Question: I have had a very sore tongue most of the time for three years now. My doctor used to think it was caused by antibiotics, but these last couple years, it is sore (even seems swollen) nearly all the time. I take Arthrotech for osteoarthritis and Plaquenil for lupus regularly. What causes a sore tongue, and what can I try for it?
Dr. Hibberd's Answer:
Glossitis is characterized by a reddened, swollen, smooth, shiny, and tender tongue. This is often seen in those people who are deficient in iron, and it has been reported with the use of Arthrotec, which you are taking.
Bacterial infection of the tongue is very rare absent traumatic injury.
A painful, burning tongue will be seen with in those deficient in B vitamins, as in pellagra (which is niacin or vitamin B-3 deficiency), or with xerostomia (which is the dry mouth often associated with connective tissue diseases such as Sjogren's syndrome, rheumatoid arthritis, or systemic lupus erythematosuis), as well as with some medications, especially diuretics, antihistamines, and some antidepressants.
Side effects of some medications and some infections (syphilis and candidiasis) may also present with a painful burning tongue.
Yeast (candida) infection of the surface of the tongue is quite common and may present as a red tender tongue with or without whitish plaques or other findings typically seen with thrush (candidal infection of the mouth). A yeast infection of your mouth should alert your doctor to check for immune deficiency states, especially when recurrent and when seen in a young person where if may be the initial symptom of HIV disease.
I believe that you will succeed in correcting your condition once the underlying cause is properly established.
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