Taking a supplement with both folic acid and vitamin B12 lowers homocysteine levels more dramatically than taking folic acid alone, according to a report in the American Journal of Clinical Nutrition.
Homocysteine is an amino acid that has been associated with a greater risk of heart disease. Previous studies have indicated that folic acid can lower homocysteine levels.
Although it has not been proven that lowering homocysteine level can prevent heart problems, the American Heart Association issued an advisory this week suggesting that those with a history of heart disease make sure that they consume the recommended daily allowance (RDA) of vitamin B6, vitamin B12, and folic acid.
And because adequate folic acid intake during pregnancy can reduce the risk of certain birth defects, namely neural tube defects, the US Food and Drug Administration ruled that all grain and grain products should be fortified with folic acid as of January 1, 1998.
In the new study of 150 women, homocysteine levels dropped by 11% in those taking 400 micrograms (mcg) of folic acid alone, 15% in those taking folic acid and 6 mcg of vitamin B12, and 18% in those taking folic acid and 400 mcg of B12.
"These results suggest that the addition of vitamin B12 to folic acid supplements or enriched foods maximizes the reduction of homocysteine and may thus increase the benefits of the proposed measures in the prevention of vascular disease and neural tube defects,'' concluded Klaus Pietrzik and colleagues at the Institute of Nutritional Science at the University of Bonn in Germany.
Folic acid is important for normal development of the brain and
the
nervous system. Pregnant women are advised to take supplements of
folic
acid in order to prevent problems with the developing brain in the
fetus.
According to this study, this nutrient may be important for the
brains of
the adults as well.
Thirty nuns have participated in the long-term study of
Alzheimer's
disease. At the time of their death, about half had brain changes
characteristic of this condition and they also had much lower
levels of
folic acid than the nuns without Alzheimer's disease. The
researchers have
found no correlation between Alzheimer's and any other nutrients
measured
in blood samples.
It does not mean that folic acid supplements will definitely
prevent
Alzheimer's disease and additional research into this matter will
be
helpful. But since folic acid is important for the immune system,
formation of blood cells, prevention of heart disease and many
other
normal functions, it is a good idea to take at least 400 mcg of
this
nutrient daily, especially if you are pregnant.
American Journal of Clinical Nutrition 2000;71:993-998.
Folic
Acid - a key player in any good nutritional program.
Folic Acid
(also known as Folate or Folacin), is a member of the B-Complex family,
and was given its name because it is found in foliage such as dark green
leafy vegetables.Other natural sources of folic acid are apricots, avocados,
carrots, egg yolks, liver, melons, whole grains, and yeasts. Only discovered
in 1945, folic is used by the body to synthesize and break down amino
acids, and to synthesize DNA/RNA-like nucleic acids, which are needed
to build new cells, especially new blood cells. Ideally, our food is our
best source of folate, but food alone may not be meeting your bodies need
for this most important of nutrients.
Folic Acid
has been made rather a fuss of lately, and for more than just one good
reason! Folate has proven to be of significant benefit in preventing the
extremely serious, yet very common birth defect known as neural tubes.
The two major forms of neural tube defects are Spina Bifida (deformed
spine), and Anencephaly (where large portions of the baby's brain is missing).
It is now known that the easiest way to prevent such birth defects (by
75%) is for a women to begin taking a supplement of folic acid at least
3 months prior to becoming pregnant, and continuing it throughout the
pregnancy.
It is also
known that deficiencies of folic acid during pregnancy can add to pregnancy
complications such as spontaneous abortion, low birth weight, and premature
rupture of the membranes. Some complimentary doctors recommend women continue
supplementing well after delivery, as folic acid has been shown to be
beneficial during the breast-feeding phase, and in helping to relieve
post-natal depression. Some complimentary doctors recommend 20mg a day
for post-natal depression, and boast impressive results. Many in the health
industry (including many conventional doctors), believe the supplement
recommendation of 500mcg a day as a preventative for neural tubes, is
way too low, and that 5mg (milligrams, not micrograms) is perfectly safe
for pregnant women, and a is lot closer to what is optimally desirable
levels for prevention of birth defects.
