Can mouth sores occur due to deficiencies?

Question

Hello doctor,

My mother is 67 years old with 127 lbs and is about 5' 4" tall. She is diabetic and hypertensive and also suffered from depression about 6 to 7 years back. And now she is better. Her hemoglobin levels were low when we tested about three months back about 10.9, and the doctor started her on Orofer XT. Now it has come to 11.9.

Also, she has been given two vitamin B12 vaccinations in the past four days. She has been complaining of mouth sores on her tongue and under the tongue, which prevents her from eating anything spicy. The dentist two feels that it could be because of deficiencies. I am attaching her latest iron profile and haemogram. Please let us know if all is fine and also can you get slow healing sores due to deficiencies.

Answer 1

Hello,

Welcome to the icliniq.com.

I have read the attached reports (attachment removed to protect patient identity). The hemoglobin level, serum ferritin, HCT values, and all iron profile values are within range. So your iron deficiency anemia seems to be treated well with Orofer tablet (Ferrous Ascorbate, Folic acid). The transferrin saturation is slightly low, and peripheral smear examination report shows microcytic anemia. But as all other parameters are within range, no need for further treatment.

However, it is advisable to rule out hemoglobinopathy by HB electrophoresis by HPLC method as suggested. The mouth sore could be due to multivitamin, especially vitamin B deficiency. So your doctor has treated you correctly with Multivitamin injection. I hope I have answered your question. Let me know if I can assist you further.

Answer 2

Hello,

Welcome back to icliniq.com.

Your mother can continue with Orofer for one more month. In hemoglobinopathy, red blood cell mass is usually elevated. However, iron deficiency anemia can hinder the elevation of red blood cells. So based on the CBC report, the hemoglobinopathy cannot be ruled out. So it is better to rule out hemoglobinopathy by HB electrophoresis by HPLC method.

The HPLC is considered to be conclusive for rule out hemoglobinopathy. No need to worry also if hemoglobinopathy like any thalassemia comes in a report. Your mother's CBC (complete blood count) report is improving, so no need to worry as well. You can revert once HPLC (high-performance limited tomography) report is done. I hope I have answered your question. Let me know if I can explain more to you.