Vitamin B12 Reduces Frequency and Severity of Canker Sores

We’ve previously reported that taking supplementary lysine can significantly reduce the frequency and severity of canker sores, medically referred to as recurrent aphthous stomatitis (RAS). Up to 25% of the general population suffers from these oral lesions, and they can be extremely painful, take weeks to heal, and occur many times per year. So it would be really nice to have some options to help alleviate problems with canker stores.

Happily, vitamin B12 has been found to be yet another option for preventing canker sores. A recent study was published in the January 2009 issue of the The Journal of the American Board of Family Medicine that covered a small double-blind placebo-controlled trail following 58 patients suffering from RAS for a period of 6 months. 31 participants received 1000mcg (1mg) of vitamin B12 via sublingual lozenges (mouth-dissolving tablets used under the tongue), and 27 participants received placebos.

The study found that usage of vitamin B12 in this manner significantly reduced the frequency and severity of canker sores. In the last month of the 6 month study, 74.1% of the group using the vitamin B12 supplements had no canker stores versus only 32.0% in the control group receiving the placebo. The number of RAS outbreaks per month was reduced by about 77% by the use of vitamin B12.

Of particular interest, it appeared to take about 4 months for the effects of the vitamin B12 supplements to clearly differentiate the results in the two groups. It is theorized that the relatively low dosage of vitamin B12, at 1000mcg per day, took about four months to accumulate enough to have significant effect. Previous observations by the doctors conducting the study were that injection vitamin B12 at higher doses achieved a more rapid response. Vitamin B12 has very low risk of toxicity, so dosages much higher than 1000mcg per day present little risk. For instance, sublingual tablets with 5000mcg are readily available without prescription.

Some questions that remain about this study’s conclusions. For one, it is not clear if forms of vitamin B12 other than sublingual tablets would have similar effects. Regular vitamin B12 tablets that can be swallowed are very inexpensive, sublingual tablets are somewhat more expensive but can be directly absorbed into the bloodstream.

Secondly, the study does not state which form of vitamin B12 was used. Most inexpensive B12 supplements use the cyanocobalamin form of B12 that can be converted by most human bodies into the biologically active form known as methylcobalamin. However, some people, especially the elderly and those with digestive problems, may have trouble absorbing the cyanocobalamin form and would benefit from the more expensive methylcobalamin form available in such dietary supplements as those shown to the left of this paragraph. Also, doctors have the option of prescribing Metanx which is a swallowed tablet containing 2000mcg of methlycobalamin along with metabolically active forms of folate and vitamin B6.

If the inexpensive “swallowed tablets” form of B12 as cyanocobalamin work as effectively as the sublingual tablets did, the treatment could cost less than US$0.04 (4 cents) per day. For instance, two bottles of Puritan’s Pride Vitamin B12 (cyanocobalamin) having 250 tablets with 1500mcg of B12 per tablet cost about US$23.99 as of this writing on the latest “buy 1 get 1 free” sale or US$47.98 for five bottles on “buy 2 get 3 free” sale. That works out to between US$0.038 (3.8 cents) to $0.048 (4.8 cents) per day or about US$14 to $17 per year.

The sublingual form at higher dosages would likely achieve a faster effect, but the cost will be somewhat higher. For instance, five bottles of Puritan’s Pride Vitamin B12 (cyanocobalamin) containing 100 lozenges each with 2500mcg of B12 would cost US$28.78. That works out to a daily treatment cost of US $0.058 (5.8 cents) per day or about US$21 per year.

If you combine one of these products or similar vitamin B12 supplements with L-lysine supplements, we suspect you’ll get a better overall result.

Further Reading

Canker Sore Prevention with Lysine

Mouth Probiotics Speed Canker Sore Healing and Reduce Cavities, Arthritis Pain, Heart Disease

Effectiveness of Vitamin B12 in Treating Recurrent Aphthous Stomatitis: A Randomized, Double-Blind, Placebo-Controlled Trial

Medline Plus Medical Encyclopedia: Mouth sores

Wikipedia: Vitamin B12

Life Extension: Vitamin B12 helps prevent canker sores

Vitamin B12 Overdose

Too Much of a Good Thing: an Overdose of Vitamin B12

Topic: OVERDOSE ???????? on B-12 ?????

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Vitamin B12 Reduces Frequency and Severity of Canker Sores — 3 Comments

    • Gretta,

      In theory the spray should work via absorption via the soft tissue in the mouth just like the lozenges do. I haven’t tried the spray product you mentioned myself, but do use the 5000 mcg lozenges from Life Extension and Swanson Vitamins and they do definitely boost vitamin B12 levels according to blood tests.

      To be absolutely sure the spray is working, you could get a baseline vitamin B12 test and then repeat it again after a few months of using the spray.


  1. Pingback: Sjögren’s Syndrome Patients and Others With Dry Mouth May Benefit from Oral Probiotics | EmediaHealth

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