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ulcers on tongue...vitamin deficiency

on 12/30/10 2:47 pm
So after griping about my tongue hurting all week, iwent todr, I have 5 ulcers on my tongue and appaently the cause is a vitamin B deficiency. This is not my reg dr & she is not WLS savvy.

In oct I switched from BA chewables to OTC pills for all my vitamins. I tried to talk her into checking all my labs to see if anything else is off, but no go. She only checked my B12. So vita-gurus how concerned should I be about everything else in lieu of any actual symptoms?

I will be placing a BA order today, but worry if I need to up anything to resolve a deficiency. Any suggesrions?
on 12/30/10 2:56 pm - Ranson, WV
ulcers on ur tongue neverheard of that, heard of the blisters on the tongue and my doctor told me when you get blisters on ur tongue and they continue ur allergy to something that you have eaten. per my allergic doctor
on 12/30/10 3:29 pm - TX
Wow, good to know! I always thought it was allergies too. Sorry you are having to go through that but glad you got it figured out!
Dave Chambers
on 12/30/10 3:31 pm - Mira Loma, CA
RNY on 05/10/06 with 27399-63.html offers some insight.  Says about 20 of cases may be due to b12, folic acid...shortages as a possible reason. DAVE

Dave Chambers, 6'3" tall, 365 before RNY, 185 low, 200 currently. My profile page: product reviews, tips for your journey, hi protein snacks, hi potency delicious green tea, and personal web site.
                          Dave150OHcard_small_small.jpg 235x140card image by ragdolldude

on 12/30/10 3:46 pm - Puyallup, WA
RNY on 10/05/94
has anyone checked your labs since your WLS? should be about 14 vials?

Are you taking the B12 as sublingual or considering that you actually get what is in your multi?

Do they hurt? Thrush is fairly commonn in first year ppl, but it's not particularly painful.

RNY, distal, 10/5/94 

P.S.  My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.

Pam T.
on 12/30/10 4:10 pm - Saginaw, MI
I quick google search found this:

Ulceration (on tongue)

Severe deficits of vitamin C, as in scurvy, cause ulcers of the tongue. The lips, inside of the cheeks and throat also develop painful ulceration, according to "Nelson Textbook of Pediatrics." Scurvy ulcers may bleed or be covered by a thick grey membrane.

Deficiency of niacin -- vitamin B3 -- causes redness of the tongue and pain throughout the mouth before progressing to ulceration, according to "The Merck Manuals Online Medical Library." The ulcers of a niacin deficit start under the tongue and on the lower lip, then progress to the rest of the mouth. In advanced niacin deficiency, the ulcers, like those of scurvy can bleed and cause significant pain.

Read more:

As for using BA vs OTC. Don't jump to conclusions until you have lab tests run. BA vitamins are no different than many other over the counter vitamins. I use Centrum and it's fine. I use a B-complex from Puritan Pride or GNC and my numbers are fine. The actual vitamin quality is no different -- you only need to worry about low-quality OTC vitamins that do not include all the vitamin ingredients we need. 

So if your PCP won't order lab tests, then go to your surgeon and get the request in. You're coming up on your one year anniversary, so now is the time to get this stuff tested anyway.

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on 12/30/10 4:50 pm, edited 12/30/10 4:53 pm
I had my labs checked in Sept and all was well.  Then I switched my vitamin source in Oct.  Pam, I am not trying to say that OTC is not a good choice, but I was doing well on BA and for me it is easier to go back to what was working rather than to try new products to find something that works.  I was already planning to go back to BA because I miss the chewables....they were my sweet at the end of a meal. 

It is quite painful, the ulcers are all around the bottom edge of my tongue on both sides.  I am barely talking and have been living on cottage cheese, yogurt and r/f beans exclusively this week.  Dr. gave me a topical analgesic to ease the pain enough for me to eat  and that helped immensely.  Tonight I had a bit of baked chicken with my r/f beans. 

Michelle, my PCP has been checking my labs, but not to my satisfaction...definitely not 14 vials worth!  I have discussed this with my surgeon and for my next labs he will write the orders.  He did not feel it necessary to rerun them in Sept right after my PCP had done them.  I am using a sublingual B12 that I got at my local health food store. 

