Treatment of Atrophic Glossitis When No Vitamin B12, Folic Acid, or Iron Deficiency Is Found
Atrophic glossitis (AG) in a patient where laboratory workup reveals no deficiency of vitamin B12, folic acid, or iron — that is, no definite hematinic deficiency. Standard hematinic replacement is not indicated; a distinct supplementation approach applies to this subgroup.
In a cohort of 91 AG patients, a subgroup (group V) had no identifiable hematinic deficiency — in contrast to those with isolated vitamin B12, folic acid, or iron deficiency, or combined deficiencies. Patients in this subgroup still present with the characteristic oral symptoms of AG.
Management centres on oral vitamin B-complex (vitamin BC) supplementation. The specific formulation, dosing schedule, and full component details are available in the structured protocol below — the complete regimen is not reproduced here.
- Reduction of elevated serum homocysteine to significantly lower levels
- Increase of blood haemoglobin level
- Disappearance of oral symptoms: burning sensation of the oral mucosa, dry mouth, numbness of the tongue, dysfunction of taste
- Endpoint expected over a mean treatment period of 8.3–11.6 months
References
- Moreover, our 91 AG patients can be divided into five groups: group I, patients with vitamin B12 deficiency only (n = 39); group II, patients with folic acid deficiency only (n = 10); group III patients with iron deficiency only (n = 9), group IV, patients with both vitamin B12 and iron deficiencies (n = 19); and group V, patients without definite hematinic deficiencies (n = 14).
- Furthermore, group IV patients are treated with additional intramuscular injection of vitamin B12 and oral administration of iron tablet, and group V patients are treated with vitamin BC capsules only.
- We found that our supplement treatments for groups I, II, III, IV, and V patients can reduce the high serum homocysteine levels to significantly lower levels after a mean treatment period of 8.3–11.6 months.
- In addition, our five supplement treatments can raise the mean blood Hb levels from relatively lower to significantly higher levels after a mean treatment period of 8.3–11.6 months.
- The end point of vitamins, iron or zinc supplement treatments is the disappearance of all oral symptoms including the burning sensation of oral mucosa (91 patients), dry mouth (71 patients), numbness of the tongue (51 patients), and dysfunction of taste (22 patients).