Vitamin B-12–fortified toothpaste improves vitamin status in vegans: a 12-wk randomized placebo-controlled study

• Published in: The American journal of clinical nutrition Vol. 105; no. 3; pp. 618 - 625
• Main Authors: Siebert, Anne-Kathrin, Obeid, Rima, Weder, Stine, Awwad, Hussain M, Sputtek, Andreas, Geisel, Juergen, Keller, Markus
• Format: Journal Article
• Language: English
• Published: United States American Society for Clinical Nutrition, Inc 01.03.2017
• Subjects: Adult; Biomarkers - blood; blood serum; Clinical trials; Dental care; Diet; Double-Blind Method; Female; homocysteine; Homocysteine - blood; Humans; Male; methylmalonic acid; Methylmalonic Acid - blood; mouth; Mouth Mucosa - metabolism; Nutritional Status; placebos; toothpaste; Toothpastes; Transcobalamins - metabolism; vegan diet; Vegans; Vegetables; Vitamin B; Vitamin B 12 - blood; Vitamin B 12 - pharmacokinetics; Vitamin B 12 - pharmacology; Vitamin B 12 Deficiency - blood; Vitamin B 12 Deficiency - prevention & control; Vitamin B Complex - blood; Vitamin B Complex - pharmacokinetics; Vitamin B Complex - pharmacology; vitamin B12; vitamin status; Young Adult; holotranscobalamin; methylmalonic acid; supplementation; vitamin B-12; deficiency; vegans
• ISSN: 0002-9165; 1938-3207; 1938-3207
• DOI: 10.3945/ajcn.116.141978

The oral application of vitamin B-12 may prevent its deficiency if the vitamin is absorbed via the mucosal barrier. 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. In this 12-wk, double-blinded, randomized, placebo-controlled study, 76 vegans received either a placebo ( = 34) or vitamin B-12 ( = 42) toothpaste. Sixty-six subjects ( = 30 in the placebo arm; = 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. 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; < 0.001). After adjustment for baseline tHcy, postintervention concentrations of tHcy tended to be lower ( = 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. 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.