Best Supplement for Canker Sores

Best Supplement for Canker Sores
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Vitamin C, turmeric, beta glucan fiber, and vitamin B12 are put to the test for recurring canker sores (aphthous ulcers).

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Canker sores can be a painful, recurring inflammatory process of the lining of our mouths. And, “[s]imilar to other chronic inflammatory conditions,…DNA…damage [due to] oxidative stress [free radicals] is thought to play a…role.” Normally, free radical “production is balanced with antioxidants.” However, if the free radical concentration gets too high, and our antioxidant enzymes and the antioxidants we get in our diet “cannot [adequately] compensate” for these radicals, the balance is shifted in a pro-oxidant direction, which can lead to oxidative damage within our body. Okay; so, do those with recurring canker sores have fewer antioxidants, more oxidation, and more DNA damage? Yes, yes, and yes. More pro-oxidants and more oxidative stress in their bloodstream, lower antioxidant status, and more DNA damage—suggesting it might be possible for antioxidants to help, but you don’t know, until you…put it to the test.

16 boys and girls around age 12 with recurring canker sores given a whopping two grams of vitamin C a day. That’s considered the tolerable upper daily limit for adults before you start getting diarrhea, and 1,200 mg may do that in a 12-year-old. But, it’s all about risks versus benefits. How did they do? 15 out of 16 cut the number of canker sores they were getting at least in half. In the three months before they started the vitamin C, they averaged four canker sores, but in the three months they were on it, they had less than one on average. Then, they tried stopping the C for another three months, and the ulcers started coming back. So, they added the C back, and the canker sore rate dropped again.

What about applying antioxidants directly, like a turmeric gel—a gel containing 2% curcumin, the yellow pigment in the spice turmeric? Swabbed directly onto the canker sores twice a day, it did seem to “significantly reduce…pain intensity” and ulcer size compared to placebo, and compared to a gel containing no active ingredient. But, it would be nice to see a comparison to some active treatment, and from an independent research group not funded by the curcumin gel manufacturer. And…here it is. A randomized clinical trial: a generic 2% curcumin gel versus a prescription steroid gel, and the curcumin worked just as well, providing “strong evidence that [it] can be used as an effective and safer alternative to steroids” for the treatment of recurring canker sores.

But, if you remember, topical honey beat out that same steroid for both ulcer healing, compared to the steroid, and pain reduction, compared to the steroid. So, if you’re going to use something topically, honey seems best. But, what if you just want to swallow something instead—but something that doesn’t give you diarrhea?

31 patients with recurring canker sores were split into two groups, getting either 20 mg of yeast beta-glucan fiber a day or placebo. That’s the amount found in just an eighth of a teaspoon of brewer’s yeast or nutritional yeast. In the placebo group, no significant change, whereas in the yeast group, ulcer severity was cut nearly in half; so, that’s something else you can try.

If it’s an antioxidant thing, can’t you just eat a plant-based diet, lots of fruits and vegetables, and treat it that way? That’s never been put to the test, though a plant-based diet could also make things worse, if one is not ensuring a regular reliable source of vitamin B12 through supplements or fortified foods. For example, a 30-year-old woman with four years of recurring canker sores eating so few animal products, and no supplementation, she became vitamin B12-deficient and started feeling weakness, tiredness, numbness, and tingling. So, they immediately started her on B12, and, thankfully, her B12 deficiency symptoms got better. But, so did her canker sores—”a rapid and complete recovery” within weeks of starting B12, after years of suffering.

We’ve known B12 deficiency could lead to canker sores since the 70s—so much so that a recommendation has been made to consider B12 deficiency any time you see a patient with recurring canker sores. In fact, a number of nutrient deficiencies may do it. If you compare the lab tests of those with recurrent canker sores to those without, more than half of the canker-sore group show evidence of “haematinic deficiencies”—in other words, blood-forming nutrient deficiencies, compared to less than one in 10 in the non-canker sore group. So, we’re talking like iron deficiency and folate deficiency, in addition to B12 deficiency. So, they gave them supplements and their canker sores improved, especially among those who didn’t have a family history of canker sore problems.

Okay; you could see how vitamin and mineral supplements might help people who are deficient. But might a supplement like vitamin B12 help even in people not B12-deficient? Apparently so. As the title says” Cyanocobalamin [the most common form of supplemental B12] may be beneficial in the treatment of recurrent [canker sores] even when vitamin B12 levels are normal.” They took a group of 72 patients with frequent canker sores, and gave them B12—regardless of what their levels were—and in 96% of cases, they got better. And, that was among both those who started out deficient, and those who started out with regular B12 levels in their blood. But, there was no control group. So, you don’t know how many would have gotten better anyway. And, they injected the B12, and injections can have an even greater placebo effect than pills, especially, perhaps, with something like B12, which has a striking mad-scientist-looking ruby red color in the syringe. But, there had never been a randomized, double-blind placebo-controlled trial of oral B12 for canker sores until, there was.

