A common reason people get recurrent canker sores is a deficiency of certain vitamins and micronutrients. A frequent recurrence of canker sores could be your body’s way of telling you that it is out of balance. You must ensure that your body has the important nutrients it needs to properly heal and to keep the oral ulcers away. The micronutrients listed below have been studied and have shown evidence of benefits for canker sores.

Key Vitamins and Micronutrients for Canker Sore

Vitamin B-12

• Formation of red blood cells
• Cell function and metabolism
• Production of DNA

Food sources rich in vitamin B-12 include poultry, eggs, meat, fish, and dairy. People who follow a vegan diet are at risk for vitamin B-12 deficiency because it is not present in plant foods. There are some people who may have a problem absorbing this vitamin due to different factors. In addition, certain medications can interfere with the absorption of vitamin B-12. If you suspect that your body is not absorbing vitamin B-12 adequately, ask your doctor to order a test for vitamin B-12 levels.

Even in healthy people, vitamin B-12 has poor absorption through the stomach. The recommended daily requirement for vitamin B-12 is 25 micrograms, which is quite small. However, high doses of vitamin B-12 supplements have been found to be safe because your body will get rid of the excess.

There are studies that compare vitamin B-12 levels in patients with recurrent canker sores and those without. It was found that vitamin B-12 levels of those with recurrent canker sores were significantly lower than the control group. Vitamin B-12 supplementation has also been shown to reduce the frequency of canker sore episodes in a study published in The Journal of the American Board of Family Medicine. Here are some results of the study:

• Patients with recurrent aphthous stomatitis were randomly assigned to be treated with 1,000 mcg of vitamin B12 sublingual nightly versus a placebo;
• Patients were followed for six months;
• It was found that 74% of the treatment group and 32% of the placebo group were free of canker sores at the end of the study.

If you have recurrent canker sores, you may consider supplementing with vitamin B-12 at a dose of 1,000 mcg daily. In patients with malabsorption due to an underlying medical condition such as Celiac disease, the required dose could be higher. Discuss with your doctor for an optimal dose.

Vitamin B-9 (folate/folic acid)

Folate is used by your body to make DNA and is important for tissue growth and cell function. Folate is found naturally in many foods, including nuts, beans, and green leafy vegetables. Many cereals are fortified with folic acid, which is a more bioavailable form of folate (1mcg of folate from food = 0.6 mcg of folic acid from fortified foods or supplements).

Here are some causes of folate deficiency:

• A diet low in folate-rich foods;
• Pregnancy or lactation: If you are pregnant or lactating, your body will use more folate than usual. It’s very important to take folic acid supplements, not just for your own health, but for your baby’s health as well; and
• H. Pylori infection: It has been found that H. pylori infection is associated with poor absorption of vitamin B-12 and folic acid.

Folate has been shown to play an important role in helping people with recurrent canker sores get fewer episodes. In a study of people with recurrent canker sores (at least 3 episodes in the last 12 months), it was found that these people had significantly lower intake of vitamin B-12 and folate.

If you have recurrent canker sores, be sure to choose foods that have a high content of folate or those that have been fortified with folic acid. You may also take a supplement of folic acid to be sure your levels are adequate. The recommended daily dose of folate for adults is 400 mcg/day. Women who are pregnant or planning pregnancy may take up to 1,000 mcg/day.

Lysine

Lysine is one of nine essential amino acids, which means it is not made by the body and must be obtained from food sources. Foods that are rich in lysine include those that are high in protein such as fish, beef, chicken, milk, eggs, and peas. 

There is evidence that lysine supplementation prevents canker sore outbreak as well as shortens their duration when they occur. Lysine becomes more active at the site of damage and helps speed up the healing process by facilitating the formation of collagen. Lysine is also involved in antibody responses and immune responses.

Some people get canker sore outbreaks when they have tiny invisible cuts in their mouths. Lysine facilitates the healing of these minor cuts before they have a chance to erupt into a full-blown canker sore. This could be the reason why a supplementation of lysine helps these individuals prevent outbreaks.

Lysine taken at a dose of 1000 mg daily for a short duration (less than 6 months) seems effective and safe. Note that there are risks associated with high doses and long-term supplementation of lysine such as kidney damage, abdominal pain, and diarrhea. There is not enough evidence on the safety of lysine supplement for pregnant and breastfeeding mothers. Discuss with your physician if you have kidney disease or osteoporosis before taking lysine.

Final Thoughts

Having canker sores not only disrupts your daily life, but also puts your body out of equilibrium. You want to ensure you are giving your body the optimal environment to keep these oral ulcers away. An easy way is to supplement your body with the nutrients it needs.