canker sores Archives - Amazing Health Advances

How to Treat Canker Sores

AHA Publisher — Wed, 02 Nov 2022 07:00:22 +0000

Michael Greger M.D. FACLM via Nutritionfacts – Vitamin C, turmeric, beta-glucan fiber, and vitamin B12 are put to the test for recurring canker sores (aphthous ulcers). Canker sores can be “a painful and often recurrent inflammatory process of the oral mucosa,” the lining of our mouths. Similar to other chronic inflammatory conditions, DNA damage due to oxidative stress caused by free radicals is thought to play a role. Normally, free radical production is balanced with antioxidants, but if the concentration of free radicals gets too high and our antioxidant enzymes and the antioxidants we get in our diet “cannot compensate for these radicals, the balance changes in favor of the oxidants”—that is, in a pro-oxidant direction. This can lead to oxidative damage within our body. Does that mean that people who experience recurring canker sores—also known as recurrent aphthous stomatitis (RAS)—have fewer antioxidants, more oxidation, and more DNA damage? Yes, yes, and yes. As you can see in the graph below and at 0:51 in my video Best Supplement for Canker Sores, they exhibit more pro-oxidants and more oxidative stress in their bloodstream, lower antioxidant status, and more DNA damage. This suggests it might be possible for antioxidants to help improve the DNA damage caused by recurring canker sores, but you don’t know until you put it to the test. Sixteen boys and girls around age 12 with recurring canker sores were given a whopping 2,000 mg (2 g) 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 have that effect on a 12-year-old, but it’s all about risks versus benefits. How did they do? As you can see in the graph below and at 1:33 in my video, 15 out of the 16 kids cut the number of canker sores they were getting at least in half. In the three months before they started the vitamin C, they had averaged four canker sores each, but in the three months they were on it, they each had less than one on average. When they stopped the vitamin C for another three months, the ulcers started coming back. Then, when they once again added the vitamin C, the canker sore rate dropped again. What about directly applying antioxidants, like a turmeric gel? Let’s find out. A turmeric gel containing 2 percent curcumin, the yellow pigment in the spice turmeric, was swabbed directly onto canker sores twice a day and “significantly reduced pain intensity and size of the aphthous ulcer [canker sore] compared to placebo,” which was a gel containing no active ingredient. Okay, but wouldn’t it be nice to see a comparison to an active treatment from an independent research group, rather than this study without an active treatment that was funded by the curcumin gel manufacturer? Yes, and here we go. This randomized clinical trial compared a generic 2 percent curcumin gel to a prescription steroid gel and found that the curcumin worked just as well. This provides “strong evidence that [topical] curcumin gel can be used as an effective and safer alternative to steroids in treatment of RAS.” You may remember I’ve previously discussed that topical honey beat out the same steroid for both ulcer healing and pain reduction, as you can see in the graph and at 2:46 in my video. So, if you’re going to use something topically, honey seems better, but what if, instead of a topical application, you just want to swallow something like vitamin C but want something that doesn’t give you diarrhea? Thirty-one patients with recurring canker sores were split into two groups and received either 20 mg a day of placebo or yeast beta-glucan fiber, which is the amount found in just an eighth of a teaspoon of brewer’s yeast or nutritional yeast. As you can see below and at 3:17 in my video, the placebo group experienced no significant change, whereas ulcer severity in the yeast group was cut nearly in half. So, now you have another useful alternative. If it’s all about antioxidants, can’t you just treat recurring canker sores by eating a plant-based diet high in fruits and vegetables? That hasn’t been put to the test, but keep in mind 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 women had recurring canker sores for four years. She ate few animal products and didn’t supplement with vitamin B12, so she became B12-deficient and began experiencing weakness, tiredness, numbness, and tingling. She was immediately started on vitamin B12, and her deficiency symptoms got better. Her canker sores also improved and she experienced “a rapid and complete recovery” within weeks of starting vitamin B12 after years of suffering. We’ve known since the 1970s that vitamin B12 deficiency can lead to canker sores—so much so that it’s recommended to consider B12 deficiency any time a patient has with recurring canker sores. In fact, a number of nutrient deficiencies may