Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Vitamin B supplementation, particularly B-complex vitamins, is scientifically justified in the management of cirrhosis of the liver. Cirrhosis often leads to malnutrition and deficiencies in several micronutrients, including B vitamins (such as thiamine, riboflavin, niacin, B6, folate, and B12). This is due to impaired liver metabolism, decreased dietary intake, malabsorption, and increased urinary losses. Multiple clinical studies and guidelines recommend the assessment and correction of B vitamin deficiencies in patients with chronic liver disease, as these deficiencies can contribute to symptoms like fatigue, neuropathy, and cognitive dysfunction.

Thiamine (vitamin B1) supplementation is particularly important in patients with a history of alcohol use, as alcohol both damages the liver and increases the risk for thiamine deficiency, which can lead to Wernicke’s encephalopathy and other neurological complications. Folate and vitamin B12 deficiencies are also common and can contribute to anemia and neurological impairment. Randomized and observational studies have found that correcting B vitamin deficiencies improves clinical outcomes and quality of life in cirrhosis patients.

While B vitamins do not treat the underlying cause of cirrhosis or reverse liver damage, their supplementation is a well-established component of supportive care to prevent and address complications arising from deficiencies. Guidelines from hepatology societies endorse the use of B-complex vitamins in patients with cirrhosis who are at risk for, or have, confirmed deficiencies.

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