Aphthous Ulcer Mystery Solved

Aphthous Ulcer Mystery Solved
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A dairy-free diet may stop the recurrence of canker sores.

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Lichen planus is not the same thing as aphthous ulcers (also known as canker sores), which are much less serious, but much more common. Some people have recurring problems with them, where they keep coming back over and over—and we didn’t know why, in most cases, until last year.

An immune reaction against cow’s milk proteins and wheat proteins—gliadin is a gluten protein—within the cause of recurrent aphthous ulcers? You tell me—dairy, gluten, both, or neither?

Gluten had nothing to do with it. It was the dairy. Two-thirds of the recurrent canker sore sufferers had high levels of anti-cow’s milk protein antibodies in their bloodstream.

The thought is that the cow’s milk proteins themselves penetrate deep into the lining of the mouth, inducing a major immune disorder—where our body attacks the foreign cow proteins, and in doing so, ulcerates our mucosal lining.

To test this, a few of the patients stopped eating all dairy; a cow’s milk protein-free diet. And the ulcers disappeared, with no reappearance of clinical disease—until they tried adding back dairy.
Same thing with the next patient—went into complete remission, with a reappearance of ulcerations only after some ice cream had been consumed. This is really exciting news for sufferers of this painful condition.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by veganmontreal.

Please consider volunteering to help out on the site.

Lichen planus is not the same thing as aphthous ulcers (also known as canker sores), which are much less serious, but much more common. Some people have recurring problems with them, where they keep coming back over and over—and we didn’t know why, in most cases, until last year.

An immune reaction against cow’s milk proteins and wheat proteins—gliadin is a gluten protein—within the cause of recurrent aphthous ulcers? You tell me—dairy, gluten, both, or neither?

Gluten had nothing to do with it. It was the dairy. Two-thirds of the recurrent canker sore sufferers had high levels of anti-cow’s milk protein antibodies in their bloodstream.

The thought is that the cow’s milk proteins themselves penetrate deep into the lining of the mouth, inducing a major immune disorder—where our body attacks the foreign cow proteins, and in doing so, ulcerates our mucosal lining.

To test this, a few of the patients stopped eating all dairy; a cow’s milk protein-free diet. And the ulcers disappeared, with no reappearance of clinical disease—until they tried adding back dairy.
Same thing with the next patient—went into complete remission, with a reappearance of ulcerations only after some ice cream had been consumed. This is really exciting news for sufferers of this painful condition.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by veganmontreal.

Please consider volunteering to help out on the site.

Doctor's Note

For more on health concerns related to dairy, check out these videos:

And check out my other videos on dairy

For additional context, also see my associated blog post: Do Vegans Get More Cavities? 

In 2017, I released a couple of new videos on canker sore: Is Sodium Lauryl Sulfate Safe? and Is CAPB in SLS-Free Toothpaste Any Better?. And in 2018, I published a new one: The Role of Dairy & Gluten in Canker Sores

If you haven’t yet, you can subscribe to my videos for free by clicking here.

67 responses to “Aphthous Ulcer Mystery Solved

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    1. Dr. Greger, what are your thoughts on zonulin and gliadin as they relate to intestinal permeability and a possible cause of inflammation?

  1. Hi, I am a Vegan but keep getting ulcers in my mouth lately (last 2 weeks). Im not sure but it’s been since I stopped eating lot’s of white bread and switched to brown and I also drink 4-5 cups of coffee a day and eat a far amount of pasta (brown). Any ideas Michael?
    Cheers

    1. Mouth ulcers are a challenge. The studies show clear link to milk products. People due have reactions to plant foods which can be difficult to figure out. Dr. McDougall’s December 2002 newsletter(available for free on website) contains an article, Diet for the Desperate. Below is a quote from that article which talks about the plant foods most likely to cause allergic problems. Hopefully by now the problem has vanished and is no longer an issue but if the problem has persisted you might consider avoiding some of these foods. “If the elimination diet seems too severe for you right now, then follow the McDougall Program, which eliminates six of the leading causes of food allergies: dairy products, eggs, chocolate, nuts, shellfish, and fish. If your problems persist, then the next suspects to eliminate are wheat, corn, citrus fruits, tomatoes, and strawberries–the most frequent causes of adverse reactions among foods in the vegetable kingdom.”

