Geographic Tongue

Dr. Greene’s Answer:

Cheryl, you certainly have your hands full. What an exciting (and busy) time lies ahead! Two in diapers is always a challenge – especially when they are numbers two and three. Be sure to ask for the help you need.

Geographic tongue is a marvelous, descriptive name for one of the most common medical conditions of the tongue. Parents usually are the ones to notice several large, red, slightly depressed, unusually smooth patches on the surface of their child’s tongue — when nothing was there hours before. Often the red areas are bordered with distinct white bands. The sharp borders of these irregularly shaped lesions give the surface of the tongue the appearance of a map, perhaps a map of a group of uncharted islands. The rather dramatic appearance of geographic tongue looks to many like a burn, or like some kind of nasty infection.

How many parents must puzzle over geographic tongue? The exact prevalence varies widely from study to study, but at any given time, somewhere between 0.1 percent and 14.3 percent of otherwise healthy people have it. It has been found to be present in about 0.6 percent of Americans (Community Dental and Oral Epidemiology Aug 1994), about four percent of healthy Iraqi schoolchildren (Community Dental and Oral Epidemiology Aug 1982), and about 2 percent of young Finns (Oral Surgery, Oral Medicine, and Oral Pathology, Feb 1982).

The healthy tongue is a mass of muscle fibers covered by a mucous membrane. On the underside of the tongue, the mucous membrane is smooth. On the upper side, the tongue is covered with many tiny protrusions called papillae. These papillae come in four types with different shapes. Three of these types contain taste buds; the fourth does not. This fourth type are called filiform papillae, and they are packed tightly together over the entire upper surface of the tongue.

For some reason, medical conditions of the tongue often have picturesque names (such as “black hairy tongue” or “scrotal tongue”). Most of these conditions are abnormalities of the papillae, of one type or another. In geographic tongue, the filiform papillae are missing in the reddish areas and are overcrowded in the gray-white borders.

We still do not know exactly what causes geographic tongue, but we do know that it strongly tends to run in families (Oral Surgery, Oral Medicine, and Oral Pathology, Nov 1976). Geographic tongue has polygenic inheritance — it is associated with several different genes. We also know that it is associated with a number of other genetic medical conditions.

It has been most closely linked to psoriasis, and is notably more common in those who have psoriasis (British Journal of Dermatology, Sep 1996). The two conditions have been linked to the same gene and are probably produced in the same manner; nevertheless the great majority of those with geographic tongue do not go on to develop psoriasis.

Geographic tongue is also significantly more common in people who are sensitive to the environment — those with allergies, eczema, and/or asthma (Oral Surgery, Oral Medicine, and Oral Pathology, Aug 1984).

It is also four times more common in those with diabetes (Oral Surgery, Oral Medicine, and Oral Pathology, Jan 1987). But a great many conditions are more common in those with diabetes, and geographic tongue has never been noted as an early warning of diabetes.

In young women with geographic tongue who are also taking oral contraceptives, the geographic tongue is worst on day 17 of the cycle (British Dental Journal, Aug 1991). This suggests that hormone levels probably play a role. Perhaps there is even some truth to the unproven belief that stress can trigger geographic tongue.

Weaker links have been reported to anemia, seborrhea, and eating spicy foods.

Most people with geographic tongue are otherwise healthy. The condition is usually entirely painless. While it can produce a burning sensation in the mouth, this is very rare in children. If there is any pain or burning, this usually can be successfully controlled with antihistamines (Pediatric Dentistry, Nov 1992).

There is no loss of the sense of taste (hurrah for the glorious sense of taste!), nor is there any loss of the dexterity of the tongue. There is, however, a measurable decrease in the tongue’s sense of touch. This was studied by carefully assessing response to mechanical vibration (Journal of Laryngology and Otology, Mar 1984).

Geographic tongue’s rather spectacular appearance in the mouth has frequently caused parents to worry. In the years since 1955, when the condition was first described (Journal of the American Dental Association, Sep 1987), several treatments have been tried for geographic tongue. Topical Retin-A was the most successful (Cutis Aug 1979). No treatment is currently recommended, however, for this benign, self-limited condition.

Geographic tongue heals spontaneously. The individual lesions often heal at the same time new ones are forming, changing the appearance of the tongue over hours or days. This gives rise to the appearance that the map is migrating across the face of the tongue. Thus, geographic tongue is also called benign migratory glossitis. Although benign, this condition may last for months — or even longer — and often recurs.

The same pattern holds true for the rare, but real, variation — geographic lip.

In the future we may know more about geographic tongue, what causes it, and why it recurs. In the meantime, Cheryl, you can rest assured knowing that even though geographic tongue is spectacular in appearance, it will not harm your precious daughter.

