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February 13, 2009

Vitamin B12 helps prevent canker sores

Vitamin B12 helps prevent canker sores

The painful condition known as recurrent aphthous stomatitis (RAS), or canker sores, might be prevented by supplementing with vitamin B12 according to research published in the January/February issue of The Journal of the American Board of Family Medicine. The cause of RAS is unknown, although local trauma and stress have been proposed as the most likely triggers.

Dr Ilia Volko and colleagues at Ben-Gurion University of the Negev and Calit Health Services in Beer-Sheva, Israel gave 58 men and women with RAS 1,000 micrograms sublingual vitamin B12 or a placebo to be taken before sleep for six months. Blood samples were evaluated for serum vitamin B12 levels at the beginning of the study. Participants were instructed to keep an “Aphthous Ulcers Diary” which was reviewed monthly by the research staff. Duration of aphthous stomatitis episodes, monthly number of ulcers, and pain severity were tracked in each group.

During the last two months of the trial, the average duration of outbreaks, number of ulcers, and pain decreased in the group treated with vitamin B12. By the end of the treatment period, 74 percent of those who received vitamin B12 and 32 percent of those who received the placebo had achieved remission, defined as the absence of aphthous ulcers. No differences were observed in the treatment group between those with varying initial serum vitamin B12 levels.

Because over 80 percent of the participants who received vitamin B12 were not classified as deficient in the vitamin due to having serum levels higher than 250 picograms per milliliter, the authors questioned the possibility of correction of vitamin B12 deficiency as a mechanism of action against aphthous ulcer, although they admitted that the identification of functional deficiency would have been improved by the inclusion of additional blood measurements such as methylmalonic acid and homocysteine. They suggest that vitamin B12 may have some still unrecognized functions. Since response to the vitamin took about four months, it was hypothesized that the oral treatment dose of 1,000 micrograms may be low. Prior research has demonstrated that injections of higher doses of vitamin B12 promote more rapid responses.

“Vitamin B12 seems to be an effective treatment for patients suffering from RAS regardless of their serum vitamin B12 level,” the authors conclude. “This treatment is simple and inexpensive and has no known significant toxic effects.”

“The frequency of RAS is as much as 25 percent in the general population,” observed Dr Volkov, who is a lecturer in Ben-Gurion University's Department of Family Medicine in its Faculty of Health Sciences. "Until now, there has been no optimal therapeutic approach."

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