  2. I have found that using a toothpaste without sodium laurel sulfate completely prevents these ulcers. There is clinical evidence for this as well, though I don’t have a citation off the top of my head. Rembrandt made a SLS free toothpaste for this very reason- not sure if they still do. I just look in the “natural” section of my grocery store for a toothpaste with fluoride, but no SLS. Nature’s Gate, Jason, and Trader Joe’s all make them, but you need to read the labels.

    1. I have had great success using Rembrandt Canker Sore Toothpaste.  It does not have sodium lauryl sulfate in it.  My local stores no longer carry it so I order it directly from the company.  I think it may also be available on Amazon.  While it is expensive, it is worth the cost to avoid the terrible pain.  I stumbled on it in a magazine article about 10 years ago at my doctor’s office.   Before I found this special toothpaste I had suffered with frequent canker sores for years (since my teens), often with several at once.  They wouldn’t heal on their own but had to be cauterized with silver nitrate sticks I got from my family doctor–a painful process in itself.  I got them whenever I injured the inside of my mouth–biting my lip or cheek or scraping the tissue somehow.  Now I almost never get the sores, and if I do they heal up promptly.  What a relief!  I will consider the milk angle, but since this toothpaste has virtually eliminated my problem I’ll probably just stick with that.  I highly recommend that all canker sore sufferers try Rembrandt’s Canker Sore Toothpaste.  Don’t just look for Rembrandt though–several of their varieties have SLS–get the Canker Sore type!   : )

  3. cool thanks I use co-op tooth paste cos it’s vegan but i’ve never read the label properly. Why is coffee bad for you? I gave it up this week and am feeling pretty good for it and I feel like I can think much better too. :-)

    1. Its not the coffee bean itself that’s bad for you; it is a bean after all. Check out the video on its health benefits
      http://nutritionfacts.org/videos/is-coffee-bad-for-you/
      http://nutritionfacts.org/videos/update-on-coffee/

      But as always, one must weigh out the pros and cons. It has many health benefits but the caffeine itself is not a beneficial substance. It is after all, an unnatural stimulant. Check out these few articles on coffee by Dr. McDougall.
      http://www.nealhendrickson.com/mcdougall/2004nl/040700pucoffee.htm
      http://www.drmcdougall.com/misc/2005nl/july/050700fav5.htm
      Drinking 4-5 cups of coffee a day is an extreme amount, since depending on what type you drink, such as filtered, it can have up to 100 mg of caffeine, and the daily limit is 200! You should aim for 2 cups a day max or drink decaf. A much healthier choice would be to drink Decaf Chai Tea
      http://nutritionfacts.org/videos/the-healthiest-beverage-2/

  4. I’ve suffered with mouth ulcers my entire life.  I’ve never found a dentist or doctor who had an answer to the cause.  Eleven months ago, I started a whole foods, plant-based diet (thus, eliminating all animal and dairy).  I was still getting the mouth ulcers.  In January I was searching the internet for causes for mouth ulcers (as I have done many times before) and found an article about SLS in toothpaste as a cause.  I switched to a natural toothpaste and the ulcers went away.  That is until June when I spent a month traveling Europe.  The interesting thing about this is that I decided not to be plant-based while I traveled (I wanted to eat what the locals eat) and I ate dairy.  I also ran out of my natural toothpaste and switched back to SLS toothpaste for a couple of weeks.  By the time I got home, I had mouth ulcers once again.  So, was it the dairy or was it the toothpaste?  I’m back off of both, so perhaps I will never know for sure, but I suspect it is the SLS in the toothpaste since I was still getting them after several months on a non-dairy diet. They are sooooo painful and frustrating!

  5. Not a single canker sore in my mouth since avoiding all dairy years ago. I had forgotten all about them until I saw this video. Pleasant change explained!

