An interventional study of Natural Panmol-B-Complex and Synthetic Vitamin B-Complex in Healthy, Thiamine and Niacin Deficiency States and Pyridoxine Deficiency, sponsored by Medical University of Graz. Completed at 1 site in Austria. Open to participants aged 18 Years to 65 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-04-26.
Sponsored by Medical University of Graz · Not applicable, Interventional, and Basic science
In a cross-over study the investigators evaluate the effects of natural (Panmol-B-Complex) (Pan [Greek] = all; moles [Latin] = molecules/particles - brand name) versus synthetic vitamin B complexes to identify the bioavailability of distinct vitamins as well as long-term effects. The primary hypothesis for this study: "Natural Vitamin B-complexes are as effective as synthetic Vitamin B-complexes or better." For this reason 30 subjects (18 to 65y; BMI >19 to \<29) were recruited for this study. The study population was divided into 2 groups of each 15 subjects in a cross-over trial. Vitamin supplementation consisted of Thiamine (2.93 mg), Riboflavin (3.98 mg), Niacin (29.85 mg), Pantothenic acid (10.95 mg), Pyridoxine (3.38 mg), Biotin (0.108 mg), Folic acid (0.69 mg) and Cobalamin (8.85 µg) per day in both groups. Blood samples are taken at baseline - 1.5h after vitamin supplementation - 4h - 7h - 6 weeks - wash out phase I (2 weeks); start cross-over: baseline - 1.5h after vitamin supplementation - 4h - 7h - 6 weeks - washout phase II (6 weeks). In case of main target criteria Thiamin, Riboflavin, Pyridoxine, Folic acid and Cobalamin were measured in serum as well as total peroxides (µmol/L), peroxidase-activity (U/L), total antioxidant status (mmol/L) and polyphenols (mmol/L).
Design:
Monocentric double-blind experiment
Scientific background:
Vitamin B-complex is water-soluble and essential for humans. Vitamin B deficiency is associated with neurologic diseases, heart insufficiency, diminished hormone production and maldigestion. Due to the fact that literature search did not reveal distinct information about natural versus synthetic Vitamin B-complexes this study was initiated to investigate bioavailability and long-term effects of natural Vitamin B-complexes in comparison to synthetic Vitamin B-complexes.
Vitamin B complex was filled in hydroxypropylmethylcellulose capsules (size 0, ivory-coloured). Daily dose = 3 capsules in the morning with 250ml water.
Blinding/Randomization:
The person in charge for manufacturing and blinding arranged an identical packaging of both verum as well as synthetic Vitamin B-complex. Each package consists of 126 capsules per subject and period. Each product was tagged with the subject-number and period (period I and period II).
Study-subjects were blinded by the person in charge for randomization through a sealed envelope. The allocation was in the relation of 1:1 between group A (verum in period I and synthetic Vitamin B-complex in period II) and group B (synthetic Vitamin B-complex in period I and verum in period II). The ultimate subject list was forwarded to the person in charge for randomization after the run-in phase.
Method:
Blood sampling:
Blood (max. 20ml) was collected in a seated position from an antecubital vein.
Time schedule:
Run-in-phase: 3 weeks (no supplementation) Determination of inclusion criteria, nutrition advice, randomization.
Phase I: 6 weeks (supplementation) Group A - natural Vitamin B-complex supplementation every day Group B - synthetic Vitamin B-complex supplementation every day
Blood sampling:
First day:
Fasting value (basic) - Vitamin B-complex supplementation - After 1.5 hours After 4 hours After 7 hours
End of first supplementation:
After 6 weeks
Wash-out period: 2 weeks (without supplementation)
Phase II: 6 weeks (supplementation) Group A - synthetic Vitamin B-complex supplementation every day Group B - natural Vitamin B-complex supplementation every day
Blood sampling:
First day:
Fasting value (basic) - Vitamin B-complex supplementation - After 1.5 hours After 4 hours After 7 hours
End of second supplementation:
After 6 weeks
Wash-out period II: 6 weeks (without supplementation) Final exam - last blood sampling
Drop-out-criteria:
Drawback Compliance (\<80% of Vitamin B-complexes) Supplementation of Vitamin B-complexes during run-in-phase or wash-out periods
Primary-target parameters:
Serum concentrations for vitamins B1, B2, B6, B9 and B12
Secondary-target biomarkers:
Serum concentrations for Total antioxidants, total peroxides, peroxidase-activity, polyphenols and homocysteine.
