In This Article
Pitta Dosha and Canker Sores
According to research, pesky canker sores in the mouth affect about 20% of the population! From the Western medicine perspective, there is no known cause of canker sores, which are small, painful sores that appear inside the mouth on the lips, cheeks, on the gums, and tongue. They are not bacterial or viral infections, which means they are not contagious.
Canker sores are officially called aphthous ulcers, which comes from the Greek word aphthae, meaning “to be set on fire.” This, Ayurvedically speaking, is a pitta (or heat) imbalance. As the body builds excess heat, it attempts to dissipate it through the skin, including the skin on the inside of the mouth. This type of inner skin disruption may indicate that there is excess heat in the stomach and digestive system.
A common imbalance in the digestive system is called udvarta, also known as upward-moving digestion. This is similar to gastro paresis in Western medicine, in which the stomach holds onto the food contents too long. The result is a buildup of heat and acid in the stomach that can press upward onto the diaphragm and push heat into the head and neck. When heat from the stomach rises, you can release some of it from the mouth.
See also Balance Your Pitta Body Type
How to Identify and Recalibrate Pitta Imbalance
Pitta imbalances are commonly worse in the summer when we all accumulate heat. If your body type is also predominantly pitta, then you are more likely to be even more susceptible to building up excess heat and having a pitta imbalance. Signs of pitta imbalance, beyond canker sores and aggravated skin, are irritability, burnout, inflammation, and pain anywhere in the body.
If you’re a pitta body type in the summer (pitta season) and you are consuming lots of pitta-aggravating foods, like cheese, beer, wine, coffee, tea, chocolate, eggs, nuts, strawberries, kombucha, fermented foods, spicy foods, garlic, onions, meats, or excess citrus, you run the risk of “stacking pitta.” Combining a hot body type with a hot season and an excessive amount of heat-provoking foods will increase the internal heat that causes a pitta imbalance and throw you even more out of whack.
The good news is that nature has a plan for not letting us accumulate too much excess heat. The summer harvest provides an abundance of cooling fruits and vegetables. Download my free summer grocery list and circle the foods you are attracted to. Give yourself permission to eat more of those. While avoiding excess amounts of the heating foods mentioned above, start thinking about what you can eat more of in-season, rather than constantly thinking about what your cannot or should not eat!
Get LifeSpa’s free monthly seasonal eating guide with recipes.

4 Nutritional Deficiencies Linked to Canker Sores
Through the foods you eat, plus supplementation, you can get the nutrients you need to balance pitta, improve skin health, and vanquish canker sores.
1. Vitamin D and Calcium
The skin is vulnerable to nutritional deficiencies because it is the last organ to receive certain nutrients, such as vitamin D, which delivers calcium into the blood for healthy skin. Even though we absorb vitamin D through our skin, it gets activated in the liver and kidneys, then sent back to the skin.
In one study, the vitamin D levels of 40 volunteers who had chronic occurrences of canker sores were compared with 70 volunteers who didn’t have canker sores. The results showed that low levels of vitamin D, and therefore calcium, were significantly associated with increased incidence of canker sores.
See also Vitamin D Science and the Top 12 Foods You Need Now
2. B Vitamins
Stress depletes B vitamins and a deficiency of B vitamins, including B1, B2, B6, B12, and folate, has been linked to an increased recurrence of canker sores. In the same study mentioned above, 28% of the patients who had recurrent canker sores had a deficiency in at least one B vitamin. After supplementing B vitamins there was a significant improvement in one month. The best B-vitamin foods are whole grains, meat, eggs, dairy, legumes, green leafy vegetables, nuts, seeds, and fruits.
Vitamin B12 plays a unique role among the other B vitamins. It is absorbed with the exclusive help of a protein made in the stomach called the intrinsic factor. This protein is dependent on the balanced production of stomach acid. If there is a pitta imbalance in which stomach acid is either too low or too high, the intrinsic factor will not be produced in the stomach, resulting in no absorption of dietary B12.
To remedy this, B12 shots were the gold standard for decades. Recently, sublingual B12 supplements have been found to deliver B12 by bypassing the need for the intrinsic factor to absorb B12.
See also Fatigued? You Could be B12 Deficient
3. Zinc
In a study with 25 patients with a history of canker sores compared to 25 control patients without canker sores, zinc levels were evaluated. A zinc deficiency was found in 28% of the canker sore group and only 4% of the control group. The highest source of dietary zinc, an essential mineral, is found in meat, legumes, shellfish, nuts, seeds, dairy, eggs, whole grains, potatoes, green beans, kale, and dark chocolate,
See also Are Multiminerals the New Multivitamins?
4. Iron and Ferritin
Ferritin is the stored form of iron that is commonly low in patients with recurrent canker sores. It’s always important to get your ferrtin levels checked when you get a blood test because it is common for iron levels to be normal but ferritin to be depleted. In one study, 50 patients with recurrent canker sores were compared to 25 control patients who did not get canker sores. Sixty-six percent of the canker sore group was deficient in ferritin.
See also Iron Deficiency Anemia? Restore Your Ferritin Reserves
This was an amazing enlightening. I have suffered with canker sores since childhood….they are often severe. They especially occur now on the tongue when they used to be on the gums. I just healed from a very severe canker sore on my tongue making it almost impossible to eat without much discomfort. I also found it interesting about the pressure (heat) build up. I’ve been working with Cleveland Clinic Functional Medicine to try and determine why after eating some foods I have palpitations and tachycardia??? No one seems to know the answer to this. I can tell they are groping for answers. I have tons of allergies and my system tends to be acidic anyway which I’m sure contributes to these problems. I’m currently on a severe elimination diet which helps but loosing weight is a constant issue and drop pounds easily. I’m trying to maintain 110lbs but difficult. Thank you. Linda Meyer
Hello Linda Meyer,
here is a link that might interest you. Dr. Arthur Coca’s pulse test for food and environmental allergies seems to confirm your experience.
https://www.soilandhealth.org/wp-content/uploads/02/0201hyglibcat/020108.coca.pdf
Best wishes, Sibylle.
Old family remedy for canker sores: Dissolve a little alum directly on the sore. It really works. In light of what you know about these sores, why do you think this works?
Since my childhood I have been getting canker sores. Whenever I didn’t eat well or skipped a meal and my blood sugar went down, I can tell that I’ll be getting a sore in my mouth, same reason to this day. I don’t have diabetes or any other health issues.
But this article surprised me with new information.
Great article! Such an important topic. Dr Douilliard explains it so well ! Thank you so much!
A lovely talk about Pitta concerns during the summer.. Just highlights the importance of eating with the season, Thank you very much for sharing your wisdom with us. Much appreciated!