Pharmacists Can Recommend Vitamin B1 to Cure Chronic Fatigue Linked With Bowel Conditions

Vitamin B1—also identified as thiamine—could help patients regain their energy, depending on the individuals’ gut bacteria, according to new research conducted in a Danish study led by Christian Lodberg Hvas, PhD, clinical professor at Aarhus University. The findings could provide a cure for many individuals with unexplained fatigue.¹

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"We know that about half of the fatigued patients benefit from treatment with vitamin B1, but we haven't been able to find anything that distinguishes those who had an effect from those who did not. Now we know that it's especially the bacterium Faecalibacterium prausnitzii that is the key," said Lodberg Hvas in a news release.¹

Chronic fatigue is a related symptom with inflammatory bowel disease (IBD), as patients can experience overwhelming exhaustion, reduced energy levels, recurrent feelings of physical and mental weariness that significantly impacts their quality of life. Previous research has connected microbial diversity and butyrate-producing bacteria to the fatigue pathogenesis, according to study authors.²

Individuals commonly obtain vitamin B1 through diet, which is absorbed in the small intestine. However, the release provided that when an individual experiences vitamin B1 deficiency, or irregular transport to the mitochondria, it creates an energy shortage that could result in organ failure occurring in the central nervous system.²

F. prausnitzii is a bacterium that previous studies identified to have beneficial properties, specifically among individuals with a healthy gut. In the current study, the researchers assessed how the gut microbiota could influence the efficacy of a high dose of vitamin B1 in lessening chronic fatigue among individuals with IBD.^1,2

The randomized, double-blinded, placebo-controlled, crossover study included 40 individuals with IBD and chronic fatigue. The aim of the study was to assess the influence of a high dose of vitamin B1 to reveal its treatment outcomes, determined by the IBD-fatigue questionnaire section 1 score (IBD-FQ1), according to study authors.² Each individual received both vitamin B1 and a placebo in 2 periods of the 4-week study, with a break in between. Throughout the study, the researchers evaluated the individuals gut bacteria to find a connection between certain bacteria with the treatment.¹

"We thought we were looking for a 'fatigue microbiome,' a composition of gut bacteria that is particularly seen in patients with chronic fatigue. But we didn't find that. Instead, we found that the microbiome of the fatigued largely resembles the microbiome of those who are not fatigued," said Lodberg Hvas in a news release.

The results displayed that butyrate and butyrate-producing bacteria were comparable in individuals with or without fatigue and did not display changes with vitamin B1. However, FP was more significant in vitamin B1 responders compared with non-responders in pre-treatment and post-treatment. Additionally, F. prausnitzii and Roseburia hominis connected with IBD fatigue score changes, pre- and post-treatment among individuals with chronic fatigue (PRE; R=-0.48, p=0.004, and R=-0.40, p=0.018; POST; R=-0.42, p=0.012, and R=-0.40, p=0.017). However, the study authors noted that despite finding the connection between F. prausnitzii and individuals’ response to treatment, they are unaware why.^1,2

"The bacterium is largely present in people with good health and only present in low numbers in people with chronic diseases. We don't know if it's just a marker for health or if it's part of the reason why healthy people are indeed healthy," said Lodberg Hvas, in a news release. "But the more studies that point to a beneficial effect of [F. prausnitzii ], the more it suggests that the bacterium is involved as a cause of health and not just as a bystander.”¹

The results could allow pharmacists to provide knowledge and a cure for a large group of individuals with IBD that have unexplained chronic fatigue, that is free from adverse effects.

“We now recommend high-dose vitamin B1 treatment to all our patients where we don't find any obvious explanation for chronic fatigue. We know that it only works for half, but it's still a good chance, and a month's treatment is cheap," said Lodberg Hvas in a news release.¹

REFERENCES

1. Vitamin B is an effective cure for many intestinal patients with chronic fatigue. EurekAlert!. News release. September 2, 2024. Accessed September 9, 2024. https://www.eurekalert.org/news-releases/1056434.

2. Thiamine-reduced fatigue in quiescent inflammatory bowel disease is linked to Faecalibacterium prausnitzii abundance. Elsevier Inc. August 16, 2024. Accessed September 9, 2024. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.ghadvances.org/article/S2772-5723(24)00127-4/pdf.