  6. Dr. Greger,

    My husband, a sufferer from recurring, painful canker sores, is inclined to try eliminating dairy, after seeing this video. My question: Is cows’ milk the only dairy source that could trigger this condition? Does goat milk have the same negative effect; or could he consume goat milk products in exchange? He is having a hard time giving up cheese…

    Thank you!

    ~ Ute

  7. Hi, I am Sahithi,i am suffering fro mouth ulser from 2 weeks.I am getting mouth ulcer after eating food made up of chick peas powder,i wonder what is the cause of it.

    1. chick peas powder is procesed food like enithing else form modern style life. Try to eat chick peas raw…very healthy!!! ( my experience)

  8. Hi everyone,
    I suffered with these horrible canker sores for years, never knowing what was causing them, a hapless victim of their merciless pain that often lasted for two weeks. Sometimes the pain was so great I could not even sleep or eat normal food. I finally saw a world reknown dermatologist who advised me to eliminate one of the possible food groups that cause them at a time, and for me it was the dairy products.
    Here’s the thing: I thought I was doing everything right and I was still getting them, until I found out the margarine I was using contained whey which is a dairy product. Ever since then, I began looking at food labels, avoiding the whey and have rarely had a problem.
    I found that the more concentrated forms of dairy such as butter and cheese were the worst causes, as well as milk chocolate, moreso than regular milk. If you’re searching for a solution as I was, try eliminating ALL dairy from your diet, which you really have to watch food labels (and ask annoying questions at restaurants) to do. Best wishes everyone.

  9. Makes sense. I wasn’t vegan til I moved out of my parents house. The whole time at my parents’ house I had recurring mouth ulcers. I thought it was because I started cooking on my own and reduced my salt intake, but this could make sense too! Either way, just another victory of a healthy diet!

  10. Would the dairy issue with the body attacking itself ..autoimmune… cause the same problems in the gut.. as in crohns disease? And if so, what is the best way to test to see if your body fights against dairy like this?

  11. Michael, I have seen huge progress from that expo in Chicago….just go, an go….I’m 100% on Your side…we have to change the world…and I think we allready did!!!

  12. And, You never answer that question about “smoke is healthy”?….more than 78% smokers have no simptoms of AH decease…no parkinson, and very low level of alergy sensitive between smokers?!

  13. I have never had ulcers until I became a vegetarian .My body was clean of meats,dairy for months at a time.Once in a blue moon I would
    eat a cheeseburger and get a ulcer on my tongue right after eating it.This happened 3 times.This must be a signal of rejection of my body.

  14. After watching this video, I have been recommending it to my patients. The results have been very good! Unfortunately, the dentists I have shared it with are not willing to give it a try. Old habits die hard.

    1. Dr. Jones, I would like to chime in here re mouth (tongue) ulcers. I have been vegan for a few years now and was taking 2000 ug B12 once a week. I have also experienced ulcers mostly on my tongue every so often going way back. I also have a history of Crohn’s going back 30 some years. In the past year I started experiencing other symptoms like fuzzy thinking, fatigue, moodiness and just overall yuckiness. Long story short, I kept digging for a solution and the only thing that put it all together was a vitamin B12 deficiency! So, knowing you can’t OD on B12 and that massive oral doses could be just as effective as intramuscular injections, I started taking daily 5000 ug sublingual methylcobalamin. Within two weeks my symptoms cleared up and I haven’t had any tongue ulcers again even though I drink coffee and eat a lot of tomato paste.

