A new study suggests high doses of B vitamins may halve the rate of brain shrinkage in older people experiencing some of the warning signs of Alzheimer's disease.
Brain shrinkage is one of the symptoms of mild cognitive impairment, which often leads to dementia.
Researchers say this could be the first step towards finding a way to delay the onset of Alzheimer's.
Experts said the findings were important but more research was needed.
The study, published in the journal Public Library of Science One, looked at 168 elderly people experiencing levels of mental decline known as mild cognitive impairment.
This condition, marked by mild memory lapses and language problems, is beyond what can be explained by normal ageing and can be a precursor to Alzheimer's and other forms of dementia.
Half of the volunteers were given a daily tablet containing levels of the B vitamins folate, B6 and B12 well above the recommended daily amount. The other half were given a placebo.
After two years, the rate at which their brains had shrunk was measured.
The average brain shrinks at a rate of 0.5% a year after the age of 60. The brains of those with mild cognitive impairment shrink twice as fast. Alzheimer's patients have brain shrinkage of 2.5% a year.
The team, from the Oxford Project to investigate Memory and Ageing (Optima), found that on average, in those taking vitamin supplements, brain shrinkage slowed by 30%.
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In some cases it slowed by more than 50%, making their brain atrophy no worse than that of people without cognitive impairment.
These vitamins are doing something to the brain structure - they're protecting it, and that's very important because we need to protect the brain to prevent Alzheimer's�
Professor David Smith
Oxford University
The study authors believe it was the B vitamins' effect on levels of homocysteine that helped slow the rate of brain shrinkage.
The study author, Professor David Smith, said the results were more significant than he had expected.
"It's a bigger effect than anyone could have predicted," he said, "and it's telling us something biological.
"These vitamins are doing something to the brain structure - they're protecting it, and that's very important because we need to protect the brain to prevent Alzheimer's."
He said more research was now needed to see whether high doses of B vitamins actually prevented the development of Alzheimer's in people with mild cognitive impairment.
The Alzheimer's Research Trust, which co-funded the study, also called for further investigation.
"These are very important results, with B vitamins now showing a prospect of protecting some people from Alzheimer's in old age," said chief executive Rebecca Wood.
"The strong findings must inspire an expanded trial to follow people expected to develop Alzheimer's."
B vitamins are found naturally in many foods, including meat, fish, eggs and green vegetables.
Experts are advising against taking higher than recommended levels in the light of these findings.
Chris Kennard, chair of the Medical Research Council's Neurosciences and Mental Health Board, said: "We must be cautious when recommending supplements like vitamin B as there are separate health risks if taken in too high doses.
"Further research is required before we can recommend the supplement as a treatment for neurodegenerative diseases, such as Alzheimer's."
Abstract
Background
An increased rate of brain atrophy is often observed in older subjects, in particular those who suffer from cognitive decline. Homocysteine is a risk factor for brain atrophy, cognitive impairment and dementia. Plasma concentrations of homocysteine can be lowered by dietary administration of B vitamins.
Objective
To determine whether supplementation with B vitamins that lower levels of plasma total homocysteine can slow the rate of brain atrophy in subjects with mild cognitive impairment in a randomised controlled trial (VITACOG, ISRCTN 94410159).
Methods and Findings
Single-center, randomized, double-blind controlled trial of high-dose folic acid, vitamins B6 and B12 in 271 individuals (of 646 screened) over 70 y old with mild cognitive impairment. A subset (187) volunteered to have cranial MRI scans at the start and finish of the study. Participants were randomly assigned to two groups of equal size, one treated with folic acid (0.8 mg/d), vitamin B12 (0.5 mg/d) and vitamin B6 (20 mg/d), the other with placebo; treatment was for 24 months. The main outcome measure was the change in the rate of atrophy of the whole brain assessed by serial volumetric MRI scans.
Results
A total of 168 participants (85 in active treatment group; 83 receiving placebo) completed the MRI section of the trial. The mean rate of brain atrophy per year was 0.76% [95% CI, 0.63�0.90] in the active treatment group and 1.08% [0.94�1.22] in the placebo group (P = 0.001). The treatment response was related to baseline homocysteine levels: the rate of atrophy in participants with homocysteine >13 �mol/L was 53% lower in the active treatment group (P = 0.001). A greater rate of atrophy was associated with a lower final cognitive test scores. There was no difference in serious adverse events according to treatment category.
Conclusions and Significance
The accelerated rate of brain atrophy in elderly with mild cognitive impairment can be slowed by treatment with homocysteine-lowering B vitamins. Sixteen percent of those over 70 y old have mild cognitive impairment and half of these develop Alzheimer's disease. Since accelerated brain atrophy is a characteristic of subjects with mild cognitive impairment who convert to Alzheimer's disease, trials are needed to see if the same treatment will delay the development of Alzheimer's disease.
