Yes, you do need to clean your tongue. Here’s how and why

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Has your doctor asked you to stick out your tongue and say “aaah”? While the GP assesses your throat, they’re also checking out your tongue, which can reveal a lot about your health.

The doctor will look for any changes in the tongue’s surface or how it moves. This can indicate issues in the mouth itself, as well as the state of your overall health and immunity.

But there’s no need to wait for a trip to the doctor. Cleaning your tongue twice a day can help you check how your tongue looks and feels – and improve your breath.

luisrsphoto/Shutterstock

What does a healthy tongue look like?

Our tongue plays a crucial role in eating, talking and other vital functions. It is not a single muscle but rather a muscular organ, made up of eight muscle pairs that help it move.

The surface of the tongue is covered by tiny bumps that can be seen and felt, called papillae, giving it a rough surface.

These are sometimes mistaken for taste buds – they’re not. Of your 200,000-300,000 papillae, only a small fraction contain taste buds. Adults have up to 10,000 taste buds and they are invisible to the naked eye, concentrated mainly on the tip, sides and back of the tongue. https://www.youtube.com/embed/uYvpUl7li9Y?wmode=transparent&start=0

A healthy tongue is pink although the shade may vary from person to person, ranging from dark to light pink.

A small amount of white coating can be normal. But significant changes or discolouration may indicate a disease or other issues.

How should I clean my tongue?

Cleaning your tongue only takes around 10-15 seconds, but it’s is a good way to check in with your health and can easily be incorporated into your teeth brushing routine.

A toothbrush and a silver tongue scraper on an orange background.
Build-up can occur if you stop brushing or scraping your tongue even for a few days. Anthony Shkraba/Pexels

You can clean your tongue by gently scrubbing it with a regular toothbrush. This dislodges any food debris and helps prevent microbes building up on its rough textured surface.

Or you can use a special tongue scraper. These curved instruments are made of metal or plastic, and can be used alone or accompanied by scrubbing with your toothbrush.

Your co-workers will thank you as well – cleaning your tongue can help combat stinky breath. Tongue scrapers are particularly effective at removing the bacteria that commonly causes bad breath, hidden in the tongue’s surface.

What’s that stuff on my tongue?

So, you’re checking your tongue during your twice-daily clean, and you notice something different. Noting these signs is the first step. If you observe any changes and they worry you, you should talk to your GP.

Here’s what your tongue might be telling you.

White coating

Developing a white coating on the tongue’s surface is one of the most common changes in healthy people. This can happen if you stop brushing or scraping the tongue, even for a few days.

In this case, food debris and microbes have accumulated and caused plaque. Gentle scrubbing or scraping will remove this coating. Removing microbes reduces the risk of chronic infections, which can be transferred to other organs and cause serious illnesses.

Two young men laughing while they brush their teeth.
Scrubbing or scraping your tongue only takes around ten seconds and can be done while brushing your teeth. Ketut Subiyanto/Pexels

Yellow coating

This may indicate oral thrush, a fungal infection that leaves a raw surface when scrubbed.

Oral thrush is common in elderly people who take multiple medications or have diabetes. It can also affect children and young adults after an illness, due to the temporary suppression of the immune system or antibiotic use.

If you have oral thrush, a doctor will usually prescribe a course of anti-fungal medication for at least a month.

Black coating

Smoking or consuming a lot of strong-coloured food and drink – such as tea and coffee, or dishes with tumeric – can cause a furry appearance. This is known as a black hairy tongue. It’s not hair, but an overgrowth of bacteria which may indicate poor oral hygiene.

Smoke wafting from a cigarette in a woman's hand.
Smoking can add to poor oral hygiene and make the tongue look black. Sophon Nawit/Shutterstock

Pink patches

Pink patches surrounded by a white border can make your tongue look like a map – this is called “geographic tongue”. It’s not known what causes this condition, which usually doesn’t require treatment.

Pain and inflammation

A red, sore tongue can indicate a range of issues, including:

Dryness

Many medications can cause dry mouth, also called xerostomia. These include antidepressants, anti-psychotics, muscle relaxants, pain killers, antihistamines and diuretics. If your mouth is very dry, it may hurt.

