Vitamin B12-fortified toothpaste improves vitamin status in elderly people: a randomized, double-blind, placebo-controlled study

  • Ayman Zant
  • Hussain M. Awwad
  • Jürgen Geisel
  • Markus Keller
  • Rima ObeidEmail author
Original Article



Elderly people are at risk for vitamin B12 deficiency.


We studied the ability of vitamin B12-enriched toothpaste vs. placebo to increase vitamin B12 status in elderly subjects.


We conducted a randomized double-blind placebo-controlled intervention in 103 elderly subjects. Serum concentrations of vitamin B12, holotranscobalamin (holoTC), methylmalonic acid (MMA), and plasma total homocysteine (tHcy) were measured at baseline and after 3 months.


92 subjects met the inclusion criteria, completed the 3 months study, and were included in the data analysis. After the intervention, concentrations of vitamin B12 were higher [mean (SD) = 368 (123) vs. 295 (123) pmol/L; p = 0.005] and holoTC tended to be higher [112 (48) vs. 91 (68) pmol/L; p = 0.088] in the vitamin B12 group compared with the placebo group. The changes of serum vitamin B12 [54 (74) vs. 3 (60) pmol/L, p < 0.001], holoTC [21 (34) vs. 2 (32) pmol/L, p = 0.007], and tHcy [− 0.9 (2.3) vs. 0.3 (1.9) µmol/L, p = 0.010] were significantly different between the intervention groups. Mean percentage increase of serum vitamin B12 (+ 23% corresponds to + 54 pmol/L) in the vitamin B12 toothpaste group suggests that the intervention had provided an additional daily intake of approximately + 7 µg oral B12. Common diseases and drugs did not predict the change of blood markers in the vitamin group. No side effects were observed.


The toothpaste enriched with 100 µg cyanocobalamin/g has increased vitamin B12 status and can thus be used for preventing vitamin B12 depletion in elderly people. The trial was registered at NCT02679833.


Vitamin B12 deficiency Elderly Holotranscobalamin Supplementation 





Methylmalonic acid


Total homocysteine



The study was partly funded by Logocos Naturkosmetik AG (Salzhemmendorf, Germany). The funder had no role in planning the study, data acquisition, analyses or interpretation, and writing or approval of the article.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

The study was conducted in accordance with the ethical principles stated in the Declaration of Helsinki. The study protocol was reviewed and approved by the Ethics Committee of the Saarland Region (Approval Number: 244/14).

Statement of human and animal rights

All procedures were approved by the review board of the Saarland Medical Committee.

Informed consent

All participants provided written informed consent to the study.

Supplementary material

40520_2019_1125_MOESM1_ESM.docx (27 kb)
Supplementary material 1 (DOCX 26 KB)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ayman Zant
    • 1
  • Hussain M. Awwad
    • 1
  • Jürgen Geisel
    • 1
  • Markus Keller
    • 2
    • 3
  • Rima Obeid
    • 1
    • 4
    Email author
  1. 1.Department of Clinical Chemistry and Laboratory MedicineSaarland University HospitalHomburgGermany
  2. 2.Fachhochschule des MittelstandsUniversity of Applied SciencesCologneGermany
  3. 3.Institute of Alternative and Sustainable NutritionBiebertalGermany
  4. 4.Aarhus Institute of Advanced StudiesAarhus UniversityAarhus CDenmark

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