Pernicious Anemia Tongue: Causes, Symptoms & Treatment Options

Pernicious Anemia Tongue: Causes, Symptoms & Treatment Options
profile picture of Dr. Jay Khorsandi, DDS
Pernicious Anemia Tongue: Causes, Symptoms & Treatment OptionsClinical Content Reviewed by Dr. Jay Khorsandi, DDS
Last Modified:

Clinical content featured by Byte is reviewed and fact-checked by a licensed dentist or orthodontist to help ensure clinical accuracy.

We follow strict sourcing guidelines and each page contains a full list of sources for complete transparency.

Table of Contents

  1. What is Pernicious Anemia Tongue?
  2. Symptoms
  3. Treatment Options
  4. Prevention
  5. References

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.


Symptoms of Pernicious Anemia Tongue

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

Other symptoms can include a cracked or swollen looking tongue. Individuals who are dealing with certain blood disorders may notice ulcers or other 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 be a causation factor for pernicious anemia, for example, 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 (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 anti-bacterial mouthwash to your oral care routine.


Preventing pernicious anemia and symptoms like glossitis, a swollen, beefy tongue and mouth ulcers 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 multi-vitamin 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 frightening medical name that doesn’t make it seem like something you want to have.

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.


Pernicious Anemia. National Heart, Lung and Blood Institute. Date fetched: August 22, 2021.

Pernicious Anemia Presenting as Glossitis. (April 2020). CMAJ. Date fetched: August 22, 2021.

Pernicious Anemia. (February 2014). Registered Dental Hygienists Magazine. Date fetched: August 22, 2021.

The A List of B12 Foods. (December 2018). Harvard Health Publishing. Date fetched: August 22, 2021.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.