Biometry:
Comparison of interventions in a cross-over approach descriptive and exploratory.
Group comparison: Parametric and non-parametric cross-over comparison Gaussian distribution - (Kolmogorov-Smirnov-test with Lilliefors-significances, alpha =10%).
Effect size: Two-sided 95%-confidence intervals
Analysis:
Intent-to-treat-analysis Per-protocol-analysis Full analysis set
Vitamin B and Homocysteine analysis was done in a routine laboratory. Antioxidants (TAC), peroxidase-activity (EPA), peroxides (TOC) and polyphenols (PPm) were measured by the use of commercially available microtitre assays at a wavelength of 450 vs. 620 nm. In case of PPm a wavelength of 766nm was used.
Implausible values will be scored as missing values. Missing values are not substituted.
Presentation of results:
Minimum-Median-Quartiles-Maximum-Mean-Standard deviation. Box Plots, Bar graph, tables.
Exclusion Criteria:
Participants first received a Natural Vitamin B-complex, i.e., Panmol-B-Complex - B1 (2.93 mg), B2 (3.98 mg), B3 (29.85 mg), B5 (10.95 mg), B6 (3.38 mg), B7 (0.108 mg), B9 (0.69 mg), B12 (8.85 µg) daily each morning for 6 weeks. After a wash-out period of 2 weeks, they then received a synthetic Vitamin B-complex - B1 (2.93 mg), B2 (3.98 mg), B3 (29.85 mg), B5 (10.95 mg), B6 (3.38 mg), B7 (0.108 mg), B9 (0.69 mg), B12 (8.85 µg) daily each morning for 6 weeks.The study finished after the second wash-out period for another 6 weeks.
Dietary Supplement: Natural Panmol-B-Complex
Participants first received a Synthetic Vitamin B-complex - B1 (2.93 mg), B2 (3.98 mg), B3 (29.85 mg), B5 (10.95 mg), B6 (3.38 mg), B7 (0.108 mg), B9 (0.69 mg), B12 (8.85 µg) daily each morning for 6 weeks. After a wash-out period of 2 weeks, they then received a natural Vitamin B-complex, i.e., Panmol-B-complex - B1 (2.93 mg), B2 (3.98 mg), B3 (29.85 mg), B5 (10.95 mg), B6 (3.38 mg), B7 (0.108 mg), B9 (0.69 mg), B12 (8.85 µg) daily each morning for 6 weeks.The study finished after the second wash-out period for another 6 weeks.
Dietary Supplement: Synthetic Vitamin B-Complex
Natural Panmol-B-Complex: B1 (2.93 mg), B2 (3.98 mg), B3 (29.85 mg), B5 (10.95 mg), B6 (3.38 mg), B7 (0.108 mg), B9 (0.69 mg), B12 (8.85 µg) - Synthetic Vitamin B-Complex - B1 (2.93 mg), B2 (3.98 mg), B3 (29.85 mg), B5 (10.95 mg), B6 (3.38 mg), B7 (0.108 mg), B9 (0.69 mg), B12 (8.85 µg)
Synthetic Vitamin B-Complex: B1 (2.93 mg), B2 (3.98 mg), B3 (29.85 mg), B5 (10.95 mg), B6 (3.38 mg), B7 (0.108 mg), B9 (0.69 mg), B12 (8.85µg) - Natural Panmol-B-Complex: B1 (2.93 mg), B2 (3.98 mg), B3 (29.85 mg), B5 (10.95 mg), B6 (3.38 mg), B7 (0.108 mg), B9 (0.69 mg), B12 (8.85 µg)
