Burning Mouth Syndrome (BMS) is a chronic pain condition characterized by persistent burning in the mouth. It affects mostly females, especially postmenopausal women, and conventional approaches are often not very successful. You’ll often see articles and papers with the terms ‘refractory’ and ‘unknown etiology’/unknown causes.
Medications like SRNIs and benzodiazepines
Some studies report limited success with medications like venlafaxine/Effexor, an SRNI and topical and oral use of benzodiazepines such as clonazepam/Klonopin. In this paper, Refractory burning mouth syndrome: clinical and paraclinical evaluation, comorbidities, treatment and outcome, 8 participants saw their pain diminish by half within 3 months.
Another paper, The Effect of Clonazepam Mouthwash on the Symptomatology of Burning Mouth Syndrome: An Open Pilot Study, reports success with a benzodiazepine mouthwash in half the participants.
Other than the poor quality of life and having to continue to live with pain, the bigger concern is the side-effects of medications like these, plus concerns with tolerance and then issues with withdrawal.
New oral GABA research for burning mouth
It’s for this reason that I’m excited about the recent research, γ-Aminobutyric acid (GABA) oral rinse reduces capsaicin-induced burning mouth pain sensation: An experimental quantitative sensory testing study in healthy subjects, that finds that both and men and women experienced immediate benefits when using GABA for burning mouth pain.
The burning mouth pain was caused by the application of capsaicin to the tongues of thirty healthy males and females. Capsaicin is the compound that makes chili peppers hot. (I find it interesting that capsaicin was the compound used to cause the burning mouth sensation because this same compound is used in topical creams and patches to ease pain.)
The study concludes as follows:
Capsaicin-induced burning tongue pain and decreases in WDT (warm detection) and HPT (heat pain) can be ameliorated by rinsing the mouth with lidocaine and GABA solutions.
Rinsing the mouth with an oral GABA containing solution ameliorated burning pain and increased heat sensitivity produced by application of capsaicin to the tongue. This finding suggests that GABA can act as a local analgesic agent in the oral cavity.
Lidocaine, a numbing medication, was part of the GABA solution in this study, but because it has side-effects that may include anxiety, I recommend a trial of a GABA-only solution to ease the burning mouth pain.
Using a GABA-only oral solution
Using a GABA-only oral solution makes sense given that the likely mechanism of action of topical benzodiazepines in burning mouth pain is via local action on peripheral GABAA receptors found in the nerve fibers of the tongue.
This is also very feasible based on how effective GABA is for other pain such as proctalgia fugax/rectal spasms, and the visceral pain and muscle tension in your gut caused by the bloating symptoms of SIBO (small intestinal bacterial overgrowth) and muscular back pain after a fall.
How much GABA will help?
As with any use of GABA and the other amino acids, how much will help depends on each person’s unique biochemistry and needs at the time. In the same way I do a trial of GABA with my anxiety clients to determine how much would help, I do the same with burning mouth pain (and other pain situations).
I recommend a trial of a GABA-only product and starting low with 100 to 200mg of GABA swished held in the mouth with some water for a few minutes. This can be used three or four times a day in between meals and with the mg increased slowly based on results. You can find the GABA supplements I recommend here.
GABA is an amino acid that is recognized for calming physical anxiety and tension and since anxiety (and depression) is very common in those with burning mouth pain, the GABA is going to provide calming benefits too.
As with any health condition, finding the underlying root causes using a comprehensive functional medicine approach is key. One such root cause may be low GABA and using oral GABA is going to address this one and provide some relief while other root causes are identified and addressed.
These other root causes can be very varied as explained in the paper Burning Mouth Syndrome. They can include: age-related reduction in estrogen and progesterone levels, lower cortisol, diabetes mellitus and hypothyroidism, allergic reactions to foods, additives and even metals in the mouth, autoimmune connective tissue disorders, nutritional deficiencies (B1, B2, B6, B12. folate, and/or zinc), smoking and candida, and medication side-effects as mentioned above.
Have you experienced burning mouth pain and seen relief with GABA or other nutritional approaches?
If you’re a practitioner, is burning mouth pain common in your postmenopausal clients or patients and what approaches have you found most successful? Have you found GABA to be helpful?