What about cancer?

White or red patches on the tongue that can’t be scraped off, are long-standing or growing need to checked out by a dental professional as soon as possible, as do painless ulcers. These are at a higher risk of turning into cancer, compared to other parts of the mouth.

Oral cancers have low survival rates due to delayed detection – and they are on the rise. So checking your tongue for changes in colour, texture, sore spots or ulcers is critical.

Dileep Sharma, Professor and Head of Discipline – Oral Health, University of Newcastle

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Semaglutide for Weight Loss?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Semaglutide for weight loss?

    Semaglutide is the new kid on the weight-loss block, but it’s looking promising (with some caveats!).

    Most popularly by brand names Ozempic and Wegovy, it was first trialled to help diabetics*, and is now sought-after by the rest of the population too. So far, only Wegovy is FDA-approved for weight loss. It contains more semaglutide than Ozempic, and was developed specifically for weight loss, rather than for diabetes.

    *Specifically: diabetics with type 2 diabetes. Because it works by helping the pancreas to make insulin, it’s of no help whatsoever to T1D folks, sadly. If you’re T1D and reading this though, today’s book of the day is for you!

    First things first: does it work as marketed for diabetes?

    It does! At a cost: a very common side effect is gastrointestinal problems—same as for tirzepatide, which (like semaglutide) is a GLP-1 agonist, meaning it works the same way. Here’s how they measure up:

    As you can see, both of them work wonders for pancreatic function and insulin sensitivity!

    And, both of them were quite unpleasant for around 20% of participants:

    ❝Tirzepatide, oral and SC semaglutide has a favourable efficacy in treating T2DM. Gastrointestinal adverse events were highly recorded in tirzepatide, oral and SC semaglutide groups.❞

    ~ Zaazouee et al., 2022

    What about for weight loss, if not diabetic?

    It works just the same! With just the same likelihood of gastro-intestinal unpleasantries, though. There’s a very good study that was done with 1,961 overweight adults; here it is:

    Once-Weekly Semaglutide in Adults with Overweight or Obesity

    The most interesting things here are the positive results and the side effects:

    ❝The mean change in body weight from baseline to week 68 was −14.9% in the semaglutide group as compared with −2.4% with placebo, for an estimated treatment difference of −12.4 percentage points (95% confidence interval [CI], −13.4 to −11.5; P<0.001).❞

    ~ Wilding et al., 2021

    In other words: if you take this, you’re almost certainly going to get something like 6x better weight loss results than doing the same thing without it.

    ❝Nausea and diarrhea were the most common adverse events with semaglutide; they were typically transient and mild-to-moderate in severity and subsided with time. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events (59 [4.5%] vs. 5 [0.8%])❞

    ~ ibid.

    In other words: you have about a 3% chance of having unpleasant enough side effects that you don’t want to continue treatment (contrast this with the 20%ish chance of unpleasant side effects of any extent)!

    Any other downsides we should know about?

    If you stop taking it, weight regain is likely. For example, a participant in one of the above-mentioned studies who lost 22% of her body weight with the drug’s help, says:

    ❝Now that I am no longer taking the drug, unfortunately, my weight is returning to what it used to be. It felt effortless losing weight while on the trial, but now it has gone back to feeling like a constant battle with food. I hope that, if the drug can be approved for people like me, my [doctor] will be able to prescribe the drug for me in the future.❞

    ~ Jan, a trial participant at UCLH

    Source: Gamechanger drug for treating obesity cuts body weight by 20% <- University College London Hospitals (NHS)

    Is it injection-only, or is there an oral option?

    An oral option exists, but (so far) is on the market only in the form of Rybelsus, another (slightly older) drug containing semaglutide, and it’s (so far) only FDA-approved for diabetes, not for weight loss. See:

    A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes ← for the science

    FDA approves first oral GLP-1 treatment for type 2 diabetes ← For the FDA statement

    Where can I get these?