Serum Thiamine
Serum Thiamine in microgram per liter Minimum: 36 Maximum: 98
Time frame: 20 weeks
Serum Riboflavin
Serum Riboflavin in microgram per liter Minimum: 190 Maximum: 341
Time frame: 20 weeks
Serum Pyridoxine
Serum Pyridoxine in microgram per liter Minimum: 3.8 Maximum: 161.8
Time frame: 20 weeks
Serum Folic Acid
Serum Folic acid in nanogram per liter Minimum: 2.20 Maximum: 58.10
Time frame: 20 weeks
Serum Cobalamin
Serum Cobalamin in picogram per liter Minimum: 159 Maximum: 1230
Time frame: 20 weeks
Serum Total Peroxides
Serum Total peroxides in micromol per liter Minimum: 23 Maximum: 443
Time frame: 20 weeks
Serum Total Antioxidant Capacity
Serum total antioxidant capacity in millimole per liter Minimum: 0.31 Maximum: 2.45
Time frame: 20 weeks
Serum Endogenous Peroxidase-activity
Serum endogenous peroxidase-activity in milliunits per milliliter Minimum: 0.79 Maximum: 9.87
Time frame: 20 weeks
Serum Polyphenols
Serum Polyphenols in millimole per liter Minimum: 7.45 Maximum: 10.91
Time frame: 20 weeks
Total Homocysteine
Total Homocysteine in Micromole Minimum: 4.00 Maximum: 40.40
Time frame: 20 weeks
36 subjects were screened for eligibility at an Outpatient Clinic in Laßnitzhöhe, Styria, Austria
| Milestone | Natural Panmol-B-Complex First, Then Synthetic Vitamin B-complex | Synthetic Vitamin B-complex First, Then Natural Panmol-B-Complex |
|---|---|---|
| Started | 15 | 15 |
| Completed | 14 | 15 |
| Not completed | 1 | 0 |
| Withdrew: Adverse event | 1 | 0 |
| Milestone | Natural Panmol-B-Complex First, Then Synthetic Vitamin B-complex | Synthetic Vitamin B-complex First, Then Natural Panmol-B-Complex |
|---|---|---|
| Started | 14 | 15 |
| Completed | 14 | 15 |
| Not completed | 0 | 0 |
| Milestone | Natural Panmol-B-Complex First, Then Synthetic Vitamin B-complex | Synthetic Vitamin B-complex First, Then Natural Panmol-B-Complex |
|---|---|---|
| Started | 14 | 15 |
| Completed | 14 | 15 |
| Not completed | 0 | 0 |
Serum Thiamine in microgram per liter Minimum: 36 Maximum: 98
| "µg/L" | Panmol-B-Complex | Synthetic Vitamin B-complex |
|---|---|---|
| Baseline | 50.21 ± 8.07 | 48.33 ± 6.51 |
| 1.5 hours | 51.21 ± 8.11 | 50.60 ± 8.72 |
| 4 hours | 53.57 ± 7.45 | 51.07 ± 7.20 |
| 7 hours | 52.00 ± 7.06 | 50.27 ± 8.74 |
| 6 weeks | 61.86 ± 9.81 | 61.33 ± 9.39 |
| 8 weeks | 70.14 ± 12.04 | 72.33 ± 10.75 |
| 8 weeks - 1.5 hours | 70.21 ± 8.94 | 69.13 ± 9.77 |
| 8 weeks - 4 hours | 64.71 ± 8.91 | 65.13 ± 10.95 |
| 8 weeks - 7 hours | 64.64 ± 8.14 | 64.20 ± 7.27 |