Another reason
folic acid has risen to fame is because it is one of the key players of
"The Mighty B-Trio" which is now considered so valuable for at least one of the four major risk factors implicated
in heart disease (see below). Thanks to some very progressive research
undertaken during the latter part of this last century, we now know just
what an important nutrient folic acid is, and how less than optimum amounts
can be implicated in many health conditions, which have grave consequences
for our short and long-term health.
We also know
that few of us are getting optimal amounts of folic acid from our diet.
Unfortunately almost no one eats the kind of balanced plant-rich diet
required to meet minimal levels of this vital nutrient, even if we were
to believe the 500mcg RDA minimal level is anywhere near enough.
If we
were attempting to eat such a diet, unless all the food was grown in near
perfect conditions, i.e. Freshly picked from organic nutrient-rich soil,
completely free of inorganic fertilizers, pesticides, and other chemical
contaminants, it is still unlikely we would be getting enough folate.
As a result
of our faulty diet, and lack of awareness regarding optimal folate levels,
many of us are suffering significant folate deficiencies. For this reason
P.R.O.G.R.E.S.S proposes that a more sensible amount of folic - 1000mcg
(1mg) - should be readily available at both health shops and pharmacies.
Recent research
in the US uncovered the startling fact that as much as 93% of the American
population is deficient in folic acid.
Women's Health
Cancer:
On its own, folic acid can reverse cervical dysplasia, the abnormal cellular changes that cause a positive Pap smear, and portends the development
of cervical cancer. One study found that when 10mg was taken daily, the pre-cancerous cells were completely eliminated within just two months,
averting the need for invasive surgical procedures.
Some complimentary
doctors believe larger doses (30-60mg) are just as safe, and are even
more effective for this purpose, especially when taken with vitamin C,
vitamin B12 and vitamin A. However, please be aware that birth control
pills drain the body of folic acid, and should not be taken while being
treated nutritionally for cervical dysplasia.
Hormones:
When used with the mineral boron, large doses of folic acid can help reduce
many symptoms of menopause. Some complimentary doctors prescribe as much
as 40-60mg a day for women who cannot tolerate artificial estrogen replacement,
because in these amounts, folic acid and boron
have an estrogen-like effect on balancing hormones. In large amounts,
it is also possible to delay menopause, revive a depressed libido, and
restore menstrual regularity, and slow down the bone-loss that leads to
osteoporosis. Complimentary doctors have also found that teenage girls
who are 'late starters', or are having period difficulties, can be brought
back on track and made regular again by these nutrients.
Smoker's Health Those who smoke are
more at risk for cancers or the throat, and lung, and people who develop
these types of cancers are often found to be low in folic acid. However
there is some encouraging news for smokers. One year long study showed that
taking a course of 10-20mg of folic acid a day, along with 750mcg of vitamin
B12, reversed the pre-cancerous dysplasia in smokers lungs.
Intestinal
Disorders and cancer of the colon. Cells in the digestive tract
require ample amounts of folic acid to replicate and heal. Some medications
which are used to treat disorders such as Crohn's Disease, Ulcerated Colitis,
and other painful inflammatory bowls disorders, actually strip the body
of the folic acid so necessary for healing. These drugs can also impede
absorption of folate from food sources, which only makes the condition worse.
Some complimentary doctors have successfully tamed these conditions in their
patients, by recommending a drug-free approach and instead using mega-folic
therapy in amounts of 40-60mg a day, and adding other nutrients such as
pantethine - a type of B5. Essential Fatty Acids, and restricting sugar
from the diet. At very least, it is suggested that anyone with this type
of medical condition should seriously consider taking 5-10 mg of folic acid
each day, possibly more if they are also on prescribed medication.
One study found
that taking large amounts of folic acid and B12 reversed pre-cancerous
conditions of the colon in study participants. Folic supplements
also halved the percentage of people in whom colitis leads to cancer.
Brain Disorders In a healthy person,
the cerebrospinal fluid of the brain and central nervous system should contain
a strong concentration of folic acid, because the nutrient is essential
for normal brain function. Due to long-term faulty diet, and the result
of the natural process of aging, the brain's folic acid levels can fall
well below the 'normal' healthy range, resulting in dulled mental processing,
'fuzzy thinking' and contributing to the symptoms of Dementia. Low levels
of folic acid have been found in people suffering Alzheimer's, depression,
mania schizophrenia and even epilepsy!
