Thiamine supplement hits mark in chronic fatigue trial

High-dose thiamine supplementation is safe and helps alleviate chronic fatigue in patients with quiescent inflammatory bowel disease (IBD), as shown in a study.

The study randomized 40 quiescent IBD patients with severe chronic fatigue to receive either high-dose oral thiamine (600–1,800 mg/d based on gender and weight) or placebo for 4 weeks. These patients were crossed over to the alternative treatment for another 4 weeks following 4 weeks of washout. Fatigue was measured using the Inflammatory Bowel Disease-Fatigue Questionnaire.

Fatigue decreased in both groups throughout the study period. The primary outcome of improvement (≥3 points) in fatigue on thiamine was met at week 12 with a mean fatigue reduction of 4.7 points (95 percent confidence interval [CI], 3.4–6.0; p<0.0001) for the combined thiamine groups.

Of note, the benefit observed in patients who initially received thiamine declined after switching to placebo. Furthermore, both groups experienced an increase in fatigue during the washout period.

In the delayed treatment model, which assumed no carryover effect, thiamine produced a mean reduction of 4.5 points (95 percent CI, 2.6–6.2) in fatigue reduction as opposed to a mean increase of 0.75 point (95 percent CI, −1.3 to 2.8 point) on placebo (p=0.0003).

Furthermore, a ≥3-point improvement in fatigue was seen in 55 percent of patients initially treated with thiamine and 75 percent of those who received placebo originally while on thiamine treatment and in 25 percent and 35 percent while on placebo, respectively. This translated to a number needed to treat of 2.9.

At week 12, 18 patients (45 percent) achieved fatigue levels comparable to that of the gender-specific background population.

Only mild side effects were documented with thiamine, including headache (n=2), nausea (n=1), pyrosis (n=1), oral blisters (n=1), and sleeplessness (n=1).