Canker Sores Related to Celiac Disease
Mouth sores, known as recurrent aphthous stomatitis (RAS), or canker sores, have long perplexed the medical world. These benign and non-contagious mouth ulcers, although sometimes very small, cause a great deal of pain and discomfort. They can interfere with eating, drinking and articulation, and in more severe cases they can be debilitating. RAS affects 2.5 billion people worldwide and is the most common oral disease in North America.
What causes canker sores or mouth ulcers?
So why do people get canker sores? It can OFTEN be traced to nutritional factors linked to anemia (caused by the lack of iron, folates and B vitamins), neutropenia, local trauma, emotional stress, metabolic disorders, hormonal disorders and chronic diseases, which cause immunodeficiency. MANY OF THESE CAN BE THE RESULT OF or related to CELIAC DISEASE, provoked by gluten in the diet which causes major systemic issues. A related condition which is NOT autoimmune is gluten sensitivity, also found to be factor in ulcers formation.
At least 40% of people with RAS have a positive family history, suggesting that some people are genetically predisposed to suffering with oral ulcerations.
RAS is usually first noticed during childhood or adolescence. In addition to genetic influences, ulcers can accompany systemic diseases and conditions such as allergic reactions, Crohn’s disease, ulcerative colitis, gluten sensitivity, HIV infection, and Behçet’s disease.
With STRESS they can get much worse, which shows the connection between the immune system, “parafunctional activities,” like lip or cheek chewing during times of stress and the brain-body connection.
There is no ‘cure’ –and MEDICAL treatment is limited to f corticosteroids, immunostimulants and vitamin therapy, which alleviate the symptomatic pain and try to speed healing of the mucosal lining. Low-level laser therapy has also been shown to decrease the healing time, pain intensity, size and recurrence of the lesions in patients with RAS. BUT you can improve the condition using a few guidelines.
WHAT CAN YOU DO? FIRST 5 STEPS: Learning Goals
1) Gluten free diet- learn all you can about this diet. Gluten can come in many shapes and sizes. Slowly limit your intake and try to ban it from your life. I will be writing much more about this.
2) Sugar compromises immunity BIG TIME… Colas and sodas are the major source of “added sugars” in the diet which seem to relate to many issues. Ban the “Big Gulp” in all its forms.
3) Avoid processed foods as much as possible, breakfast cereals, things in a box…. they are full of additives, GMO’s and are basically worthless to the body. They are FORTIFIED with vitamins and minerals. BUT DONT let this fool you. These vites and mins are synthetic and can even be HARMFUL.
4) The use of vitamin B12 and folate (NOTE folic acid is NOT A GOOD CHOICE) is simple, inexpensive and low-risk. Learn about B12 and folate and how you can include them in your everyday life. Foods contain good amounts of both but if you are celiac or have digestive issues, you probably aren’t getting these nutrients from foods– supplements may be more effective.
**Vitamin D3 and A (preformed, not carotene ) are necessary for healthy skin and linings of mouth and nose.
For vegetarians, B12 injections are useful. These require a prescription…. ask for “no preservatives” and the methylcobalamin form.
–For B12 you need to use sublingual tablets of methylcobalamin, NOT cyanocobalamin. Sublingual spray is available.
–For folate, the 5-methylfolate, also called metafolin, is recommended and better metabolized in contrast to the cheap version, folic acid, which can cause major problems. Researchers now link too much folic acid to autism, development of asthma in babies, lowering immunity, even problems with cognition in post menopausal women.
5) Become a LABEL READER.
THE RESEARCH: Vitamin B12 and Folate
In research studies, vitamin B12 deficiency was found to play a role in the cause of mouth ulcers, giving promise to B12 supplementation as an added treatment for RAS. Patients with RAS were found to have lower dietary intakes of vitamin B12 and folate than the control group, indicating a link between the etiology of RAS and hematological deficiencies of both vitamin B12 and folate. Low red cell folate levels were found in 47% of patients with RAS as compared to the control group, showing a statistically significant low red cell folate in the RAS patients. Another study found both serum B12 and red blood cell folate to be significantly lower in RAS patients. (1-2)
Patients with RAS had improved symptoms from B12 supplementation, in spite of having no signs of clinical deficiency. (1-2)
STUDY CONCLUSIONS : In light of the complex causes of RAS and other individualized sensitivities that may trigger it, therapeutic vitamin dosage must be formulated for the patient to address the metabolic management of the underlying processes of RAS. Therefore, consuming sufficient amounts of these vitamins maybe be a good strategy to reduce the number or duration of the RAS episodes.
PMID number takes you to study page)
(1)–Folate and vitamin B 12 levels in patients with oral lichen planus, stomatitis or glossitis. PMID:11944731
(2)–Low folate levels in recurrent ulcers: Hematologic abnormalities in recurrent oral ulceration. PMID:12757242