Depression
Many chemicals are responsible for the smooth functioning of a healthy human
brain, and as mentioned above, folic acid is one of them. What may be optimal
levels of folate for one person may not be enough for another. Those with
depression for instance, may not be operating with optimal levels for them,
and may benefit from or require supplemental folate. It is known that those
with low folate levels do not respond well to some antidepressant drugs,
yet one study has reported that when higher folate levels are achieved through
supplementation, mental disposition can improve as markedly as it does with
drugs developed for this purpose. Which would you rather take?
Peripheral
Neuropathy This condition is indicated by a tingling pain and numbness
in the legs and arms. For those afflicted, this condition can be maddening,
and it can also be the result of lower than 'normal' levels of folic acid.
Some complimentary doctors administer intramuscular Folic Acid to their patients
to treat this disorder, but supplementing with folic acid would likely be
beneficial too.
Skin
disorders Folic acid deficiencies are commonly found in people
with skin conditions such as psoriasis, vitiligo (white patches of unpigmented
skin), and acne conditions. When used with B12, folic acid can markedly
reduce and improve these conditions.
Pain
control and other. Published research shows that folic acid taken
at a 6.4mg dose, along with some vitamin B12, is just as effective for pain
control of arthritis, as NSAIDs (nonsteroidal anti-inflammatory drugs).
Folic acid has also been beneficial for those suffering restless leg syndrome,
chronic fatigue, HIV infection, and as an effective mouthwash for periodontal
disease. Those who suffer lethargy, and insomnia may benefit from taking
folate supplements.
Heart
Disease and homocysteine:
Cholesterol is
no longer public enemy number one, as it has now been established that
there are a handful of other significant markers for cardiovascular disease,
coronary heart disease, heart disease, some of which are quite independent
of cholesterol. Risks such as high levels of homecysteine - an amino acid,
high levels of triglycerides - blood fats associated with blood sugar
disorders, and elevated lipoproteins - a sticky by-product of LDL "bad"
cholesterol). Harvard researcher Meir Stampfer M.D., Dr. P.H. has noted
that most heart attack patients do not have elevated cholesterol, and
acknowledges that high levels of homocysteine may play a greater role
than cholesterol in the incidence of atherosclerosis and heart attacks.
Until a few years
ago, nobody had ever heard of homocysteine, an amino acid whose elevated
level in the blood, has been found to corresponds to greater rates of
heart attack and stroke. These days we are learning that a certain amount
of cholesterol is needed in our diet, and low fat diets may not be as
good for us as we once thought. At the same time, more and evidence about
the danger of high homocysteine levels (not just for heart disease), is
being gathered. So while high cholesterol alone, may not be the complete
rogue it was once believed to be, many medical experts now believe high
homocysteine endangers our health, and is therefore set to take cholesterols
place as our newest harbinger of sudden heart attack and heart disease.
Don't panic though,
as research has also shown that high blood levels of homocysteine can
be effectively lowered to safe levels, simply by taking 5mg of folic acid,
(along with amounts of vitamins B12 and B6) each day. This information
could save many lives, if enough of us learn about it! When so many of
us have high homocysteine levels which can lead to heart disease and other
health disorders, why aren't our health authorities pounding this information
at us as you might expect? Why aren't our doctors suggesting "The Mighty
B-Trio" to all of us? Surely this advice would seem logical, at a time
when our hospital waiting lists are choked with people waiting for heart
surgery? Yet this is not happening, and although this is only our opinion,
two reasons immediately spring to mind, which may account for this.
1. The medical
dogma (not science) that infers nutrients are useless for correcting
health problems, other than obvious deficiency conditions (scurvy etc),
coupled with that professions "drugs only" mindset on health matters.
Also the misbelief that a "good diet" will supply all the nutrients
we need.
2. Because our
governmental health authorities take much of their lead from the US
Food and Drug Administration, which despite unbelievable evidence attesting
to its safety and efficacy, will not change their RDA recommendations
for folate. They know that when taken in larger amounts it is quite
safe, yet they have stubbornly refused to budge on the decision they
made for folic acid some 50 years ago - recommendations, which may have
been O.K. back then. 50 years ago, it may have been possible to "get
all we need from our food", but now we know better - we know that in
addition to pregnant women, many thousands of people could regain their
health if they took folic acid supplements in amounts higher than 500mcg!
