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Purple Tongue Symptoms and Causes


What causes a tongue that is purple in color? Uncover the causes including on the tip, side, under or back of the tongue. We will also look at Chinese medicine interpretation of this phenomenon. 

Discolored tongue
Tongue discoloration 


A tongue turning purple is not only a problem of dogs or cats but also human beings. Sometimes, for any of the many reasons or causes, we will look at, you might end up with this condition.

However, it is a less often discoloration problem as compared to the white, yellow and black tongue.

Besides being entirely purple in color, you could also have other shades including purple-red, dark or deep, black or bluish purple.

Furthermore, these colors could be on the side, under (including the blue or purple veins underneath the tongue), on the back or even on your tongue tip.

Although rare, anyone can end up with this issue, i.e., the problem affects children (infants, toddlers or babies) as well as adults. Your age might not matter much.


When you have this problem, depending on what causes it, you might have some symptoms that include soreness, swelling, discharge, bumps, among others. There could also be more symptoms that are related to the underlying causes.


What does a purplish tongue mean or what makes it this color? This discoloration could mean so many things because there are many causes. Some of the common causes of this discoloration including patches and bumps are:

1. General blood circulation problem

The first possible reason is a blood circulation problem. Circulation problem could be as a result of many diseases and conditions including peripheral artery disease, blood clots, varicose vein, diabetes, obesity, Raynaud’s disease, among others.

You will have other symptoms such as numbness, pain, muscle cramps, stinging or throbbing limp pain as well as body tingling.

2. Nutritional deficiencies

Nutritional deficiency is another common cause, especially riboflavin or vitamin B2 deficiency. However, this is not a typical symptom of ariboflavinosis (a disease that results from riboflavin deficiency).

When you have ariboflavinosis, you will are likely to have other symptoms including those of stomatitis such as painful red tongue accompanied by a sore throat, fissured lips (chapped lips), etc.

Furthermore, deficiencies in vitamin B12 and folic acid has also been associated with a reddish-purple color.

If nutritional deficiencies cause the discoloration, ensure you include eggs, meat, fish, cheese, green leafy vegetables and yogurt which are rich in riboflavin in your diet.

3. Chronic bronchitis

Chronic bronchitis that affects oxygenated blood supply in the body can lead to tongue that is purple especially dark purplish or dark blue. Chronic bronchitis is also likely to cause a bluish-purple skin and veins.

To know it is chronic bronchitis, you will expect other symptoms such as wheezing, breathlessness, “a persistent cough that brings up mucus (phlegm)” [] as well as frequent chest infections.

4. High cholesterol levels

Most naturopathy often links the problem with elevated cholesterol levels. High cholesterol usually causes heart problems as well as blood circulation problems.

5. Injuries leading to sores and lesions including piercings

Sustaining significant injuries including tongue biting, dental appliances or piercing can lead to this color.  In such a case, it will be bruised, sore and swollen. Furthermore, such lesions can be as a result of Kaposi’s sarcoma (a kind of cancer) or from, purpura or hemangiomas as well as other bacterial and viral infections.

6. Veins under the tongue

Sometimes, the purplish under the tongue is due to blood veins. There is nothing wrong with you, and it is normal to have them unless they are swollen or painful.

 Ordinarily, the veins will tend to be dark, blue or black purple if there is less blood flowing to this area. This problem can affect anyone including babies and adults.

However, larger, i.e., veins that are thick, visible and looking swollen, it could be varicose vein problem. People can get varicose vein even in their mouth.

7. Purple tongue syndrome or disease

When you have this condition, you will end up with a swollen tongue (that might block airways) that has large purplish spots. It commonly affects teens and preteens and can cause death. To reduce infection chances, there are two vaccines, i.e., the purple immune and shots.

8. Could it be oral cancer?

Although many people often fear it could be oral cancer or salivary glands cancer. The truth is that unless you have a reddish, bluish or purplish lump sores or ulcers that do not go away, and other cancer symptoms such as numbness in the mouth that does not go away, persistent sore throat, tongue pain, difficulties in eating, etc. It is unlikely you have cancer.

9. Other conditions associated with the issue

  • Weak digestive system.
  • lymphatic drainage system problem as well as the weakening of blood vessels
  • Weak immunity system especially in people with terminal illnesses such as HIV Aids, and unattended to diabetes.
  • Having a reddish purple colored tongue could be due to pellagra, sprue, Plummer-Vinson syndrome or pernicious anemia
  • Prolonged use of some medications (such as antibiotics) or reactions to some diets or foods
  • Eating foods such as beets, grapes, Kool-Aid, temporarily cause this color.
  • Food debris accumulation and bacterial growth.
  • Smoking can make your tongue and lips to look purplish in color. 
  • Prolonged inflammation

These are not the only causes. There are many other disease and syndromes which can be the problem. Ensure you get the right diagnosis from a qualified medical practitioner.

Chinese medicine

According to Chinese medicine, having a tongue that is purplish indicates you have excessive heat, depleted fluids (due to heat), cold condition or blood stagnation, i.e., “blood stagnation, poor circulation or too much sugar in the body which makes you feel tired and cold” [].

The probable cause of this could be eating mostly cold foods. You need to ensure you have warm ingredients in your diets such as ginger, coriander or garlic.

Other deductions from Chinese medicine about this condition include:

  • If you have a light, greenish, or bluish purple tongue body color, you are likely to have blood stagnation and coldness in the body.
  • Dark reddish purplish shows your body fluids are depleted due to excessive heat.
  • Reddish purple discoloration shows blood stagnation and heat.
  • Blush purplish stiff tongue shows you have an impending or potential wind stroke

Purple spot and bumps

Instead of the whole tongue being purple, or having purple patches spots, i.e., on the side, under, on the tip, back or anywhere, which could be on toddlers (children), teenagers as well as adults.

What are some of the cause such spots and bumps? These bumps often result from purple tongue syndrome, trauma, colored foods, allergic reactions, vitamins deficiencies, canker sores, stress, viral and bacterial infections among others.

In Baby, infants, and toddlers

When a baby has a purple tongue (spots or bumps), you do not need to worry since it can be as a result of biting (and abrasion) especially during teething. Check for bruises, lesions or injuries.

Otherwise, the problem could be due to a congenital issue, oxygen depletion, infections, among other causes. It will rarely be purple tongue syndrome or disease unless the child is a preteen.

Purple under tongue

Now, let us focus a little more on purple under the tongue since it is a more common problem. This color could be due to veins (including varicose vein), injuries, inflamed salivary glands, canker or cold sores, excessive stress that can affect hormones as well as some of the causes we have seen.

To stop the bottom of the tongue from turning purplish, keep good oral hygiene, try saline solution as well as antiseptic mouthwashes (in case you have injuries). However, if the cause is specific to a particular underlying disease or condition, ensure you treat the underlying cause.

If you have spots that are purple beneath your tongue, most probable causes include the terminal end of blood vessels (which is normal), some allergic reactions, blood clot, innocuous benign lesions, and injuries. Also salivary glands problems, smoking, infections, among other causes, already mentioned.

When to see a doctor for diagnosis

If the problem is related to circulation problem as in the case of chronic bronchitis or it is accompanied by some life-threatening symptoms such as breathe shortness, numbness, fever, chills, tingling feeling, etc. you need to see a doctor for the right diagnosis.  

Also, if the condition it persists for several weeks, you need a doctor’s for diagnosis too.

Sources and references
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