B Vitamins As a Potential Nutritional Approach to Fatigue Management in Inflammatory Bowel Disease: A Systematic Review Publisher



Aryaeian N ; Tahvilian N ; Heydarian A ; Nouri A ; Morvaridi M
Source: Nutrire Published:2025

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. 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. © 2025 Elsevier B.V., All rights reserved.