A thousand micrograms of sublingual B12 a day for six months, and it took five months, but eventually: “The duration of [canker] outbreaks, the number of ulcers, and the level of pain were reduced significantly”—and again, “regardless of initial vitamin B12 levels in the blood.” So, B12-deficient or not, vitamin B12 supplements seemed to help. By the end of the study, twice as many in the B12 group appeared to have been cured.

So, vitamin B12 supplements represent a “simple, inexpensive,…low-risk,…effective” treatment, though it appeared to take months before it started working—whereas if you apply B12 directly to the canker sores, a randomized, double-blind placebo-controlled trial of a B12 ointment, applied directly to the canker sores, you can get at least a significant reduction in pain within two days, compared to placebo. And again, it doesn’t matter whether you’re vitamin B12-deficient or not.

Please consider volunteering to help out on the site.

Image credit: Bicanski via Pixnio. Image has been modified.

Motion graphics by Avocado Video.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Canker sores can be a painful, recurring inflammatory process of the lining of our mouths. And, “[s]imilar to other chronic inflammatory conditions,…DNA…damage [due to] oxidative stress [free radicals] is thought to play a…role.” Normally, free radical “production is balanced with antioxidants.” However, if the free radical concentration gets too high, and our antioxidant enzymes and the antioxidants we get in our diet “cannot [adequately] compensate” for these radicals, the balance is shifted in a pro-oxidant direction, which can lead to oxidative damage within our body. Okay; so, do those with recurring canker sores have fewer antioxidants, more oxidation, and more DNA damage? Yes, yes, and yes. More pro-oxidants and more oxidative stress in their bloodstream, lower antioxidant status, and more DNA damage—suggesting it might be possible for antioxidants to help, but you don’t know, until you…put it to the test.

16 boys and girls around age 12 with recurring canker sores given a whopping two grams of vitamin C a day. That’s considered the tolerable upper daily limit for adults before you start getting diarrhea, and 1,200 mg may do that in a 12-year-old. But, it’s all about risks versus benefits. How did they do? 15 out of 16 cut the number of canker sores they were getting at least in half. In the three months before they started the vitamin C, they averaged four canker sores, but in the three months they were on it, they had less than one on average. Then, they tried stopping the C for another three months, and the ulcers started coming back. So, they added the C back, and the canker sore rate dropped again.

What about applying antioxidants directly, like a turmeric gel—a gel containing 2% curcumin, the yellow pigment in the spice turmeric? Swabbed directly onto the canker sores twice a day, it did seem to “significantly reduce…pain intensity” and ulcer size compared to placebo, and compared to a gel containing no active ingredient. But, it would be nice to see a comparison to some active treatment, and from an independent research group not funded by the curcumin gel manufacturer. And…here it is. A randomized clinical trial: a generic 2% curcumin gel versus a prescription steroid gel, and the curcumin worked just as well, providing “strong evidence that [it] can be used as an effective and safer alternative to steroids” for the treatment of recurring canker sores.

But, if you remember, topical honey beat out that same steroid for both ulcer healing, compared to the steroid, and pain reduction, compared to the steroid. So, if you’re going to use something topically, honey seems best. But, what if you just want to swallow something instead—but something that doesn’t give you diarrhea?

31 patients with recurring canker sores were split into two groups, getting either 20 mg of yeast beta-glucan fiber a day or placebo. That’s the amount found in just an eighth of a teaspoon of brewer’s yeast or nutritional yeast. In the placebo group, no significant change, whereas in the yeast group, ulcer severity was cut nearly in half; so, that’s something else you can try.

If it’s an antioxidant thing, can’t you just eat a plant-based diet, lots of fruits and vegetables, and treat it that way? That’s never been put to the test, though a plant-based diet could also make things worse, if one is not ensuring a regular reliable source of vitamin B12 through supplements or fortified foods. For example, a 30-year-old woman with four years of recurring canker sores eating so few animal products, and no supplementation, she became vitamin B12-deficient and started feeling weakness, tiredness, numbness, and tingling. So, they immediately started her on B12, and, thankfully, her B12 deficiency symptoms got better. But, so did her canker sores—”a rapid and complete recovery” within weeks of starting B12, after years of suffering.

We’ve known B12 deficiency could lead to canker sores since the 70s—so much so that a recommendation has been made to consider B12 deficiency any time you see a patient with recurring canker sores. In fact, a number of nutrient deficiencies may do it. If you compare the lab tests of those with recurrent canker sores to those without, more than half of the canker-sore group show evidence of “haematinic deficiencies”—in other words, blood-forming nutrient deficiencies, compared to less than one in 10 in the non-canker sore group. So, we’re talking like iron deficiency and folate deficiency, in addition to B12 deficiency. So, they gave them supplements and their canker sores improved, especially among those who didn’t have a family history of canker sore problems.

Okay; you could see how vitamin and mineral supplements might help people who are deficient. But might a supplement like vitamin B12 help even in people not B12-deficient? Apparently so. As the title says” Cyanocobalamin [the most common form of supplemental B12] may be beneficial in the treatment of recurrent [canker sores] even when vitamin B12 levels are normal.” They took a group of 72 patients with frequent canker sores, and gave them B12—regardless of what their levels were—and in 96% of cases, they got better. And, that was among both those who started out deficient, and those who started out with regular B12 levels in their blood. But, there was no control group. So, you don’t know how many would have gotten better anyway. And, they injected the B12, and injections can have an even greater placebo effect than pills, especially, perhaps, with something like B12, which has a striking mad-scientist-looking ruby red color in the syringe. But, there had never been a randomized, double-blind placebo-controlled trial of oral B12 for canker sores until, there was.

