Response: Re: Effectiveness of Vitamin B₁₂ in Treating Recurrent Aphthous Stomatitis: A Randomized, Double-Blind, Placebo-Controlled Trial

To the Editor: We are satisfied to see that not only our last study, but recent research (including your own),^1,2 support the conclusions of our previous observations^3,4 as well. I have some commentaries on your remarks.

In my opinion, your adhering discs as well as sublingual tablets, injections, swallowed tablets, and intranasal sprays could be effective for many conditions (including recurrent aphthous stomatitis [RAS]) in regard to the effect of vitamin (Vit) B₁₂ itself. Undoubtedly, the time of response depends on the chosen form of cobalamin (cyanocobalamin, methylcobalamin, or hydroxycobalamin), the mode of use, and individual dosage. For example, according to my own 6 years experience you can receive an adequate response to injections of Vit B₁₂ (cyanocobalmin!) in first 2 or 3 wk. Nevertheless, some patients dislike injections and prefer tablets. The largest drawback our study was the issue of participant compliance. RAS is not a life-threatening disease, and therefore some patients even refused sublingual tablets.