| 14 weeks | 58.86 ± 10.50 | 61.60 ± 9.91 |
| 20 weeks | 58.43 ± 10.52 | 59.20 ± 9.70 |
Serum Riboflavin in microgram per liter Minimum: 190 Maximum: 341
| "µg/L" | Panmol-B-Complex | Synthetic Vitamin B-complex |
|---|---|---|
| Baseline | 231.93 ± 10.97 | 234.67 ± 21.87 |
| 1.5 hours | 233.86 ± 17.91 | 245.60 ± 21.88 |
| 4 hours | 240.36 ± 18.14 | 254.33 ± 27.63 |
| 7 hours | 247.21 ± 20.08 | 252.87 ± 27.03 |
| 6 weeks | 264.21 ± 17.62 | 265.00 ± 28.83 |
| 8 weeks | 232.29 ± 13.29 | 238.73 ± 14.18 |
| 8 weeks - 1.5 hours | 230.43 ± 9.72 | 233.27 ± 21.63 |
| 8 weeks - 4 hours | 237.36 ± 13.11 | 243.20 ± 15.42 |
| 8 weeks - 7 hours | 244.64 ± 8.11 | 250.13 ± 14.71 |
| 14 weeks | 258.14 ± 15.68 | 271.07 ± 20.66 |
| 20 weeks | 257.93 ± 12.75 | 274.67 ± 28.30 |
Serum Pyridoxine in microgram per liter Minimum: 3.8 Maximum: 161.8
| "µg/L" | Panmol-B-Complex | Synthetic Vitamin B-complex |
|---|---|---|
| Baseline | 23.11 ± 13.18 | 24.31 ± 25.80 |
| 1.5 hours | 35.45 ± 20.64 | 33.80 ± 29.23 |
| 4 hours | 32.96 ± 17.95 | 33.28 ± 28.81 |
| 7 hours | 36.66 ± 21.89 | 36.59 ± 25.83 |
| 6 weeks | 46.44 ± 20.10 | 48.94 ± 39.41 |
| 8 weeks | 29.23 ± 26.99 | 26.99 ± 33.38 |
| 8 weeks - 1.5 hours | 33.79 ± 20.71 | 36.93 ± 36.49 |
| 8 weeks - 4 hours | 39.14 ± 28.20 | 35.76 ± 32.58 |
| 8 weeks - 7 hours | 42.93 ± 27.35 | 40.41 ± 39.87 |
| 14 weeks | 42.24 ± 20.64 | 39.97 ± 26.30 |
| 20 weeks | 28.38 ± 26.26 | 21.39 ± 26.69 |
Serum Folic acid in nanogram per liter Minimum: 2.20 Maximum: 58.10
| "ng/L" | Panmol-B-Complex | Synthetic Vitamin B-complex |
|---|---|---|
| Baseline | 7.45 ± 3.29 | 6.00 ± 2.79 |
| 1.5 hours | 25.21 ± 10.17 | 20.75 ± 8.32 |
| 4 hours | 12.87 ± 4.67 | 10.93 ± 2.96 |
| 7 hours | 10.38 ± 3.54 | 8.23 ± 2.62 |
| 6 weeks | 13.86 ± 2.77 | 15.18 ± 4.96 |
| 8 weeks | 11.04 ± 2.80 | 10.43 ± 3.04 |
| 8 weeks - 1.5 hours | 26.63 ± 10.52 | 31.87 ± 14.51 |
| 8 weeks - 4 hours | 16.39 ± 6.82 | 14.43 ± 2.29 |
| 8 weeks - 7 hours | 12.63 ± 2.48 | 12.19 ± 2.10 |
| 14 weeks | 18.59 ± 11.64 | 18.70 ± 14.42 |
| 20 weeks | 10.46 ± 2.33 | 9.93 ± 3.36 |
Serum Cobalamin in picogram per liter Minimum: 159 Maximum: 1230
| "pg/L" | Panmol-B-Complex | Synthetic Vitamin B-complex |
|---|---|---|
| Baseline | 381.71 ± 112.73 | 440.47 ± 246.82 |
| 1.5 hours | 387.79 ± 122.48 | 453.67 ± 235.70 |
| 4 hours | 384.50 ± 105.92 | 447.00 ± 210.03 |
| 7 hours | 388.57 ± 116.72 | 442.27 ± 213.16 |
| 6 weeks | 442.36 ± 142.74 | 506.47 ± 166.44 |
| 8 weeks | 414.79 ± 125.67 | 450.33 ± 143.61 |
| 8 weeks - 1.5 hours | 414.57 ± 132.69 | 454.07 ± 141.05 |