        1. Thanks for being here. Dr. Greger and the entire NF Team are a national treasure. For the sake of brevity, I did not mention a confounding factor in my ‘race for the cure’ of my myriad symptoms, that of my recent serum B12 lab work indicating a normal level (568 pg/ml in a range of 239-931). I have come to learn that the serum tests can be misleading for a number of reasons and one needs to see their homocysteine and MMA levels as well, tests that were not ordered at the time. In addition to all the excellent B12 videos here, Dr. Greger has a great lecture on Youtube called ’40 Year Vegan Dies of a Heart Attack’ that is well worth the time of anyone who frequents this website, and especially for vegans. Another outstanding resource is the CDC continuing education course for healthcare professionals on B12 deficiency. It is suitable for lay readers and will assist the public with being more proactive when interfacing with their health care providers who may not know about the myriad problems associated with B12 deficiency and the dangers of misdiagnosis. Here’s a link to the course:

          www dot cdc dot gov/ncbddd/b12/documents/b12-030910.pdf

          1. Lawrence: I’ve seen that other Dr. Greger video too! I agree, it’s great.

            And thanks for the additional info, re: CDC continuing education course.

            Take care.

          2. We are now vegan 14 years – drinking supplemented non-dairy milks and taking sublingual B12 – but back when my husband was a big meat eater (in his 20s/early 30s), he had a serious B12 deficiency and had to get injections. Interesting that it doesn’t just affect vegans or older people with lower stomach acid.

      1. Thank you for this! Have been taking 2000 ug once a week. I will step it up to 2000 a day and see if my ulcers heal. I am vegan, eating whole foods mostly fruit and low fat. I can’t think of any reason why I should be getting ulcers other than B12 deficiency, if it is connected as you suggest. Thanks again!

  15. My son is 11 and for the past 4 years he keeps getting painful red and often bleeding sores on his lips and the edges of his mouth we ruled out lots of things but it seems he gets them especially if he drinks cow milk the kind given out at school or milk i buy at the store after switching him to coconut milk its completely. Stopped why does this happen? What is it called in medical terms it does not happen when he eats cheese or icecream

  16. Like others here i have had apthous sores my whole life.
    I have eaten dairy my whole life.
    But when i stopped eating nuts, 30 years ago – no more sores.
    I still eat dairy.
    I’d say the immune response like people in general are different.

  17. Thank you for this Video Dr Greger. It was quite a revelation to discover that it was caused by dairy. I just did not make the connection between Dairy and Oral health.
    I am wondering now if some people have a kind of an allergy or an immune system issue which makes them prone to these painful oral health issues more than others, when consuming certain foods. It would be great to see more videos like this, since people with oral health issues tend to have suffered from it for a very long time, even with regular check ups and cleaning they receive from dentists and periodontists .

  18. Never been prone to acne but had those apthous sores my entire youth. Do kids showing these sores have higher ADHD prevalence, anybody here privy to this? Scored unusually high 38/40 on a test 20 years back, with all the exorphin talk out there and now this sensitivity linked to milk again.
    I wonder….. , could I have had a normal life?

  19. I am a vegan (vegan 2 years, 6 years vegetarian) who has recently been diagnosed with Crohn’s disease 4 months ago. I have been getting canker sores for the last 4 years, I follow a strict vegan diet and every month I get these sores? Is this related to my Crohns?

    1. Hey Sam. Ughh, sorry to hear about the Crohns. Luckily symptoms can be heavily managed sometimes by diet and lifestyle. Not sure about the canker sores or if they are related. A quick search did find some common themes. One study Oral manifestation in inflammatory bowel disease: a review. And another that discusses From aphthous ulcer to full-blown Crohn’s disease. This is a serious condition and I highly suggest discussing diet with your doctor and even seeing a dietitian. There are many herbs, foods, vitamins that may be a good option for you. Let me know if I can do more. I have a few freinds with crohns and anecdotally I can say a few things really triggers flares : refined carbohydrates (soda and fruit juice), some beans (but not many of them), and raw cruciferous veggies. Funny though he dies fine with spicy foods, homemade breads (but not commercially bought), and most all other foods. Very individuals, hence why seeing a dietitian could be super helpful!