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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  1. Russel

    I have tongue problem and spices,citrus fruits,acidic fruits seem to be the worst for me…even regular black pepper tastes super hot to me…also lemons and limes will make my tongue develop something line a map side surface of the tongue and it grow in hours mean enlarge
    up… i tried nystatin and other anti-fungal but nothing and and my throat and nose mucus become thicker in certain weather environment.

    Added:
    • Hi Russel,

      This is interesting because Dr. Greene reports no loss of taste. He also says, “No treatment is currently recommended, however, for this benign, self-limited condition. Geographic tongue heals spontaneously. The individual lesions often heal at the same time new ones are forming, changing the appearance of the tongue over hours or days.” I wonder if this is a variant of Geographic Tongue? If so, you may need to discuss it with your doctor.

      Best, @MsGreene
      Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

      Added:
  2. cindy

    I don’t know the kinda tongue I have, it’s really strange and I need help, I need to know why it’s like that, has been that way since I was born

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  3. Tonia-Ky

    I was having burning, hurting, white patches on my tongue. I thought it was thrush too. but was treated for it. But it didn’t get better. I went to my regular doctor and the said it was GT. Crazy cause I have never heard of this in my life I have always had like a weird tongue design. but I never hurt like this. I am under a lot of stress right now I really do believe this is the main culprit for me, I am on anti-anxiety medicine right now, hoping this calms me down then I can focus on this tongue issue. I have literality lost 12 pounds in 1 month. I cant have anything with sugar, coffee, chili, spices, pineapple, anything citrus.

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  4. Felicia

    I’d never heard of geographic tongue. I’m currently 33weeks pregnant noticed my tongue had ugly patches n hurt bout 3months ago. Went to a dentist he said it was a really bad case of geographic tongue. He sent the pics to an oral surgeon who agreed. I also have a health anxiety problem so it drives me crazy. People tell me it shouldn’t hurt bt mine is sore n really ugly. Maybe I’m brushing to much. I also use peroxyl mouthwash dentist told me too. Mine was mostly on the top now is on the sides of my tongue. I called my dentist told him sometime when brushing the sides it’s sore n bleeds just a lit he said it’s just an awful case of geographic tongue n I may be over brushing bt if I don’t brush it it looks much worse. Any advice r similar stories would be much appreciated. Ty

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  5. Mary

    My son is having geographic tongue. He cannot eat chilli things. Which tooth paste is used can u tellme. Any remedy/medicine for cure this problem

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  6. Aaliya Patel

    Hello, kindly help me my son is 1 year 2months he has geographic tongue. I took him to the doctor was given medicine now meds are finish it coming out again. Kindly assist me

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  7. Margrit Ives

    I have had geographic tongue or one year and have tried everything under the sun to get rid of it. I was told to use toothpaste without whitener which I am using, brushing my tongue daily with peroxide.
    I came down with some kind of virus and my doctor put me on antibiotic
    Amoxicillin 875 mg-Potassium Clavulanate 125 for 7 days. I took the RX along with peroxide treatment and would say the problem is cured by
    99%. I wanted to share this with others. It is worth a try……

    Added:
    • Margrit,

      Thanks so much for writing in and sharing your experience. Has anyone else tried this? Did it work for you?

      Best, @MsGreene
      Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

      Added:
  8. Ronald

    Hi
    I was born with this condition of geographic tongue. And young man aged 30 all I know is i must not eat sour , salty or chilli foods. Cause when I eat these my either gets swollen or painful.

    Is there medication for this condition. And they say is genetic and I believe them cause my mother also have it.

    Any advice on how can I keep it painless and taking good care of it.

    Thanks

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  9. Joan

    My son would get GT right before or at the same time as he would get a cold or strep throat. This started when he was 3 years old and continued until he was around 18 years old. It would resolve in about 7-10 days after the illness started.

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  10. Darren

    Geographic tongue is caused by ureaplasma. Some bacteria produce hydrogen peroxide, while others produce catalase which breaks down hydrogen peroxide into oxygen and water ….. Good flora has some of each, which maintains balance. If you drip hydrogen peroxide on your tongue, you will find (probably) that there is visible catalase activity on the white patches (it becomes frothy) and there is no catalase activity on the red patches and the hydrogen peroxide does not froth. This means that there is no catalase bacteria on the red patches ….. You can therefore deduce that the only bacteria on the red patch are catalase negative, or they produce hydrogen peroxide.

