Canker sores and autoimmune thyroiditis
It may not be recognized widely enough that recurrent canker sores (aphthous stomatitis) is an autoimmune disorder. A study just published in the Journal of the European Academy of Dermatology and Venereology investigates the association between recurrent canker sores and autoimmune thyroid disease (the most common cause of low thyroid function in developed countries). The authors state:
"Recurrent aphthous stomatitis (RAS) is an autoimmune disorder characterized by the periodic appearance of aphthous lesions on the oral mucosa. TH1 cytokines plays a key role in the aetiopathogenesis. Autoimmune thyroid disease (ATD) is the most common autoimmune disease and is frequently accompanied by various other autoimmune diseases."
They examined ninety patients and 30 healthy volunteers by measuring thyroid stimulant hormone (TSH), free and total triiodothyronin (fT3, TT3), free and total thyroxin (fT4, TT4), thyroglobulin, and the most common antibodies found in autoimmune thyroiditis, anti-thyroid peroxidase antibody (anti-TPO) and anti-thyroglobulin antibody (anti-TG. They also performed thyroid ultrasonography. Their data showed a connection:
"The anti-thyroid antibody was positive in 31.11% of the patients with RAS, and in only 10% of the individuals in the control group. The mean anti-TG level was also higher in the RAS group. Ultrasonography revealed nodules in 28.8% of the patients with RAS and in 16.7% of the individuals in the control group. The sT4 levels were lower and the TSH, anti-TPO and anti-TG levels were significantly higher in the RAS patients with thyroid nodules than the RAS patients without nodules."
Rarely is there only one tissue target in an autoimmune state. Personally, I feel that an important question for any practitioner confronting a condition characterized by chronic inflammation is: "to what degree is there an autoimmune component?" The authors conclude:
"The frequency of thyroid autoimmune-related problems was higher in patients with RAS. It would be worthy of searching autoimmune thyroid disorders in patients with RAS."