Summary Background: Celiac patients living on a gluten-free diet show vitamin deficiency and reduced subjective health status.
Aim: To study the biochemical and clinical effects of B vitamin supplementation in adults with longstanding celiac disease.
Methods: In a double blind placebo controlled multicenter trial, 65 celiac patients (61% women) aged 45-64 years on a strict gluten-free diet for several years were randomized to:
• A daily dose of:
– 0.8 mg folic acid [vitamin B-9]
– 0.5 mg cyanocobalamin [vitamin B-12]
– and 3 mg pyridoxine [vitamin B-6]
• Or placebo for 6 months.
The outcome measures were psychological general well-being and the plasma total homocysteine (tHcy) level, marker of B vitamin status. [Note: Homocysteine levels are strongly influenced by diet & genetic factors. High tHcy is associated with harmful effects such as vascular damage, and B vitamins are known to help break it down in the body.]
Results: Fifty-seven patients (88%) completed the trial. The tHcy level was baseline median 11.7 mumol/L (7.4 -23.0), significantly higher than in matched population controls (10.2 mumol/L (6.7-22.6) (P<0.01).
Following vitamin supplementation:
• tHcy dropped a median of 34% (P<0.001),
• Accompanied by significant improvement in well-being (P<0.01), notably Anxiety (P<0.05) and Depressed Mood (P<0.05) for patients with poor well-being.
Conclusions: Adults with longstanding celiac disease taking extra B vitamins for 6 months showed normalized tHcy and significant improvement in general well-being, suggesting that B vitamins should be considered in people advised to follow a gluten-free diet.
Source: Alimentary Pharmacology and Therapeutics, Jan 20, 2009. [E-pub ahead of print] PMID: 19154566, Hallert C, Svensson M, Tholstrup J, Hultberg B. Coeliac Centre, Norrkoping Hospital, Norrkoping; Department of Internal Medicine, Varnamo Hospital ; Department of Internal Medicine, Eksjo Hospital, Eksjo; Department of Clinical Chemistry, Lund University Hospital, Lund, Sweden. [E-mail: Claes.Hallert@lio.se]