A thousand micrograms of sublingual B12 a day for six months, and it took five months, but eventually: “The duration of [canker] outbreaks, the number of ulcers, and the level of pain were reduced significantly”—and again, “regardless of initial vitamin B12 levels in the blood.” So, B12-deficient or not, vitamin B12 supplements seemed to help. By the end of the study, twice as many in the B12 group appeared to have been cured.

So, vitamin B12 supplements represent a “simple, inexpensive,…low-risk,…effective” treatment, though it appeared to take months before it started working—whereas if you apply B12 directly to the canker sores, a randomized, double-blind placebo-controlled trial of a B12 ointment, applied directly to the canker sores, you can get at least a significant reduction in pain within two days, compared to placebo. And again, it doesn’t matter whether you’re vitamin B12-deficient or not.

Please consider volunteering to help out on the site.

Image credit: Bicanski via Pixnio. Image has been modified.

Motion graphics by Avocado Video.

Doctor's Note

Here’s the link to the video I referred to about the remarkable honey results: Topical Honey for Canker Sores.

What else can be done about canker sores? Check out these vids:

I haven’t done vitamin B12 videos in a while, but here are the three most recent on the its critical importance for anyone eating a plant-based diet:

Not familiar with the benefits of nutritional yeast? Check out:

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

93 responses to “Best Supplement for Canker Sores

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  1. Interesting information for sure. Referring to the last part of the video where Vit B12 was given to people whose B12 level was normal and it helped, I’m wondering if this indicates that maybe what is considered “normal” levels are not really optimal? Perhaps we all need to get our levels into the upper range of normal? Maybe an expert can weigh in here.

    1. Hal, the B12 test is known to give false results at times. Sometimes another is performed using some other manufactures test.
      A false result can also be the result of the person having a high level of intrinsic factor antibodies. This can be checked with the IFBA test.
      Another test that can be performed when a patient has symptoms, but the B12 tested normal, is the Methylmalonic Acid test (MMA).
      Bottom line, having a normal number on the B12 test does not mean you have sufficient -active- B12.

      1. Marilyn, thank you for the extra details. I guess the B12 issue gets complicated when analyzed deeper. My B12 level has always been in the normal range ( between 200-1100 pg/mL according to the lab I use) and I don’t have any symptoms, so I guess my supplementation routine is OK.

    2. I’m certainly not an expert in this matter. What I have found to work is L-lysine 1,000 Mil grams at onset first day then next day 500 usually not neeeding further to clear it up.

      1. Dennis,

        Indeed the use of lysine works for many patients. Also reducing the amount of arginine containing foods can have an impact. High concentrations of arginine containing foods include, a number of nuts, soybeans and seeds. Decreasing the amount of arginine or increasing the lysine based foods can have a positive impact for cold sores by inhibiting some necessary proteins for viruses to become invasive.

        Goldblum N, Ravid Z, Becker Y. Effect of withdrawal of arginine and other amino acids on the synthesis of tumour and viral antigens of SV 40 virus. J Gen Virol 1968;3(1):143-146.

        Rouse HC, Bonifas VH, Schlesinger RW. Dependence of adenovirus replication on arginine and inhibition of plaque formation by pleuropneumonia-like organisms. Virology 1963;20(2):357-365.

        Plaat D, Weber J. On the mechanism of arginine requirement for adenovirus synthesis. Arch Virol 1979;60(3-4):187-196.

        Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

  2. I wish NutritionFacts had a weekly — or even biweekly/triweekly — section that addressed the latest most important research on diet and health. PCRM has a similar section called ‘Breaking News’ and Dr Joel Kahn does videos on them a few times a week on his Facebook page. It seems to me that there are massive/important studies coming out even daily but NutritionFacts tends to address them even years later, whereas news outlets address them in the space of a day or two. This seems to create a lag between the present/daily conversation on nutrition and NutritionFacts, allowing falsehoods to be promoted in the meantime. Either way thanks for everything you do.

    1. Hi M85, thanks for following Dr Greger and your comment. Dr Greger and his team of volunteers do check the research in nutrition and diet on day to day bases and have videos or blog every day and Dr Greger does a live Q and A on U tube quite frequently. As for the media as you might know they usually have something to say about a new diet or extrapolation of some information out of study to sell a story every day! One has to be vigilant to check the source of information and do more research to see if the information presented is scientific based or not. By all means ask questions regarding nutrition and diet and lifestyle at Dr Greger website and I am sure you get a response from the team within a reasonable amount of time.

