Protocol · Oral Health
Canker Sores (Aphthous Ulcers) Supportive Care Protocol
Vitamin B12 and Lysine are the core of this stack, with 6 supporting supplements. Each row gives the amount the protocol lists and the grade our evidence database holds for that supplement in Canker Sores (Aphthous Ulcers) Supportive Care.
We are re-verifying the studies cited on protocol pages; only confirmed citations are shown.
The stack
8 supplements · none graded yet
| Grade | Supplement | Amount listed | Why it’s in the stack | Evidence on file |
|---|---|---|---|---|
| Primary stackThe core of this protocol | ||||
| Vitamin B12 | Amount listed: 1,000 mcg sublingual daily (methylcobalamin) | Deficiency associated with recurrent aphthous ulcers; supplementation reduces recurrence | Not graded yet | |
| Lysine | Amount listed: 1,000–1,500 mg daily; increase to 3,000 mg during outbreaks | May inhibit viral replication and support tissue healing | Not graded yet | |
| Supporting stackListed as additions to the core | ||||
| Iron | Amount listed: Only if deficient: 30–60 mg elemental iron daily | Iron deficiency is a common cause of recurrent canker sores; correct if deficient | Not graded yet | |
| Folic Acid | Amount listed: 400–800 mcg daily | Deficiency linked to aphthous ulcers; supports mucosal health | Not graded yet | |
| Zinc | Amount listed: 25–50 mg daily during outbreaks; 15 mg maintenance | Supports immune function and wound healing; may reduce ulcer duration | Not graded yet | |
| Vitamin D | Amount listed: 2,000–4,000 IU daily | Supports immune regulation and mucosal immunity; deficiency linked to recurrent ulcers | Not graded yet | |
| Probiotics | Amount listed: 10–20 billion CFU daily (Lactobacillus strains) | Support oral and gut microbiome; may reduce inflammation and recurrence | Not graded yet | |
| Omega-3 Fatty Acids | Amount listed: 1–2 g EPA+DHA daily | Anti-inflammatory effects may reduce frequency and severity of ulcers | Not graded yet | |
How this protocol works
In plain language
Canker sores (aphthous ulcers) are painful, shallow ulcers that appear inside the mouth - on the cheeks, lips, tongue, or gums. Unlike cold sores, they're not caused by herpes virus and aren't contagious. Minor canker sores (most common) heal in 1-2 weeks; major ones can take 6 weeks. They can be triggered by mouth injury, stress, acidic foods, certain toothpastes (sodium lauryl sulfate), hormonal changes, and nutritional deficiencies. Some people get them repeatedly (recurrent aphthous stomatitis).
CRITICAL: Occasional canker sores don't require medical attention, but see a doctor if ulcers are unusually large, extremely painful, don't heal in 3 weeks, spread, accompanied by fever, or occur very frequently. Recurrent canker sores may indicate underlying conditions: celiac disease (screen if frequent), inflammatory bowel disease, Behçet's disease, or nutritional deficiencies. Rule out these conditions before assuming the cause is unknown. OTC treatments (Orajel, Kank-A) provide symptomatic relief.
Vitamin B12* has the strongest evidence for recurrent canker sores. A clinical trial showed 1000mcg sublingual B12 significantly reduced outbreaks even in patients without measurable deficiency. The mechanism may involve nerve and tissue health.
Lysine* is an amino acid that some find helpful, though evidence is limited. It may support tissue healing.
Iron, Folic Acid, and Zinc* deficiencies are all associated with recurrent aphthous ulcers. Get tested - correcting deficiencies often dramatically reduces recurrence.
Vitamin D* deficiency has been linked to recurrent canker sores in several studies.
Probiotics* support the oral and gut microbiome, which may modulate the inflammatory response that causes ulcers.
Omega-3 Fatty Acids* have anti-inflammatory effects that may help reduce ulcer frequency and severity.
Expected timeline: Topical treatments relieve pain immediately. For prevention, supplements typically require 1-3 months to assess benefit. B12 study showed significant improvement within 5-6 months.