Tag: homocysteine

Folic acid for stroke – and to remember

Claus Hancke

June 12, 2007

You must remember your folic acid, otherwise you forget it.
This sounds like nonsense, but its not.

Folic acid helps keep the brain in good shape, and if you don’t get enough you might have problems thinking clearly and remembering when you get older.

Folic acid is the vitamin that fertile women should take (0.4 mg per day) unless they are 100% sure that they will not become pregnant. Far from all do this, even though folic acid prevents children from being a lifelong invalids due to spinal chord herniation (spina bifida) and reduces the risk of cleft lip and palate! That it is preventative is so called new knowledge (1) which is to say that it was pointed out, but ignored, over twenty years ago.

But folic acid also helps the memory and thought ability. Who do we know this? The English neurologist Edward Reynolds demonstrated it 40 years ago in hi article in The Lancet. He showed that 26 epilepsy patients who suffered folic acid deficiency due to their medicine improved when they received folic acid (2). This has since been forgotten.

Now there are new studies. One had negative results. Its authors concluded that folic acid has no effect on cognitive function, which did not improve for study participants who received 0.4 mg folic acid daily (without vitamin B12, in which they were mildly deficient) (3).

There is a simple explanation for this: the only lasted 24 weeks. This is not long enough, which will be explained below, but first a couple of other results.

An issue of the American Journal of Clinical Nutrition from last February included an article which outlined that the more pronounced folic acid deficiency in elderly people, the poorer (statistically) their cognitive function. The likelihood of decreasing cognitive function was more than doubled in those with a deficiency of folic acid (4). There are many people with folic acid deficiency because folic acid is primarily found in liver and leafy vegetables, which many people push to the side if their plates.

20% fewer strokes
Lack of folic acid is shown roughly by finding increased blood levels of the substance, homocysteine. It is an amino acid which is poisonous to the blood vessels (among other things) and which is believed to lead to atherosclerosis, but that the body nonetheless creates. Normally it is neutralised in part by folic acid. If you lack folic acid, you homocysteine levels rise.

A link between lowered cognitive function and homocysteine has been shown in Sweden (5). There it was shown that elderly people with documented memory problems often had high levels of homocysteine. This was only true with the poor memory was found along with atherosclerosis, which homocysteine is believed to promote!

In addition, Dutch researchers recently showed in a randomised trail that a supplement of folic acid (o.8 mg daily) for 50 – 70 year olds not only reduced their levels of homocysteine, but also statistically improved the “brain functions which have a tendency to decline with age.” Memory, reaction time, and the ability to speak quickly and fluently were bettered. The study lasted for three years, which is a necessary time period (6).

If that is not enough, a comprehensive study of eight randomised studies has recently shown that the risk of stroke resulting from atherosclerosis generally is reduced by 20% when taking folic acid supplements. The studies which lasted longer than three years showed the best results. Participants who had already had a stroke were less protected and if those who were lucky enough to live in a country where food is enriched with folic acid (USA, Canada) showed fewer effects.

We should remember our folic acid. The daily dosage should be between 0.4 and 0.8 mg daily.

By: Vitality Council

 

References:
1. Bille C et al. Folic acid and birth malformations. BMJ 2007;334:433-34.
2. Reynolds E. Folate and aging. Lancet 2007;;369:1601.
3. Eussen SJ et al. Effect of oral vitamin B12 with or without folic acid on cognitive function in older people with mild vitamin B-12 deficiency: A randomized, placebo-controlled trial. Am J Clin Nutr 2006;84(2):361-70.
4. Haan M et al. Homocysteine, B-vitamins, and the incidence of dementia and cognitive impairment: Results from the Sacramento area latino study on aging. Am J Clin Nutr 2007;85:511-7.
5. Nilsson K et al. Plasma homocysteine is elevated in elderly patients with memory complaints and vascular disease. Dement Geriatr Cogn Discord 2007;23(5):321-6.
6. Durga J et al. Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: A randomised double blind controlled trial. The Lancet 2007;369:208-16.
7. Xiaobin Wang et al. Efficacy of folic acid supplementation in stroke prevention: a meta-analysis. The Lancet 2007;369:1876-82.

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Vitamin B12 And Folic Acid Reduce The Risk Of Blood Clots In The Brain

Claus Hancke

October 31, 2005

After Americans enriched their diet with folic acid in 1996, the frequency of blood clots in the brain was reduced by 15%. Now research shows that added supplementation of Vitamin B12 will markedly lower this risk even further.

Immediately, it sounds simple: People with high levels of the amino acid homocysteine in the blood have an increased risk of blood clots in the brain and in the heart. You also know that you can lower homocysteine with folic acid and, to a lesser extent, with B6 and B12 vitamins. When the Americans began to enrich cereal products with folic acid from 1996, both the average American’s homocysteine and the rate of blood clot in the brain decreased by about 15% in three years.

