It seems there are many potential contributing factors when it comes to apthous ulcers…
From chatgpt
Aphthous ulcers (also called canker sores) are small, painful lesions that occur inside the mouth. Their exact cause is not fully understood, but several causal and contributing factors have been identified:
1. Local Trauma
- Biting the inside of the cheek or lip
- Brushing too hard
- Dental work or ill-fitting dentures
- Sharp or broken teeth
2. Nutritional Deficiencies
- Iron
- Vitamin B12
- Folic acid
- Zinc
3. Stress and Hormonal Changes
- Emotional stress or anxiety
- Hormonal fluctuations (e.g., during menstruation)
4. Immune System Factors
- Dysfunctional immune response (hypersensitivity reaction)
- Autoimmune conditions (e.g., Behçet’s disease)
5. Food Sensitivities
- Spicy, acidic, or salty foods
- Certain food additives (e.g., sodium lauryl sulfate in toothpaste)
- Allergens like chocolate, coffee, nuts, strawberries, or gluten
6. Infections
- Viral infections (though aphthous ulcers are not caused by herpes)
- Secondary bacterial infection may worsen the lesion
7. Genetic Predisposition
- Family history increases risk
8. Systemic Diseases
- Celiac disease
- Crohn’s disease
- Ulcerative colitis
- HIV/AIDS
9. Medications
- NSAIDs
- Beta-blockers
- Chemotherapy drugs
If aphthous ulcers are frequent, persistent, or unusually severe, it may indicate an underlying systemic issue that should be evaluated by a healthcare provider.
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Herm
#1231
[Immune dysregulation linked to several triggers may facilitate the development of RAS. The roles of the immune system and inflammatory processes have been confirmed in recent large-scale bioinformatics analyses (14,15). It is known that a Th1-type hyperimmune response favors the appearance of inflammatory reactions that precede ulcerations (Fig. 1) (16,17). In addition, genetic risk factors can determine individual susceptibility to RAS; in particular, several DNA polymorphisms of the NOD-like receptor 3(18), toll-like receptor 4(19), interleukin (IL)-6(20), E-selectin (21), IL-1β and TNF-α genes (22). However, despite the large number of factors examined, the underlying cause triggering the episodes of ulcers remains to be elucidated. Therefore, clinically, the emergence of new lesions cannot be avoided at present.](Essentials of recurrent aphthous stomatitis - PMC)
For treatment, while quite messy and somewhat distasteful but not too unbearable, I applied a topical steroid clobetasol propionate 0.05%, and after an hour or so, some good old clove oil which stings at first but last a few hours.
It may be that rapa at particular doses in particularly sensitive individuals (raising hand) may induce a hyperimmune response, much as seen in older folks having better responses to flu vaccination post rapa dosing. I reckon I’m conservative and don’t really want a hyperimmune response (if that is what causes the ulcers) if I don’t need it, plus it hurts, a lot!
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Herm
#1232
I forgot to add that I also avoid toothpastes that contain sodium lauryl sulfate, which is also used to solubilize cells and “straighten out proteins for electrophoresis” i.e. disrupt secondary protein structure, and is known to be a risk factor for development of aphthous ulcers in some people.
Absolutely that seems likely for some people. I’ve only had one in the past 5 years, and at one of the lower doses that I’ve taken during that period, so I really can’t say I understand it. Others, like Peter Attia, have commented that if his young son head-butted him accidentally, the stress might cause Peter to get an apthous ulcer.
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Jonas
#1234
For practical purposes, I have decided to follow my NLR as a dosing guide, all things being equal. NLR can easily be calculated from a simple Hematology panel.
-
Neutrophils: White blood cells that fight infection and are elevated in acute inflammation or stress.
-
Lymphocytes: Immune cells involved in adaptive immunity, often decreased in chronic stress or inflammation.
NLR is a marker of systemic inflammation, stress, and immune balance, used in contexts like cardiovascular disease, cancer prognosis, and autoimmune disorders.
Some real data tracking:
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CTStan
#1235
After struggling with a very painful, non-healing tongue lesion (I had pushed my rapamycin upper limit), I got a helpful tip from a family member who suggested I try Colgate Peroxyl. It worked.
I’ve gotten ulcers again since then and needed to use it. Each time, one swish of this pleasant tasting peroxide product and the ulcer immediately stopped hurting and began to heal.
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Took my first dose of 3mg and I noticed some worsening of psoriasis. Skin splitting in a painful way on my hands, it’s actually really annoying. I’ll lower the dose next time. I might skip the next dose as well if it doesn’t heal by then.
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Hmmm… we are all different… rapamycin took my dry knuckles to smooth skin… also finger and toenails like a young person.
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I might need time to adjust to it.
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Yes. The old timers started with 1 mg a week for a month, then 2 mg in the 2nd month, then 3 mg in the 3rd month, etc… up to their terminal dose.
I, like you, started with 3 mg, but used GFJ. So 1 mg + GFJ every week for a month, then 2 mg + GFJ, etc. Now I’m at 4 mg + GFJ every week each month. More than that gave me too many side effects.
What side effects did you get?
Are you just consuming GFJ as you take the rapamycin or do you consume it elsewhere throughout the week?
I will say on the first few days after taking it I felt quite energetic. I can see this being beneficial if I get these side effects under control. I’m using a steroid cream I have for psoriasis to control this, I typically don’t use these as they’re not a long term solution.
My side effects are posted here, earlier in this thread. I suggest you read the topic from the beginning so that you know what you might expect!
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As in citric acid? Do you get it from a food or supplement?
I mix my own from the original salts. (Sodium Potassium Magnesium and sometimes Calcium).
