By Greg Arnold, DC, CSCS, March 26, 2009, abstracted from "Effect of B vitamin supplementation on plasma homocysteine levels in celiac disease" in the February 2009 issue of the World Journal of Gastroenterology

Celiac disease is an inherited autoimmune disorder that affects the digestive process of the small intestine. When a person with celiac disease consumes gluten, a protein found in wheat, rye and barley, the immune system responds by attacking the small intestine and inhibiting the absorption of important nutrients into the body. Celiac disease is estimated to affect at least 3 million Americans (1).

Because celiac disease is a disease of inflammation, one protein consistently found to be elevated in celiac patients is homocysteine (tHcy) (2, 3). So it has been suggested that one method of treatment for celiac patients may be helping maintain healthy tHcy levels. Now a new study (4) has found that supplementing with B-vitamins may help with digestive health by having a direct effect on tHcy.

In the study, 51 patients with diagnosed celiac disease according to the European Society of Pediatric Gastroenterology, Hepatology and Nutrition diagnostic criteria (5) were compared to 50 healthy patients (controls). Half of the celiac patients used vitamin supplements containing vitamin B6 (ranging from 1-6 milligrams), folate (ranging from 100-400 micrograms), and vitamin B12 (ranging from 0.5-18 micrograms) for an average of 28 months before the study began. The researchers drew blood samples from all of the patients to measure for levels of tHcy, folate, vitamin B6 and B12.

The researchers found that patients with celiac disease taking vitamin supplements had blood levels of folic acid, vitamin B6 and B12 that were 147% (29.9 vs. 12.1 nanomoles/Liter), 105% (74.0 vs. 36.0 nanomoles/Liter) and 48% (342.0 vs. 230.5 nanomoles/Liter) higher, respectively, than celiac patients not taking vitamin supplements. This resulted in tHcy levels that were 36% lower for those taking supplements than those not taking vitamin supplements.

What's more, 54% of patients not taking supplements had breakdown of the hair cells that help nutrient absorption in the intestines (called "villous atrophy") compared to 48% of those in the supplement group. Patients with villous atrophy had B6 levels that were “comparable” to those without villous atrophy, yet had higher tHcy levels.

For the researchers, "regular use of B-vitamin supplements is effective in reduction of homocysteine levels in patients with celiac disease and should be considered in disease management" and that "[if] villous atrophy persists, B-vitamin supplements can normalize B6, folate, B12 status, and tHcy levels."

Greg Arnold is a Chiropractic Physician practicing in Danville, CA. You can contact Dr. Arnold directly by emailing him at mailto:PitchingDoc@msn.com or visiting his web site at www.CompleteChiropracticHealthcare.com

Reference:
1. “Celiac Disease Facts and Figures” posted on http://www.uchicagokidshospital.org/pdf/uch_007937.pdf
2. Saibeni S, Lecchi A, Meucci G, Cattaneo M, Tagliabue L, Rondonotti E, Formenti S, De Franchis R, Vecchi M. Prevalence of hyperhomocysteinemia in adult glutensensitive enteropathy at diagnosis: role of B12, folate, and genetics. Clin Gastroenterol Hepatol 2005; 3: 574-580
3. Dickey W, Ward M, Whittle CR, Kelly MT, Pentieva K, Horigan G, Patton S, McNulty H. Homocysteine and related B-vitamin status in coeliac disease: Effects of gluten exclusion and histological recovery. Scand J Gastroenterol 2008; 43: 682-688
4. Muhammed H. Effect of B vitamin supplementation on plasma homocysteine levels in celiac disease. World J Gastroenterol 2009 February 28; 15(8): 955-960
5. Revised criteria for diagnosis of coeliac disease. Report of Working Group of European Society of Paediatric Gastroenterology and Nutrition. Arch Dis Child 1990; 65: 909-911