If you are still suffering with burning mouth please share the following when you comment:
- Your age (it seems to be more prevalent in women 59 and older)
- If you have anxiety and/or depression now and have been prone to either in the past
- How you score on the low GABA questionnaire and which symptoms you relate to? This will provide a clue that low GABA may be an issue and the oral GABA rinse is more likely to help
- How you score on the low serotonin questionnaire (same link as GABA questionnaire above) and which symptoms you relate to? SSRIs have been shown to help in some cases and we know tryptophan/5-HTP help with pain so serotonin support may help too. Perhaps a tryptophan or 5-HTP rinse is worth a trial too?
- How long it’s been an issue, what approaches you’ve tried and which approaches have helped (even if they only helped a short while or helped the pain a little)
- Current and past medications (burning mouth is caused by certain medications)
I’d love to gather a list of all this so we can help you and more women who suffer with these awful symptoms.
My 88 year old mother has been suffering with burning mouth syndrome for almost a year. We’ve tried everything. I hope and pray this works for her, I’m trying it first thing when she wakes up. I’ll let you know.
Elese
I’m sorry to hear. Please let us know how this works for her. Would you mind sharing how she scores on the low GABA questionnaire (https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution/) and which symptoms she relates to?
And what you’ve tried plus what medications she is on. I’d love to gather a list of all this so we can help more women who suffer with these awful symptoms
I’ve been suffering for over 6 years. Nothing seems to work. Have been on Endep, with little success. Hope that this new study helps me, I will be talking to my Dr shortly. I’m 66.
Glenda
I’m sorry to hear this. There is some evidence that Endep/amitriptyline may help (Pain-relieving effects of clonazepam and amitriptyline in burning mouth syndrome: a retrospective study. https://www.ncbi.nlm.nih.gov/pubmed/28473243) but I’m always in favor of nutritional approaches and finding the root cause.
When amitriptyline does help then I’d consider looking into low serotonin as one posisble root cause. When a benzo such as clonazepam helps I’d consider looking at low GABA.
Keep in mind that your doctor may or may not be open to this approach so I’d also do the low GABA questionnaire (https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution/) and share this with him too. I’d appreciate hearing how you score on the questionnaire too?
I have been dealing with what have been told as burning mouth syndrome for over 18 months. I have seen ENT, dentist, oral surgeon, acupuncture, functional medicine. Been treated for candidias with Nystatin swish/swallow 3 mons, Difflucan 3mons, antiviral medication for 2 months. I take Celexa for anxiety, adrenal repair, DHEA, Pregnenolone, T3 15mcg, bioidentical hormones. I’m told I have geographic tongue, leukoplakia, postherpatic neuralgia, I take Gabapentin for the upper palate pain. My tongue has repeating red sores that have caused cut marks on the sides of my tongue. I have kept a journal with pictures of all the repeating stages my tongue goes through.
I would like to try Gaba swish. Which Gaba product is best at what dosage, and when dissolved can it be swallowed?
I appreciate any help you could give via this site or personal contact. Barbara
Barbara
I have a link in the blog: You can find the GABA supplements I recommend here
Sharing the link again here https://www.everywomanover29.com/blog/amino-acids-pyroluria-supplements/ I have my clients do a trial with 1/2 or 1/3 of a product like Enzymatic Therapy GABA which has 205mg gamma-Aminobutyric acid (GABA). Details about purchasing via my online supplement store are at the bottom of the supplements blog. It can be swallowed.
Would you mind sharing your age and how you score on the low GABA questionnaire (https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution/) and which symptoms you relate to?
Keep in mind that Celexa, an SSRI, and other drugs such as include angiotensin-converting enzyme inhibitors [blood pressure meds], anticoagulants, antipsychotics, antiretrovirals, and benzodiazepines can cause burning mouth. Here is one paper – Antidepressant-induced Burning Mouth Syndrome: A Unique Case. https://www.ncbi.nlm.nih.gov/pubmed/25031818. It’s more common than this paper would have us believe.
I assume your functional medicine practitioner is working to find the root cause of the geographic tongue and leukoplakia, which are connected to nutritional deficiencies
Wow! Thank you so much for the reply. It arms me with more information to keep exploring a treatment and a root cause. I will take your questionnaire and review the study you shared. I am 68 years old and otherwise in good health.
I hope I can continue to update you with my progress. Thank you
I discovered by accident, when I STOPPED taking HCl [with my meals for digestion] that my burning mouth went away. I figured out my mouth was too acidic. Check your body’s pH to see if you are too acidic…maybe could have something to do with it. Just a thought…I read your comment and feel so bad for you because I know how much it hurts…hence, my comment here.