    As the tongue cells also produce catalase in order to protect themselves from the hydrogen peroxide producing bacteria, then there should always be some sort of reaction.

    ureaplasma produces a chemical that counteracts catalase and ureaplasma produces hydrogen peroxide which can now inflame the tongue cells as they are no longer protected. The catalase producing bacteria are killed because they now have no defence against the hydrogen peroxide, so the area then becomes only inhabitable by hydrogen peroxide producing bacteria. There is a possibility that other species such as streptococcus have also got this catalase destroying ability ……

    Get a ureaplasma/mycoplasma test of your tongue ….. See if it comes up positive ….. Antibiotics does cure it as it is an infection …….

    Added:
    • Jason Klinger

      Hi Darren,

      How do you know this? Any data or references? Can it be treated without antibiotics?

      Thanks

      Added:
      • Jason,

        Yes, it can be treated without antibiotics. As Dr. Greene says, “Several treatments have been tried for geographic tongue. Topical Retin-A* was the most successful (Cutis Aug 1979). No treatment is currently recommended, however, for this benign, self-limited condition. Geographic tongue heals spontaneously.”

        *Note, Retin-A is not an antibiotic, but a drug derived from vitamin A.

        By the way, the citations of references are throughout the article in parenthesis.

        Best,
        @MsGreene

        Best,
        @MsGreene

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    • Drew

      not the only cause but maybe one of them

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  11. darlene

    my toddler gets a geografical tongue fever headach sores in mouth left leg hurts. high inflamtion in body even when no out breaks. any ideas

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  12. Lacey

    I am 27 years old, I just developed GT about 2 weeks ago. The changes in my life have been as follows; currently pregnant (in my third trimester), Just found out three weeks ago I have gestational diabetes, lack of sleep, and stress… I believe these have contributed to me developing GT. This is my third pregnancy, my first two children I did not have Gestational Diabetes. This is also my first daughter, so my body’s estrogen levels are higher. Maybe it is something hormone related? I have read that having a history of psoriasis/ eczema can also increase my chances of getting it. I have both. Someone above had mention something about the possible relationship between acid reflex and this condition and I also have that, but I had acid reflex with all of my previous pregnancies and never experienced GT before. I think the more people put out their condition and possible causes the closer they will get to finding out what exactly causes it, and hopefully find a cure! Good luck to you all I hope it gets better for all of us

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  13. anonymous

    I have had very good luck. If I never miss a dose of Kroger’s brand of prenatal vitamins (a 2 pack that includes a DHA supplement) and always always always use Jason brand Sea Fresh natural toothpaste, I can keep that dang GT away. I wanted to make sure I share this somewhere because it’s working for me long term, for the past year or so, except if I miss a few doses of vitamins! As soon as I get back on the regimen, I get better. So now I’m religious about these two things.

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  14. Ktua

    My daughter was born with it and she’s only 10 months…it’s hard because some days she’ll cry and I’ll notice her patches on her tongue are bigger :(

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  15. Hannah connolly

    They say 2-3 percent of the population I think.

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  16. Kara

    I first noticed something wrong with my tongue when I was 18 years-old, I was eating a banana and my tongue started burning so I looked in the mirror to see what was wrong, the banana had caused deep grooves as though the banana had cut them.

    I then noticed that eating candy or anything with citrus would cause the same problem, unless the citrus was cooked. Raw citrus makes it worse. I can’t eat raw fruits, ketchup, steak sauce, tomato sauce, pizza sauce or even watermelon.

    Several years ago and older cousin of my dad told me that GT was inherited from one particular side of their family.

    I cannot eat cinnamon candy, it actually causes my cheeks to tear up, at one time I was told it was thrush. The GT has not ever gone away, even when not smoking. I never took birth control or hormone replacement therapy. I don’t worry about it and it usually never hurts so I never notice it unless I am brushing my teeth. I do have an autoimmune disease.

    I just watch what I eat. Mouthwash does burn my tongue, so I am careful when using that. Usually when it burns, there literally is a burn spot that is inflamed so when I eat something that will burn it, I dry it off with a napkin and wait for the burn to stop.

    I was finally officially diagnosed with GT, but I have been dealing with it for 30 years. I just watch what I eat and drink.

    I was also born “tongue-tied”. The oral surgeon told me it had nothing to do with GT, but then again he doesn’t really know what causes it. I haven’t let it give me stress, it’s just something I live with without even thinking about it, but I have noticed that the tip of my tongue that is always rubbing against my bottom teeth usually stay raw, but not to the point of really hurting me.

    It does help when I open my mouth and let my tongue dry, so I think that maybe there is something in saliva that makes it worse, like an autoimmune disorder.