      Best to you,
      Joseph

      1. I wonder if somehow the microbiome is related in some cases. Even as a long-term vegan, my husband used to get mouth sores regularly (often after accidentally scraping with food or biting the inside of his cheek) and since he has been making and eating raw sauerkraut – just cabbage, salt, a very small amount of organic sugar and a bit of starter from another jar of live kraut – they are now extremely rare for him. Incidentally, his stomach problems (bloating and pain – not Crohn’s, though) also went away. Lysine, on recommendation from a dentist, had no effect for him, although I’ve heard it helps some people, like those affected by nuts. He has a history of overuse of antibiotics for skin problems as a teenager – he was on them for at least 2 years straight.

  20. Just returned from Holistic Holiday at Sea. (Great presentations from you, Dr. Greger) One presenter, Dr. Blyweiss, addressed the treatment of Aphthous ulcers as including Lysine and “the clyclovirs”. I can’t remember what he attributed as “cause”, but I hope to receive the powerpoint slides for review soon. All my life, I have gotten random single or double “simple” sores. I usually gargled with salt water and used “Kank-a” (brand) topical solution, which burns it to numbness. About 18 months, several sores erupted simultaneously and then flared into a massive sore that spanned the length of my tongue and gums on one side of my mouth. I have never been in so much pain. It hurt to talk, and eating was out of the question. I sought out an oral specialist, and after careful interviewing and listening and the use of many reference materials, the doc cited the presence of Herpes in my system, due to past diagnoses of Chicken Pocs, Shingles and Mono. He said that the virus remains dormant and then it is activated when immunity is low. While I had already practiced healthful eating (vegan), and he was happy to hear it, I went totally sugar free and took his prescriptive action, which started with a Medral Pak 5-day steroid blast, followed by a group of things: an Rx”Acyclovir” and another Rx for Miracle Mouthwash, and over-the-counter: “Lysine”, “ACHH”, “Colostrum” and “ViraStop” as a full scale treatment. Since that time, my canker sores have appeared about every 4 months. (No regularity, no rhyme/reason) I cannot, for the life of me, figure out a true cause-and-effect for the occurrence of canker sores for me. I get more than one at a time, usually. There is no specific thing I am doing that suddenly brings them on…ie I used to think it was because of a random sugary dessert, but other times, the same dessert does not cause a break out; I have purchased natural, Laurel Sulfate-free toothpaste, and I still get them randomly; I am almost 100% vegan, with only one exception: half-n-half in my daily coffee. (I know that “needs to go” for many reasons), but still, it’s perplexing to me that, if dairy is a culprit, note that I have 1-2 TSB of half-n-half every day in my morning coffee, (for years) and I only randomly get canker sores. Is there any updated information on aphthous sores these days? It has been 5 years since this video… Anything you can present would be greatly appreciated. I have been on another dose of Acyclovir (“every 6 hours”) for about 10 days. The original canker sore on my tongue has gone away, and now I have two more getting started on the roof of my mouth and where my gums attach to my upper lip. I am willing to do anything to make them stop coming. HELP!

    1. Hi Christine. Thanks for your comment and glad you were able to connect with Dr. Greger and others on the cruise! I suggest avoiding the dairy for a bit and see if it helps? The association between canker sores and dairy seems to remain.

    2. Hi,

      My scenario is very similar. I eat fairly healthy, and have been moving towards a plant based diet. However, I get canker sores for an extended period of time. None of the topical nor over-the-counter remedies helped. Or, as soon as I got rid of one, another would surface. Finally, an oral surgeon suggested that I had Herpes (it is very contagious and probably from someone I kissed in college). The surgeon prescribed Acyclovir and that does a pretty good job at getting rid of the sores, however it has side-affects in the form of headaches. Also, I am not a fan of our medical system that is mostly prescription based. Reading up on how a Lysine rich diet helps, I changed my diet, along with a daily L-Lysine supplement, I have found that the cankers are gone. There are many articles out there that discuss Herpes and the affects of foods depending on their Lysine to Arginine balance. The challenge is that many of the dairy products are high in Lysine and this contradicts what Dr Greger is saying. Nuts are bad for cankers and I absolutely love nuts. As a matter of fact, most cankers that I have had were ‘triggered’ by downing a large amount of some nut.

      Christine, what has your experience been? Have changed your diet to be more Lysine rich and what are the results?