contribute. A study compared the lab tests of those with recurrent canker sores to those without and found that more than half of the canker sore group showed evidence of hematinic deficiencies—that is, blood-forming nutrient deficiencies. In contrast, less than one in ten in the non-canker sore group exhibited these deficiencies. In this case, we’re talking about iron and folate deficiency in addition to vitamin B12 deficiency. When the study participants were given supplements, their canker sores improved and this was more pronounced among those who had no family history of canker sore problems. You can see how vitamin and mineral supplements might help people who are deficient, but might a supplement like vitamin B12 help people who are not vitamin B12 deficient? Apparently so. As the title of the study states, “cyanocobalamin”—the most common form of supplemental B12—“may be beneficial in the treatment of recurrent aphthous ulcers [canker sores] even when vitamin B12 levels are normal.” The researchers took a group of 72 patients with frequent canker sores and gave them vitamin B12, regardless of what their levels were. Ninety-six percent of the participants got better regardless of whether they started out vitamin B12–deficient or with normal vitamin B12 levels in their blood, as you can see below and at 5:37 in my video. In this case, there was no control group, though, so we don’t know how many would have gotten better without the vitamin B12 supplement. In addition, the researchers injected the vitamin B12, and injections can have an even greater placebo effect than pills—especially with something like a syringe of vitamin B12, which has a striking mad-scientist-looking ruby red color, as you can see below and at 5:57 in my video. If only there were a randomized, double-blind, placebo-controlled trial of oral vitamin B12 for canker sores. And, here we go. In this case, 1,000 micrograms of sublingual vitamin B12 were taken every day for six months. It took five months, but, eventually, the duration of canker outbreaks, the number of ulcers, and the level of pain were significantly reduced, “regardless of initial vitamin B12 levels in the blood.” So, whether you are vitamin B12–deficient or not, B12 supplements seem to help. By the end of the study, twice as many in the vitamin B12 group appeared to have been cured. The researchers concluded that “vitamin B12 treatment, which is simple, inexpensive, and low-risk, seems to be effective,” but don’t forget that it appeared to take months before it started working. In another randomized, double-blind, placebo-controlled trial of a vitamin B12 ointment applied directly to the canker sores, a significant reduction in pain was demonstrated within only two days compared to placebo, regardless of whether the participant was vitamin B12–deficient or not. Here’s a link to the video on the remarkable honey results I mentioned: Flashback Friday: Topical Honey for Canker Sores. Key Takeaways A canker sore can be a painful and recurring inflammation of the lining of the mouth, and DNA damage from oxidative stress caused by free radicals may play a role. Antioxidants typically balance free radical production, but oxidative damage within the body can result from changes in a pro-oxidant direction if free radical concentration gets too high and our antioxidant enzymes and the antioxidants we get from food consumed cannot compensate. People with recurrent aphthous stomatitis (recurring canker sores) exhibit more pro-oxidants and more oxidative stress in their bloodstream, lower antioxidant status, and more DNA damage. A daily 2,000 mg of vitamin C resulted in 15 out of 16 kids with recurring canker sores cutting the number of ulcers at least in half. After stopping the vitamin C, the canker sores began reappearing and then dropped back down after the C was re-added. A generic 2 percent curcumin gel worked just as well as a prescription steroid gel, and a topical honey also beat out the same steroid for both ulcer healing and pain reduction. Taking a daily dose of the amount of yeast beta-glucan fiber found in an eighth of a teaspoon of nutritional or brewer’s yeast also nearly halved ulcer severity, while those in the placebo group experienced no significant change. Vitamin B12 deficiency can lead to canker sores, as can hematinic (blood-forming nutrient) deficiencies. The most common form of supplemental vitamin B12, cyanocobalamin, may benefit individuals with recurring canker sores—even with normal B12 levels. When taken sublingually, though, it may take months before it starts significantly reducing the duration of canker outbreaks, the number of ulcers, and the level of pain. Directly applying vitamin B12 ointment to canker sores, however, was found to reduce pain significantly in only two days, compared to placebo, regardless of previous B12 status. To read the original article click here.

