A nightly dose of vitamin B12 is an easy, effective, and inexpensive therapy for recurrent aphthous stomatitis (RAS), an Israeli study reports.

Ilia Volkov, MD, of Ben-Gurion University of the Negev, led a team of physicians who sought to confirm their earlier research. They randomly assigned 58 RAS patients referred by primary-care providers to a sublingual dose of 1,000 mcg of B12 at bedtime or to placebo. Both groups were assessed monthly for six months.

More than 74% of treated patients achieved remission by the end of the study, as compared with 32% of the controls. Patients in the treated group also experienced less pain, fewer ulcers, and shorter outbreaks than the controls. No adverse reactions were reported in either group (J Am Board Fam Med. 2009;22:9-16).

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Specifically, the average outbreak duration decreased in both groups during the first four months of the trial (2.36 vs. 4.74 days), but it dropped significantly further in the intervention group after months 5 and 6 (1.98 vs. 4.84 days.)

The average number of aphthous ulcers per month followed a similar pattern. It declined in both groups during months 1-4 (6.00 vs. 14.47 ulcers), then fell more sharply in the intervention arm during months 5 and 6 (3.88 vs. 13.39 ulcers).

Lastly, discomfort declined among the intervention group throughout the six months. The controls’ pain diminished during the half of follow-up, but actually increased during the second. This led to a statistically significant difference in pain levels on the Numerous Rating Scale (NRS) during months 5 and 6 (1.51 vs. 2.93 and 0.64 vs. 2.36, respectively).

This “simple, inexpensive, and low-risk treatment, seems to be effective regardless of the serum vitamin B12,” the clinicians conclude.