Abstract
- Background
Fatigue is a prevalent and disabling symptom in patients with inflammatory bowel disease (IBD), yet effective treatment options remain limited. Recent studies suggest that B vitamin supplementation, particularly high-dose thiamine, may alleviate fatigue in this population. The objective was to evaluate the efficacy and safety of B vitamin supplementation, primarily thiamine and vitamin $\text{B}_{12}$, for reducing fatigue in adult patients with IBD.
- Methods
A systematic review was conducted across PubMed, Scopus, and Web of Science through March 2025. Eligible studies included clinical trials assessing B vitamin supplementation in adults with IBD, with fatigue as an outcome. Risk of bias was assessed using the Cochrane RoB tool and structured appraisal for non-RCTs. Data were narratively synthesized due to heterogeneity.
- Results
Six studies met inclusion criteria. High-dose oral thiamine (600–1800 mg/day), adjusted for body weight and sex, significantly reduced fatigue in multiple trials, particularly in patients with quiescent IBD. A dose–response relationship was observed, with individualized dosing outperforming fixed regimens. Vitamin $\text{B}_{12}$ supplementation did not improve fatigue in patients with normal serum $\text{B}_{12}$. No major adverse events were reported.
- Conclusions
High-dose thiamine appears safe and potentially effective for reducing fatigue in IBD, even in the absence of deficiency. Vitamin $\text{B}_{12}$ may be beneficial only in deficient individuals. Further high-quality trials are needed to establish long-term efficacy and personalized treatment approaches.
https://www.researchgate.net/publication/395860788_B_vitamins_as_a_potential_nutritional_approach_to_fatigue_management_in_inflammatory_bowel_disease_a_systematic_review