B vitamin supplements reduce the risk of developing very high levels of homocystine in patients with celiac disease and "should be considered in disease management," a Dutch team concludes, based on a new study.

Celiac disease, which can affect children and adults, is the intolerance of wheat protein (gluten), resulting in symptoms such as frequent diarrhea and extreme weight loss.

Celiac disease raises the risk of folate and vitamin B12 deficiency, which can contribute to the development of excess levels of homocysteine, an amino acid, and its association with vascular disease, Dr. Muhammed Hadithi from VU Medical Center, Amsterdam, and colleagues explain in the World Journal of Gastroenterology.

They studied the effect of vitamin B6, folate and vitamin B12 daily supplements (with a gluten-free diet) on homocysteine levels in 51 adults with celiac disease and 50 healthy age- and sex-matched adults who severed as a control group. The average age of the celiac patients was 56 years and 40 percent were men.

Twenty-five of the patients (49 percent) used B-vitamin supplements. The daily dose of vitamin B6 was 1 to 6 milligrams; folate 100 to 400 micrograms; and vitamin B12, 0.5 to 18 mcg.

As expected, celiac patients on vitamin B supplements had significantly higher blood levels of vitamin B6, folate and vitamin B12 compared with celiac patients not on vitamin B supplements and the healthy controls.

Patients with celiac disease who were taking B vitamins also had lower total homocysteine levels (7.1 µmol/L) than patients not taking B vitamins (11.0 µmol/L) and healthy controls (9.7 µmol/L).

According to the investigators, B-vitamin supplements can normalize B6, folate and B12 status, and total homocysteine levels.

Even if the benefit of lowering homocysteine is debatable, Hadithi and colleagues conclude, long-term vitamin B deficiency should be avoided. That means routine monitoring in celiac patients, or "standard treatment with moderate-dose B vitamin supplements."