    Availability and prescribing regulations vary by country (because the FDA’s authority stops at the US borders), but here is the website for each of them if you’d like to learn more / consider if they might help you:

    Rybelsus / Ozempic / Wegovy

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  • The 7 Approaches To Pain Management

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    More Than One Way To Kill Pain

    This is Dr. Deepak Ravindran (MD, FRCA. FFPMRCA, EDRA. FIPP, DMSMed). He has decades of experience and is a specialist in acute and chronic pain management, anesthesia, musculoskeletal medicine, and lifestyle medicine.

    A quick catch-up, first:

    We’ve written about chronic pain management before:

    Managing Chronic Pain (Realistically!)

    As well as:

    Science-Based Alternative Pain Relief

    Dr. Ravindran’s approach

    Dr. Ravindran takes a “trauma-informed care” approach to his professional practice, and recommends the same for others.

    In a nutshell, this means starting from a position of not “what’s wrong with you?”, but rather “what happened to you?”.

    This seemingly subtle shift is important, because it means actually dealing with a person’s issues, instead of “take one of these and call my secretary next month”. Read more:

    What is Trauma-Informed Care?

    Pain itself can be something of a many-headed hydra. Dr. Ravindran’s approach is equally many-headed; specifically, he has a 7-point plan:

    Medications

    Dr. Ravindran sees painkillers (and a collection of other drugs, like antidepressants and muscle relaxants) as a potential means to an end worth exploring, but he doesn’t expect them to be the best choice for everyone, and nor does he expect them to be a cure-all. Neither should we. He also advises being mindful of the drawbacks and potential complications of these drugs, too.

    Interventions

    Sometimes, surgery is the right choice. Sometimes it isn’t. Often, it will change a life—one way or the other. Similar to with medications, Dr. Ravindran is very averse to a “one size fits all” approach here. See also:

    The Insider’s Guide To Making Hospital As Comfortable As Possible

    Neuroscience and stress management

    Often a lot of the distress of pain is not just the pain itself, but the fear associated with it. Will it get worse if I move wrong or eat the wrong thing? How long will it last? Will it ever get better? Will it get worse if I do nothing?. Dr. Ravindran advises tackling this, with the same level of importance as the pain itself. Here’s a good start:

    Stress, And Building Psychological Resilience

    Diet and the microbiome

    Many chronic illnesses are heavily influenced by this, and Dr. Ravindran’s respect for lifestyle medicine comes into play here. While diet might not fix all our ills, it certainly can stop things from being a lot worse. Beyond the obvious “eat healthily” (Mediterranean diet being a good starting point for most people), he also advises doing elimination tests where appropriate, to screen out potential flare-up triggers. You also might consider:

    Four Ways To Upgrade The Mediterranean Diet

    Sleep

    “Get good sleep” is easy advice for those who are not in agonizing pain that sometimes gets worse from staying in the same position for too long. Nevertheless, it is important, and foundational to good health. So it’s important to explore—whatever limitations one might realistically have—what can be done to improve it.

    If you can only sleep for a short while at a time, you may get benefit from this previous main feature of ours:

    How To Nap Like A Pro (No More “Sleep Hangovers”!)

    Exercise and movement

    The trick here is to move little and often; without overdoing it, but without permitting loss of mobility either. See also:

    The Doctor Who Wants Us To Exercise Less, And Move More

    Therapies of the mind and body

    This is about taking a holistic approach to one’s wellness. In Dr. Ravindran’s words:

    ❝Mind-body therapies are often an extremely sensitive topic about which people hold very strong opinions and sometimes irrational beliefs.

    Some, like reiki and spiritual therapy and homeopathy, have hardly any scientific evidence to back them up, while others like yoga, hypnosis, and meditation/mindfulness are mainstream techniques with many studies showing the benefits, but they all work for certain patients.❞

    In other words: evidence-based is surely the best starting point, but if you feel inclined to try something else and it works for you, then it works for you. And that’s a win.

    Want to know more?

    You might like his book…

    The Pain-Free Mindset: 7 Steps to Taking Control and Overcoming Chronic Pain

    He also has a blog and a podcast.

    Take care!

