Should We Screen for Vitamin and Mineral Deficiencies in Burning Mouth Syndrome?
Burning mouth syndrome (BMS), characterized by chronic pain or burning discomfort in the oral cavity, is a poorly understood disease. The diagnosis is made by exclusion rather than through definitive characteristics. Patients are often screened for vitamin, hormone, and glucose levels even though there is conflicting data about whether this is helpful in their evaluation or disease management.
A recent study examined whether there was an association between BMS and laboratory abnormalities of specific vitamins, minerals, hormones, and glucose in a small cohort of patients. The retrospective study identified 659 patients over an 11 year period with chronic mouth pain in the absence of any objective abnormalities on physical examination of the involved areas. All patients had at least one (but not all) of the following lab values tested: levels of vitamins (B1, B2, B6, B12, D3, and folic acid), zinc, fasting blood glucose, and thyrotropin (TSH). The results showed that there tended to be abnormalities in the lab values; most frequently patients had increased blood glucose and decreased levels of vitamin D3, vitamin B2, vitamin B6, zinc, and vitamin B1.
The authors note that deficiencies of vitamin B12 and folic acid were rare, as were thyroid abnormalities – less than 5% had decreased TSH and just about 5% had increased TSH. The authors conclude that based on these results it is reasonable to screen for fasting blood glucose, vitamin D (D2 and D3), vitamin B6, zinc, vitamin B1, and TSH, but based on these data it is not essential to check vitamin B12 or folate levels.
Byline: Martha L. Sikes, MS, RPh, PA-C
Posted: June 14, 2017
Source: Wiley Online
Adapted from the original article.