Mouth sores

I am presently taking 50mg Prednisone and 20mg Methotrexate for recent diagnosis of GCA/PMR.

Several weeks ago, I had mouth sores and thought it to be thrush. I took medication for this. Now, I have multiple sores on my tongue and inside my cheeks. I'm not so sure that it is thrush after all. I know that Methotrexate can cause mouth sores, and Prednisone can cause thrush. I had thrush years ago when I had a bad tooth infection for several months. I don't see the white plaque around these sores like I had then.

Have any of you had this problem? Any prevention suggestions? I will be talking to my rheumy this week, so can hopefully get a definite diagnosis on what is causing these sores, and how to treat them. I have tried some Vit. E capsules, but no relief so far.

Thanks for your help.

15 Replies

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  • If you are on methotrexate you should also have been given folic acid to prevent mouth ulcers which are a common side effect of mtx. If you are taking folic acid then you obviously need a higher dose.

  • I am on folic acid, so Imwill do some checking on the dosage. Thanks for ypur help.

  • Hi, I am also taking Methiotrexate 25mg once a week by injection and take folic acid one tablet once a week. Initially my mouth felt sore as if I had burnt it and I did have a couple of mouth ulcers. My G.P. was no help but did suggest seeing the dentist. He suggested Corsydl mouthwash which did seem to help it heal up. Apparently it's important to use the mouthwash at least an hour after cleaning your teeth as toothpaste can inactivate the antiseptic. I did use it 3 times a day but I'm not quite as carefull now but my mouth is fine.

    I wouldn't advocate upping your folic acid without the Rheumatologist suggesting it as it may affect the effectiveness of the Methiotrexate.

    Hopefully this may just be an initial side effect you can get over.

    Best wishes

  • Thank you lfu2,

    I will hold off on increasing the folic acid, as I take it daily per my rheumatologist. I will check out this mouth wash as well. Was it a prescription?

    I really appreciate your personal experience and your sharing this info with me.

  • Sorry, Sallyaches,

    I replied to you above, but called you the wrong name.

    Brain fog in the morning!

    Smiles.

  • Hi Joyful13,

    I also take methotrexate and steroids. Oral thrush is a frequent visitor to me. Nasal steroid spray is part of the culprit scene as well. I tried all the prescribed medication from my GP and although they worked briefly, the thrush kept reappearing. It was usually brought on by eating fruit. I then went down the 'natural' way... live natural yogurt... cow's yogurt didn't agree with me so now take goat's yogurt. It sooths my tongue quickly.

    Even when the thrush is not evident, my tongue feels as though it has been scalded lightly... not painful, more just sore and very sensitive. I have learned to live with it now and always have a large tub of goat's live yogurt in the fridge.

    Hope this helps.... good luck.

  • lfu2,

    Thanks for your helpful information. I have been eating a lot of fruit! I wonder if certain kinds of fruit are more problematic. I guess I'll have to do some trial and error, and cut down on the amount of fruit.

    I do eat cow's yogurt, but will try some goat's yogurt. Every little piece of information is so helpful in these challenges with steroids and methotrexate.

    Have you been able to reduce the dosage of prednisone by taking the methotrexate as well. This is what I am hoping in the long run.

  • The important part is 'in the long run'. I have been on steroids since 2011... began on 40mg... and methotrexate since 2012...after reductions and increases over the years in between, I am now down at 10mg steroids and 20mg metho. Is one dose dependent on the other ??? I don't know, but I am willing to accept the Rheumy's assurance that it is.

    The fruit that troubled me was plums, but to update that, any fruit that has a single stone in it that you would normally bite into gave me problems. Also melon. My favourite treat was to cut a melon into cubes and place it in the fridge. Any time I opened the fridge door I would snaffle two or three pieces.... lovely. Not any more. It is just a pleasant memory.

    If you google 'fresh fruit and oral thrush' there are lots of results.

    Good luck

  • I have been eating a lot of melon the past couple of weeks. I'll look up thrush and fruit. Thanks again for the suggestions.

  • In England you can buy Corsydl mouthwash in most large supermarkets and Boots and other Chemists. It's usually on the shelf by the toothpaste and mouthwashes. I've not tried to buy it anywhere else but it's just an antiseptic so I cann't see why it wouldbe on prescription.

  • Hi. Sometimes taking vit B complex can help heal mouth ulcers, but again check that it won't interfere with any other meds. The mouthwash is available on prescription, but can be bought in a pharmacy or some discount stores and supermarkets

  • Am not on Methorexate but had some bad mouth sores and peeling skin inside of my mouth. Took lozengers for the thrush but wondering if it was my toothpaste. Several years ago had same thing, and Dr. told me to go of Colgate toothpaste went away. Decided try six months later and same thing happened. This time was o n Proenamel, stopped that and went on Natures Gate, so far so good They were nasty white sores the size of half dollars. Just a thought, but know too much sugar, carbs and prednisone can cause thrush. Hope you find out what it is and feel better.

  • Cassey1879,

    Thanks for your input. i may be still eating too much sugar although am trying to cut back. I have a terrrible sweet tooth, and when I don't feel well, I seem to crave the sweets even more. I've tried to go to more fresh fruit, but perhaps am going to have to find a real balance in this area as well.

    Right now I'm using Desert Essence Natural tea tree oil and neem toothpaste. (No fluoride SLS free Gluten free).

  • have GCA a diagnosed 3 years ago have intermittent sores in mouth throughout this time sometimes they go and everything is fine then out of the blue they are back but I can cope with this as it is better than the fatigue and weakness and aches and pains when the illness is at its worse

  • I totally agree. I will see my rheumatologist this week and ask about the sores, but I am coping with them much better.

    Thanks for your input. So glad you are feeling much better.

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