The post How to Treat Canker Sores appeared first on Amazing Health Advances.

Curing Canker Sores with Diet

AHA Publisher — Thu, 04 Nov 2021 07:00:03 +0000

Michael Greger M.D. FACLM via Nutrition Facts – Does excluding dairy products, food additives, and gluten-containing grains from one’s diet help those with recurring canker sores (aphthous ulcers)? Recurring canker sores are the single most common inflammatory and ulcerative condition of the mouth, affecting as many as one in five people. As I discuss in my video The Role of Dairy and Gluten in Canker Sores, canker sores can sometimes be a sign of celiac disease, the relatively rare autoimmune condition triggered by the wheat protein gluten. But what about those without celiac disease? Thirty-seven years ago, there was a report of a small group of recurrent canker sore patients who got better after removinggluten from their diet, even though they didn’t have any signs of celiac disease. Without a control group, you can’t know if they would’ve gotten better on their own, but it was an interesting enough finding to spark further study. Given that small series of patients, researchers decided to try out a gluten-free diet on 20 patients with recurring canker sores, once again explicitly excluding those known to have celiac disease. Five of the 20 seemed to get better and, critically, got worse when they were challenged with gluten. Even though there was no control group, in the few patients who got better, the ulcers came back when gluten was added back into their diet. This was not a random group of people with canker sores, though. The reason they had gotten intestinal biopsies to rule out celiac disease was that they had some other abnormalities, so you can’t extrapolate from this study to say that one in five people with canker sores may benefit from cutting out gluten, though it does appear to help some. It would have been better if it had been a blinded challenge. If you cut out gluten (or any food) and just so happen to coincidentally feel better, you might convince yourself that gluten was the culprit. Then, when the researchers give you a piece of bread, just the stress of thinking your ulcers might come back may help trigger the ulcers to actually come back. That’s why, ideally, you do blind gluten challenges to see if gluten really is to blame. For example, if you take people who don’t have celiac disease or a wheat allergy but claim to be sensitive to gluten, you can test to see whether they’re fooling themselves by randomly assigning them to take a capsule with gluten or a placebo made of rice starch. So, the subjects are on a gluten-free diet, and you give them a gluten pill, the equivalent of two pieces of bread, and see whether they get worse. As you can see at 2:17 in my video, just the thought of taking something that might contain gluten—that is, the placebo rice starch pill—made their symptoms shoot up. The reason we know this non-celiac gluten sensitivity exists is that the actual gluten pill made them feel even worse. That is precisely what happened in the case of canker sores: Those who thought they were gluten sensitive got more canker sores when they were exposed to real, as opposed to fake, gluten. Where did they even get the idea in the original study to try cutting out gluten? Well, back in the 1960s, it was reported that the blood of patients with bad canker sores reacted to certain food proteins, such as gluten, as you can see at 3:01 in my video, but they had an even stronger reaction to the milk protein casein. This has since been more formally tested. Fifty patients with recurring canker sores were compared with 50 healthy people for their levels of anti-gluten antibodies and anti-cow’s-milk protein antibodies. Those with canker sores were no more likely to react to the gluten, but the levels of anti-milk-proteins were significantly higher. In fact, the majority reacted to the cow’s milk. These results indicate a “strong association” between high levels of anti-milk-proteins in the blood with recurring canker sores, but what we care about is whether people actually get better when they cut out milk. On hearing their results, three of the patients spontaneously decided to cut all dairy products from their diet for a few months to see what happened—and it did seem to help. There was no reappearance of the sores in the first patient or the second patient—until he had some cow’s milk ice cream. In the third patient, the ulcers seemed to come with less frequency. Those were just observations, though, not an actual