Multivitamins Reduce Fatigue, Improving Quality of Life

Multivitamin supplements reduce fatigue and improve quality of life in people with relapsing-remitting multiple sclerosis (RRMS), a new study reports.

After 70 days of continuous use, patients taking multivitamin supplements containing vitamins A, B-complex, C, and D improved their blood antioxidant status and experienced up to a 34% reduction in fatigue.

The study, “Reduction in Fatigue Symptoms Following the Administration of Nutritional Supplements in Patients with Multiple Sclerosis,” was published in the journal MDPI.

Fatigue is a subjective lack of physical and/or mental energy that interferes with a person’s usual and desired activities. It is one of the most common and disabling symptoms of multiple sclerosis (MS), affecting about 80% of patients.

Fatigue is inherently difficult to diagnose because of its subjective nature. Since it interferes with physical and mental activities, it worsens the challenges that MS already

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present and negatively affects a person’s quality of life (QoL).

Effective treatment options for fatigue in people with MS are limited, but nutrition research suggests that dietary interventions can complement pharmaceutical therapy and potentially control MS symptoms and disease progression. Previous studies have shown that people with MS have low levels of vitamins D, B12, and A, contributing to MS severity. They also have linked diets low in folate and magnesium to increased fatigue in MS.

Some vitamins, such as A and C, function as antioxidants. Antioxidants are compounds that neutralize free radicals. When free radicals build up, they cause a condition called oxidative stress, leading to damage of cells and structures, including the protective myelin sheaths that cover neurons. Myelin sheaths are extremely sensitive to oxidative stress.

Adequate antioxidant nutrient intake, therefore, is crucial to prevent oxidative stress.

While observational studies have linked dietary patterns to MS severity, few have examined the possible therapeutic effects of adding multivitamin supplements to the diets of people with MS.  Moreover, the impact of multivitamin supplements on fatigue and QoL is unclear.

An international team of researchers now sought to investigate the effect of two nutritional supplements containing several vitamins and folic acid on the antioxidant status, fatigue, and QoL in people with MS.

A total of 50 female volunteers with RRMS were recruited to the study. The mean age of the participants was 39.6 years, with a mean body mass index of 24.11 (indicative of a healthy body weight), and a mean weight of 69.04 kilograms (about 152 pounds).

Participants were assigned randomly to two groups. For 70 days, one group (25 participants) took two commercial vitamin-rich dietary supplements — Citozym and Ergozym — while the second group (25 participants) received a placebo made with distilled water, honey, and approved food pigments to have the same color as Citozym and Ergozym. Citozym contained vitamins C, B5, D, and folic acid (B9), while Ergozym contained vitamins A, B2, B3, B6, B9, B12, and biotin.

Participants’ blood samples were collected to assess the total antioxidant status after 70 days. Fatigue symptoms and QoL were quantified using two psychometric tests: Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS), after 5, 10, 20, 35, 50, 60, and 70 days of treatment.

After 70 days, the total antioxidant status levels were significantly higher in the supplemented group compared to the placebo group, as measured by antioxidant enzyme activities.

Fatigue was reduced in the supplemented group by 34% based on the FSS scale assessment and by 33% with MFIS after 70 days. Interestingly, fatigue reduction was observed as early as 10 days after treatment with supplements. No significant differences in fatigue scores were observed in the placebo group.

“This reduction indicates a clear improvement in the symptom of fatigue after 70 days of supplementation with Citozym and Ergozym,” the researchers wrote. Moreover, “the reduction in fatigue observed after 70 days of multivitamins supplement was accompanied by the reduction in [oxidative stress]…, which suggest the reactivation of the detoxification process after the administration of Citozym and Ergozym.”

Although previous studies investigating the use of single vitamins for reducing MS symptoms have produced conflicting studies, the researchers noted the data obtained indicates “a significant reduction in fatigue and an improvement in the QoL in individuals who received multivitamin supplementation. These clinical outcomes were accompanied by a significant increase in oxidant capacity and a reduction in inflammatory markers.”

Nonetheless, the team noted that “further studies including a larger cohort of patients will be needed to confirm diet’s role in this disabling symptom [fatigue] in MS.”