Surplus vitamin B12 use does not reduce fatigue in patients with Irritable Bowel Syndrome or inflammatory bowel disease: A randomized double-blind placebo-controlled trial

Scholten, Anne-Marie; Vermeulen, Esther; Dhonukshe-Rutten, R.A.M.; Verhagen, Teuni; Visscher, Angeline; Olivier, Anouk; Timmer, Lilian; Witteman, Ben J.M.

doi:10.1016/j.clnesp.2017.10.004

Cited by 12 publications

(9 citation statements)

References 26 publications

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“…Vitamin B12, cobalamin, plays a role in reducing the virulence of gut commensal bacteria 61 and has immunomodulatory properties, contributing to the immune response via natural killer cells and CD8 + T cells, 62 which may potentially benefit patients with IBS who have increased circulating T cells 63 . However, a randomized controlled trial investigating the utility of vitamin B12 supplementation revealed that it does not reduce fatigue or improve quality of life in IBS or IBD patients 64 . Lastly, vitamin D plays important roles in immune system regulation, 65 electrolyte reabsorption, 66 and maintenance of skeletal health 67 .…”

Section: Discussionmentioning

confidence: 99%

“…63 However, a randomized controlled trial investigating the utility of vitamin B12 supplementation revealed that it does not reduce fatigue or improve quality of life in IBS or IBD patients. 64 Lastly, vitamin D plays important roles in immune system regulation, 65 electrolyte reabsorption, 66 and maintenance of skeletal health. 67 Six randomized controlled trials have demonstrated that vitamin D supplementation is beneficial in IBS, whether in improving symptoms or quality of life.…”

Section: Discussionmentioning

confidence: 99%

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Association between irritable bowel syndrome and micronutrients: A systematic review

Bek

Teo

Tan

et al. 2022

J of Gastro and Hepatol

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Background and Aim Irritable bowel syndrome (IBS) is a highly prevalent disorder of gut brain interaction with a multifactorial etiology. Food trigger avoidance is common among individuals with IBS and exclusion diets are gaining popularity. However, recent guidelines on IBS management cautioned regarding the use of unsupervised dietary therapy with concerns of development of poor eating habits and even nutritional deficiencies. We aimed to review the available literature on the effect of habitual and exclusion diets on micronutrient status as well as the role of micronutrient supplementation in alleviating IBS symptoms. Methods Four electronic databases (PubMed, Embase, Cochrane, Web of Science) were searched for articles that reported micronutrient data in patients with IBS. Serum micronutrient levels and dietary intake of micronutrients in patients with IBS were collected. The extracted data were tabulated and organized by micronutrient type to observe for trends. Results Twenty‐six articles were included in this systematic review (12 interventional and 14 observational studies). Studies showed that generally IBS subjects had lower levels of vitamin B2, vitamin D, calcium, and iron at baseline compared with non‐IBS subjects. Studies also found that exclusion diets were associated with lower intake of micronutrients especially vitamin B1, B2, calcium, iron, and zinc. There was a lack of interventional studies on micronutrients. Conclusion Irritable bowel syndrome patients are at risk of developing multiple micronutrient deficiencies that may have both localized gastrointestinal as well as systemic effects. Dietary management of IBS patients should include a proper dietitian review to ensure nutritional adequacy where possible.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association between irritable bowel syndrome and micronutrients: A systematic review

Bek

Teo

Tan

et al. 2022

J of Gastro and Hepatol

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“…Other meta-analyses 107 , 111 , 112 and RCTs 106 , 108 did not indicate significant results in relieving pain, fatigue, or neurologic symptoms by supplementation with these vitamin B 12 forms. However, the authors of these meta-analyses listed some limitations that open the way for carrying out more RCTs to answer questions: a small number of available trials and high heterogeneity between included studies 107 ; a long time difference between the start of vitamin B 12 supplementation and the appearance of measurable benefits; heterogeneity in the included studies; only 1 high-quality RCT evaluated the effects on fatigue, making it impossible to estimate the meta-analysis 111 ; small variations in combined estimates in sensitivity and subgroup analysis; and a low number of studies for subgroup analyses.…”