Anne – thanks for sharing! glad you found your solution
Is it something that I can purchase? If so, where? I did not see anything about purchasing it. Please let me know. Thank you.
Anne
Yes, I have a link in the blog: You can find the GABA supplements I recommend here 🙂
Sharing the link again here https://www.everywomanover29.com/blog/amino-acids-pyroluria-supplements/ I have my clients do a trial with 1/2 or 1/3 of a product like Enzymatic Therapy GABA which has 205mg gamma-Aminobutyric acid (GABA). Details about purchasing via my online supplement store are at the bottom of the supplements blog.
Would you mind sharing your age and how you score on the low GABA questionnaire (https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution/) and which symptoms you relate to?
Hi Trudy: I am truly thankful for all you write about…I am 75 as of last Fri!! I would share with you my score on the low GABA questionnaire, however, when I look at that link I see no place to answer questions…all I see are descriptions of symptoms from various low amino acids. Am I missing something to find the questionnaire? I have loved the study of free form amino acids since way back with Dirk Pearson and Sandy Shaw…kind of got away from it until I saw you come up on some functional summits I’ve been watching for a few years.
Anne
You have the correct list of symptoms.
I’m not familiar with the study of free form amino acids by Dirk Pearson and Sandy Shaw?
Hi Trudy,
Wow!! If this could be the answer to my 5 1/2 yrs of mouth pain…I would be forever in your debt. I am 53 and had believed I got leaky gut from taking several antibiotics which opened me up to a cascade of toxins and symptoms. The constant mouth and throat pain, that eventually also became stuffed sinus’, numb head, tinnitus, cognitive issues including varying degrees of anxiety and depression, have kept me from working and living life to the fullest. It’s like having Strep Throat 24/7. I do also have chronic Lyme, Strep and EBV. I was taking Compounded Porcine Thyroid med for 4 years but started on Protandim supplement and now have so much energy I went off thyroid meds over a week ago. I also take 4.5 mg of Low dose Naltrexone. Neither have done anything for my pain. I have taken GABA, L-Theanine with Relora and Tryptophan for anxiety and sleep which worked for awhile and I then went off but did nothing for the mouth pain. The only thing that has helped some is bioresonance. My practitioner will find the Strep and EBV in my white blood, nick lymph or throat on his scan and send the cancelling frequency through my body. After 4 yrs of monitoring my chronic Strep number with blood tests and it always being well above the normal range, the D-Nase number is finally into norm bc of bioresonance. Pain is a little better but nerve damage can take 6 months to heal. Yesterday I talked to a ND who said it could be Silent Reflux -and based on some old EDG’s I had, she could be right, so I want to experiment with Digestive Enzymes that she recommended. Years ago I read about BMS. Since there was no “cure” I was a bit hopeless. I did read that it can go into remission for up to a long period of time so if what I have is BMS-I am desperate for remission. It is torture living in constant pain and having to talk everyday!!!
I know you want me to take the Questionaire and using your link, it just bullet points things that can happen with various “Low …”. If that’s the Q you are speaking of, these are my answers:
-Low GABA- 6 out of 8
-Low Sero- 13 out of 21
-Low Cat- 5 out of 8
-Low Endo and BS- 1 or 2 out of 6
Hope this helps. Thanks for all you do. Your recommendations stopped the 24/7 fight and flight jitters I had for 3 yrs and grounded me back to my life. That was an amazing gift in and of itself.
Lisa
Yes you have the correct list of low GABA symptoms. I use these to decide if doing a trial is worth considering and we do a trial and observe the response. If someone has burning mouth and many low GABA symptoms it’s a clue GABA may help ease the pain or reduce it.
Low estrogen is a factor in burning mouth in menopausal women and estrogen and serotonin are closely connected so when a client has many low serotonin symptoms, a trial of tryptophan or 5-HTP (also swished in the mouth and held for a few minutes) may help too.
But as I mentioned all the other underlying causes do need to be addressed so working with a practitioner to address the Lyme and other infections is key. They can actually deplete GABA and serotonin and zinc and other nutrients.
So glad my recommendations “stopped the 24/7 fight and flight jitters I had for 3 yrs and grounded me back to my life.” – Love feedback like this!
