Vitamin B12 toothpaste

Vitamin B-12–Fortified Toothpaste Improves Vitamin Status in Vegans: A 12-wk Randomized Placebo-Controlled Study

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
Publication Year: 2017


Study Design

This study was a 12-week double-blinded, randomized, placebo-controlled trial investigating the effects of vitamin B-12–fortified toothpaste on vitamin B-12 status in vegans.


Funding Sources

The study was partially supported by a grant from Logocos Naturkosmetik AG. The funders did not influence study design, data collection, analysis, interpretation, or manuscript preparation.


PICO Framework – what was studied and how?

Population:
Healthy vegans aged 18–50 years, following a vegan diet for at least 2 years.

Intervention:
Use of a vitamin B-12–fortified toothpaste twice daily for 12 weeks.

Comparison:
Use of an identical-appearing placebo toothpaste without vitamin B-12.

Outcomes:
Changes in blood markers of vitamin B-12 status:

  • Serum vitamin B-12

  • Holotranscobalamin

  • Methylmalonic acid (MMA)

  • Total homocysteine (tHcy)

In Paragraph Form:
This study investigated whether brushing twice daily with a vitamin B-12–fortified toothpaste could improve vitamin B-12 biomarkers in healthy vegans, comparing changes to those using a placebo toothpaste over a 12-week period.


Inclusion and Exclusion Criteria

Inclusion Criteria:

  • Aged 18–50

  • Vegan for ≥2 years (or ≥5 years total vegan)

  • Apparently healthy

Exclusion Criteria:

  • High-dose B-12 therapy (≥1 mg)

  • Pregnancy or lactation

  • Anemia or malabsorption syndromes

  • Chronic medication use (except oral contraceptives)

  • Gastrointestinal diseases

  • Prior use of B-12–fortified toothpaste


Demographics and Study Groups

Total Recruited: 76 participants

  • Placebo group: 34 participants (30 completed)

  • Vitamin B-12 group: 42 participants (36 completed)

Subjects were evenly distributed by age (mean ~29 years) and BMI (~21.6 kg/m²). About 69.7% reported some B-12 supplement use.


Primary Outcome Variable Results

Key Biomarker Changes (Adjusted for Baseline Levels):

Marker Placebo (Change) B-12 Toothpaste (Change) p-value
Serum B-12 −27 ± 64 pmol/L +81 ± 135 pmol/L <0.001
Holotranscobalamin +2 ± 17 pmol/L +26 ± 34 pmol/L <0.001
MMA −0.036 ± 0.544 µmol/L −0.169 ± 0.340 µmol/L 0.045
tHcy +2.0 ± 5.6 µmol/L −0.7 ± 4.4 µmol/L 0.043

Conclusions

The study concludes that vitamin B-12–fortified toothpaste significantly improves vitamin B-12 biomarkers in vegans. The benefits were particularly notable in those who were not taking other B-12 supplements. The oral mucosa allows sufficient B-12 absorption to correct or improve subclinical deficiency markers.


Discussion: Strengths and Limitations

Strengths:

  • Rigorously controlled, randomized, double-blind design

  • Relevant population (vegans, who are at higher risk for B-12 deficiency)

  • Multiple validated biochemical markers assessed

  • High compliance and consistent methodology

Limitations:

  • Self-reported supplement use could not be fully verified

  • Short intervention period (12 weeks)

  • Unknown absorption mechanism and amount of B-12 actually absorbed

  • No data on long-term sustainability of improved B-12 levels


Citation

Siebert A-K, et al. Vitamin B-12–fortified toothpaste improves vitamin status in vegans: a 12-wk randomized placebo-controlled study. Am J Clin Nutr. 2017;105(3):618–625. 

Link to article.


Visual Aids

Simple Chart: Change in Vitamin B-12 Biomarkers Over 12 Weeks

Biomarker Placebo Group B-12 Toothpaste Group
Serum B-12 (pmol/L) -27 ± 64 +81 ± 135
Holotranscobalamin (pmol/L) +2 ± 17 +26 ± 34
MMA (µmol/L) -0.036 ± 0.544 -0.169 ± 0.340
tHcy (µmol/L) +2.0 ± 5.6 -0.7 ± 4.4