study. As you can see at 4:10 in my video, the same can be seen with certain food additives; people with recurring canker sores may react more to certain food dyes. So, if you try people on a gluten-free diet, a dairy-free diet, or a diet free of certain food additives, people will likely respond in different ways. In this case, for example, 6 out of 11 “responded to a dietary withdrawal”—some were better on the gluten-free diet, others improved on the dairy-free diet, while others still on the additive-free diet—but the responses were pretty dramatic, seen within just one week. It seems it might be worth giving these exclusion diets a try to see whether there’s a significant improvement. Can’t you just take an allergy test or something? Apparently not. For example, one poor young woman had recurring canker sores since the age of two—“multiple painful lesions” in her mouth almost constantly. They asked her about milk, and she replied that she rarely drank it because it appeared to trigger more canker sores almost immediately. So, they decided to look into it. They tested her for sensitivities to dairy, both so-called prick and patch allergy tests, and both were negative. Even still, if she felt worse on dairy, she might as well try cutting out all dairy products completely, right? She did, and for the first time in her life, the ulcers went away and stayed away. They only started to appear again when she accidentally had milk. So, even if tests come back negative, it may be worth a try to cut out all dairy and see what happens. We know cow’s milk may play a role in other allergic and autoimmune type diseases, and reports going back decades suggest there’s a subgroup of canker sore patients for whom dairy is a causative factor. “However, awareness of this association is low among both patients and health care providers.” Improvement can happen rapidly. For example, a boy and a girl both had frequent multiple ulcerations for years and then were apparently cured within two weeks of eliminating dairy from their diets. We don’t know how often it works; we just know it does—sometimes. So, as a 2017 paper in the Journal of the American Dental Association suggested, why not give a cow’s milk protein elimination trial a try, “particularly before use of medications with potential side effects.” Other ways to help prevent future outbreaks can include avoiding foaming agents in toothpaste. Learn more by watching my videos Is Sodium Lauryl Sulfate Safe? and Is CAPB in SLS-Free Toothpaste Any Better?. What about treatment? See Topical Honey for Canker Sores and Best Supplement for Canker Sores. KEY TAKEAWAYS As many as one in five people experience recurring canker sores, the most common inflammatory and ulcerative condition of the mouth. Canker sores may be a sign of celiac disease, the autoimmune condition triggered by gluten, a wheat protein. Researchers put 20 patients with recurring canker sores who did not have celiac disease on a gluten-free diet, and five appeared to improve and, critically, got worse when gluten was added back to their diet. There was no control group, however, and it was not a blinded challenge so it’s possible the subjects were expecting an outcome, knowing they were getting gluten. In fact, just the thought of getting gluten made symptoms shoot up in a study performing a blind gluten challenge. Gluten was first identified as a possible culprit in the 1960s, when it was reported that the blood of patients with bad canker sores reacted to certain food proteins, such as gluten. However, they had an even stronger reaction to the milk protein casein. In a more formal test, those with canker sores were no more likely to react to the gluten, but the levels of anti-milk-proteins were significantly higher and the majority reacted to the cow’s milk, indicating a “strong association” between high levels of anti-milk-proteins in the blood with recurring canker sores. Certain food dyes or other additives may also cause more reactions in people with recurring canker sores. Exclusion diets, such as a gluten-free diet, a dairy-free diet, or a diet free of certain food additives, may be informative and seem worthwhile in trying to achieve any significant improvement. Allergy tests do not appear to be useful. Improvement can happen rapidly. In one case, children who had suffered with frequent and multiple ulcerations for years were apparently cured within two weeks of eliminating dairy from their diets. To read the original article click here.

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