  3. Interesting. I used to suffer terribly from canker sores as a kid & young adult, but have almost never been bothered by them since going vegan, especially since improving our diets to chiefly whole plant foods (we eat a lot more legumes, beans, & nuts*). Now I wonder how much our B-12 supplementation has also helped! Back in my adult days when they were bad, and since on the very rare occasions I’ve gotten one (usually due to an injury like biting the inside of my cheek or trauma caused by a slip of the toothbrush), taking L-Lysine (*an amino acid found in legumes, beans, & nuts) has knocked them out quickly.

    1. Several years ago I had an immediate onset of severe environmental and food allergies and developed a mouthful of sores. My allergist at the time recommended lysine which quickly healed and eliminated all sores.

    2. Thanks for mentioning Lysine; it is what I rely on for these sores as well as anything to do with herpes, including zoster. Very effective, and I’m a lifelong vegetarian/vegan and have never taken a B12 supplement. A chemist friend of mine said that if you pull carrots from the garden and don’t scrub them too much, you’ll get more than enough B12 from the soil or even the dust in the air…. Guess it pays to live in the country.

    3. Laloofah, most legumes, beans, have some lysine, but generally balanced with arginine which competes with lysine for absorption.
      Nuts, on the other hand, have very little lysine, and a high arginine content. They are best avoided if trying to raise your lysine levels.
      Unfortunately the food highest in lysine is dairy.

      1. Thank you, Marilyn, almost none of the online resources I found that identify good plant sources of lysine – all of which list legumes, beans, nuts & seeds, among others – brought up the arginine issue. So I went looking more specifically & found only a couple, one of which was focused on arginine sources & how lysine can interfere with *its* absorption. Dairy is never gonna happen at Chez Laloofah, of course, but we do love our avocados and that is listed on the other resource I found as having a good lysine-arginine ratio (1.5:1) while many other foods we eat regularly have a 1:1 ratio (http://innatewellnesshealthshop.com/the-truth-about-arginine-lysine-and-herpes/). I must be getting it right because I suffer from the onset of no more than 1 canker sore every 2-3 years now, and that’s when I rid myself of it quickly with L-Lysine supplement. (Though now maybe I’ll just eat extra avocado). ;-) Anyway, thanks again – good to know!

  4. Suffered!! with them since childhood. No one had any solution. A couple of years ago I thought perhaps B12. Started taking sublingual 1000 a couple of years ago, have not had an occurrence since!!

  5. Dr. Greger alluded to the issue of bowel tolerance (diarrhea) and Vitamin C. Here is a much more detailed description by Dr. Robert Cathcart, MD on how to optimally titrate to bowel tolerance: http://www.doctoryourself.com/titration.html It is good to see Dr. Greger starting to uncover and provide the research results on Vitamin C. I wonder if the individuals in the study titrated to bowel tolerance correctly, if they would have achieved even more outstanding results with Vitamin C–also called the ascorbate effect.

    1. I wouldn’t take too much notice of the claims made by Andrew Saul or the papers reproduced on his site.

      They are very interesting and worth a read, certainly. There is a lot of food for thought there However, many of the claims and papers are based on very old studies and trials which would be regarded today as methodologically flawed. They need to be fact checked against the results from more modern and better-designed studies.

      If people want a modern, methodologically rigorous assessment of the effectiveness of supplemental vitamin C in promoting good health, I would suggest that the Linus Pauling Institute at Oregon State University is a good place to start:

      https://lpi.oregonstate.edu/mic/vitamins/vitamin-C

  6. I like this review, and am glad it was published, but i wish it had a little more information on possible negative consequences of B vitamin supplementation.
    For example
    Heavy vitamin B use raises lung cancer risk. The results showed that high doses of vitamins B-6 and B-12 (well above standard supplement dosage) over a 10-year period increase the risk of lung cancer in male smokers. No relationship was found with vitamin B-9 (folate) or in women.Aug 23, 2017
    Vitamin B linked to increased lung cancer risk – Medical News Today
    https://www.medicalnewstoday.com/articles/319083.php

    1. Hi bill,
      Thanks for your comment. You are right in pointing that vitamin supplementation in certain population has adverse reaction to health. As you might know Dr Greger often indicates to get ones nutritional benefit from food. He has looked into supplements in videos as follows. He points out that [our bodies] are so complex that the effects of supplementing [a few] components is generally ineffective or actually does harm.” Maybe, we should get our nutrients in the way nature intended.

      The accompanying editorial concluded “Enough is Enough; [we should] Stop Wasting [our] Money on Vitamin and Mineral Supplements.” Americans spend billions on such supplements. “A better investment in health would be eating more fruits and vegetables.” Imagine if we instead spent those billions on healthy food? Also Dr Greger in the other video mentions the importance of supplementation of vitamin D and B12 for Vegan based diet.
      Should We Take a Multivitamin?

      Vitamin Supplements Worth Taking

    2. Bill, possibly because most B vitamins on the market are synthetics?
      Also, when high amounts of vitamins, far more than normally in food are taken, other vitamins can be blocked. That was probably the case with beta-carotene raising risk of cancer in smokers. Other forms of carotenoids, gamma for one, are better at blocking cancer cells. But the high level of the beta form likely prevented them from being absorbed by the receptors.

  7. The only time I ever suffered from canker sores was after my dental appointments. Because of this, I thought they were bacterial or viral . I seem ro be allergic to b12 supplements so I make do with the tiny amount added to soy milk.

