My grown son takes 2,500mg tablets of lysine daily, and it keeps him from getting canker sores. His eight-year-old son also has canker sores, but the pediatrician advised against using lysine to control them. He said it is not for children. Is this so? If not, and my grandson can take lysine, how much daily?

A.

First it is important to establish whether your son and grandson have canker sores or cold sores, since cold sores are the ones that lysine is used to treat. Canker sores, also known as recurrent apthous stomatitis, are recurrent painful ulcers that occur on the mucous membranes of the inside of the mouth. While the cause is not well established, they appear to be a type of local allergic reaction, and are associated with deficiencies of iron, folic acid and vitamin B12. Cold sores or oral herpes, begin as blisters in the mouth and on the lips which rupture and form ulcers in the mouth and crusted lesions on the lips. They are also recurrent and are caused by the herpes simplex virus. Your son's doctor can diagnose which one they have.

Evidence from studies indicates that canker sores can be an allergic reaction to foods (especially the gluten in grains) and common preservatives like benzoic acid, sorbic acid and methylparaben. Elimination of the offending foods and preservatives will give complete resolution or at least significant improvement. Since canker sores are associated with nutrient deficiencies, supplementation of all the B vitamins and iron (if it is low) has been shown to help. The use of liquid or chewable deglycyrrhizinated licorice three to four times a day in one study resulted in improvement in 75% of patients.

The herpes simplex virus that causes cold sores requires high levels of the amino acid arginine and low levels of the amino acid lysine in order to reproduce. Taking lysine will help to inhibit replication of the virus. While the use of a lysine supplement is effective, increasing lysine and decreasing arginine in the diet is also effective. I am not aware of any contraindication to using lysine supplements in children, but to be on the safe side, your grandson can use dietary changes to get the same results with cold sores. Foods that are high in arginine are chocolate, peanuts, nuts and seeds and should be avoided completely. Foods high in lysine are fish, turkey, chicken, beans and most vegetables and should be eaten liberally. Again, supplementation of certain nutrients has been shown to be helpful for cold sores. Zinc, vitamin C and bioflavonoids are particularly effective. Doses for an 8 year old are 10 mg of zinc once a day and 100 mg each of vitamin C and bioflavonoids three times a day. A topical application of lemon balm (Melissa officinalis) cream several times a day will heal the cold sores faster and help to prevent their recurrence.

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