The effect of folate and cobalamin on osteoarthritic hands.
OBJECTIVE
Historically diet and arthritis have been cause/effect associated but the idea is controversial with little evidence that specific diet components are effective treatment. This controlled, double-blinded, crossover study reports the effect of folate and cobalamin supplements in 26 humans diagnosed for an average 5.7 years with idiopathic osteoarthritis of the hands who had been medicated by prescribed nonsteroidal anti-inflammatory drugs (NSAID).


METHODS
Subjects entered the study after a 10-day washout period from use of all anti-arthritis drugs, vitamins, and minerals. They were randomly allocated to consume daily 6400 micrograms folate or 6400 micrograms folate plus 20 micrograms cobalamin or lactose placebo each for 2 months within self-selected diets. Pain was to be medicated by acetaminophen as needed, and at the end of each phase they returned for assessment and dispensing of the next treatment. Serum folate and cobalamin, red blood cell folate, blood smears, diet records, standard rheumatology assessment and hand grip measurements were reviewed and statistically analyzed.


RESULTS
For all subjects mean right and left hand grip values were higher with combined cobalamin-folate ingestion than with other "vitamin" supplements and were equivalent to NSAID use. Number of tender hand joints were greater with use of NSAID than with use of cobalamin-folate. Side effects with the vitamin combination were none; side effects of NSAID are many, and the cost of vitamins and acetaminophen also is lower.


CONCLUSIONS
The limited number of subjects in this study demonstrates that ingestion of a prescribed cobalamin-folate supplement and acetaminophen as needed resulted in positive outcomes.
Department of Family and Community Medicine, University of Missouri-Columbia 65212.
M A
MA
Flynn
W
W
Irvin
G
G
Krause
D000082:Acetaminophen / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005492:Folic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D006225:Hand; D010003:Osteoarthritis / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D014805:Vitamin B 12 / Q000008:administration & dosage / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D005492:Folic Acid; D014805:Vitamin B 12