“The money fits”, and then the result is almost obvious in advance, if you want to conduct a lottery experiment, where every other participant gets folic acid, B6 and B12 vitamins. Of course, they get fewer blood clots in the brain.

But the reality is more varied. In Norway, such an experiment (NORVIT) was conducted with 3,750 patients who had just survived a blood clot in the heart. For 3.5 years, they were supplemented with either folic acid (0.8 mg), vitamin B6 (40 mg), both or blind tablets (placebo). Among those who only received folic acid, mortality decreased approx. 10%, but not statistically certain. But in the other two groups the death tolls were increased, not statistically certain either.

Perhaps it is too late to start taking supplements when you are already severely calcified. Or, as will appear, perhaps it was more decisive that the Norwegians “forgot” to give the participants vitamin B12.

An experiment has also been carried out in the USA (VISP). It was with people who had recovered from a blood clot in the brain, but had an increased risk of a new one. Admittedly, the Americans did not initially find any effect either. Supplementation of folic acid (2.5 mg), vitamin B6 (25 mg) and vitamin B12 (0.4 mg) did not reduce or improve mortality or risk of blood clots in the brain. Therefore, the experiment was simply stopped after two years. It was useless, they thought.

B12 is useful if it is absorbed
A close explanation could be the aforementioned enrichment of cereal products with folic acid. After all, the average homocysteine had already fallen by approx. 15% in the Americans. During the trial, it only dropped a further 2%.

But the Americans have since studied the numbers more closely. In doing so, they discovered one important source of error in particular: Many of the 3,680 elderly participants had reduced absorption of vitamin B12 from the gut and therefore had relatively little B12 in their blood (less than 250 pmol/l). This is often seen in the elderly, and it is now known that these elderly need supplements of at least 1,000 micrograms of vitamin B12 per day. But the participants had only received 400.

What would it look like if you now disregarded these participants and concentrated on those with normal B12 uptake? It was decided to investigate. At the same time, participants with reduced kidney function were disregarded, as they also respond sluggishly to these supplements. Finally, participants who were previously receiving medical treatment with B12 were naturally disregarded.

There remained 2,155 people who had no problems absorbing B12. In this large group, the supplements both lowered homocysteine further and reduced the overall risk of death, blood clot in the heart or blood clot in the brain – by 21%! The treatment helped anyway; even a lot when the ability to absorb B12 was intact.

As stated, it appears that the fortification of cereal products with folic acid has reduced the Americans’ risk of blood clots in the brain by approx. 15%. Now it seems that a solid supplement of vitamin B12 on top of that can reduce it significantly more – but the many elderly people, who absorb vitamin B12 poorly, presumably need larger supplements.

This is the result at the moment. It must be verified before it is approved. But the indications are there.

By: Vitality Council

References:
1. Toole JF, et al. Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial. JAMA. 2004 Feb 4;291(5):565-75.
2. Bonaa KH. NORVIT: Randomized trial of homocysteine-lowering with B-vitamins for secondary prevention of cardiovascular disease after acute myocardial infarction. Program and Abstracts from the European Society of Cardiology Congress 2005; September 3-7, 2005; Stockholm, Sweden. Hot Line II. Iflg. Linda Brooks. NORVIT: The norwegian vitamin trial. Medscape sept. 2005. (Ikke publiceret i trykt medie)
3. Spence DJ et al. Vitamin intervention for stroke prevention trial. An efficacy analysis. Stroke 2005;36:2404-2409.

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You Must Plug The Hole Before The Boat Sinks

Claus Hancke

October 11, 2005

A Norwegian study has shown that if you have already experienced an acute myocardial infarction, the risk of another such infarction will not be reduced by taking folic acid, Vitamin B6, and Vitamin B12, even if homocysteine levels are lowered thereby.
If you get a great deal of folic acid, the blood content of the amino acid homocysteine will be relatively low. So much is certain. When the content is low, the risk of blood clots in the heart or brain hemorrrhage – other things being equal – is also low. It is also safe, but both are statistics only.

With these facts in the bag, one is tempted to think that supplementation with folic acid must be a good idea. As you know, folic acid is the B vitamin that young women should take to avoid having children with spina bifida. One can agree with the American Heart Association, which advises everyone to get 0.4 mg of folic acid a day, the same dose that women should take as a supplement.

In Tromsø in Norway, the so-called NORVIT trial (Norwegian Vitamin Trial) was the first to test whether supplements also help heart patients who have already had a blood clot in the heart. If the media is to be believed, it ended with a scare.

The results, which were presented in September at this year’s congress of the European Society of Cardiology (ESC), led directly to warnings against folic acid in the press: B vitamins could be dangerous for heart patients, it said, and our own Danish heart association was quick to announce, that folic acid is “still” not recommended for heart patients – even though the month before was said something close to the opposite.

But, as is so often the case, the reports were misleading. Strictly speaking, the Norwegian trial did not show that folic acid is dangerous. If you want to argue that it showed anything at all, it was that the risk of heart attack, stroke, or death decreased—albeit by only a few percent—in those who took 0.8 milligrams of folic acid a day for 3.5 years . However, this was not statistically certain.