      1. Perhaps not an allergy so much as metals generating free-radicals in the mouth. I know that excessive copper or iron in the diet is said to be a source of free radicals.

      1. Thank you Deb, Ron, and Casper for your replies! Deb, I have only tried the cyano and methyl forms of b12. I’ll keep a look out for the other two to try. TG suggested trying a really low dose daily to see what happens, and so far it’s good.. no reaction. Ron and Casper, I have a hunch you are both right re allergies and trauma. Next time I’ll take a benedryl prior, and rinse with warm salt water afterwards to see if it makes a difference. Easy enough to try! Thanks again!

  8. While I appreciate this information for those it might help, I do wish there was some help for me and my angular cheilitis which neither my dermatologist nor my primary seem to have a solution for. I have tried so many remedies but to no avail. It is apparently not a bacterial or yeast issue since the meds for those did not help. I honestly wonder if it might be a nutritional issue or a lack of some nutrient that I am unaware of.

    1. Lida,

      I always feel for people when they get something and the experts can’t seem to help.

      What have you tried?

      What kind of B-12 are you taking? We had someone on this site with B-12 insufficiency being on Methyl version.

      Are you taking Zinc or eating enough beans, seeds, and nuts? Are you eating plant food sources of iron?

      If you aren’t eating well, are you using fortified cereals or fortified milk?

      For other things do you keep the moisture of your living space fairly stable? Do you still have it in the humid months? In the dry months use a good humidifier for sure or fill a crockpot up to the max height with water and turn it on.

      Also up your drinking of water. Dehydration can cause it. Are you drinking things like soda which cause dehydration?

      Have you tried Petroleum jelly?
      Have you tried Gels like: https://www.bluemcare.com/product/oral-gel-15-ml/
      When I was doing caretaking, there was a product with honey I used to protect my relative’s skin and it worked well.
      I know that it worked very well because whenever I brought my grandmother into the hospital, everyone would come and comment to me that she had such excellent skin for a long-term bed-bound person in diapers. When the first people commented, I thought, “That is nice” but by the time every visiting nurse and the aides and hospital staff had commented, I started to think that perhaps other people are doing something differently.

        1. Hi, Deb
          Thanks for all the information that you provided…..I don’t even know where to begin in responding but yes I do take methyl B-12…1000 mcg daily in addition to other B vitamins. I have tried, honey both raw and manuka, coconut oil, aloe gel, in addition tothe RX med that my primary ordered which was supposed to target both fungal and yeast. I do use vaseline nightly and throughout the day if I am home.

          I feel that my diet is nutritious and adequate in whole grains, fruits and vegetables. I am largely plant based although I do eat sardines and alaskan wild salmon occasionally.

          I have never had herpes, HIV, or even canker sores (thankfully). This situation began about a year ago and although I am of a “certain age” I see no indication that I have been drooling. But i do suffer from dry eyes and dry mouth for sure and again it has been moreso this past year or two. I wear a nightguard due to TMJ but have worn it for years without any issues.

          Not sure what else to report. Neither my dermatologist or primary doc seem concerned enough to suggest an allergist and have not steered me in the direction of any helpful supplements. My dentist suggested vitamin B but I already take those and have for years.

          1. Lida,

            So, dry mouth is one to try possibly.

            Is there any wear on the mouthguard?

            With dentures, they said that wear on them can cause them to be misaligned. Not sure about night guards, but if your TMJ has gotten worse in any way, it might need to be adjusted.

            Your dentist could answer if that has changed.

            1. The Methyl B-12 doesn’t work for everyone and we had someone recently on this site who became insufficient even though she was supplementing Methyl B-12.

          2. Just a thought: I had success(!) healing wintertime facial issues, (on my nostrils however,) by breaking a piece off an aloe plant I have here in my house for that purpose. Intuitively, (not scientifically,) I am wondering if such would help for you. E.g., not capsules, not ingesting, just wiping some of the natural fresh plant “nectar” on the sides of your mouth/lips.

    2. Okay, I am going to post Wikipedia’s answers so you can have a checklist.

      Candida can be detected in 93% of angular cheilitis lesions.[2]
      Staphylococcus aureus alone, which accounts for about 20% of cases,[14]
      β-hemolytic streptococci alone. These types of bacteria have been detected in between 8–15% of cases of angular cheilitis,[2]
      Or a combination of the above organisms, (a polymicrobial infection)[8] with about 60% of cases

      That one I question if you tried a few different antifungals and antibacterials.

      22% of cases of angular cheilitis are due to irritants.[2] Saliva contains digestive enzymes, which may have a degree of digestive action on tissues if they are left in contact.[2] The corner of the mouth is normally exposed to saliva more than any other part of the lips. The tendency of saliva to pool in these areas is increased, constantly wetting the area,[10] which may cause tissue maceration and favors the development of a yeast infection.[14]

      That one the barrier cream would help.

      Ill-fitting dentures are one cause and that one would require a visit to the dentist. Improved denture hygiene is often required thereafter, including not wearing the denture during sleep and cleaning it daily.

