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Background <p>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.</p> Objective <p>To evaluate the efficacy and safety of B vitamin supplementation, primarily thiamine and vitamin B12, for reducing fatigue in adult patients with IBD.</p> Methods <p>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.</p> Results <p>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 B12 supplementation did not improve fatigue in patients with normal serum B12. No major adverse events were reported.</p> Conclusion <p>High-dose thiamine appears safe and potentially effective for reducing fatigue in IBD, even in the absence of deficiency. Vitamin B12 may be beneficial only in deficient individuals. Further high-quality trials are needed to establish long-term efficacy and personalized treatment approaches.</p>

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B vitamins as a potential nutritional approach to fatigue management in inflammatory bowel disease: a systematic review

  • 期刊论文

  • 发表日期：

    2025年9月25日

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  • Naheed Aryaeian,
  • Negin Tahvilian,
  • Azadeh Heydarian,
  • Ali Nouri,
  • Mehrnaz Morvaridi

摘要

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.

Objective

To evaluate the efficacy and safety of B vitamin supplementation, primarily thiamine and vitamin B12, 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 B12 supplementation did not improve fatigue in patients with normal serum B12. No major adverse events were reported.

Conclusion

High-dose thiamine appears safe and potentially effective for reducing fatigue in IBD, even in the absence of deficiency. Vitamin B12 may be beneficial only in deficient individuals. Further high-quality trials are needed to establish long-term efficacy and personalized treatment approaches.