Section: Effects Of Vitamin B 12 On Symptoms During and After Covid-19mentioning

confidence: 91%

The role of vitamin B12 in viral infections: a comprehensive review of its relationship with the muscle–gut–brain axis and implications for SARS-CoV-2 infection

Batista

Cintra

Lucena³

et al. 2022

Nutrition Reviews

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This comprehensive review establishes the role of vitamin B12 as adjunct therapy for viral infections in the treatment and persistent symptoms of COVID-19, focusing on symptoms related to the muscle–gut–brain axis. Vitamin B12 can help balance immune responses to better fight viral infections. Furthermore, data from randomized clinical trials and meta-analysis indicate that vitamin B12 in the forms of methylcobalamin and cyanocobalamin may increase serum vitamin B12 levels, and resulted in decreased serum methylmalonic acid and homocysteine concentrations, and decreased pain intensity, memory loss, and impaired concentration. Among studies, there is much variation in vitamin B12 doses, chemical forms, supplementation time, and administration routes. Larger randomized clinical trials of vitamin B12 supplementation and analysis of markers such as total vitamin B12, holotranscobalamin, total homocysteine and methylmalonic acid, total folic acid, and, if possible, polymorphisms and methylation of genes need to be conducted with people with and without COVID-19 or who have had COVID-19 to facilitate the proper vitamin B12 form to be administered in individual treatment.

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“…Fatigue perception is greater in stroke patients with a lacunar infarct and B12 deficiency relative to those without ( P = 0.01) 114 suggesting an association between B12 deficiency and fatigue. However, B12 supplementation fails to improve fatigue symptoms in patients with a lacunar infarct 115 and in both IBD and IBS outpatients 116 suggesting B12 deficiency is not an aetiological factor in quiescent IBD fatigue.…”

Section: Factors Associated With Ibd Fatiguementioning

confidence: 99%

Review article: The aetiology of fatigue in inflammatory bowel disease and potential therapeutic management strategies

McGing

Radford

Francis

et al. 2021

Aliment Pharmacol Ther

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Background: Fatigue is the inability to achieve or maintain an expected work output resulting from central or peripheral mechanisms. The prevalence of inflammatory bowel disease (IBD) fatigue can reach 86% in active disease, persisting in 50%-52% of patients with mild to inactive disease. Fatigue is the commonest reason for work absence in IBD, and patients often report fatigue burden to be greater than that of primary disease symptoms. Relatively few evidence-based treatment options exist, and the aetiology is poorly understood. Aim:To review the available data and suggest a possible aetiology of IBD fatigue and to consider the efficacy of existing management strategies and highlight potential future interventions. Methods:We reviewed fatigue-related literature in IBD using PubMed database. Results: Disease related factors such as inflammation and pharmacological treatments negatively impact skeletal muscle and brain physiology, likely contributing to fatigue symptoms. Secondary factors such as malnutrition, anaemia, sleep disturbance and psychological comorbidity are potential determinants. Immune profile, faecal microbiota composition and physical fitness differ significantly between fatigued and non-fatigued patients, suggesting these may be aetiological factors. Solution-focused therapy, high-dosage thiamine supplementation and biological therapy may reduce fatigue perception in IBD. The effect of physical activity interventions is inconclusive. Conclusions: A multimodal approach is likely required to treat IBD fatigue. Established reversible factors like anaemia, micronutrient deficiencies and active disease should initially be resolved. Psychosocial intervention shows potential efficacy in reducing fatigue perception in quiescent disease. Restoring physical deconditioning by exercise training intervention may further improve fatigue burden.| 369 MCGING et al.

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Surplus vitamin B12 use does not reduce fatigue in patients with Irritable Bowel Syndrome or inflammatory bowel disease: A randomized double-blind placebo-controlled trial

Cited by 12 publications

References 26 publications

Association between irritable bowel syndrome and micronutrients: A systematic review

Association between irritable bowel syndrome and micronutrients: A systematic review

The role of vitamin B12 in viral infections: a comprehensive review of its relationship with the muscle–gut–brain axis and implications for SARS-CoV-2 infection

Review article: The aetiology of fatigue in inflammatory bowel disease and potential therapeutic management strategies

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