Awesome Trudy. Thanks for the additional information!! Keep doing what you’re doing please!!
Trudy, one more question…can I swish the GABA and tryptophan around in my mouth together? What dose should I start at and how high should I go before I decide it isn’t working? Thanks again!!
Lisa
They can be used together but I like to have my clients do one at a time until we figure which one is helping and how it helps. I discuss doses and the trial in the amino acid chapter of my book “The Antianxiety Food Solution.” I really encourage everyone to read it and review the precautions before starting to use any amino acids
Hi Trudy,
My sister has been dealing with burning mouth pain for about a year. She takes gabapentin and I am wondering if GABA can be taken at the same time? Also do you recommend opening a capsule into water and swishing around the mouth or just opening it on the tongue directly. I am unclear on delivery of the supplement for the burning mouth. Thank you for your help
Kelly
When someone is on meds I always have them check with their doctor but can say I haven’t had any issues with clients using both.
GABA doesn’t mix very well in water but it can be taken as follows: 1) opening a capsule into water, mixing as best you can and swishing around the mouth, holding it for a few minutes then swallowing or 2) opening on the tongue and holding it for a few minutes and then swallowing or 3) opening a capsule and tipping the amount needed into a teaspoon, putting it in the mouth and then taking a big swig of water and swishing it around, holding it for a few minutes and then swallowing. The latter is best for burning mouth so the GABA goes everywhere in the mouth.
Thank you Trudy! I will have her give this a try.
Does the body’s pH have anything to do with burning mouth? …like being too acidic? I do get results by brushing tongue with baking soda.
Anne
Good to know!
Trudy: Dirk Pearson and Sandy Shaw wrote the book very long ago [maybe the 1970s] called Life Extension. They used to appear on Merv Griffon’s tv show.
Anne – thanks, will check it out!
Hi Trudy…Yes, Dirk Pearson and Sandy Shaw were the first ones to talk about free form amino acids and how they can help people. The book Life Extension was the go to book, and first of its kind.
Hi Trudy…Yes, Pearson and Shaw were the first ones to write the go-to book on the subject. I had a health food store and referenced it all the time. And now I’m so glad to see you come along with more on aminos and health.
My yoga teacher sent your article to me. Dry mouth for me is as painful and distracting as the BMS which is now chronic at 3 years. I too have tried everything including the meds for Shogrens. I have almost eliminated gluten, sugar and dairy and I take no medications. I feel so self centered because I am always focusing on where my gum, water or XyliMelts are. We lost our daughter 6 years ago and I believe trauma or grief contribute to autoimmune illness. I am sad for my husband because I avoid social situations as much as possible. So far, I have resisted anti depressants, which are drying and I don’t think they help everyone. I will try Gaba rinse and I thank you for addressing this terrible problem and also for your kindness.
Janice
I am sorry about the loss of your daughter. And trauma/grief can contribute to autoimmunity. With an autoimmune condition such as Sjogren’s syndrome or any other one, a 100% elimination of triggering foods such as gluten and often dairy is important. An autoimmune paleo (often called AIP) is often very beneficial too. Izabella Wentz’s book is wonderful https://www.everywomanover29.com/blog/hashimotos-protocol-izabella-wentz/ – it’s on Hashimoto’s but many of the autoimmune principles apply.
Please thank your yoga teacher and let us know if the GABA rinse helps the burning mouth and also eases any anxiety you may have and helps with carb cravings https://www.everywomanover29.com/blog/gaba-for-ending-sugar-cravings-and-anxiety-and-insomnia/. Many of my clients use this and other amino acids to quit gluten without feeling deprived.
Do also look into the other possible root cause of BMS listed in the blog as it’s often multi-faceted.
Thank you for your blog .
I am a 44 year old woman from Denmark. I have suffered for 18 months with BMS and extreme tongue pain. I link it to the reduction of Lyrica (which was prescribed for anxiety)
I am very interesed to know more about the link between GABA and tongue pain. I have been to several doctors and have had many tests done. They do want to help, but they don’t know what to do.
I am so desperate as the pain interfers with my whole life and makes me so miserable.
