Everything about canker sores

General
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In terms of negative side effects, a small percentage of patients have canker sores inside of their mouths. These seem to be temporary in the small percentage of patients who get them.

For the patients that do get canker sores, we recommend that patients take lysine, a supplemental amino acid that resolves canker sores.

HSV causes canker sores. Furthermore HSV reproduction is stymied by the inhibition of arginine synthesis by L-lysine. Arginine is needed for HSV replication. Studies conducted since 1978 have shown that lysine is a viable treatment of canker sores. Lysine has been shown to reduce lesion frequency, recovery time, clinical manifestations, and recurrence rate.

It’s also recommended that you take a zinc and vitamin C supplement to provide your immune system with an additional boost.

Singh BB, Udani J, Vinjamury SP, Der-Martirosian C, Gandhi S, Khorsan R, Nanjegowda D, Singh V. Safety and effectiveness of an L-lysine, zinc, and herbal-based product on the treatment of facial and circumoral herpes. Altern Med Rev. 2005 Jun;10(2):123-7. PMID: 15989381. Link

Johnston C, Wald A. Herpes simplex infection. BMJ Best Practice Web site.
Link. Accessed August 29, 2015.

Wright EF. Clinical effectiveness of lysine in treating recurrent aphthous ulcers and herpes labialis. Gen Dent. 1994;42:40-42.

Gaby AR. Natural remedies for Herpes simplex. Altern Med Rev. 2006;11:93-101.

No author listed Lysine and cold sores. Med Update. 2004;29(12):7.

Tomblin FA, Lucas KH. Lysine for management of herpes labialis. Am J Health Syst Pharm. 2001;58:298-300, 304.

Griffith RS, Norins AL, Kagan C. A multicentered study of lysine therapy in Herpes simplex infection. Dermatologica. 1978;156:257-267.

Milman N, Scheibel J, Jessen O. Lysine prophylaxis in recurrent herpes simplex labialis: A double-blind, controlled crossover study. Acta Derm Venereol. 1980;60:85-87.

Walsh DE, Griffith RS, Behforooz A. Subjective response to lysine in the therapy of herpes simplex. J Antimicrob Chemother. 1983;12:489-496.

Miller CS, Foulke CN. Use of lysine in treating recurrent oral herpes simplex infections. Gen Dent. 1984;32:490-493.

Thein DJ, Hurt WC. Lysine as a prophylactic agent in the treatment of recurrent herpes simplex labialis. Oral Surg Oral Med Oral Pathol. 1984;58(6):659-666.

Ozden FO, Turanli AY, Acikgoz G, Eroglu C. Clinical success of lysine in association with serumal and salivary presence of HSV-1 in patients with recurrent aphthous ulceration. J Exp Integr Med. 2011;1(3):191-196.

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Are Zinc and Vitamin C supplements recommended just for people who experience canker sores, or for people on Rapamycin in general?

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Welcome to the board @Krebbs . I’ll ask @Jake for any insights he has.

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Not typically Zinc and Vitamin C. We recommend taking lysine, however.

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Just to clarify the information posted by Jake, canker sores are not caused by herpes nor by any other infectious agent. Canker sores are aphthous ulcers that occur inside the mouth. What people refer to as “cold sores” or “fever blisters” ARE caused by herpes. Those are on the lips, not inside the mouth. Rapamycin does cause aphthous ulcers in some people. As far as I know, it does NOT cause herpes.

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Is this a side effect of rapamycin?

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Some patients do experience canker sores. Most of which are temporary. The occurrence seems to be dose-dependent, which is a reason why it’s good to start with a conservative dose and then gradually increment the dose month-to-month.

There was a paper on the use of rapalogs (other mTOR inhibitors that mimic rapamycin) that had some data on the occurrence and duration.

According to their study, 9% of patients had canker sores. They found that in patients that did have canker sores, it would resolve within two weeks and do not seem to recur as severely with subsequent doses.

However, this dosing was in transplant patients, who take the dose every 7-days. Whereas, longevity dosing is on cyclical dosing of a single dose once a week, which is why we see a much smaller occurrence of canker sores among our patients.

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This is incorrect information. Canker sores are NOT caused by the herpes virus, cold sores are. None of these remedies/references are helpful.

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