      It is thought that in about 25% of people with AC, iron deficiency or deficiency of B vitamins are involved.

      Have you had labs done for your nutrition?

      In general, these nutritional disorders may be caused by malnutrition, such as may occur in alcoholism or in poorly considered diets, or by malabsorption secondary to gastrointestinal disorders (e.g. Coeliac disease or chronic pancreatitis) or gastrointestinal surgeries (e.g. pernicious anemia caused by ileal resection in Crohn’s disease).[5] (A rice and veggies diet has put 92% of Crohn’s patients into remission if you have something like that.)

      A compromised immune system can cause it. Beta Glucan from Nutritional Yeast and/or Medicinal mushrooms seem helpful for that.

      It can be a side effect of medicines or things like Diabetes or HIV.

      Allergic reactions may account for about 25–34% of cases of generalized cheilitis and there can be a patch test to figure out whether you are allergic to your lipstick or mouthwash or face cream, etc.

      Drooling can cause it, but dry mouth can also cause it. There are dry mouth types of toothpaste and mouthwash.

          1. Lida,

            I am saying that sometimes the Methyl form doesn’t work for everybody.

            We had that with someone else on the site.

            If you are on that, I would like to hear it and, yes, I would suggest looking at what you are taking and how much.

            1. Lida, I am just curious because of the debate of which type of B-12 to take, which is raging within the WFPB community.

              Cyano works better in studies.

              That being said, if you have dirty genes you might need a Methyl donor, but still, Methyl doesn’t always work for everybody, so adding to it if you are on Methyl is my thought.

              And if it ends up being your B-12, come back and tell us is my request.

    3. Hi Lida, thanks for your question. I am under the impression that angular cheilitis is fungal or bacterial issues. I noticed Deb had good questions for you regarding whether you have tried B12, Zinc? And I would also ask if you tried Lysine, reducing leucine in your diet. Have you tried topical application of honey or coconut oil? Also I would look into food and diet and life style that helps to boost immune system as our immune system is the ultimate healer in our body.
      Topical Honey for Canker Sores
      How to Boost Your Immune System with Wakame Seaweed
      All Videos for Leucine

      1. Thanks, Spring03 for a more official answer!

        And Lida, if you are Diabetic, try lowering those saturated fats and vegetable oils.

        Smoking is another risk factor.

        So is licking the corners of the mouth habitually.

        Also, changing your toothbrush more frequently and make sure your toilet lid is down when you flush the toilet. They used to have a toothbrush sanitizer. Can’t remember who sold it.

        If you have an inhaler, they say to rinse your mouth with water after using it.

        If all that fails, wrinkles can cause it.

        1. I can safely say NO to all of the things you mentioned except for wrinkles (haha) but
          My toothbrush is far away from my toilet and safely encased in a sonicare holder and has an indicator when it is time to change
          I don’t smoke or lick my lips and I am thankfully not diabetic

        2. “If all that fails, wrinkles can cause it.”
          – – – – – – – –

          Wrinkles? How would anybody know for sure?

          “Out, damn wrinkle!”

          1. Deb will probably never see my comment. She likes to move toward the future rather than dwell on the past.

            Just wondered if she could provide a link regarding her (IMO outrageous) wrinkle statement. :-)

      2. Hi, Spring 03
        I failed to mention that I do take zinc in a daily formula and my dermatologist ruled out fungus, bacteria and as I mentioned earlier the medication that addressed both fungus and yeast failed to improve it and I was told to stop it after two weeks.
        I hope my immune system is functioning well. I am not aware of any indication otherwise. My lab workup just done in June of this year showed no abnormal findings.
        It’s quite a mystery. I suspect it is functional vs. organic (?) but not sure yet what the offending culprit may be. No changes in makeup, etc.

        Other than vaseline I am not sure what barrier cream or gel might help.

          1. Yes as I mentioned previously I have tried honey
            Even tried tea tree oil in a carrierAmong other homeopathic suggestions I read on a pharmacy site

            1. Did he swab your mouth or just give you things to try?

              I ask because my dog had an infection and the vet just put him on two antibiotics and neither worked.

              Oregabiotic and Olive Leaf Extract and D. Mannose and a tiny bit of Garlic worked. Not sure which, but his WBC came back in the normal range for the first time in a few months.

              Anyway, my friend just tried chlorine dioxide for her yeast infection and toenail infection and had a marked improvement overnight.

              I had gotten it from Jkat when my dog had ringworm and none of the antifungals had worked for it, but chlorine dioxide genuinely did work overnight for that, too.

              Not telling you to use chlorine dioxide, but if nothing works this round, look back at the various infections again and try something natural.

    4. Lida,
      Some years back I suffered from angular cheilitis that would never go away… it was pretty much constant for over a year. But then while at my dentist getting a cleaning, I asked him about the condition, which was very much present at that appointment. He immediately said to buy a bottle of chlorhexidine gluconate and apply it topically with a q-tip. I did that and it disappeared in just a few days and has never come back since then, now years later. So it appears to have been a complete solution for me.

      Chlorhexidine gluconate is generally used as an oral rinse to treat gingivitis but it certainly got rid of my angular cheilitis.

