title: Vitamin B-12-fortified toothpaste improves vitamin status in vegans: a 12-wk randomized placebo-controlled study.
abstract: Background:The oral application of vitamin B-12 may prevent its deficiency if the vitamin is absorbed via the mucosal barrier.Objectives:We studied the effect of the use of a vitamin B-12-fortified toothpaste on vitamin-status markers in vegans and assessed the efficiency of markers in the identification of vitamin-augmentation status.Design:In this 12-wk, double-blinded, randomized, placebo-controlled study, 76 vegans received either a placebo (n= 34) or vitamin B-12 (n= 42) toothpaste. Sixty-six subjects (n= 30 in the placebo arm;n= 36 in the vitamin B-12 arm) completed the intervention. Serum and plasma concentrations of vitamin B-12, holotranscobalamin, total homocysteine (tHcy), and methylmalonic acid (MMA) were measured before and after the intervention.Results:Both postintervention concentrations of vitamin B-12 and holotranscobalamin and their changes over 12 wk were higher in the vitamin B-12 group (mean ± SD change: 81 ± 135 pmol/L for vitamin B-12 and 26 ± 34 pmol/L for holotranscobalamin) than in the placebo group (-27 ± 64 and -5 ± 17 pmol/L, respectively) after adjustment for baseline concentrations. Postintervention concentrations of MMA and their changes differed significantly between groups (MMA changes: -0.169 ± 0.340 compared with -0.036 ± 0.544 μmol/L in vitamin B-12 and placebo groups, respectively;P< 0.001). After adjustment for baseline tHcy, postintervention concentrations of tHcy tended to be lower (P= 0.051), and the changes in tHcy (-0.7 ± 4.4 compared with 2.0 ± 5.6 μmol/L, respectively) were greater in the vitamin B-12 group than in the placebo group. Changes in vitamin B-12 markers were more prominent in vegans who reported that they had not taken vitamin B-12 supplements.Conclusion:Vitamin B-12 that is applied to the oral cavity via toothpaste enters the circulation and corrects the vitamin B-12 markers in the blood of vegans who are at higher risk of vitamin B-12 deficiency. This trial was registered at clinicaltrials.gov as NCT02679833.
authors.affiliation: Institute of Alternative and Sustainable Nutrition, Biebertal, Giessen, Germany.
authors.forename: Anne-Kathrin
authors.identifier: 0000-0001-7245-7323
authors.initials: AK
authors.lastname: Siebert
authors.affiliation: Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark.
authors.forename: Rima
authors.identifier: 0000-0002-0064-7029
authors.initials: R
authors.lastname: Obeid
authors.affiliation: Institute of Alternative and Sustainable Nutrition, Biebertal, Giessen, Germany.
authors.forename: Stine
authors.identifier: 0000-0001-5360-1940
authors.initials: S
authors.lastname: Weder
authors.affiliation: Department of Clinical Chemistry and Laboratory Medicine, Saarland University Hospital, Homburg, Saarland, Germany; and.
authors.forename: Hussain M
authors.initials: HM
authors.lastname: Awwad
authors.affiliation: Center for Laboratory Medicine and Microbiology, Essen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Sputtek
authors.affiliation: Department of Clinical Chemistry and Laboratory Medicine, Saarland University Hospital, Homburg, Saarland, Germany; and.
authors.forename: Juergen
authors.initials: J
authors.lastname: Geisel
authors.affiliation: Institute of Alternative and Sustainable Nutrition, Biebertal, Giessen, Germany; markus.keller@ifane.org.
authors.forename: Markus
authors.identifier: 0000-0001-5789-6280
authors.initials: M
authors.lastname: Keller
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008764:Methylmalonic Acid / Q000097:blood; D009061:Mouth Mucosa / Q000378:metabolism*; D009752:Nutritional Status; D014100:Toothpastes; D014155:Transcobalamins / Q000378:metabolism; D000066989:Vegans; D014805:Vitamin B 12 / Q000097:blood / Q000493:pharmacokinetics / Q000494:pharmacology*; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000517:prevention & control*; D014803:Vitamin B Complex / Q000097:blood / Q000493:pharmacokinetics / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014100:Toothpastes; D014155:Transcobalamins; D006710:Homocysteine; D014803:Vitamin B Complex; D008764:Methylmalonic Acid; D014805:Vitamin B 12
keywords: deficiency; holotranscobalamin; methylmalonic acid; supplementation; vegans; vitamin B-12