Safety:
Folic acid is very safe, possibly one of the safest nutrients in fact. There
is a slight possibility that taking folic acid long term may mask the symptoms
of pernicious anaemia (B12 deficiency), however, this can easily be avoided
by taking a B12 supplement along with folic acid, and this is why you so
often find these two supplements mentioned together.
To
Sum up: Folic Acid combats so many health problems so successfully,
because optimum amounts are so frequently absent from our bodies. Complimentary
doctors, natural therapists, and Ortho molecular Nutritionists, and some
research scientists are all tell us that the RDA (500mcg) for Folic Acid
is a joke, and that almost everybody would benefit from supplementing with
between 1-5mg a day because this nutrient is so deficient in our diets.
Even with a good diet, it is unlikely you are getting enough to combat existing
medical conditions, or prevent others. Because B12 and B6 are so beneficial
too, (especially for lowering high homocysteine levels) if you are concerned
about your heart health, you may want to consider taking the whole mighty
trio.
Please
Note: Individual B-Group vitamins can be effective for preventing
and treating many medical conditions, but B vitamins all work together in
our body, so to avoid imbalances, it is also advisable to take a 50mg strength
B-Complex tablet in addition to individual B's, and "The Mighty B-Trio".
Taking B vitamins in the evening may give you a burst of energy, so unless
you want to go out and party all night, (or do other things that require
a lot of energy), they are best taken in the morning with or after food.
If you have never used B vitamins before, be warned that your urine may
take on a fairly strong odour, along with a delicate shade of green for
at least your next few visits to the toilet…this is quite normal!
Vitamin
B12 - cobalamin
A vitamin B12 deficiency
is never very far away, in fact amongst the elderly B12 deficiencies are
fairly common - about 40%. This is usually due to a lack of B12 in the
diet, absorption problems involving 'intrinsic factor', or inadequate
stomach acid production. Severe deficiencies of B12 can cause pernicious
anaemia, which can results in severe and permanent nerve damage.
B12 deficiencies
have been implicated in the development of Alzheimer's disease, and various
other neuropsychiatric disorders, however, supplementation with 1mg (1000mcg)
a day oral (sublingual) B12 will prevent deficiencies and is considered
entirely safe. Another recent study shows that a lack of B12 and folic
acid plays a role in hearing loss in the elderly.
As mentioned in
folic acid (above), high homocysteine levels have been shown to increase
the risk of vascular disease, coronary heart disease, and neural tube
birth defects, and it has been shown that supplementing with B12, folic
acid and B6 can safely and effectively lower homocysteine to normal levels
within a relatively short period of time. Folic acid's homocysteine lowering
capacity can be markedly increased though, when it is taken with a supplement
of B12, and contrary to old wisdom, new research has shown that B12 taken
orally is well absorbed by most people.
Those most at risk
of a B12 deficiency are those on an inadequate diet, smokers, anyone with
long-term chronic diarrhea, people with AIDS, and pregnant women. Vegetarians
or anyone on "low meat" diets are at high risk because B12 is only available
in animal foods, although some is made in our stomach from beneficial
bacteria. Those on anti-ulcer drugs are also at risk of deficiency because
these drugs interfere with 'intrinsic factor' and absorption. These problems
can generally be overcome by taking large doses (1000mcg or more) of B12
each day, although injections may prove beneficial those with seriously
impaired absorption.
The following
are conditions, which can improve when B12 levels are made optimal - Heart
disease, multiple sclerosis, sleep disorders, asthma and allergy conditions,
nerve pain, low blood pressure, viral infections, hearing disorders, infertility,
and cancer.
To sum up: Most
of us could probably do with more B12, though blood tests to ascertain your
levels are not always accurate. According to one complimentary doctor, Robert
C Atkins M.D. it is better to ask your doctor to test your levels
of methylmalonic acid - a nerve-damaging toxic compound responsible for many
misdiagnosed cases of Alzheimer's disease. Higher methylmalonic acid readings
mean the body isn't absorbing or receiving enough B12. When normal levels
of B12 are reached, methylmalonic levels will have declined again. Most people
would probably benefit from taking at least 100-200mcg a day, and anyone over
40 more like 200-400mcg, and those over 60 may need as much as 1000mcg. As
B12 is so safe, some doctors prescribe amounts of up to 60mg (milligrams,
not micrograms) to patients with conditions such as MS, with no adverse reactions.
