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Home » Celiac Disease » Celiac Mouth Sores: The Truth about Canker Sores and Cold Sores

Celiac Mouth Sores: The Truth about Canker Sores and Cold Sores

Last Updated January 20, 2022. Published August 1, 2019 Good For You Gluten Free

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Celiac Mouth Sores: The Truth about Canker Sores and Cold Sores

Suffering from mouth sores related to unmanaged (or undiagnosed) celiac disease or gluten intolerance? This article discusses gluten’s effect on canker sores and cold sores. No information should be used as a substitute for medical advice from your doctor. This post contains affiliate links. Please see my disclosures and disclaimers.

The topic of celiac disease and mouth sores keeps coming up in my Gluten Free Diet Support Group (on Facebook), so I thought I would explore this topic a bit in today’s post.

Beware, though, because I’m about to get personal!

Before I was diagnosed with celiac disease, I suffered from a few embarrassing mouth issues. I had canker sores, occasional cold sores, and chronic geographic tongue.

These conditions were sometimes painful, always majorly embarrassing, and, on top of it all, I had no idea what caused them to happen in the first place (I was just a kid dealing with this stuff!).

I have now come to see the mouth as the doorway to the gut. My gut wasn’t right, and my mouth was showing signs of a serious disorder.

In this article, I discuss how mouth sores may have been oral manifestations of my unmanaged celiac disease all along.

What are Canker Sores, Cold Sores and Geographic Tongue?

First, let’s define each of these celiac-related mouth disorders.

Canker Sores: Canker sores, or aphthous ulcers, are found on the soft tissues inside your mouth and on your lips, cheeks and tongue. Canker sores can be painful.

While the exact trigger of a canker sore is unknown, many say it is triggered by a vitamin deficiency, weak immune system (hello celiac disease!), food sensitivities and hormonal changes. Canker sores aren’t viral nor contagious like cold sores.

Aphthous stomatitis (aka, canker sore)

Cold Sores: Cold sores are caused by a virus called herpes simplex virus and they are contagious (it’s wise to not touch your lips, kiss or share drinks when you have an outbreak).

Cold sores are inflamed blisters that typically occur on the external surfaces of your lips although they can also occur on your nose, cheeks or eyes.

Don’t judge someone for having a cold sore because ninety percent of all people get at least one cold sore in their lifetime!

Many people develop antibodies to cold sores after their first one and never have to deal with them again, but about 40 percent of the population gets recurring cold sores. Why the virus afflicts some more than others is unknown.

Cold sores (aka, herpes simplex virus)

Geographic Tongue: Geographic tongue, or benign migratory glossitis, is another one of those unexplained phenomenons that occurs inside the mouth. The condition gets its name from the map-like appearance that shows up on the top and side of the tongue. It almost looks like crop circles on the tongue.

The cause of geographic is unknown, although some consider geographic tongue an oral form of psoriasis. Geographic tongue affects 1-3 percent of the population and unlike cold sores, it is not viral nor contagious. I can attest that geographic tongue feels like your tongue is chronically inflamed.

I’ve written extensively about geographic tongue, so if you suffer from this condition, please read this article.

Geographic tongue

How Do these Conditions Relate to Celiac Disease and Gluten Sensitivities?

It’s hard to believe that some of the early signs of celiac disease can begin in your mouth, but it does. This makes your dentist a viable – if not crucial – part of the diagnosis team.

I’ve asked every doctor and dentist since childhood about my geographic tongue. I was told not to worry about it, it’s nothing. In other words, it was just something I had to live with.

I’ve realized over the years that these mouth conditions may have be tied to undiagnosed celiac disease or early celiac disease development. While the research isn’t quite there to make this firm correlation, there are inklings of truth from the research currently available.

Canker Sores Tied to Celiac Disease?

Did you know that people with celiac disease are more prone to canker sores than the rest of the population?

In a large survey of a Canadian population with confirmed celiac disease, 16 percent of children with celiac disease and 26 percent of adults with celiac disease reported having recurrent oral ulcers.

While the exact cause of canker sores is unknown, many researchers believe it to be related to iron, B12, and folate deficiencies, which are nutritional deficiencies commonly found in people with unmanaged celiac disease.

Additionally, five percent of patients with recurrent canker sores had celiac disease. It may not sound like a lot, but this is FIVE TIMES the rate of celiac disease in the general population, making a strong case for those with recurrent canker sores to get tested for celiac disease.

