Q: What would cause a swollen tongue? Can this be a side effect of medicine?
A: There are many reasons for a swollen tongue. Indeed, a reaction to a medication is one of the more common causes. This is especially true when the swelling occurs rather suddenly.
Swelling of the face, lips and tongue can come on quickly in people taking an ACE inhibitor. The reaction may happen when the drug is first started or at any time thereafter. Sometimes people get this reaction even though they've been taking the drug for several years. For reasons we don't understand, ACE inhibitors are more likely to cause angioneurotic edema in African-Americans.
Many other medications can also cause angioneurotic edema or other types of allergic reactions that make the tongue swell.
Inflammation of the tongue, called glossitis, can lead to a swollen tongue. The inflammation might be related to an infection, such as thrush. Or a vitamin deficiency, especially B12 deficiency.
A tongue that gets larger over many months can sometimes be related to an underactive thyroid gland (hypothyroidism).
Rare conditions can also cause a markedly enlarged tongue. One example is amyloidosis. In this condition, amyloid protein deposits build up in the organs. Another example is acromegaly, a condition that happens when the pituitary gland produces too much growth hormone. However, if you had one of these conditions, you would expect additional symptoms. Not just a swollen tongue.
(Howard LeWine, MD, is a practicing internist at Brigham and Women's Hospital, Boston, Mass., and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.)
(For additional consumer health information, please visit http://www.health.harvard.edu.)
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The Medicine Cabinet-Ask the Harvard Experts: Reaction to medication just one possible cause for tongue swelling
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