Does excluding dairy products, food additives and gluten-containing grains from the diet help people with recurring canker sores (aphthous ulcers)?
Recurrent canker sores are the most common inflammatory and ulcerative disease of the mouth. influence up to one in five people.
As I discuss in my video The role of dairy products and gluten in canker sores, Cancerous sores can sometimes be a sign of celiac disease, the relatively rare autoimmune disease caused by the wheat protein gluten. But what about those without celiac disease? 37 years ago there was a report of a small group of patients with recurrent cancerous ulcers who got better afterwards remove Gluten out of their diet even though they had no signs of celiac disease. Without a control group, there is no way of knowing whether they would have gotten better on their own, but it was an interesting finding to initiate further studies. Given the small number of patients, the researchers decided to try a gluten-free diet on 20 patients with recurrent cancerous ulcers, once again explicitly excluding those with celiac disease. Five of the 20 seemed to get better and, crucially, get worse when challenged with gluten. Although there was no control group, the few patients who got better had ulcers recurring when gluten was reintroduced into their diet.
However, this was not a random group of people with canker sores. The reason they had colon biopsies to rule out celiac disease was because they had some other abnormalities. Therefore, it cannot be extrapolated from this study that one in five people with canker sores could benefit from removing gluten, although it appears to be helping some. It would have been better if it had been a blind challenge. If you skip gluten (or other foods) and happen to feel better, you can convince yourself that gluten was the culprit. Then, when the researchers hand you a piece of bread, the stress of just thinking that your ulcers might return can help the ulcers actually return.
For this reason, ideally, you will conduct blind gluten challenges to see if the gluten is really to blame. For example, if you take people who don’t have celiac disease or wheat allergy but say they are gluten sensitive, you can test to see if they are fooling themselves by randomly assigning them a capsule of gluten or a placebo made of rice starch. So the subjects are on a gluten-free diet and you give them a gluten pill, the equivalent of two pieces of bread, and see if they get worse. As you can see in mine at 2:17 am Video, just the thought of to take something that might contain gluten – that is, the placebo rice starch pill – made her symptoms skyrocket. The reason we know this non-celiac gluten sensitivity exists is because the actual gluten pill made them feel even worse. This is exactly what happened with canker sores: those who thought they were sensitive to gluten got more canker sores when exposed to real, not fake, gluten.
Where did they get the idea to try it in the original study? Cut Gluten out? Well, in the 1960s, it was reported that the blood of patients with bad cancerous ulcers responded on certain dietary proteins like gluten, like you at 3:01 in my. can see Videobut they would have an even stronger reaction to the milk protein casein. This has since been tested more formally. Fifty patients with recurrent canker sores were made compared with 50 healthy people on their anti-gluten antibodies and anti-cow’s milk protein antibodies. Those with canker sores were no longer likely to respond to gluten, but the anti-milk protein levels were significantly higher. In fact, the majority reacted to the cow’s milk. These results suggest a “strong association” between high levels of anti-milk proteins in the blood and recurrent cancerous ulcers, but what interests us is whether people actually feel better when they leave milk out. When they heard their results, three of the patients spontaneously decided to cut all dairy products from their diet for a few months to see what happened – and it seemed to help. In the first patient and the second patient, the wounds never reappeared – until he had some cow’s milk ice cream. In the third patient, the ulcers appeared to be less frequent. However, these were just observations, not an actual study.
As you can see in mine at 4:10 Video, the same can be seen with certain food additives; People with recurrent canker sores can react more about certain food colors. So if u Try People who eat gluten-free, dairy-free, or free of certain food additives are likely to react differently. In this case, for example, 6 out of 11 responded to “diet withdrawal” – some were better on the gluten-free diet, others on the dairy-free diet, while others were still on the additive-free diet – but the reactions were quite dramatic, within just one Week. It seems worthwhile to try these elimination diets to see if there is any significant improvement.
Can’t you just do an allergy test or something? Apparently not. For example a poor young woman would have cancerous ulcers that have returned since she was two – “multiple painful lesions” in her mouth almost constantly. They asked her about milk, and she replied that she seldom drank it because it caused more canker sores almost immediately. So they decided to look into it. They tested her for sensitivities to dairy products, both prick and patch allergy tests, and both were negative. Even if she felt worse about dairy products, she might as well try to cut out all dairy products, right? She did, and for the first time in her life the ulcers went away and stayed away. They only reappeared when she accidentally got milk. Even if the tests come back negative, it may be worth trying to cut out all dairy products and see what happens. We know that cow’s milk can play a role in other allergic and autoimmune diseases, and decades of reports suggest that there is a subset of cancer ulcer patients for whom dairy products are a causative factor. “However, there is little awareness of this relationship among both patients and healthcare providers.”
An improvement can be made quickly. For example, a boy and a girl both had frequent multiple ulcerations for years and then apparently healed within two weeks of removing dairy products from their diets. We don’t know how often it works; we just know it does – sometimes. So why not give it a try to eliminate cow’s milk proteins, as a 2017 article in the Journal of the American Dental Association suggested, “especially before taking medications with potential side effects.”
Other ways to prevent future breakouts can include avoiding foaming agents in toothpaste. Find out more by checking out my videos Is Sodium Lauryl Sulphate Safe? and Is CAPB Better in SLS-Free Toothpaste?.
How about Treatment? See Topical honey for canker sores and Best supplement for canker sores.
THE CENTRAL THESES
- Up to one in five people will have recurrent canker sores, the most common inflammatory and ulcerative disease of the mouth.
- Cancer sores can be a sign of celiac disease, an autoimmune disease caused by gluten, a wheat protein.
- The researchers put 20 non-celiac cancer patients on a gluten-free diet, and five appeared to improve and, crucially, get worse when gluten was added back to their diet. However, there was no control group and it was not a blinded challenge, so it is possible that the subjects expected a result knowing they were getting gluten.
- In fact, the very thought of getting gluten made symptoms skyrocket in a study that conducted a blind gluten challenge.
- Gluten was first identified as a possible culprit in the 1960s when it was reported that the blood of patients with severe canker sores reacted to certain food proteins, such as gluten. However, they reacted even more strongly to the milk protein casein.
- In a more formal test, those with canker sores were no longer likely to respond to gluten, but the anti-dairy protein levels were significantly higher and the majority reacted to the cow’s milk, suggesting a “strong association” between high levels of anti-dairy proteins in the blood in recurrent cancerous ulcers.
- Certain food colors or other additives can also cause more reactions in people with recurrent cancerous ulcers.
- Exclusion diets like a gluten-free diet, a dairy-free diet, or a diet without certain food additives can seem enlightening and worthwhile for making significant improvement. Allergy tests don’t seem to make sense.
- An improvement can be made quickly. In one case, children who had suffered from frequent and multiple ulcers for years apparently healed within two weeks of removing dairy products from their diet.
I also examined the role of gluten and dairy free diets in autism:
Should Everyone Avoid Gluten? Cash:
Michael Greger, MD
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