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Symptoms of Vitamin B12 Deficiency on the Tongue

author image Sharon Perkins
A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.
Symptoms of Vitamin B12 Deficiency on the Tongue
Woman touching her tongue Photo Credit: Thinkstock Images/Stockbyte/Getty Images

Vitamin B12, an essential water-soluble vitamin, is stored in large amounts in your body and absorbed from animal fats and brewer’s yeast. B12 helps create new red blood cells. B12 deficiency often causes anemia, or low red blood cell count. B12 deficiency has two causes: a low dietary intake, most common in the elderly and vegetarians and an inability of your body to absorb B12. B12 absorption depends on a substance secreted by the stomach cells called intrinsic factor. Problems with the stomach lining, removal of part of the stomach or diseases that slow movement of food through the intestine can lead to B12 deficiency. B12 deficiency can cause symptoms on the tongue.

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Color Changes

Your tongue may become red and swollen, with a beefy appearance if you have B12 deficiency. This change in appearance comes from depapillation of the tongue: loss of the little bumps that that normally give the tongue a light pink, velvety appearance, dentist Martin Spiller, D.M.D states on his website. Without these little bumps, called papillae, the tongue looks red and beefy. Medical personnel may call it a “beefsteak” tongue. If you have pernicious anemia, often caused by B12 deficiency, the tongue may look pale, the Merck Manuals Online Medical Library explains.


Your tongue may feel sore or painful if you have a B12 deficiency, or you may complain of a burning sensation in the tongue. Burning may occur in the absence of any other symptoms, Tuft University states.

Small Tongue

You may develop microglossia, a small tongue, with B12 deficiency. Microglossia occurs when the papillae atrophy, or shrink. Microglossia occurs late in the disease, Charles Huguley Jr. explains in the third edition of “Clinical Methods: The History, Physical and Laboratory Examinations,” published in 1990.

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