      Dr Greger, what are your thoughts on the scenario where one has a virus such as Herpes? When my family started moving from dairy to almond milk, along with whole wheat for baking, my canker sores grew and multiplied. However, if I focus on Lysine rich vegetables, along with fish and some meats and dairy, the canker sores go away.

      1. Thank you for contacting NutritionFacts. You might like this video Dr. Greger made that mentions herpes among other viruses.
        https://nutritionfacts.org/video/how-to-boost-your-immune-system-with-wakame-seaweed/

        We would recommend focusing on Lysine rich plant based sources- beans, tempeh, soy products, Quinoa are great sources that don’t carry with them the dangers of dairy, meat, and fish.

        Good luck to you.
        NurseKelly
        NutritionFacts Moderator

  21. I used to get canker sores when I was little and didn’t consume any dairy products.Now I eat a lot of dairy foods but hardly get any mouth sores anymore.I just hope they don’t come back to haunt me:/

  22. As a Chiropractor and an occasional canker sore sufferer, i have seen that stress is my trigger. And always in the same spots. I think they are mediated thru the nerves AND Cow Milk Protein antibodies.

  23. I had these ulcers for years. I did an Internet search about 5 years ago and read about vitamin B deficiency as. A. Possible cause. Since I eat little meat, I decided to try Vatamin B supplement. I don’t recall which B it is( not folic acid) but ever since I started on a small ( once per week) virtamin B supplement I have had no problem. BTW the mouth ulcers are not like just a small thing. They are extremely painful so that during a bout( which would last up to a week) I could barely eat. Vitamin B was my savior!!! I drink milk- always have and I love it!

  24. A friend recently commented on this, and wondered is there’s any difference between pasteurized milk/dairy and raw milk/cheese. In case there’s any change/damage to the milk proteins involved in Pasteurization, such that [possibly speciously] “Raw is better.”

    I’m dubious on any distinction. Casein is casein is casein, right?

    Are there any studies that would tell one way or the other? OR has anyone even looked into this distinction? Most milk these days is Pasteurized, and “raw” is all but banned in most areas, right?

  25. I will try to eliminate dairy to see if my canker sores disappear forever, but it seems to me that I get them when I eat acidic foods. If I eat cooked tomatoes for more than one meal, if I consume any drink with malic or citric acid added, or cooked or processed lemon or lime drinks or foods, among others. Fresh tomatoes, fresh lemons and fresh limes seem fine and I can consume them with no consequences.
    Still, dairy also causes acidity in the body and it’s worth a try.
    Amosan Oral Rinse takes care of the swelling and pain associated with them and helps speed healing, for anyone who has never heard of it. You can only find it on Amazon right now as it may have been discontinued… BOOOOO!!!

  26. Last time my husband and I went vegetarian a couple years ago we both got canker sores really bad. We’ve recently recommitted ourselves, this time through whole foods plant based veganism and his canker sores are back. I’ve also got really bad angular cheilitis which I get from time to time. Searching the internet, I see LOTS of posts regarding new vegans and canker sores or angular cheilitis, so this seems pretty common with the transition. Most speculation is that it’s Lysine, B12, or iron deficiency, but I track my nutrients through Cronometer App and those nutrients are above the RDA for me. Our diet is similar as it was before, except with a higher fruit consumption, beans and tempeh instead of meat, more brown rice, no dairy, and of course LOTS more vegetables. We eat a ton of nutritional yeast too with careful amounts of seaweed.

    If you could disseminate any information out there for us it would be much appreciated, there’s a lot of speculation. Hydrogen peroxide seems to make my angular cheilitis better, he’s developed an additional canker sore today after a week of having one. This is our third week of whole foods plant based veganism.