    Added:
    • Joan

      Hi Kara, My name is Joan/ I had a terrible amount of stress starting last Jan, when a bad mammogram plunged me into a needle biopsy, but even before the biopsy came back, the radiologist had me booked with a breast surgeon. At the same time as this I’d had crown work done and 2 months later a route canal. That dentist gave the strongest Antibiotic for the infection which ultimately gave me Thrush. That was treated twice as once didn’t clear it, and shortly after, came several other stressful situations and the tongue thing along with what looks like cankerous eruptions on the insides of the lips. Dentist gave a swish & spit which numbs but does not take the GT away. I’m going to start Vit C & E as this is suppose to help the immune system battle illness. I can’t stand it, it is somewhat painful/uncomfortable kind of stings/burns and many food/beverages hurt. I’ve also started Baking Soda for a more alkaline system. Wish me luck. Best to you also.
      Joan. feel free to email me

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    • Drew

      its cause those foods are high in histamine thats what flares it up

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  17. John

    I developed geographic tongue about a year ago. After searching in vain I came across the suggestion to use Vitamin B supplementation. I took a vitamin B12 complex. I did that for a good three weeks. I took a bottle of it with me wherever I went and consumed less than a teaspoon seven or eight times a day. I swished it around in my mouth for 30 seconds or so and swallowed. The break out healed normally over about two weeks. After four weeks, there has not been another break out. Usually one episode would heal and immediately another would ensue.

    I am not sure if it is vitamin B12 or Vitamin B2 that helped in particular. I’ve read that it could be one or the other.

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  18. jason

    Hello- 40 yr old man here. I developed geographic tongue right around the time I was taking arginine and supplements to help increase my testosterone (aromatase inhibitor) and lower my estrogen levels (DIM, Calcium glucarate). could there be a connection? im really puzzled and this is very painful and frustrating

    Added:
    • Amanda Y.

      I developed it after going off birth control and completely believe it’s hormone related, I was just trying to figure out what hormones I needed to increase or decrease to fix it. In my body, it was also a response then too a lower level of estrogen and a surging level of testosterone! I wonder if it’s one or the other or the combination, but yes I believe them to be strongly linked!

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  19. lance

    Ya I have a Perty bad case of this condition. I actually am very rare with my condition. Because I am a male and I was diagnosed when I was about 7 or 8. But that was just when I was actually diagnosed. I have had it for a very long time. I also believe in it being stress activated. I have ADD. A very stressful condition also. And I would get ragged on alot as a kid because I had tics that were annoying and I couldn’t stop them from happening. And I would get in trouble and punishment for ticking. And I tell you this cause when I would be stressed about that as a kid the legions would be so bad and so deep u could set a dime in the hole and it would fit flush. So ya I think stress activates them. I am 26 now and it still works the same now as it did back then..I hope this helps..

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    • Joan

      I got mine after a strong antibiotic gave me thrush once the thrush was gone, I had GT, but also stress has been very high since Jan and stress is bad for the immune system. I’m starting on Vitamins to see if that helps. Mine is painful too. Contact is welcome.
      Joan
      joan1031@verizon.net

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  20. pranay

    I am having geographical tongue problem. Can anybody give me treatment solution for geographical tongue?

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    • Zilleh Huma Syeda

      My little girl has this problem she can’t eat spice her normal tongue has paches & nothing pls advise me.
      Thank s

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  21. Shirley W

    Hi there, I developed a sudden onset of geographic tongue in Sept last 2014, so its been almost 6 months now. I never suffered with this before and have tried numerous things in the last number of months to get it diagnosed and see what will help it. I’ve been told theres no cure for it and have no idea if or when it will go away. From what I’ve read, it mostly isn’t sore or bothersome, but mine is sore nearly all the time, even when I’m not eating! The borders move around my tongue but its mainly the sides of my tongue that are the most irritated. I’ve tried all sorts, gluten-free, herbalists, antibiotics, anti-fungal medications, acupuncture, taken Vitamin B complex, zinc tablets, but all to no avail. My diet is so bland, its boring. I normally would eat everything but its literally impossible now. I’ve cut out sugar (definitely makes it worse!), salt, spicy foods, coffee, you name it! I don’t know what else I can do, any ideas would be greatly appreciated….. Thanks.

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    • Perla

      I just wanted to see if you can help me with anything you can my 3 year old son has a GT since he was only a couple months old and all of sudden he stopped eating and saying his mouth hurts he points to his tongue and under it idk if it’s cause he has GT or idk what to think does GT hurt?

      Added:
      • Perla,

        Thanks for writing in.

        Stopping eating can be a serious sign in a 3 year old. It may be related to GT, but likely it’s something different since he just started this behavior. I think it’s worth having your son’s doctor take a look.

