Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten-free diet.
BACKGROUND
Patients with coeliac disease living on a gluten-free diet show vitamin deficiency and reduced subjective health status.


OBJECTIVE
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.
Hallert
C
C
Coeliac Centre, Norrköping Hospital, Norrköping, Sweden. Claes.Hallert@lio.se
Svensson
M
M
Tholstrup
J
J
Hultberg
B
B
D001007:Anxiety / Q000523:psychology; D002446:Celiac Disease / Q000097:blood / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000523:psychology; D055050:Diet, Gluten-Free; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D006304:Health Status; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011736:Pyridoxine / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D014805:Vitamin B 12 / Q000627:therapeutic use*; D014803:Vitamin B Complex / Q000627:therapeutic use*
D006710:Homocysteine; D014803:Vitamin B Complex; D005492:Folic Acid; D011736:Pyridoxine; D014805:Vitamin B 12