Cold Sores Tied to Gluten?

While I cannot find data to support my experiences, I have to tell you that I rarely get cold sores anymore since I implemented a gluten-free diet nearly seven years ago.

While your body develops antibodies to cold sores over time, and many people can grow out of cold sores, it can’t just be coincidental that this virus disappeared the minute I broke things off with gluten. Could there be a correlation? I think so.

Your doctor will tell you that cold sores are viral and there is no scientifically proven direct connection between the consumption of gluten and cold sores.

However, experts say a cold sore outbreak can be triggered by a compromised or weakened immune system. In other words, if you have the virus, and your immune system is out of sorts because you have undiagnosed celiac disease, perhaps it’s the perfect storm for a cold sore to rear its ugly head.

This theory might explain why once I eliminated gluten and finally managed my celiac disease, I was able to rebuild my immune system and keep the cold sores away. (Unfortunately, in year eight of my celiac disease journey, I got a cold sore. Bah humbug!)

Geographic Tongue and Gluten

Unfortunately I get geographic tongue from time to time (very rarely, though) despite being fully gluten free. It could signal that I’ve had trace gluten exposure but I cannot know for sure.

Regardless, those pesky crop circles have plagued my tongue for decades, although they have since been downgraded to a slight and occasional annoyance.

Evidence suggests there is a strong tie between geographic tongue and celiac disease.

One study found that 15 percent of individuals with geographic tongue had celiac disease. This is 15 times the rate of celiac disease in the general population – wow!

On top of that, only a fraction of the 15 percent of patients with geographic tongue had any gastrointestinal symptoms that most people associate with celiac disease. This means that the individuals with geographic tongue had “silent” or “atypical” forms of celiac disease.

Research suggests that any inflammation in the mouth, geographic tongue included, may be caused by a vitamin B12 deficiency. Again, people with unmanaged or undiagnosed celiac disease often suffer from a slew of nutrient deficiencies.

Read more about the cause and treatment options for geographic tongue in this article.

Mind Your Mouth

Celiac disease – and gluten sensitivities – can manifest in your mouth in more ways than sores. It can also be evident through receding gums, gum disease, excessive cavities and even discolored enamel. All of these issues can be the sign of nutrition deficiencies … and nutritional deficiencies are a roaring symptom of celiac disease.

Dentists need to be aware of such oral manifestations of celiac disease because they can be an important part of the celiac disease diagnostic team.

If a dentist or doctor sees recurring canker sores, geographic tongue or even cold sores when treating a patient, they should encourage that patient to get tested for celiac disease.

Additionally, if you are suffering from any of these mouth sore disorders, consider the following:

(1) Are You Eating Gluten? Make sure you’re not eating any gluten, even accidentally, as mouth sores might be a manifestation of continued or accidental gluten exposure. Do not indulge in “cheat” days.

(2) Are You Getting Enough Nutrients? Experts agree mouth sores can be the sign of a Vitamin B deficiency or other nutrient deficiencies. Make sure you’re eating plenty of fruits and vegetables, and take a daily supplement. I recommend this brand for a daily supplementation, and these for Vitamin B12 supplementation. (Read: Supplements for Celiac Disease and Gluten Intolerance)

(3) How’s Your Gut Health? Remember, the mouth is the gateway to your gut. Improve your gut health and you’ll improve your whole body health. I write a lot about the benefits of probiotics and why people with celiac disease should pay attention to their guts.

(4) Do You Really Know Your Symptoms? Remember, celiac disease can manifest itself in many ways. Even if you don’t have traditional gastrointestinal issues traditionally associated with celiac disease, it doesn’t mean you don’t have the autoimmune disease. If you suffer from canker sores, cold sores or geographic tongue, get tested for celiac disease – it’s the only way to know for sure.

Your Turn

Do you (or did you) suffer from any of these oral manifestations of celiac disease? Did your mouth sores improve or clear up upon ditching the gluten?

Filed Under: Celiac Disease, Gluten Free Information, Gluten Sensitive 9 Comments

Reader Interactions

Comments

  1. Good For You Gluten Free says

    January 27, 2021 at 6:52 am

    It could be the sign of a nutritional deficiency and it will take time for your body to recover. It took years for my tongue to fully clear and my body to heal.