Katrine
I’m sorry to hear. The easiest way to know if GABA will help is to do a trial. Also consider some of the other possible root causes as listed in the blog. Please let us know how you go
I received a nerve block in my mouth for damaged gum from a bad implant and it stopped my horrid many years of suffering with burning tongue, thanks, Val
I suffered with dry mouth for 20 years, nothing helped. I don’t drink coffee or soda, non smoker, one social drink once weekly. I drink lots of filtered water, not over weight, good diet, work out, etc. I have been to many docs (hormone, ENT, dentist,etc) to figure out a remedy. No remedy!
Dr Ben Lynch, Seeking Health has a product Optimal Electrolytes that has helped me so much. Also use Propel in a single serve package that I can take with me. Propel can be purchased at Walmart, Kroger, HEB and many other stores. It taste so sweet that I only add one third of a propel package to my water during the day. Although I drink lots of water, it is apparent that I was dehydrated. I have difficulty drinking the no dye Gatorade but added some of that to my routine. I no longer use any mouth moisturizer. I hope this helps other ladies. It is amazing the instant relief I experienced. This has been over the last 4-6 weeks.
Price
Thanks for sharing your dry mouth solution. I’d look for an alternative to Propel which contains sucralose and other artificial sweeteners and flavors. Also, other than dehydration the following can cause dry mouth: thyroid issues, medication side-effects, stress, mouth breathing etc
Thank you Trudy for the follow up. I take Armour Thyroid 120 every day for 20 years.
Synthroid, etc were a disaster for me. I had benign thyroid nodules, removal of my thyroid and was told no Hashimoto which I suspect is wrong. I am sensitive to gliaden and avoid wheat, dyes, and other food items that are my triggers. I am disciplined! I use Gaba calm daily, have no other known illnesses. I don’t take other medications.. Use a mouth guard for cletching. Enjoy good health, BP 100/63. Thank you for all your info, valuable for all!
Do you swallow the rinse? Is there a certain amount that you recommend? My doctor thinks it’s acid reflux but I’ve been too scared to try the prilosec. I have been experiencing burning mouth since Feb 2018. I have pp anxiety and pp depression. No meds.
Jo
In most instances swallowing the GABA rinse is perfectly fine and if I was working with someone with anxiety I’d have them swallow it for sure as it will help with many of low GABA physical type of anxiety too. I use the trial method to figure out the dose and typically start with 100mg, increasing based on results
I’m 53 and I’ve been suffering from BMS 2 1/2 years. I’ve tried a nerve block, a gaba/lido/keta compounding rinse prescribed by my neurologist, and many mouth pain/numbing over-the -counter products. Like others, I’ve been to many doctors. I’ve had tinnitus for the past 4 years am I do suffer anxiety and depression and take Zoloft. I am desperate to find something that will take this pain away. My pain gets worse as the day goes on and by evening is really bad.
Katie
Sorry to hear about your burning mouth pain. The gaba/lido/keta compounding rinse likely contains the medication gabapentin rather than the amino acid GABA and is very different. I use a GABA-only product with my clients, opened and held in the mouth.
Keep mind that finding the root cause is key and the BMS, tinnitis, anxiety and depression may all be connected (one example is gluten issues https://www.ncbi.nlm.nih.gov/pubmed/27443108). Also, medication side-effects include BMS https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4099245/
Is there a gaba only rinse? Or should I buy the supplements and dump the powder out? Thank you for responding!
Katie
I have clients buy the supplement and open it. Here are the products I use with my clients https://www.everywomanover29.com/blog/amino-acids-pyroluria-supplements/
Hi
I’ve suffered 7 years with BMS I’m 49 years old have seen millions of doctors and trialled so many meds I can’t even remember
I’ve just started the GABA is it possible to feel worse I feel like My tongue is stinging/burning more only been 5 days. Should I push through the pain to see if this gaba will help me
Thanks sherrie
Sherrie
I would not push through worse pain/stinging. I am curious which GABA product and how much you’re using and how?
Hi Trudy
I’m working with my naturopath in Australia the label says RN LABS gaba powder. I have a picture of the bottle but not sure if I can upload
I am starting with 100mg in bit of water swishing and swallowing once a day
Thanks sherrie
Sherie
I suggest having your practitioner check for other ingredients in the product. The dose may be too high.
Hi again Trudy
I also just read on the bottle
Ultra-pure gamma amino butyric acid gaba powder
Hope this helps
Thanks again sherrie
Sorry Trudy,
not sure if this message got to you. I take 100mg in a bit of water and swish around for a minute then swallow , this is to add to the previous message