The full text of the article is online and free at the above link.
This form of B12 is regarded as the best absorbed and therefore an improvement on the type used in the study.
It is double the amount used more about More about Vitamin B12 here from which you see
Quote:
Safety
Large intakes of vitamin B12 from food or supplements have caused no toxicity in healthy people. No adverse effects have been reported from single oral doses as high as 100 mg and chronic administration of 1 mg (500 times the RDA) weekly for up to 5 years. Moreover, there have been no reports of carcinogenic or mutagenic properties, and studies to date indicate no teratogenic potential. The main food safety authorities have not set a tolerable upper intake level (UL) for vitamin B12 because of its low toxicity.
More on Folic acid
This is exactly as used in the study.
The links provided to examples go to IHERB because their shipping to UK is cheapest.The total cost is $14.94 and that provides a longer supply than using a Vitamin B complex and I haven't actually (only spent a short time searching) found an exact equivalent Vit B complex to match the study. Introductory code WAB666 saves $5 at IHERB.
Don't forget this isn't to say that correcting vitamin D, omega 3 and magnesium deficiency status won't also improve brain function as all three work as anti inflammatory agents in the brain. So please don't take the results of this study to ditch those and convert to vitamin B complex alone. Mercola has a reasonable article on strategies to reduce Alzheimer risk so you can cover all options.
B12 and Folate do so much for the body. Way more than most people recognize. I suspect decline starts with impaired digestion and B12 depleation. One shot a month for old folks is not enough.
They have a new liposomal B12 this is suppose to be superior to other oral applications.
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Pure Advantage, B-12, 500 mcg Spray, 1 fl oz $10.82 Servings Per Container: 175
Providing you get a methylcobalamin version I'm sure it will be fine.
I've not seen any research on the benefits of spray versus sublingual lozenges.
Elevated homocysteine levels have now been correlated with a wide array of illnesses besides Alzheimers Disease, including heart disease, stroke, osteoporosis, depression, schizophrenia, macular degeneration, cervical cancer, and birth defects.
The main causes of high homocysteine levels as well as aging and genetics, are smoking,alcohol and poor diet lacking B vitamins.
This article gives an in depth report of all the research on homocysteine and various diseases.
Some people have a genetic defect which makes it difficult for them to convert folic acid into its active form 5-MTHF(Methyltetrahydrofolate).
For them replacing the normal inactive folic acid with the active form will overcome the problem.
Whereas
Now Foods, B-6 Pyridoxine HCl, 50 mg, 100 Tablets $3.50
Now Foods, Methyl B-12, 1000 mcg, 100 Lozenges $7.63
Now Foods, Folic Acid with Vitamin B-12, 800 mcg, 250 Tablets $3.81
Total $15.25 so the better selection is $26.37 more expensive
So if people cannot afford the ideal choices are they doomed?
Those who have read the full text of this study will know those study participants who were on a multivit before the study and who continued to use a multivit alongside the study protocol B vits, showed no change in the rate of atrophy because their baseline tHcy averaged 9.9, pretty close to the 9.5 mmol/L where the study found no treatment effect.
However as Liferock and Arrowwind09 have pointed out the benefits of Lowering Homocysteine go well beyond Alzheimer's and 9.9 really isn't low enough
As multivit makers usually pack their products with the cheapest, least effective forms available I'm quite surprised they do actually seem to reduce homocysteine levels effectively.
But do they go far enough for safety?
The link Liferock offered shows
Quote:
Osteoporosis: Women with high homocysteine levels were found to have significantly lower bone mineral density in the hip than control subjects. In fact, the risk of low bone density was 96% higher among women with high homocysteine (greater than 15 μmol/L) compared to women with lower homocysteine less than 9 μmol/L).
So I think we should be aiming for homocysteine level between 7 �mol/L and 8 �mol/L.
Homocysteine levels are also lowered by intermittent fasting. Fasting increases B12 and folate WITHOUT FURTHER DIETARY INTAKE, so apparently the reduction is mediated by B12 and folate.
Although low carbohydrate "dieting" (ie to achieve weight loss in obese subjects) has been associated with slight elevation of Hcy, in the longer term lo carbing will reduce insulin levels, which have been shown in at least one study to be strongly linked to Hcy levels.
Could it be nutraceutical approach is only necessary to fix years of poor dietary discipline?
Homocysteine levels are also lowered by intermittent fasting. Fasting increases B12 and folate WITHOUT FURTHER DIETARY INTAKE, so apparently the reduction is mediated by B12 and folate.
https://www.proteinpower.com/drmike/i...ttent-fasting/
Although low carbohydrate "dieting" (ie to achieve weight loss in obese subjects) has been associated with slight elevation of Hcy, in the longer term lo carbing will reduce insulin levels, which have been shown in at least one study to be strongly linked to Hcy levels.