    Thank you,
    You’re amazing.
    I love you.
    You’re my hero :)

    Gwen

    1. Hi Gwen, I am one of the site moderators. So sorry about the nasty sores in your mouths. I used to get them frequently and know how painful they can be. It seems there are many theories on what causes them and it seems that it is a process of elimination for most. As Dr. Greger’s video discusses some people have found avoiding dairy clears them up, for others – especially with the angular stomatitis getting an adequate amount of vitamins can be the key. I have found that I am extremely gluten sensitive and if I indulge more than just a little I will often get a nasty sore in my mouth. Depending upon your past a huge change in diet is a major stress on your system and illness of many sorts seem to rear their ugly head in protest of the change. I applaud you using the cronometer site to log your food as it is very comprehensive. The other idea may be to ease into your new way of eating as you both acclimate to new sources of food. Finally, I have also heard of people having severe mouth sores due to allergic reactions to fruit acids when they increase their consumption of fruit and at times to the sprays that are used on produce. Wish I could be more specific but these sores each seem to have their own story. Best wishes for quick healing.

  27. Hello, I have been suffering from aphthous ulcers since I was 9 (currently 24). They have gotten progressively worse as time has gone on and I currently average at least 5-10 ulcers at a time, all the time. During severe outbreaks, I can have up to 30 and they have scarred my cheeks, lips, and perhaps my tongue (looks like part of my tongue is smooth). I am currently on Dapsone and Colchicine daily. Although the ulcers have decreased and heal quicker they have never gone away fully. I have seen many doctors but they seem to pass me off to someone else after a few visits.

    I have been tested for several different things and everything has come back normal so far. My bloodwork (which I get done monthly for the dapsone), has all come back normal.

    I have considered that I might have a food allergy/ sensitivity but no doctor seems to think this could be an issue since the oral ulcers are my only symptoms and I am otherwise healthy. I would like to try an elimination diet but am not sure where to start or find out who I need to see. I know I have more severe outbreaks after consuming any fruit that has juice (ie: apples, grapes, oranges, lemons, limes etc.), chocolate and some flavored seems to make my mouth feel tingly.

    Do you have any suggestions on how to go about starting an elimination diet?

    Thanks for reading!

    Thanks for reading.

  28. Hi, Nicole. There are many resources available if you want to start an elimination diet. You could begin by avoiding the most common allergenic foods, which are peanuts, tree nuts, seafood, eggs, dairy, wheat, and soy, focusing instead on fruits, vegetables, non-allergenic grains (rice, millet, quinoa, gluten-free oats, etc.), and legumes (beans, peas, lentils, etc.). It seems, however, that you have already identified some foods that may be triggers for you, and that they may not fit into the most common allergens category. Instead of an elimination diet, what I would suggest for you is to keep a food journal for a few weeks, documenting everything you put into your mouth, how you feel when you eat it, and any symptoms you experience afterward. This will help you to see patterns between diet and symptoms. If a food appears to increase the likelihood and/or severity of an outbreak and you wish to minimize or avoid intake of that food, that may be a good solution for you. I hope that helps!

  29. I haven’t had canker sore for years. I used to eat yogurt, eggs and whey protein powder regularly and never had a problem with mouth ulcers. Since going vegan, it has become a horrible problem- big painful ulcers that are very slow to heal. I take a b-12 fortified nutritional yeast and eat a legume-rich whole food diet. I don’t eat any junk food. I’m seriously considering bringing yogurt and grass-fed whey protein powder back into my diet as this is painful.

    1. My husband and I both had mouth issues at the same time when we started eating vegan. He got mouth ulcers, several, huge and painful, while I got angular cheilitis. We stopped eating pineapple and started swishing with hydrogen peroxide alternating with mouthwash after EVERY meal and we both cleared up in a week. I think it was a combination of the enzymes breaking down our healthy tissues that allowed bacteria to flourish where it previously hadn’t been able to penetrate, plus all the fruit we were eating gave fuel to the fire.

      Neither of us has had a problem in more than six months.

      Good luck!
      Gwen

  30. The last time I got a canker sore was before 2009! 2009 was the year I decided I wanted to go from junk food vegan to healthy vegan. Four months ago, I decided to start doing monthly liver cleanses. I’ve been on a high raw (at times even completely raw vegan) diet. The only non-raw thing I would take once a month would be a cooked, whole foods vegan version of a favorite soup dish I had from when I was a kid. My current supplements are: probiotics, digestive enzymes, and B12 supplements.

