this on
04 Jan 2014 8:50:08 AM PDT
Your article caught my eye, but it would have been helpful if you had given the symptoms of this affliction. I went to a link within your article that did this, but your article never said specifically what it was. I still am not sure, but it sounds like a possibility. I have had celiac disease diagnosed in 1999 with an endoscopy, and was just diagnosed in October 2013 with Type 1 Diabetes. Shortly before this latter diagnosis, I started having a swollen, coated sore tongue with round red spots, and it will lessen or go away, but keeps returning. I don't know if this is the condition you have described, but my oral surgeon and dentist didn't seem concerned or seem to know what it was. Very frustrating.


said this on
03 Mar 2014 7:09:48 PM PDT
To Soeren Rasmussen,

Please experiment on a true gluten-free diet. Meaning no grains at all including corn and corn derived ingredients, milk because it contains casein protein, soy. I cannot eat eggs as well.
My symptoms were very like MS. I have read stories of people with MS, after gluten-free diet symptoms diminished.

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said this on
16 Aug 2015 7:37:25 AM PDT
I, too, have geographic tongue, chronic vitamin B12 deficiency, fibromyalgia, peripheral neuropathy, ataxia, bloating and daily diarrhea - but am hoping to be tested for celiac or non-celiac sensitivity, when I get an appointment with a gastroenterologist at the local govt. hospital. It could take up to 6 months to get the appointment. In the meantime, I'm suffering and eating food containing gluten in case the test is a false negative. Sometimes, the stomach cramps are so severe that I faint.

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Learn more about testing for celiac disease here: http://www.cureceliacdisease.org/screening/ You do have to be on a gluten diet for ANY of the celiac tests (blood and biopsy) to work. While the endoscopy (with biopsies) can reveal villi damage, many other things besides celiac disease can cause villi damage too: http://www.cureceliacdisease.org/faq/what-else-can-cause-damage-to-the-small-intestine-other-than-celiac-disease/ So, both the blood test and endoscopy are usually ordered. There are some exceptions, but those are not common.

Exactly what are your allergy symptoms? Were they IgG or IgE? Allergy testing as a whole is not super accurate -- especially the IgG. Were you on any H1 or H2 antihistamines for the last five days when you were tested? As far as celiac testing, four days without consuming gluten probably would not impact testing.

I've been seeing my dr for a few weeks now about my stomach issues. We've ruled out the gallbladder and h-pylori and today I had the celiac blood tests done. From the reading I've done the past two days, it seems to me that it's highly likely that I have it. I've had digestive issues for years, but they've gotten progressively worse over the past 6 months or so. Pain and nausea when eating, bloat, eternal constipation, dh rash, at it's worse, tight cramp-like pain in a fist under my sternum, radiating through my back and around my right side keeping me up at night. Also heartburn/reflux and trouble swallowing, etc. Anyway, about 2 months ago, I needed a change. I didn't go to the dr immediately because it seemed pointless. (I've mentioned stomach ache when eating to drs before and been blown off.) So, I started the Whole30 elimination diet (takes out soy, grains, dairy, peanuts, and leaves you basically eating meat & veggies). Figured it would show me what I needed to take out of my diet and hopefully feel better. It worked- I felt great! And it seems that grains and gluten are my biggest offenders. But, now I've been off gluten prior to celiac testing. It's been 7 weeks. After 4 weeks I tested steal cut oats, that I later found out were probably glutened. And then nothing until yesterday. Yesterday I had 2 pieces of bread and a muffin and today I had two pieces of bread and then the blood test. Is this going to be enough to show up on the tests? My dr said that it would probably show up, since I had some yesterday and today and was currently having symptoms. But, google seems to say that I should be glutened for 2 wks straight before testing. Has anyone tested positive after just a little gluten? If it's negative should I insist on doing it again after weeks back on gluten? I feel awful, but do want clear answers. Obviously, gluten's not going to be a part of my life any more either way.

So just to clarify had not consumed any gluten for about 4 days before testing. I was assured by my allergist that it wouldn't affect the test. But what was alarming was that she retested my food allergies (my most recent reaction was two weeks ago) and every food allergy I have came back negative. I don't understand how that is possible. These food allergies developed when I was 20 and I am almost 24 now.

Thanks! You too! I have learned from this experience to take charge of my own health. It's nice at least that we can try the gluten-free treatment without a firm diagnosis or a doctor confirming the disease. I've also felt some of the gluten withdrawal symptoms, and my stomach pain ebbs and flows, but I'm determined to stick with the gluten-free diet to see what a difference it makes. Gemini, thank you! This was really validating and useful for me to hear. I've felt so confused through this process and just want some answers. If the biopsy results do come back negative, I'm going to follow your advice and do the gluten-free diet with repeat blood testing after a while. If they come back positive, well, then I'll have my answer. I'm supposed to get them back next week.