Could it be nutraceutical approach is only be necessary to fix years of poor dietary discipline?
That's a great link.
Indeed but how are you going to solve the problem for Vegans and Vegatarians without supplements?
There is some useful information here on the problems arising from Elevated Homocysteine levels
Indeed but how are you going to solve the problem for Vegans and Vegatarians without supplements?
There is some useful information here on the problems arising from Elevated Homocysteine levels
Guess I'm a dogged antisupplementarian - having said that, I recognise the near impossibility of having sufficient dietary omega 3 and D3 - so these I do take..
As for vegans & vegetarians - possibly Lierre Keith is right?
Whereas
Now Foods, B-6 Pyridoxine HCl, 50 mg, 100 Tablets $3.50
Now Foods, Methyl B-12, 1000 mcg, 100 Lozenges $7.63
Now Foods, Folic Acid with Vitamin B-12, 800 mcg, 250 Tablets $3.81
Total $15.25 so the better selection is $26.37 more expensive
So if people cannot afford the ideal choices are they doomed?
Those who have read the full text of this study will know those study participants who were on a multivit before the study and who continued to use a multivit alongside the study protocol B vits, showed no change in the rate of atrophy because their baseline tHcy averaged 9.9, pretty close to the 9.5 mmol/L where the study found no treatment effect.
However as Liferock and Arrowwind09 have pointed out the benefits of Lowering Homocysteine go well beyond Alzheimer's and 9.9 really isn't low enough
As multivit makers usually pack their products with the cheapest, least effective forms available I'm quite surprised they do actually seem to reduce homocysteine levels effectively.
But do they go far enough for safety?
The link Liferock offered shows
So I think we should be aiming for homocysteine level between 7 �mol/L and 8 �mol/L.
Ordinary multivitamin supplementation would be a very hit and miss attempt at correcting high Hcy. Even taking the suggested amounts of B6,B12 and folate mentioned in studies may not be effective at lowering all cases of Hcy.
There is no problem in deciding the optimum level of Hcy to aim for but the correct amount of the various supplemental factors required to attain this target will vary depending on several factors including genetics. Besides problems with the MTHF folate defect another problem with Cysteine Beta Synthase enzyme regulation can cause Hcy methylation problems.
These can be helped to a certain extent by such measures as IF and low carb diets. However a lot of people dont have the will(and staying) power also low carb to most people other than vegetarians usually means high protein, which means high Hcy if you have poor methylation.
TMG in varying amounts, added to the standard Vitamin B6.B12 and Folate can help in lowering Hcy and in some cases as outlined here B6 may have to be raised.
Its a bit like Vitamin D levels,you can take the suggested amounts but you wont know whether your at the optimum level unless you get tested.
Guess I'm a dogged antisupplementarian - having said that, I recognise the near impossibility of having sufficient dietary omega 3 and D3 - so these I do take.
She says don't do it for moral, political, or health reasons - the book is deeply disturbing, and quite well researched, if a little too emotional.
The problem is it's very worrying when you see how much money goes into Subsidizing the production of cheap and dangerous foods I spent last night listening to Gary Taubes most recent online presentation and it's deeply depressing to hear how little response he's had to his efforts to change consensus medical opinion back to where it was prior to the start of the obesity epidemic. In the Q&A session at the end you can detect an air of resignation and hopeless despair in his tone.
Another magensium calculator
The problem is it's very worrying when you see how much money goes into Subsidizing the production of cheap and dangerous foods I spent last night listening to Gary Taubes most recent online presentation and it's deeply depressing to hear how little response he's had to his efforts to change consensus medical opinion back to where it was prior to the start of the obesity epidemic. In the Q&A session at the end you can detect an air of resignation and hopeless despair in his tone.
Must get around to reading some of his books - he seems to be bang on (as was Weston Price)
Thanks for the Mg info - actually I'm just about on target, thanks in part to my liberal nut/seed consumption, though I need to make a conscious effort to offset the omega 6 surfeit consumed from those sources..!
I'm going to start a magnesium thread - look under nutrition.
Do read the Lierre Keith book - she quotes Taubes avidly.
Do read the Lierre Keith book - she quotes Taubes avidly.
Sorry I should have made clear that I have done so. I found it a very moving read. I've never been a veggie although we do have relatives/friends who are so often have veggie meals. I've also got some pastureland that requires grazing so am well aware of the economics of pasture raised animals and the care local small farmers take over the welfare of those animals.
Vitamin B 'puts off Alzheimer's
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