Burning mouth

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Burning mouth

Postby Nenu » Wed Apr 30, 2008 8:12 pm

Is driving me crazy! This was almost completely gone during my steroids treatment and a bit after, but it's slowly come back.

Anyone else dealt with burning mouth before? It can be pure agony. I get the burning in the mouth, esp. on my top right side and my cheek feels like it's on fire (on the inside), my tongue feels like a million bees are stinging it, and my lips can feel a slight burning too. Not to mention my facial nerves kick up and twitch :(
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Postby jimmylegs » Wed Apr 30, 2008 9:26 pm

hi nenu, sorry if you've already elaborated on this, but have your levels been checked associated with the burning mouth(glossodynia)??
any or all of:

iron
folate (vitamin B-9)
riboflavin (vitamin B-2)
pyridoxine (vitamin B-6)
cobalamin (vitamin B-12)

http://www.ncbi.nlm.nih.gov/pubmed/2693058
Various types of nutritional deficiencies can produce glossodynia and associated signs of inflammation. Changes such as swelling of the tongue, papillary atrophy, and surface ulceration are possible in most of the deficiency states. To further complicate the clinical picture, the patient commonly will suffer from multiple nutritional deficiencies [29]. Therefore, it is not advisable to diagnose a specific nutritional deficiency on clinical impression alone. To establish iron, folate, or vitamin-B12 deficiency, a hematologic screening that includes complete blood count, red-cell, serum iron, B12, and folate levels should be performed [30]. Although they are rarely required, specific tests for suspected niacin, pyridoxine, and riboflavin deficiency are available. Although glossodynia related to nutritional deficiency is statistically uncommon, it is easily curable with replacement therapy. Identification of a vitamin deficiency through early oral symptoms can forestall development of serious and irreversible systemic and neurologic damage.


i've seen mention of thiamine and zinc as indicative also.

anyway i know you have an ms compound vitamin and it looks very good, but i also notice it doesn't include iron as mentioned above, nor some of the b-complex, such as niacin and pyridoxine. the b-complex does need to work as an ensemble, as i've learned the hard way.

what do you think?[/url][/quote]
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Postby Nenu » Thu May 01, 2008 5:38 am

I did have all those vitamins tested as part of my diagnosis for MS, as far as I know. I remember the list had a ton of vitamins indicated on it. I'll have to ask my doctor Monday to show me the results of the blood work (I hope she has that available for viewing) to find out more.
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Postby jimmylegs » Thu May 01, 2008 7:38 am

that's so good that they went through lots of things for you.
with me the only nutrient they looked at originally was b12, and i guess probably iron too, but i'd have to double check.
i should think you could get your results. i'm not *supposed* to call my doc's office for results but last time i just called to see if they were in yet, and they offered to fax them to me, so that was great!
if you've had a riboflavin test you're doing better than i am. i had this long requisition and the local lab couldn't do it, so i went to the big lab at mcmaster and they couldn't do it either. i haven't searched further afield yet, just because the rest of the complex looked acceptable and it would be sort of weird i think for just one to be down too far.
keep us posted on what you find out re: the dx bloodwork?
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Postby Nenu » Thu May 01, 2008 7:56 am

I shall. I told my neuro at the time that I wanted to know of any deficiencies, because I was taking vitamins and supplements at the time of diagnosis already (B2 I had been taking for a long, long time). He said none came up on the blood work and that I was 'exceptionally healthy'.

I go to the doctor on Monday, so I'll push for further info then :)
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Postby jimmylegs » Thu May 01, 2008 9:55 am

excellent - i'm very curious.
i have had enough outright deficiencies on the record, that it would be interesting to see what they have said was fine in your case.
even some of my 'normal' results have turned up suspicious after indepth reading on the subject.
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Postby Nenu » Wed May 07, 2008 7:25 am

I'm actually surprised... my mouth was killing me yesterday, today it's not as bad (we'll see this PM). I talked to Shared Solutions today (nurse), who told me she's known and seen quite a few with MS that also have burning mouth, and it's very much a part of the disease. So I don't feel so alone now, whew. I do think too now that it's neurological... it got worse yesterday when my stress was reaching a high. Now granted I'm not de-stressed today (long story short, sale of house fell through and life on hold yet again), but the mouth isn't so bad today. Just based on the severity/trend of it, I was able to pinpoint it to neurological.

Now I'm wondering if perhaps one of the drugs commonly used for neurological pain could help this? Hrm.
Dx RRMS March 5, 2008.
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Postby jimmylegs » Wed May 07, 2008 7:47 am

keep up your magnesium until you figure out the pharma angle - stress makes you dump minerals from your system so you definitely need to replenish! if it comes back take some more and see what happens, good luck!
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Postby jimmylegs » Wed May 07, 2008 8:23 am

i like this mg-related info i found before, pertaining to fibromyalgia but still neuropathic pain and the role of magnesium.

http://web.mit.edu/london/www/magnesium.html
if you follow the link it's well referenced to pubmed abstracts.

here are some highlights:

And unfortunately, urinary magnesium loss can be increased by many factors, both physical and emotional. Magnesium loss increases in the presence of certain hormones. Stress can greatly increase magnesium loss...

...magnesium is also the activating mineral for at least 350 different enzymes in the body, more than any other mineral, so it is crucial for many of the metabolic functions in the body. Magnesium is necessary for almost all the enzymes that allow the glycolytic and Krebs cycles to turn the sugar and fat we eat into ATP. Low levels of ATP have commonly been found in people with fibromyalgia, and it is believed that this plays an important role in many of the fibromyalgia symptoms...


low atp? axon degeneration/death?

