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:
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Serum vitamin B-12
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Holotranscobalamin
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Methylmalonic acid (MMA)
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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:
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Aged 18–50
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Vegan for ≥2 years (or ≥5 years total vegan)
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Apparently healthy
Exclusion Criteria:
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High-dose B-12 therapy (≥1 mg)
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Pregnancy or lactation
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Anemia or malabsorption syndromes
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Chronic medication use (except oral contraceptives)
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Gastrointestinal diseases
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Prior use of B-12–fortified toothpaste
Demographics and Study Groups
Total Recruited: 76 participants
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Placebo group: 34 participants (30 completed)
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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:
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Rigorously controlled, randomized, double-blind design
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Relevant population (vegans, who are at higher risk for B-12 deficiency)
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Multiple validated biochemical markers assessed
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High compliance and consistent methodology
Limitations:
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Self-reported supplement use could not be fully verified
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Short intervention period (12 weeks)
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Unknown absorption mechanism and amount of B-12 actually absorbed
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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.
Visual Aids
Simple Chart: Change in Vitamin B-12 Biomarkers Over 12 Weeks
Biomarker | Placebo Group | B-12 Toothpaste Group |
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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 |