Please
note: B12 is very safe, and even in high amounts, no toxicity has
ever been noted. However, like all other B-group vitamins, B12 should always
be taken in consideration of a 50mg B complex. This will ensure and maintain
a good balance of B vitamins, which all need each other in order to work effectively.
Vitamin
B6 - Pyridoxine
Vitamin B6 is probably
the most valuable of all the B-group vitamins, because of the multiple
biochemical reactions in which it is involved - reactions so essential
to sustaining life. In light of what we now know about this very essential
nutrient, the RDA for B6 is still pitifully low (2mg). When you consider
all that B6 can do for our health, the daily recommended amount should
be more like 50mg.
But is worth mentioning that because B6 is obtained
from grains, and due to milling and refining of our food, this nutrient
now very low in our diets, in fact some authorities tell us it may be
our most significant deficiency. Because of it incredible value for the
prevention and alleviation of so many health conditions, and due to its
important role as one of "The Mighty B-Trio", we will include a list of
health complaints, which are either associated with low levels of B6 or
can be substantially improved or alleviated by supplementation. It is
important to note that B6 is crucial for so many physiological process,
we can only touch on a few of them here.
|
Heat
disease
|
Immune system weakness
|
|
Hormonal
disturbances
|
Pregnancy-related
problems
|
|
Candidiasis
|
Kidney
Stones
|
|
Brain
and nerve impairment
|
Arthritis
& joint pain
|
|
Skin
disorders
|
Cancer
protection (women)
|
|
Water
retention
|
|
Those
who may need vitamin B6 the most are those with high levels of homocysteine,
and quite independent of homocysteine, those at risk of heart attack
or blood clots, because B6 has anti-clotting properties. In some ways,
women need B6 more than men, especially women taking oral contraceptives,
which deplete B6. The nutrient is also crucial to women because of its
important role in converting the female estrogen hormone estradiol,
into a less carcinogenic form of estrogen called estriol. B6 also acts
as a diuretic, which helps with PMS water retention and bloating, and
helps maintain hormone balance through out the monthly cycle, and at
menopause. During pregnancy, a woman's need for B6 increases, and often
she doesn't get enough to meet her own or her babies needs from diet
alone. Taking a B6 supplement during pregnancy can greatly relieve pregnancy-related
morning sickness/ nausea, and reduces the complications of gestational
diabetes, high blood pressure and preeclampsia.
To
sum up: Pyridoxine
is completely non-toxic, and as long as you follow the recommendations to
also include a 50mg B Complex with B6 supplements, you will maintain a good
balance of B nutrients. Some practitioners recommend a magnesium supplement
as a companion to B6, and most doctors and natural heal experts recommend
50mg a day as an adequate amount to address most deficiencies, but serious
health conditions may require more.
References for B6 can be found below.
References:
Folic
acid
M. Super - Lancer, Sept 21, 1991; pp 755-756
The MRC Vitamin Study Research Group - Lancet, July 20, 1991; 338: pp131-137
M.J. Stampfer - New England Journal of Medicine, 1995; 332: pp 328-329
P. Verhoef - American Journal of Epidemiology, May 1996; 143(9); pp 845-859
G.H.J. Boers - Netherlands Journal of Medicine, 1994; 45: pp 34-41 M.
