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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
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Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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I have a tongue that appears to have black taste buds on the

Resolved Question:

I have a tongue that appears to have black taste buds on the posterior 30% to 40% of the sides where the buds tend to be larger than on the top. These have been there for many years, at the least. The (is it?) morphology has not changed and the top of my tongue appears unremarkable for the most part.

I have a belief that this is probably a result of a very long-term condition I have which manifests itself primarily by extreme fatigue and debility and has been with me at least thirty years. My age is 66.

I have been tested for both B12 and biotin several times. The serum levels always come back *extremely* high and I am told not to worry because it is only significant if they are low. The B12 has ranged as high as 2000 and the biotin over 1500, and I have also taken methylmalonic acid test with results of 9.8. This makes me think my biotin and B12 are OK unless the vitamins in the serum are not being used.

I include the vitamins tests as I understand black tongue is associated with some vitamin deficiencies. But my question is about the cause of the black tongue on the posterior side. What could cause that?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 2 years ago.
Hello
There is not specific cause for this.
What is your race?
Expert:  Dr. Thomas, MD replied 2 years ago.
OK
HAve not heard back from you.
This can be normal in dark skinned individuals, from collections of melatonin.

Conditions that can be associated with this are
heavy metals
Addison's disease
amalgam
scleroderma
B12 deficiency
some chemotherapy agents and antibiotics.

good luck

Let me know if you have further questions, details or need clarification, just use reply.......

Customer: replied 2 years ago.
I did not scroll down far enough. Consequently, most of the followup will appear as a new question to you. I will OK that, say I am paying $ and then not pay that secopnd question as it is a followuop to the first. The window also limit character space I think. So what is below is continuation:

My GP posits a genetic problem and wants to follow that up. I will, but am not totally convinced. The addition B6 has reversed many, many old problems and seems to be allowing me to restore muscle mass which had atrophied much. Like POWs.

A B6 serum test, done after suspicions of the B6 problem surfaced showed, low-normal levels of B6. But, as evidenced by my recovery, it is obviously completely resetting my metabolism and health. But there is virtually no iformation available to me about what is such a huge vitamin deficiency.

So the question is whether the tongue could be, if there are no other ready answers, a esult of the B6 deficit also. Ifso, what is the connection that causes the black taste buds.

So,
Expert:  Dr. Thomas, MD replied 2 years ago.
B6 is not generally associated with this.
The connection is melatonin deposition.
See the above list
Also add to that
Peutz Jeghers syndrome.
Hemachromatosis. Very important and probably what your doc is thinking.

Go over the whole list when you follow up.
Please Click Accept to give answer credit so I am compensated for time and expertise. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only, not to replace your physician advice or visit.
Customer: replied 2 years ago.
I do not see my second email messaage to you shown. Did you read that?
Expert:  Dr. Thomas, MD replied 2 years ago.
That you are going to follow up with your doctor, etc.
We only receive posts here, not emails.
See my second answer

Let me know if you have further questions, details or need clarification, just use reply.......

Customer: replied 2 years ago.
It will probably show up eventually. It was emailed from a link in an email to me, I think.

At any rate, it was the middle part of the story. Probably significant. After decades of debility, I stumbled on to answer that my GP thinks is it. It was B6 deficiency that now yields excellently to 1800 mg daily, split doses. Though even at a crisis in at 10/2011, the B6 serum tests showed normal. But metanephrines were not even measurable, probably due to inability to convert enough stuff to make necessary neurochemicals. Hypothalamic signs (i.e., hypothermia below 67 and hyper above 78, gasping with yawns, etc.) were prominent. Temperature generally around 97 or less.

The B6 supplements have ended the faitgue, malaise, brain fog, etc., that used to hallmark everyday. My appetite returned, gone for decades. My temperature has returned to normal. My hair has stopped falling and eyelashesd are regrowing. Surprisingly, muscles are regenerating and gaining mass while I am losing fat. Perhaps like returned POW, except for the fat which I retained because I always had enough calories.

The sole change in my regimen, except for the increased ADLs that I can now perform, is the addition of the B6. First to 600, then, 1400, then 1800, while finding best dose. That and the almost ravenous consumption of about 70 to 80 pounds of sirloin beef, grilled very rare, which developed an overwhelming craving for. I assume my body was wanting the amino acids. But the muscle recovery is stunning. Nearly like in my teens and twenties, if you can believe that.

Anyway, my condition was extreme and longlived, and I needed to convey the degree top which it had effected me. Nearly every other complaint I had including carpal tuinnel, numb feet, Reynaud's signs, etc. have vanished. My main concern about the tongue is that it might herald something apart from the B6 dependency.

I am a male Caucasian (something info in the lost email) who is an Atlantic Modal Haplotype genetically, mainly from the British Isles.

Unless there is other info you need, this should allow you to figure what may have happened to the tongue during those years if caused by B6 dependency.

Your point about melanin was well taken. I am educated enough to understand this biology, so toss it at me if you wish. But as you note, it is melanin (though the buds are purplish black, miostly) that causes it. My question would be what physical process, for what reason, deposited there.

I will wait. I haven't figured it out. If you do, the money is well earned.
Expert:  Dr. Thomas, MD replied 2 years ago.

Conditions that can be associated with this are
heavy metals
Addison's disease
amalgam
scleroderma
B12 deficiency
some chemotherapy agents and antibiotics.

Peutz jeghers

Hemachromatosis

I do not think it had anything to do with B6 and I don't think B6 caused this.

Hemachromatosis is the most likely and you need iron studies and ferritin at this point, but the other conditions need consideration as well

good luck


Please Click Accept to give answer credit so I am compensated for time and expertise. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only, not to replace your physician advice or visit.

Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 57418
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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