        I hope that helps.
        Best, @MsGreene
        Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

        Added:
  22. Stefanie

    Hello, I have had Geographic tongue for years. I am about to be 23. It never occurred to me what it was, and I never said anything to anyone because it never bothered me, however after I had my two children (first one I had at 18, second I had at 21) my tongue started hurting. I noticed at about 18 years old, that my tongue started hurting when eating. My Doctor diagnosed me with it. I can’t eat salty foods, like crackers, or BBQ. I can’t eat beef jerky, or pineapple, strawberries, smoothies… it all hurts!!

    I have taken YEARS of medical assisting, in college and technical schools. I have learned a lot, and I know my body more than anyone and I honestly think it is hormones.

    I have been on birth control (orthro evra patch) on and off for years at a time. When I am not on it, I realized it starts to hurt again, but when I start taking my birth control it goes away!!!

    Another thing I would take that I noticed would help, is COMPLEX B vitamins. The B2 is what I believe helped…. I haven’t been on birth control in 5 months and lately my tongue has been hurting so bad, its hard to eat! Its so painful. Come to think of it, I think I actually started getting geographic tongue when I hit puberty because I don’t remember having it as a kid.. but as a teenager I remember it.

    I wish there were some sort of treatment though. I scheduled an appointment to get back on my birth control and get my hormones because they seem to be the only thing that helps!

    Added:
    • Hannah connolly

      I am in a lot of pain as well. I would love to discuss what’s worked/not worked for both of us and share our experiences. Also, if you have a Facebook join the geographic tongue club. It’s a support group for GT.

      Added:
    • Amanda Y.

      I DEFINITELY believe it to be hormone based. I never had it til went off BC for the first time in 12 or so years. I think it’s either high testosterone or low estrogen or both. I’ve had it since going off BC and trying to stay off it and balance hormones naturally.

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  23. Donna Kirkland

    My 6 month old granddaughter was just diagnosed with geographical tongue. She has GERD and is taking Ranitidine twice daily. Could GERD be a possible reason for her geographical tongue?

    Added:
    • Stefanie

      I don’t think so. I have geographical tongue, have had it for years and I don’t have any acid reflux issues at all. I honestly think personally in my experiences with birth control and all, that it is possibly hormones and vitamin B. I started to take complex B vitamins and it helped.

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    • Ashley

      My daughter just got put on the same meds for GERD. And I noticed this for the first time about a week after. I think they are linked. I have brushed her teeth since she was a baby now at 6 I notice this and I know it’s new. I REALLY do think it’s this medicine.

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  24. Kayla

    I am 14 years of age and i have had a geographic tounge since birth and i don’t think it is going away anytime soon because i still have it!.

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  25. Teresa Reaves

    I have geographic tongue and spices seem to be the worst for me…even regular black pepper tastes super hot to me…also lemons and limes will make my tongue swell up…is in the geographic tongue or a separate
    issue?

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    • Hannah connolly

      Definitely sounds like my GT. You have a severe case

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  26. CW

    I have had what I believe to be geographic tongue 3 times in the past year. All 3 episodes happened while on Cipro. Do you know if there is a relationship between the condition and taking antibiotics?

    Added:
    • Stefanie

      You might be thinking of thrush. Thrush can be caused through medications, and it is similar to geographic tongue. The only way to know for sure is go to a doctor, let them scrape your tongue and see if it is thrush or not. Then you will get a certain diagnosis.

      Added:
    • Joan

      Hi Kara, My name is Joan/ I had a terrible amount of stress starting last Jan, when a bad mammogram plunged me into a needle biopsy, but even before the biopsy came back, the radiologist had me booked with a breast surgeon. At the same time as this I’d had crown work done and 2 months later a route canal. That dentist gave the strongest Antibiotic for the infection which ultimately gave me Thrush. That was treated twice as once didn’t clear it, and shortly after, came several other stressful situations and the tongue thing along with what looks like cankerous eruptions on the insides of the lips. Dentist gave a swish & spit which numbs but does not take the GT away. I’m going to start Vit C & E as this is suppose to help the immune system battle illness. I can’t stand it, it is somewhat painful/uncomfortable kind of stings/burns and many food/beverages hurt. I’ve also started Baking Soda for a more alkaline system. Wish me luck. Best to you also.
      Joan. feel free to email me

      Added:
    • Joan

      I got mine after a strong antibiotic gave me thrush once the thrush was gone, I had GT, but also stress has been very high since Jan and stress is bad for the immune system. I’m starting on Vitamins to see if that helps. Mine is painful too. Contact is welcome.
      Joan
      joan1031@verizon.net

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Comments are closed.