| 8 weeks - 4 hours | 389.21 ± 115.06 | 432.07 ± 131.89 |
| 8 weeks - 7 hours | 404.93 ± 111.60 | 453.13 ± 129.37 |
| 14 weeks | 483.57 ± 139.02 | 564.27 ± 170.41 |
| 20 weeks | 421.07 ± 134.95 | 494.80 ± 176.79 |
Serum Total peroxides in micromol per liter Minimum: 23 Maximum: 443
| "µM/L" | Panmol-B-Complex | Synthetic Vitamin B-complex |
|---|---|---|
| Baseline | 100.00 ± 46.17 | 111.17 ± 96.01 |
| 1.5 hours | 101.64 ± 38.65 | 112.67 ± 88.23 |
| 4 hours | 132.55 ± 43.72 | 137.08 ± 95.05 |
| 7 hours | 122.18 ± 46.42 | 132.75 ± 108.81 |
| 6 weeks | 97.36 ± 39.69 | 99.58 ± 31.84 |
| 8 weeks | 79.27 ± 25.86 | 71.25 ± 25.69 |
| 8 weeks - 1.5 hours | 97.27 ± 22.36 | 86.92 ± 25.04 |
| 8 weeks - 4 hours | 99.91 ± 23.28 | 92.50 ± 24.99 |
| 8 weeks - 7 hours | 89.18 ± 20.04 | 90.17 ± 27.33 |
| 14 weeks | 102.91 ± 23.78 | 115.83 ± 64.46 |
| 20 weeks | 104.91 ± 39.91 | 116.33 ± 105.86 |
Serum total antioxidant capacity in millimole per liter Minimum: 0.31 Maximum: 2.45
| "mM/L" | Panmol-B-Complex | Synthetic Vitamin B-complex |
|---|---|---|
| Baseline | 1.15 ± 0.43 | 1.45 ± 0.23 |
| 1.5 hours | 1.27 ± 0.31 | 1.24 ± 0.24 |
| 4 hours | 1.13 ± 0.33 | 1.23 ± 0.34 |
| 7 hours | 1.22 ± 0.44 | 1.39 ± 0.40 |
| 6 weeks | 1.45 ± 0.38 | 1.54 ± 0.22 |
| 8 weeks | 1.20 ± 0.22 | 1.31 ± 0.29 |
| 8 weeks - 1.5 hours | 1.68 ± 0.52 | 1.86 ± 0.30 |
| 8 weeks - 4 hours | 1.14 ± 0.38 | 1.30 ± 0.34 |
| 8 weeks - 7 hours | 1.38 ± 0.32 | 1.18 ± 0.57 |
| 14 weeks | 1.46 ± 0.32 | 1.48 ± 0.33 |
| 20 weeks | 1.34 ± 0.28 | 1.47 ± 0.38 |
Serum endogenous peroxidase-activity in milliunits per milliliter Minimum: 0.79 Maximum: 9.87
| "mU/mL" | Panmol-B-Complex | Synthetic Vitamin B-complex |
|---|---|---|
| Baseline | 3.37 ± 1.74 | 3.07 ± 1.09 |
| 1.5 hours | 3.35 ± 1.49 | 3.90 ± 2.03 |
| 4 hours | 4.37 ± 1.26 | 4.22 ± 1.03 |
| 7 hours | 5.31 ± 1.13 | 4.84 ± 0.93 |
| 6 weeks | 4.36 ± 0.83 | 4.34 ± 0.55 |
| 8 weeks | 6.05 ± 1.82 | 5.15 ± 1.24 |
| 8 weeks - 1.5 hours | 3.97 ± 1.62 | 3.60 ± 1.03 |
| 8 weeks - 4 hours | 3.99 ± 1.12 | 3.93 ± 1.41 |
| 8 weeks - 7 hours | 4.35 ± 1.30 | 5.48 ± 1.74 |
| 14 weeks | 3.89 ± 1.53 | 4.95 ± 2.01 |
| 20 weeks | 3.04 ± 1.34 | 2.96 ± 1.14 |
Serum Polyphenols in millimole per liter Minimum: 7.45 Maximum: 10.91
| "mM/L" | Panmol-B-Complex | Synthetic Vitamin B-complex |
|---|---|---|
| Baseline | 9.88 ± 0.34 | 9.57 ± 0.34 |
| 1.5 hours | 9.73 ± 0.45 | 9.77 ± 0.67 |
| 4 hours | 9.97 ± 0.38 | 9.81 ± 0.45 |
| 7 hours | 9.72 ± 0.31 | 9.54 ± 0.43 |
| 6 weeks | 9.49 ± 0.35 | 9.46 ± 0.41 |
| 8 weeks | 9.73 ± 0.29 | 9.54 ± 0.53 |