I have not posted my labs in the past for input mostly because I am too lazy, but I think I will go dig them out and make the effort.
on 12/30/10 5:10 pm - OH
I am very skeptical that your B12 was good in Sept and now is low enough to cause ulcers in your mouth.  What was it in Sept and what is it now?  I''m thinking it was already low in Sept but they probably told you it was OK even though it really wasn't (happens a lot) and then it just got lower.

They should definitely be taking at least 14 tubes of blood - I think mine is usually more like 20.

on 12/30/10 5:08 pm - OH
When is the last time you had a full set of labs done?

You really should not wait until symptoms develop to get labs done - by then serious problems, some irreversable, may have occurred.

How low is your B12?  What are you doing to bring it up?

on 12/30/10 5:48 pm
I am going to have to call Dr tomorrow to get #s.  The report I have does not have the Sept or today's B12. 

As for how to bring it up, the Dr just told me to go back to BA since that was working for me before.  I insisted on the test today to see how low I am in case I need to double up on my supplement to bring it up.  Do you have any other suggestions?

I will call leave a message with surgeon tomorrow to let him know what is up and get his feed back on the situation.
on 12/30/10 6:51 pm - OH
I agree with going back to BA since it worked well before.

I would also want a complete set of labs right now, though, to make sure nothing else is low.  If it is low, you would need to add additional amounts of whatever it is to get back up to normal, just the BA would not likely do it.

What are you doing to bring the B12 up?  Really, you need the number to figure out what to do and how much.

I've learned the hard way - always, always get the numbers.

on 12/30/10 6:04 pm - Owings Mills, MD
I have one friend who has not had WLS and my husband and I both just finished up over a week of canker sores/mouth ulcers.

I have had them occasionally since i was a kid....  

my vitamin levels are fine.... sometimes they just happen.
Ticker is from Day of Surgery.. weight goal is personal preference as I've MET my doctor's goal



on 12/30/10 6:21 pm
I have horrible canker sores in the same spots you are talking about, I would rather waste away than eat anything when they are bad. But what I figured out causes them 50% of the time is using highly flouridated tooth paste, or the sensitive tooth kind, the one the dentist sells as a prescription paste and/or a highly flouridated mouth wash...

I know it sounds weird but I can only use that for 3-5 days on and then 2-3 weeks off.

on 12/30/10 7:01 pm
RNY on 01/19/11 with
Please don't slam me for sounding like I'm off my rocker, but do you by any chance come into contact with young children??  There's a viral infection which can cause something called Hand, Foot, and Mouth disease.  In young children, blisters will appear on the palms of the hands, the soles of the feel, and on the toungue/in the mouth.  In adults, the blisters are often just on the tongue/in the mouth.  I had this a few years ago (along with my youngest son).  It came on very suddenly, as you described, and the blisters were exactly where you described them.  Because it's viral, there's really nothing do do but wait for it to pass (about a week), but there was a "magic mouthwash" that my doctor prescribed & it really helped with the pain.  I believe that the mouthwash was basically liquid lidocaine (prescription) + maalox (mix them together at home, once you have the prescription), although you can find several different recipes on the internet. And you don't swallow the stuff, just swi**** around in your mouth, so it would be ok for you to use it.

Even if what you have isn't viral, the mouthwash might help with the pain until you can get your vitamins straightened out.  Not good that your doctor didn't recommend something like this.  Blisters on the tongue are SO painful!!

HW: 270/ CW: 139.0/ GW: 135
40 lbs lost prior to surgery
RNY surgery date: 1-19-11
on 12/30/10 7:13 pm
The suddenness & # of ulcers, kind of rules out the "it just happens sometimes". 

I do not come into contact with young children.  There were a few at the family Christmas, but I didn't interact with them.  Dr. did consider the viral cause, but felt the vitamin deficiency was much more likely the cause.

I did get an Rx for the liquid lidocaine....rather than mouthwash, I just apply it to the ulcers with a Qtip. 


on 1/1/11 9:23 am
just an FYI...
I am presurgical and I also have vitamin b-12 deficiency and developed sores in my mouth.   Labs were done when I went to PCP because my mouth was so sore, as I guess this commonly happens according to my PCP and turned out fine, but when I was at my dentist a few days later, he thought maybe my mouth was too dry because having a dry mouth all the time can also cause sores.  Dry mouth can be from medications or not drinking enough or a c-pap machine he said.  He recommended using biotine mouth wash and toothpaste, and since I started using it in november, the sores have improved greatly... maybe the biotine can help things feel a little better or maybe depending on how your labs come out, it may not be a deficiency causing them