We have all heard that the way to someone’s heart is through their stomach and that the eyes are a window to the soul. But, tongues may be a window to heart health. We have spoken about the importance of good oral health for your heart. Now, research shows that the appearance of your tongue and the microbiome on your tongue may be an indicator of heart health.

“The tongues of patients with chronic heart failure look totally different to those of healthy people,” said study author Dr. Tianhui Yuan, of the Hospital of Guangzhou Univ. of Chinese Medicine. “Normal tongues are pale red with a pale white coating. Heart failure patients have a redder tongue with a yellow coating and the appearance changes as the disease becomes more advanced.”

In addition to these visual cues, the bacteria on people’s tongues is different between healthy people and people who have heart problems. Previous research has shown that the tongue’s microbiome could be used to diagnose pancreatic cancer.

The study looked at 70 people — none of the participants had oral health problems. There were two groups: 28 healthy people for a control group and 42 with heart failure. Samples were taken from tongue scrapings. The people with heart failure had the same microorganisms in the coating of their tongues as each other. Healthy people also had microbiomes that resembled each other. But the two groups were distinct from each other. People who had recently had a chest infection, were pregnant or had taken several medications were also excluded.

“More research is needed, but our results suggest that tongue microbes, which are easy to obtain, could assist with wide-scale screening, diagnosis, and long-term monitoring of heart failure,” said Dr. Yuan. “The underlying mechanisms connecting microorganisms in the tongue coating with heart function deserve further study.”

That could mean that a simple tongue scraping with a stainless steel spoon could allow doctors to screen for heart failure in people who are at risk without more complicated tests. It could be a first step in diagnosing people. It might be less expensive and faster. The appearance of a tongue can be determined at a glance as a first step.