Plain language summary
In many cases, adults diagnosed with coeliac disease (CD) that adhere to a long-term gluten-free diet (GFD) present with vitamin deficiency and lower levels of health-related quality of life. CD patients often do not meet the recommended daily intake levels of B vitamins as they are often consumed in fortified bread and cereals. The aim of this trial was to study the biochemical and clinical effects of 6-months of B vitamin supplementation in adults with longstanding CD. The trial included 57 participants aged 45-64 with evidence of remission from CD and on a gluten-free diet for at least 8 years. Patients were randomized to a daily dose of vitamin B complex and outcome measures were psychological wellbeing and homocysteine levels, a marker of B vitamin status. The findings of this study showed that in adult with longstanding coeliac disease, B vitamin supplementation resulted in normalized homocysteine levels and a significant improvement in general wellbeing. Based on this study, the authors’ suggest that B vitamins should be considered in people advised to follow a gluten-free diet.
Abstract
BACKGROUND Patients with coeliac disease 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 coeliac disease. METHODS In a double blind placebo controlled multicentre trial, 65 coeliac 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,0.5 mg cyanocobalamin and 3 mg pyridoxine or placebo for 6 months. The outcome measures were psychological general well-being (PGWB) and the plasma total homocysteine (tHcy) level, marker of B vitamin status. RESULTS Fifty-seven patients (88%) completed the trial. The tHcy level was baseline median 11.7 micromol/L (7.4-23.0), significantly higher than in matched population controls [10.2 micromol/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 coeliac 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.
Methodological quality
Jadad score
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3
Allocation concealment
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Not applicable