Rodier - Diabetes and Metabolism, 1993; 19: pp 560-565
A.L. Lehninger - Biochemistry, 2nd Edition, 1975, pp 345-347
A Moustapha & K. Robinson - Geriatrics, April 1999; pp 41-45
S.S. Kang - Journal of Clinical Investigation,1986; 77: pp 1482-1486
P. Verhoef - American Journal of Medicine, Feb,1995; 332: pp 328-329
C.J. Boushey - Journal of the American Medical Association,1995; 274: pp 1049-1057
G.J. Custelly - Lancet, March9, 1996; 347: pp 657-659
K. Maurer - Family Practice News, June 1, 1996; p 20
E. Joosten - Journal of Gerontology: Medical Sciences, 1997; 52(2): M76-M79
B. Jancin - Family Practice Newsarch1, 1996; 4
O Nygard - Journal of the American Medical Association, 1995; 274: pp 1526-1533
I.J. Perry - The Lancet,1995; 346: pp 1395-1398
M.G.A.J. Wouters - European Journal of Clinical Nutrition, 1995; 25: pp 801-805
S.L. Morgan - Arthritis and Rheumatism. Jan 1990; 33(1): pp 9-18
M.R. Nehler - Cardiovascular Pathology, 1997;6: pp 1-9
J.E. Leonard - Annals of the Royal Journal of England, 1990;72: pp 152-154
L.J. Caruthers - Lancet, 1946; 1: p 849
H. Morrison - Journal of the American Medical Association, 1996; 275: pp 1893-1896
P. Verhoef - American Journal of Epidemiology, 1996; 143: pp 845-859
Mohammed H Moghadasian - Archives of Internal Medicine, 1997; 157: pp 2299-2308
P. C Fallest-Strobi - American Family Physician, 1997; 56: pp 1607-1612
E.B. Rimm - Journal of the American Medical Association 1998; 279: pp 359-364 & pp 392-393
Randomised folate/homocysteine trials published in The British Medical Journal 1998; 316: pp 894-898
M.W.P. Carney - Journal of Affective Disorders, 1990; 9: pp 207-213
M. Fava - American Journal of Psychiatry, 1997; 154:pp 426-428
R. Crellin - presented at Annual Meeting of the Royal College of Psychiatrists, Dublin, July 24-27, 1992
C.E. Butterworth Jnr - Journal of the American College of Nutrition, 1993; 12(4): pp 438-431
R.W. Haile - Cancer Epidemiology, Biomarkers and Prevention, 1995; 4: pp 709-714
M Flynn - Journal of The American College of Nutrition, 1994; 13(4) pp 351-356
G Cuskelly - Lancet. 1996; 347: pp 657-659
K Tucker - Journal of the American Medical Association, 1996; 276: pp 1878-1885
R Clarke - Archives of Neurology, Nov,1998; 55: pp 1449-1455
R Diaz-Arrastia, Archives of Neurology, Nov 1998; 55: pp 1407-1408
Vitamin
B12 - Cobalamin
R. Carmel - Annals of Internal Medicine 1996; 124: pp 338-339
A.K. Al-Momen - Journal of Internal Medicine 1995; 231: pp 551-555
J.D. Scarlet - American Journal of Hematology 1992; 39: pp 79-83
A Sumner - Annals of Internal Medicine 1996; 124: pp 469-475
J. Salzman - Journal of the american College of Nutrition 1994;
13: pp 584-591
I Bell - Nutrition Report 1991; 9: pp 1-8
R Narang - Trace Elements in Medicine 1992; 9: pp 43-44
B.C. Herzlich - American Journal of Gastroenterology 1992; 87(12): pp 1781-1788
J. Kira - Internal Medicine 1994; 33: pp 82-86
T Ohta - Japanese Journal of Psychiatry and Neurology 1991; 45: pp 167-168
K. Honma - Experientia 1992; 48: pp 716-720
M Caruselli - Riforma Medica 1952;: 66: pp 841-864
B Yaqub - Clinical Neurology and Neurosurgery 1992; 94: pp 105-111 .
J Fahey - New England Journal of Medicine 1990; 322: pp166-172
A Tang - Journal of Nutrition 1997; 127: pp 345-351
J Shemesh - American Journal of Otolaryngology 1994; 14: pp 94-96
J.B. Brodsky - New England Journal of Medicine, Jan 1993: pp 284-285
M Saito - Chest, 1994; 106: pp 496-499
R Clarke - Archives of Neurology, Nov,1998; 55: pp 1449-1455
R Diaz-Arrastia, Archives of Neurology, Nov 1998; 55: pp 1407-1408
A Bronstrup - American Journal of Clinical Nutrition 1998; 68: pp 1104-1110
A Lobo - American Journal of Cardiology 1999; 83: pp 821-825
A Moustapha & K. Robinson - Geriatrics, April 1999; pp 41-45
F.A. Lederie - Journal of the American Geriatrics Society 1998; 46: pp 1125-1127
J.A. Simon & E.S. Hudes- Archives of Internal Medicine 1999; 159: pp 619-624
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