| 8 weeks - 1.5 hours | 8.87 ± 0.66 | 8.71 ± 0.42 |
| 8 weeks - 4 hours | 8.25 ± 0.70 | 8.18 ± 0.70 |
| 8 weeks - 7 hours | 8.68 ± 0.35 | 8.57 ± 0.40 |
| 14 weeks | 8.72 ± 0.52 | 8.82 ± 0.44 |
| 20 weeks | 9.67 ± 0.34 | 9.46 ± 0.64 |
Total Homocysteine in Micromole Minimum: 4.00 Maximum: 40.40
| "µM" | Panmol-B-Complex | Synthetic Vitamin B-complex |
|---|---|---|
| Baseline | 8.89 ± 1.99 | 11.49 ± 7.57 |
| 1.5 hours | 8.96 ± 2.32 | 11.89 ± 8.20 |
| 4 hours | 8.68 ± 1.98 | 11.38 ± 8.01 |
| 7 hours | 8.91 ± 2.03 | 11.31 ± 7.89 |
| 6 weeks | 7.76 ± 1.43 | 7.85 ± 1.89 |
| 8 weeks | 7.89 ± 1.58 | 8.16 ± 1.58 |
| 8 weeks - 1.5 hours | 7.91 ± 1.47 | 7.97 ± 1.45 |
| 8 weeks - 4 hours | 7.34 ± 1.45 | 7.39 ± 1.31 |
| 8 weeks - 7 hours | 8.00 ± 1.70 | 8.13 ± 1.69 |
| 14 weeks | 7.01 ± 1.59 | 7.44 ± 1.55 |
| 20 weeks | 7.62 ± 2.03 | 7.95 ± 1.88 |
Collected over 6 months. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Natural Panmol-B-Complex | 0/30 (0%) | 0/30 (0%) | 1/30 (3.3%) |
| Synthetic Vitamin-B-Complex | 0/30 (0%) | 0/30 (0%) | 0/30 (0%) |
| Event | Natural Panmol-B-Complex | Synthetic Vitamin-B-Complex |
|---|---|---|
| FlushSkin and subcutaneous tissue disorders | 1/30 | 0/30 |
| Age, Categorical(Participants) | Natural Panmol-B-Complex First, Then Synthetic Vitamin B-complex | Synthetic Vitamin B-complex First, Then Natural Panmol-B-Complex | Total |
|---|---|---|---|
| <=18 years | 0 | 0 | 0 |
| Between 18 and 65 years | 14 | 15 | 29 |
| >=65 years | 0 | 0 | 0 |
| Sex: Female, Male(Participants) | Natural Panmol-B-Complex First, Then Synthetic Vitamin B-complex | Synthetic Vitamin B-complex First, Then Natural Panmol-B-Complex | Total |
|---|---|---|---|
| Female | 11 | 10 | 21 |
| Male | 3 | 5 | 8 |
| Ethnicity (NIH/OMB)(Participants) | Natural Panmol-B-Complex First, Then Synthetic Vitamin B-complex | Synthetic Vitamin B-complex First, Then Natural Panmol-B-Complex | Total |
|---|---|---|---|
| Ethnicity (NIH/OMB) — Hispanic or Latino | 0 | 0 | 0 |
| Ethnicity (NIH/OMB) — Not Hispanic or Latino | 14 | 15 | 29 |
| Ethnicity (NIH/OMB) — Unknown or Not Reported | 0 | 0 | 0 |
| Race (NIH/OMB) — Hispanic or Latino | 0 | 0 | 0 |
| Race (NIH/OMB) — Not Hispanic or Latino | 14 | 15 | 29 |
| Race (NIH/OMB) — Unknown or Not Reported | 0 | 0 | 0 |
| Region of Enrollment(Participants) | Natural Panmol-B-Complex First, Then Synthetic Vitamin B-complex | Synthetic Vitamin B-complex First, Then Natural Panmol-B-Complex | Total |
|---|---|---|---|
| Austria | 14 | 15 | 29 |
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Medical University of Graz