    5. Lida,  betonite green clay will probably work for you, after all it has worked on the flesh eating ulcers when other stuff did not.  I myself got rid of an ulcer on my shoulder while I was waiting for an appointment in the hospital to have it surgically removed. Also it shifted a black suspicious wart from my dogs paw.  You can get food grade and non food grade betonite clay from a good health shop. The clay is an excellent pain killer too when used topically on aching joints and muscles.  It is important to use only good water and don’t put any metals near it like a spoon or dish.  The green French clay is the only one to use.For anyone who doubts this you can also research the test on Pub-Med site.

  9. NOT put to the test: I was a chronic sufferer of canker sores — any time there was a rupture of the mucous membrane, which could come from something as benign as cinnamon. Since going plant-based two years ago after CABG, I have had none. But I am taking B12 supplements, so… file under A for anecdote.

  10. Doctors do a great disservice by not putting out the word there is a cure for canker sores. The cure is to take L-Lysine tablets in great dosage (3 grams) at the first tingling on the lip. Then, follow up with one 1 gram tablet every hour for eight hours. No blister will ever appear. None. Gone. And, after you do this every time it occurs, you will stop getting them, or the time between getting them will become much longer.

  11. For me, the clear trauma inducing culprit is DAIRY. When I went plant-based 5 years ago, the canker sores stopped. However, the reason I’m confident it’s dairy is because in the first 2 years I cheated and had pizza and ice cream occasionally and sure enough I’d get 1 or 2 sores within the week. Since then, I’ve been dairy free and have not had any recurrences (except for if I bite my cheek or accidentally jab my gum with the toothbrush).

    1. That is interesting Casper.

      It wasn’t dairy for me but might have been meat, because I haven’t had one 30 years and the only thing I can think of that I cut out back then would have been meat.

      I didn’t give up dairy until this year and didn’t give up sugar and junk food until maybe 2 years ago and still eat it on birthdays and holidays.

      I got them when I was in my teens and early twenties, though nutritional deficiency in everything could also be an explanation in my case.

  12. Off topic, but when is the video on soy coming out on whether it interacts with berry antioxidants? And hopefully other things will be addressed, like if it interacts with tea (I know it does in a petri dish), cacao/cocoa, etc. I’ve been anxiously awaiting that one and I know a lot of people would like to know. Any estimated time period as to when that video will come out?

    1. S,

      Dr Greger did do a video on soy milk undoing the antioxidants in tea, just like regular milk had.

      That video is already on the site.

      Not sure if that answers your questions.

      I call my green tea latte “my placebo effect tea” because the only way I am going to get the benefit from the Matcha is to believe I am getting it, even if I am not.

  13. I seldom get a “regular” canker sore, however, if I am prescribed an NSAID that I am advised to take for more than a couple days, my mouth erupts with canker sores. Is there any research/solutions into this particular problem? (I am vegan and I do take a weekly B12 sublingual supplement.)

  14. Hi mow, thanks for your question. I was curious to find any studies that show adverse effect of NSAID consumption and oral tissue and the study below findings demonstrate that NSAIDs not only pose a well-known risk of gastrointestinal injury, but also interfere with soft oral tissue repair. The impairment in buccal mucosal ulcer healing by NSAID ingestion is manifested in up-regulation in the expression of ECE-1 responsible for ET-1 generation, suppression in cNOS, and amplification of apoptotic events that delay the healing process.
    Nonsteroidal anti-inflammatory drugs impair oral mucosal repair by eliciting disturbances in endothelin-converting enzyme-1 and constitutive nitric oxide synthase.

    1. Thank you for the article, spring 03.
      Assuming I am understanding this study correctly, the author says that NSAIDs interfere with oral healing. My issue is that the NSAIDs actually cause the canker sores. I now refuse to take them because a mouth full of canker sores is far worse than whatever pain/inflammation the NSAIDs were supposed to have been helping.

    1. Leese,

      Dr. Greger has a video on the better test for B-12 levels.

      I am hoping it is marked properly.

      If I remember properly, one or two or more of the B-12 topics were missing their tags and I had a hard time finding one a while back.

    2. Great point: abnormal levels of methylmalonic acid and homocysteine are associated with B12 deficiency, and in some cases levels of MMA and HC should be checked. This could be needed if B12 levels are normal, but there are signs or symptoms of low B12, like neuropathy (nerve pain) or macrocyctic anemia (large red blood cells). -Dr Anderson, Health Support Volunteer

  15. B12 is but one of the nutrients that may play a roll in canker sores. Iron, zinc, and folic acid all also play the same roll. A person might dose themselves with more and more B12 under the above advice and not do a thing to correct the cause. Another culprit is food allergies (especially wheat and milk)that have nothing to do with any deficiency.

    Dr Julian Whitaker MD, who has worked with natural products and written books for decades advocates DGL (deglycyrrhizinated licorice) chewable. In one study, DGL led to complete healing within three days in 75% of the patients. One of the patients has recurring canker sores for over 10 years without an ulcer free period for the past year. He had multiple ulcers on his tongue, lips, inside of cheek, palate, and back of the throat. By the seventh day of treatment with DGL the patient was completely free of the mouth ulcers. The patient remained on DGL for over a year and after battling recurrent canker sores for over 10 years did not have one single recurrence.