Adequate magnesium is necessary for proper muscle functioning. Magnesium deficiency promotes excessive muscle tension, leading to muscle spasms, tics, restlessness, and twitches. This is due to an imbalance of the ratio of calcium to magnesium, as calcium controls contraction, while magnesium controls relaxation...

Magnesium may also help Myofascial Pain Syndrome...
i'm looking for more info on that myofascial part...

And it's because of magnesium's ability to regulate nerve functions that other fibromyalgia symptoms occur. Migraine headaches, mitral valve prolapse, and Raynaud's phenomenon, all problems commonly found in people with fibromyalgia, are also problems that have been associated with a magnesium deficiency.

Without enough magnesium, nerves fire too easily from even minor stimuli... emotional reactions will be exaggerated, and the brain will be too stimulated to sleep...

Not only that, but magnesium also affects carbohydrate metabolism in a different manner, as a magnesium deficiency appears to create resistance to insulin, Insulin resistance increases levels of insulin, which may result in a form of diabetes. Additionally, insulin resistance by itself can distrupt intracellular magnesium levels...

Magnesium also appears to be able to also affect the nervous system by regulating the release of hormones, which occurs due to many different forms of stress...

Many forms of oral magnesium supplements are hard to assimilate. The most common, magnesium oxide and citrate, happen to be the worst to assimilate, which is why both have a strong laxative effect. If you suffer from that effect when you take magnesium, it is often not because you are taking too much, but because you are not assimilating it well. And it may take long term use of supplements before magnesium levels are raised in all the tissues, and for damaged cell functions to be restored...

A magnesium deficiency increases cell membrane permeability...Changes in cell membranes and subsequent intracellular imbalance in cells reduces the body's defenses against toxins...


lots of links to the kinds of issues people have here.
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Postby Nenu » Wed May 07, 2008 10:38 am

Very interesting, because originally this whole ordeal began as myofacial pain, which lead me to my TMJ diagnosis...

That's where I originally was put on magnesium :p
Dx RRMS March 5, 2008.
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Postby jimmylegs » Wed May 07, 2008 11:20 am

funny! square one.
has the lessening of pain since last night's dose worn off?
is it possible you've had too long a break from the high dose, once it clogged you up before?
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Postby Nenu » Wed May 07, 2008 11:48 am

Perhaps. I can't recall when I began taking magnesium before, if it was prior to or after the burning mouth began. In any event, yay for minerals today :p

As for lessening, well it's difficult to tell. The way the burning mouth goes is, get a good night's sleep, wake up with almost no pain, then it comes on as the day goes by. My problem is, last night was 4 hours of sleep, due to stress and then my phone ringing non stop from 10 am on :(
Dx RRMS March 5, 2008.
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Postby jimmylegs » Wed May 07, 2008 11:57 am

ugh that's crappy. is it getting worse now, through the day today?
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Postby Nenu » Wed May 07, 2008 12:02 pm

Seems like no worse.. I soaked a bit earlier, and while relaxing, go figure, the burning decreased. It's all about relaxation. Maybe I should be doing yoga.

Raining right now... possibility of tstorms but nothing yet thankfully :)
Dx RRMS March 5, 2008.
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Postby jimmylegs » Wed May 07, 2008 12:07 pm

ya, relaxing is def better for your biochem than any kind of stress.

i searched myofascial and burning mouth together and ran across this:

RELATIONSHIP BETWEEN BURNING MOUTH DISORDER
AND MYALGIA OF FACIAL MUSCLES. W. W.
Herman, J. L. Konzelman, J. Guinn III, J. A. Braselton,
Medical College of Georgia School of Dentistry, Augusta, Ga.
Background. Burning mouth disorder is a poorly understood
clinical entity that has perplexed clinicians and frustrated patients.
Affected individuals typically present with profound chronic burning
sensations of the tongue, lips, and/or palate without apparent cause.
Myalgia presenting as myofascial trigger points (TrPs) is common in
chronic orofacial pain. Characteristically, TrPs refer symptoms to areas
other than the affected site.
Objective. This investigation assessed whether (1) there is
a relationship between burning mouth disorder and myalgia and (2)
treatment focused upon myalgia can have a beneficial effect upon
burning mouth disorder.
Study design. A retrospective analysis of all patient records with
the diagnostic code of 529.6 (glossodynia) seen in the Oral Medicine
Clinic during the period from 1997 to 2003 was conducted. Records
were analyzed by at least 2 independent investigators using a data
collection form. Exclusion criteria were presence of confounding
mucosal disease, insufficient follow-up, and/or lack of outcome data.
Data collected were patient age, gender, duration of symptoms, number
of previous providers, presence/source of myalgia, and response to
treatment.
Results. From a total of 103 records, 46 records remained after
applying the exclusion criteria. The study population consisted of 9
males (average age 68) and 37 females (average age 58). Duration of
burning symptoms was >1 year for 56% of subjects, between 6 months
and 1 year for 37%, and \6 months for 7%. The average number of
providers previously seen was 3. Myalgia as demonstrated by 1 or more
areas of muscular tenderness was found in 39 of the 46 subjects (85%).
Muscles most commonly identified with tenderness were the external
pterygoid (82%), anterior belly of the digastric (69%), myelohyoid
(59%), and zygomaticus major (15%). Myofascial treatment modalities
such as trigger point injections, penetrating ointments, TENS, and
intraoral orthotics were tailored to individual patients needs. Response
to myofascial treatment was judged to be completely successful in 9
patients (22%), moderately successful in 8 (17%), and partially helpful
in 7 (15%).
Conclusions. This retrospective analysis of burning mouth
disorder and myalgia demonstrates that these 2 conditions occur
concomitantly in a significant number of individuals. Clinical relief of
burning mouth disorder by treatment of myalgia was obtainable in
some individuals.
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