    Back when I got canker sores, I would get them one at a time. The other day, I got a whopping 5!!! 3 on one side of my tongue and two on the other. I was speaking with a nurse who told me to go back on cooked brown rice. I told her that I didn’t want to because I noticed that brown rice (or any rice/grain for that matter!) gave me acne. She then suggested a vitamin b-complex supplement in addition to what I have.

    I hope it helps!

  31. It took me until I was in my 40s to realize that coffee was the culprit for me. Well, acids of all kinds, but particularly coffee. Yet I can drink it if I immediately swish my mouth out with water. I do this after eating chocolate, too. And mostly I don’t go near citrus. HUGE difference.

  32. Hello,

    I eat raw majorly in a day and been vegan since 2012. I have been having painless mouth sores around the lower jaws. I eat fruits all day (about 1000gms of mixed fruits like banana apple grapes, papaya, chickoo etc ), melons separately and green juice till dinner which is a whole food plant diet.I add chia and lettuce to my fruit salad. i have coconuts or peanuts in the evenings or some light snack. I switched to organic fruits a month ago (feb 2018) assuming its due to non organic fruit consumption all day. My veggies greens and cooked are all organic since 2016. Could my mouth sores be just eliminations that i must not bother ? They flare up on and off in the same place. offlate when i eat some spicy indian dinner or non organic fruit accidently. I also spoke to a dentist who thinks its not harmful. Any insights ?

  33. Food allergies can be related to some aphthous ulcers. The precise cause isn’t fully known, and the triggers differ form person to person. You could potentially have an allergy to one of the fruits you eat. Even when organic, allergies can develop. Citrus is sometimes a trigger. If a dentist has seen them and believes they are aphthous ulcers, they are not harmful. But if they’re very bothersome, you could try eliminating single foods from your diet to assess the effects of this on the ulcers.

    -Dr Anderson, Health Support Volunteer

  34. I have had Crohn’s disease for many years, diagnosed in 2000 and operated on shortly afterwards. Before my diagnosis I had aphthous ulcers almost weekly. Several operations and a change of diet and years of trying to work it all out, and I haven’t had an ulcer for years. I am no dairy free, mostly anyway, I have the odd small bar of chocolate and brioche bun when I am out but no cheese, milk or butter and I seem to be ok. I have completely eradicated soya from my diet as that gives me chronic pain and bloating, even though I used to drink soya milk. I bake my own bread and steer clear of processed foods as much as possible, don’t have any fruit apart from cranberry juice, sometimes with a slice of lime in it. If I had pineapple or kiwi fruit I got a very itchy tongue, also any citrus fruit seemed to give me sores in my mouth. I had a biopsy done once as I have for years got blisters in my mouth and throat, they didn’t draw any conclusions but I still get them if I eat anything too acidic. They are small and filled with liquid and I can usually pop them with my tongue or finger. They feel like I have got food stuck in my throats if I get them at the back of my throat so they are really unpleasant but the dietician and my consultant don’t seem to know what they are. I wonder if anyone else gets them?

  35. Sorry for the bad spelling! My iPad always auto corrects me but I was so intent on listing I didn’t check it through thoroughly.

    I also had Hives once as I used some over the counter cold sore cream and was using acyclovir too so not sure which it was but I am allergic to something. I was then diagnosed with Orafacial Granulomatosis as my lips swelled up and cracked and stabbed. So painful and not oral steroids got rid of it. I have been trying to avoid benzoates ever since as they, along with chocolate and cinnamon are known to cause this. I hope this helps someone.

  36. I really don’t know the cause of, mouth ulcer, i don’t eat dairy and my diet is 90% plant based. B U T…
    … I HAVE FOUND THE CURE!!
    Clove oil. 2-3 drops in water and i do mouth wash 2-3 times a day. In 1-2 day’s the ulcer are gone
    ShapeUpStudiomike

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