    Das SK,et al,:Deglycyrrhizinated liquorice in apthous ulcers. JAPI 37:647,1989

  16. I will proclaim that I officially love Beta Glucan!

    I still haven’t figured out whether Yeast Beta Glucan (which has more Beta Glucan) is better or the Mushroom Beta Glucans (which have additional powerful things in it) but they extend survival times in Cancer patients, including dogs. Hooray!

    1. Thanks for sharing it Anne.

      I looked it up and it is good for a lot of things.

      “In June 2007, Arizona State University featured the work of Lynda Williams and Shelley Haydel in the Research Stories section of their website. Geochemist Williams and microbiologist Haydel have partnered to study the antibacterial properties of clay, including French green clay. The goal of their research was to understand why two types of French clay, mined specifically in France, were able to heal a deadly bacterial disease known as Buruli ulcer. This bacterial disease produces a toxin which eats away at the fatty tissue deposited below the surface of the skin, leading to large ulcers. According to the World Health Organization, without early antibiotic treatment, the disease causes deformities, long-term disabilities and, in some cases, death due to secondary infections. The study of French green clay as a treatment for Buruli was inspired by the positive treatment results using French green clay poultices recorded along the Ivory Coast by philanthropist and health advocate Line Brunet de Courssou. According the the Arizona State University report, the researchers have found French green clay effective in inhibiting Escherichia coli, Salmonella typhimurium, Pseudomonas aeruginosa, Staphylococcus aureus and Mycobacterium marinum, bacterial pathogens that cause serious and sometimes drug-resistant skin infections.”

  17. Has anyone considered a sulfate or sulfide allergy as the cause of mouth ulcers? I find that toothpaste with sodium laurel sulfate and dried fruit with sulfides big triggers. I wonder why that hasn’t been studied

  18. My dentist recommended taking L Lysine and that did the trick. Definitely something to look into if you don’t get a lot of lysine through your diet.

  19. Long ago a nurse friend of mine suggested Lysine supplements for treatment of Canker sores.

    I found it to work well. Usually knocking them out in a day. The many folks I shared this with over the years have reported similar good results.

  20. I stopped getting canker sores when I switched toothpastes. I don’t know if it was the saccharin or the SLS or something else in the usual drugstore toothpastes. I now use Squigle or Jasons toothpaste – no more more canker sores.

  21. Very interesting video packed with usefulI extra information on how to prevent canker sores! I have them rarely, but the last time I did, I remembered the older video about topical honey on nutritionfacs and applied some organic honey on the sore a few times. To my amazement the pain diminished soon and so did the tightness of the sore. It felt as if it melted. The sore disappeared in no time.

  22. One of the side effects of a targeted CLL drug is canker sores. They began proliferating, despite the fact that I already take B12 as I am vegan, and take 1000mg Lypospheric Vitamin C daily. In my effort to reduce use of typical remedies known to most physicians, I try to look outside of the box.

    Since I have used anti-inflammatory Oil of Oregano for other issues, I started putting two drops of Oil of Oregano on my toothpaste for two brushings a day. Existing mouth sores healed within two days. As long as I continue this regimen, no more sores develop. If I relax and don’t use it, canker sores resurface. This is sufficient incentive to be vigilant. Having shared this remedy with fellow patients, many have now adopted the Oil of Oregano practice, with good results. Others use Tea Tree Oil. It is an easy and relatively inexpensive method to deter canker sores.

    Since weak, tearing nails are also a side effect of this drug, many of us have discovered that at least 2500mcg of Biotin are necessary to help the nails regain strength as they grow out. Many of us also benefit from drops of Oil of Oregano for the cuticle inflammation that the CLL drug causes around finger and toe nails. Many also take Magnesium to control the muscle cramps that the drug induces. All this makes me wonder if some of these drugs somehow deplete or affect absorption of B vitamins and other elements, requiring us to take megadoses to compensate.

  23. Yes, 2000 mg of vitamin C as ascorbic acid may cause bowel irritation due to the acidic nature of ascorbic acid (pH 3). However, the study used 2000 mg ascorbate. Ascorbate is a form of vitamin C that is not acidic (pH 7). There are no upper limits for ascorbate and many studies have used large amounts. Please correct the transcript and note that the study used the correct, non-acidic form of vitamin C.

  24. When I was in my late 20s I had a long history of canker sores and cold sores as well. Then I read in a health magazine that golden seal was a specific for the herpes simplex virus that caused cold sores. I bought some and put a few spoonfuls in a bottle of honey. I swallowed the extremely bitter potion until the jar was gone. I have never had either a cold sore or canker sore since.

  25. I have successfully used L-Lysine for my mouth ulcers for about 25 years. Its supposed to help cold sores but I found it also helps mouth ulcers. It makes the ulcers clear up quicker and it takes the edge off the pain. Could be placebo but it works for me. Being vegan I take B12 and L-Lysine.

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