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Vitamin B12 useful for recurrent aphthous stomatitis

NEW YORK (Reuters Health) – The results of a small trial suggest that vitamin B12 is a safe, effective, and inexpensive treatment for recurrent aphthous stomatitis (RAS).

“The frequency of RAS is as much as 25% in the general population, however, until now, there has been no optimal therapeutic approach,” lead author Dr. Ilia Volkov, from Ben-Gurion University of the Negev, Beer-Sheva, Israel, said in a statement.

The cause of recurrent aphthous stomatitis is unknown and over the years a variety of treatments, including adhesive pastes, antiseptics, vitamins, herbs, and steroids have been tested. Although these treatments may reduce pain or the number of lesions in the short term, very few have had any lasting beneficial effect.

In a previously published report, Dr. Volkov’s team described the excellent long-term outcomes achieved in their clinical experience of treating recurrent aphthous stomatitis with vitamin B12. The current focus was to confirm the efficacy of vitamin B12 in a randomized, double-blind, placebo-controlled trial.

Included in the trial were 58 patients who were randomized to receive sublingual vitamin B12 (1000 mcg) or placebo daily for 6 months. The findings are reported in the January/February issue of The Journal of the American Board of Family Medicine.

Relative to placebo, treatment with vitamin B12 significantly reduced pain, the number of ulcers, and the duration of outbreaks at 5 and 6 months (p < 0.05 for all). Moreover, this benefit was not affected by the patients’ initial serum vitamin B levels.

In the last month of treatment, 74.1% of vitamin B12-treated patients were aphthous ulcer-free compared with 32% of those given placebo (p < 0.01).

Exactly how vitamin B12 achieves these beneficial effects is unclear, the authors acknowledge. The fact that the treatment worked equally well regardless of the initial vitamin B12 level suggests that the vitamin may possess some unrecognized functions.

Reference:
J Am Board Fam Med 2009;22:9-16.