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What Is Burning Mouth Syndrome? A Functional Medicine Expert Explains

This Bizarre Symptom May Be Linked To A Vitamin D Deficiency
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At my telehealth functional medicine clinic, I regularly see cases of what people might consider "mystery illnesses." However, what seems like an "out-there" symptom may actually be an important clue to help get to the root cause of the issue. One of those lesser-known health problems I've seen time and time again is something called burning mouth syndrome. 

While this condition's cause and treatment might be elusive, functional medicine practitioners are beginning to peel back the layers of this increasingly pervasive health problem. If you have ever wondered what burning mouth syndrome is or are currently suffering from it yourself, let's take a look at what's going on.

What is burning mouth syndrome?

Burning mouth syndrome (BMS) is exactly what it sounds like: A burning sensation throughout the entire mouth, similar to the feeling of being scalded with hot water. 

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BMS can be debilitating for those who suffer from it because, unfortunately, researchers don't fully understand why it occurs in the first place and therefore aren't able to come up with any adequate treatments or specific medications to address this issue.

This insidious condition tends to appear out of nowhere and can take many forms: very little pain that gradually increases as the day goes on, pain that ebbs and flows throughout the day, or pain that lasts all day at the same level.

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BMS symptoms.

For those who struggle with burning mouth syndrome, the burning sensation is rarely isolated to just a small area of the mouth and often occurs throughout the entire mouth, including the tongue, roof of the mouth, gums, on the inside of the cheeks, and even the lips.

Symptoms can also include a loss of taste, dry mouth, increased thirst, and a constant metallic or bitter taste when eating.

Other issues associated with BMS.

Even though there is no officially recognized cause, burning mouth syndrome can be classified as primary or secondary depending on the potential trigger.

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Primary BMS

This type of burning mouth syndrome occurs when there are symptoms without any identifiable clinical abnormalities linked to this condition. However, some studies have begun to look at the relationship between primary BMS and an autoimmune-inflammatory issue with the central nervous system.

Secondary BMS

On the other hand, secondary BMS occurs when doctors can find a link between symptoms and another health problem, including:

  • Oral conditions such as fungal infections
  • Dry mouth caused by medication or other health problems
  • Ongoing mouth irritation from acidic drinks and food or harsh oral products
  • Chronic stress, trauma, and anxiety

Functional medicine practitioners also believe certain factors may increase your risk, including:

  • Autoimmune diseases
  • Neuropathy
  • Recent illness
  • Nutrient deficiencies
  • Trauma
  • Chronic stress
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A functional medicine approach.

As we believe in functional medicine, there is always an underlying cause to any health problem. In my experience, I've found this often involves an imbalance of something in the body (inflammation, nutrients, hormones, etc.).

Combining that knowledge with the known risk factors of BMS, we can begin to address this condition by working backward, uncovering possible triggers, and addressing symptoms naturally. Here are some resources I use when addressing BMS:

1. Lab work

Since we know that burning mouth syndrome is often closely associated with autoimmune inflammation and stress, we can run specific labs to see whether or not these are a factor in your case. Inflammation labs like hs-CRP and homocysteine, autoimmune-reactivity labs, and a cortisol awakening response (CAR) test can show us if your inflammation and stress levels are sky-high. (You can learn more about this in the unit I teach with mindbodygreen's functional nutrition training program.)

With cases of burning mouth syndrome I almost always run labs to assess: gut microbiome health; low-grade biotoxin chronic infections (such as Lyme disease) and other co-infections; as well as mold toxins (mycotoxins). In my experience, any one of these can shift the body into an inflammatory state, putting the immune and nervous systems into hyperdrive.

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2. Comprehensive health history

In my clinic, we always go through a comprehensive health history to better determine underlying factors that could have led to symptoms or still be triggering them and influencing lab work. Some of the things we look at are:

  • Toxin exposure: Are you exposed to chemicals at your job? What products do you use on a daily basis?
  • Past trauma: Were you under constant stress growing up? Did you experience a traumatic event?
  • Home and work environments: Do you spend time in an environment with mold or other air pollutants?
  • Past medications: Did you take any medications or were chronically prescribed antibiotics?

3. Supplements

Studies have shown strong promise for both vitamin B and zinc supplementation in reducing burning sensations in those with BMS. Since research has also seen a connection between vitamin D deficiencies and BMS, it could also be beneficial to supplement with vitamin D.

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4. Diet

On a surface level, it is best practice to avoid spicy and acidic foods that can further irritate your mouth and heighten BMS symptoms. Going a little deeper, avoiding foods that can further perpetuate inflammation is most likely going to be helpful, due to inflammation's role as a risk factor for BMS. In my practice, these include:

I also advise anyone with BMS to work with their doctor on an elimination diet to determine exactly what foods trigger inflammation in your body. If you want to learn more about how to do an elimination diet yourself, check out my book, The Inflammation Spectrum.

As for the foods to prioritize, there are a few I'd recommend. Since studies show vitamin D deficiency to be a factor and B vitamin supplementation to help, focusing on foods high in both of these vitamins could be useful:

  • Salmon (high in vitamins D and B)
  • Cod liver oil
  • Sardines
  • Dark leafy greens
  • Grass-fed beef

Additionally, focusing on anti-inflammatory foods like turmeric and foods high in zinc might help influence the pathways involved in BMS.

The takeaway.

As we continue to learn more about this health problem, the more concrete solutions we will be able to find. By looking at the body through the lens of functional medicine and how everything is interconnected, we can begin to give hope to anyone struggling with BMS and give them back the health they deserve.

William Cole, IFMCP, DNM, D.C.
William Cole, IFMCP, DNM, D.C.
Will Cole, IFMCP, DNM, D.C., is a leading functional medicine expert who consults people around the...
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William Cole, IFMCP, DNM, D.C.
William Cole, IFMCP, DNM, D.C.
Will Cole, IFMCP, DNM, D.C., is a leading functional medicine expert...
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