  2. Stacy says

    January 26, 2021 at 8:41 am

    interestingly, I was just diagnosed with celiac a few weeks ago and have had so many issues with my tongue. I have always had an “ugly” tongue but it never caused the sores or pain until about a month ago. I was eating gluten like crazy to ramp up for my scope. I have been gluten free for about 2 weeks and its not going away exactly. What makes it go away? I am on a plethora of pro/prebiotics and vitamins to heal my gut, they probably arent being absorbed until there is more healing I supposed. I have on occasion gotten Canker sores, but it was not often, maybe 1 a year or less and usually wasn’t a big deal and would go away in a day or two. I don’t recall every having a cold sore, but my sister gets them.

  3. Randi says

    December 27, 2019 at 11:46 am

    This is an interesting article. I’ve had cold sores for as long as I can remember. I was getting them at least every few months. I had 2 bad cold sores when I was first diagnosed. I was so stressed from the diagnosis. Then it was over a year afterwards before I had another one. That was unheard of for me. I just had one (15 months after going GF). It was very mild compared to my normal ones. Another positive benefit to add to the list for not having gluten.

  4. Jenny Finke, Integrative Nutrition Coach says

    November 19, 2019 at 5:42 pm

    Wow, I’m glad I could help you connect the dots. Our bodies are intricately intertwined. What happens in the mouth can be caused by something happening in you gut. Be well friend!

  5. Carol Pomeroy says

    November 19, 2019 at 12:31 pm

    Thank you for this article. I was diagnosed this past August 2019. I have lived with a bad stomach, constant cold sores, canker sores my whole life. This past spring my dentist hygienist mentioned I have geographical tongue. I had never heard of it before her mentioning it and then I read this article. Everything makes sense now. I am B12 deficient and many other deficiencies. Since being diagnosed I hadn’t had a cold sore until a week ago and I do believe I was crossed contaminated from the restaurant I ate at or the bakery that I bought a gluten free cake from. They claimed they watched how they made it as far as cross contamination, but I definitely was sick that night and the next day I had sores in my mouth, sores on my neck and a cold sore. I look forward to reading more of you articles. Thank you again.

  6. Bonnie M Kottong says

    August 21, 2019 at 10:22 pm

    I’ve had huge cold sores on my mouth and nose, at least one a month between October and March every year from early twenties until winter before last when I was 68. Nothing I tried helped. I went gluten free about 10 years ago and have never been tested for celiac disease but am definitely gluten sensitive. I stopped eating gluten after reading the Wheat Belly book by Dr. Davis. As soon as I went GF have been pretty careful to not eat gluten, but possibly will try to be even more careful. I also had trouble with large “pimples” that were painful on my face which have gone away.

  7. Hilda says

    August 2, 2019 at 11:08 pm

    I also get a small blisters on my tongue and they are very painful. I only get them when I have eaten gluten. I m gluten sensitive and have noticied it when I have eaten gluten more than a cheat.

  8. Jenny Finke, Certified Integrative Nutrition Health Coach says

    August 2, 2019 at 3:07 pm

    Thank you for sharing Deb. Im glad you figured things out. I hate hearing of people suffering and hopefully together we can bring more attention to this important topic.

  9. Deb Melkus says

    August 2, 2019 at 11:50 am

    I read your articles and always find something I didn’t know . I had cold sores since childhood. I don’t mean one or two, I mean sometimes my mouth would be covered inside and very painful. Naturally my Mom thought I was very skinny because I couldn’t eat. The dentist had no idea except I should avoid citrus, acid such as tomatoes etc. Didn’t help. It wasn’t until adulthood that my gut hurt so bad I couldn’t eat my chicken noodle soup. I had diarrhea so bad , I dreaded going out. My abdomen was so bloated and hard, I had to lie down many times during the day. My arthritis started in my twenties and got so bad in my fifties. To make a long story short, I only get mouth sores when glutened . I never cheat. I mean never. Nothing not even homemade chocolate cake. So chalk the nugget of mouth sores up as more info is knowledge. Thank you

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Hi, I'm Jenny Levine Finke and am passionate about the gluten-free lifestyle. I'm a certified integrative nutrition coach and self-taught expert on [most] gluten-free things. I have celiac disease and know the struggles you're going through first-hand. This is why I've dedicated this blog to serving the celiac and gluten sensitive communities with important information, product and restaurant reviews, and simple recipes I hope you'll love. Read More…

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