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  • Is Marine Collagen Worth Taking?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Questions and Answers at 10almonds

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    I wanted to ask if you think marine collagen is decent to take. I’ve heard a lot of bad press about it

    We don’t know what you’ve heard, but generally speaking it’s been found to be very beneficial to bones, joints, and skin! We wrote about it quite recently on a “Research Review Monday”:

    See: We Are Such Stuff As Fish Are Made Of

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  • Real Self-Care – by Pooja Lakshmin MD

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    As the subtitle says, “crystals, cleanses, and bubble baths not included”. So, if it’s not about that sort of self-care, what is it about?

    Dr. Lakshmin starts by acknowledging something that many self-help books don’t:

    We can do everything correctly and still lose. Not only that, but for many of us, that is the probable outcome. Not because of any fault or weakness of ours, but simply because one way or another the game is rigged against us from the start.

    So, should we throw in the towel, throw our hands in the air, and throw the book out of the window?

    Nope! Dr. Lakshmin has actually helpful advice, that pertains to:

    • creating healthy boundaries and challenging guilt
    • treating oneself with compassion
    • identifying and aligning oneself with one’s personal values
    • asserting one’s personal power to fight for one’s own self-interest

    If you’re reading this and thinking “that seems very selfish”, then let’s remember the “challenging guilt” part of that. We’ve all-too-often been conditioned to neglect our own needs and self-sacrifice for others.

    And, while selfless service really does have its place, needlessly self-destructive martyrdom does not!

    Bottom line: this book delivers a lot of “real talk” on a subject that otherwise often gets removed from reality rather. In short, it’s a great primer for finding the right place to draw the line between being a good-hearted person and being a doormat.

    Click here to check out Real Self-Care and “put your own oxygen mask on first”!

    Don’t Forget…

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  • Break the Cycle – by Dr. Mariel Buqué

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Intergenerational trauma comes in two main varieties: epigenetic, and behavioral.

    This book covers both. There’s a lot more we can do about the behavioral side than the epigenetic, but that’s not to say that Dr. Buqué doesn’t have useful input in the latter kind too.

    If you’ve read other books on epigenetic trauma, then there’s nothing new here—though the refresher is always welcome.

    On the behavioral side, Dr. Buqué gives a strong focus on practical techniques, such as specific methods of journaling to isolate trauma-generated beliefs and resultant behaviors, with a view to creating one’s own trauma-informed care, cutting through the cycle, and stopping it there.

    Which, of course, will not only be better for you, but also for anyone who will be affected by how you are (e.g. now/soon, hopefully better).

    As a bonus, if you see the mistakes your parents made and are pretty sure you didn’t pass them on, this book can help you troubleshoot for things you missed, and also to improve your relationship with your own childhood.

    Bottom line: if you lament how things were, and do wish/hope to do better in terms of mental health for yourself now and generations down the line, this book is a great starting point.

    Click here to check out Break the Cycle, and do just that!

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  • Natto vs Tofu – Which is Healthier?

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    Our Verdict

    When comparing nattō to tofu, we picked the nattō.

    Why?

    In other words, in the comparison of fermented soy to fermented soy, we picked the fermented soy. But the relevant difference here is that nattō is fermented whole soybeans, while tofu is fermented soy milk of which the coagulated curds are then compressed into a block—meaning that the nattō is the one that has “more food per food”.

    Looking at the macros, it’s therefore no surprise that nattō has a lot more fiber to go with its higher carb count; it also has slightly more protein. You may be wondering what tofu has more of, and the answer is: water.

    In terms of vitamins, nattō has more of vitamins B2, B4, B6, C, E, K, and choline, while tofu has more of vitamins A, B3, and B9. So, a 7:3 win for nattō, even before considering that that vitamin C content of nattō is 65x more than what tofu has.

    When it comes to minerals, nattō has more copper, iron, magnesium, manganese, potassium, and zinc, while tofu has more calcium, phosphorus, and selenium. So, a 6:3 win for nattō, and yes, the margins of difference are comparable (being 2–3x more for most of these minerals).

    In short, both of these foods are great, but nattō is better.

    Want to learn more?

    You might like to read:

    21% Stronger Bones in a Year at 62? Yes, It’s Possible (No Calcium Supplements Needed!)

    Take care!

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