The fact is that there were in fact not one, but three trials, with a total of 3,750 people, all of whom had had blood clots in the heart. One showed that a combination of folic acid, vitamin B6 and B12 led to approx. 20% more cases of blood clots in the heart than placebo (cheat pills). The second – the only one where only folic acid was used – showed no difference in reality. There was also no difference in the third trial, where the participants only received vitamin B6.

In one area, the experiments turned out to be successful: those who received folic acid achieved a drop in the blood homocysteine content of approx. 30%. Enough so that one could hope for a nice drop in the number of new blood clots. Which did not appear.

But the questions arise: Is it appropriate for heart patients to be careful about taking folic acid, vitamin B6 and vitamin B12 at the same time?
Or are we talking about completely different anatomical conditions with secondary prophylaxis than there are with primary prophylaxis? After all, you have had a blood clot.

Also at the congress, the ESC’s designated commentator, Ian Graham, doubted the result. He believed that the experiment might have been too small and too complicated to be credible.

One can go a step further and think that the result is purely due to chance. In any case, it is not supported by any theory.
It is more likely that folic acid is simply not suitable for preventing blood clots in severely arteriosclerotic patients. – In other words secondary prophylaxis.

There is a lot of evidence that folic acid – and low homocysteine – slows the development of atherosclerosis in healthy people – i.e. primary prophylaxis. But the usefulness of this function diminishes when the calcification is already very advanced. The bottom plug must be inserted before the boat is sunk.

If folic acid is to prevent blood clots, you probably have to start in good time. On the other hand, the vitamin has other benefits. Among other things. experiments convincingly indicate that it helps to keep the brain young, even in the elderly.

By: Vitality Council

Reference:
Bonaa KH. NORVIT: Randomized trial of homocysteine-lowering with B-vitamins for secondary prevention of cardiovascular disease after acute myocardial infarction. Program and Abstracts from the European Society of Cardiology Congress 2005; September 3-7, 2005; Stockholm, Sweden. Hot Line II. Iflg. Linda Brooks. NORVIT: The Norwegian vitamin trial. Medscape Sept. 2005. (Not published in a printed media).

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Folic Acid Lowers Blood Pressure and Prevents Blood Clots

Claus Hancke

April 19, 2005

While folic acid lowers blood pressure, the dose must be large enough to have this effect. Diet alone will not provide a significantly large enough dose, so it is essential to take folic acid as a supplement. The vitamin also simultaneously protects the heart and brain against blood clots.

It has long been documented that the B vitamin, folic acid, prevents the birth defect Spina bifida. For eight years, Canada has fortified all flour with folic acid and has thus prevented 80% of these sad cases. Enrichment is also required in the United States, but in Denmark, expectant mothers must manage on their own. It’s their own problem to find out to take a supplement – before they get pregnant!

The main source of folic acid is green vegetables (“folium” means “leaf”). Many people do not like them, and a lack of folic acid is therefore the most common vitamin deficiency. Unfortunately, this not only harms the unborn, but also adults, where it increases mortality from both blood clots in the heart and from apoplexy (blood clot in the brain). Not only that: the deficiency probably also increases the tendency to high blood pressure.

The previously unknown connection with blood pressure was discovered when 156,000 American nurses were observed for eight years. 1) Their risk of developing high blood pressure as a young adult (27-44 years old) was only half as high when they received one mg of folic acid per day as when they received only 0.2 mg. The latter amount is a very common dietary intake in both the United States and Denmark (average 0.25 mg per day). On the other hand, it is almost impossible to get 1 mg, five times as much, without supplementation.

With regard to stroke and blood clots in the heart, very interesting knowledge has emerged in recent years:

In the USA, where flour fortification was introduced in 1996, mortality from stroke has since fallen very dramatically, in all population groups and for both men and women, i.e. quite independently of lifestyle.

Before 1996, the annual decline in mortality from stroke was just over one percent and could be attributed to better treatment and prevention. But in the following three years, mortality fell 3-4 times as much, a total of 10-15%! This has only been statistically explained by the fact that the typical American now has twice as much folic acid in their blood as before. 2)

Stroke is also particularly harmful if you lack folic acid. This was recently demonstrated in mice. They were artificially induced to have a stroke by simply clamping an artery to the brain. It turned out that the brain damage was only half as extensive when the mice had received enough folic acid as when they suffered from a deficiency. 3)

But apparently folic acid also protects the heart. This was most recently revealed when Italian doctors examined approximately 900 patients who were hospitalized with and without a blood clot in the heart.

They divided all the hospitalized patients according to how much folic acid they received daily, and of the third who received the least folic acid, the researchers found that most were admitted to the cardiac ward. This third had a risk that was twice as high as those who received the most folic acid. When taking into account the intake of vitamin B6 – B6 works together with folic acid – those who received the most had a relative risk of only 29%. 4)

It is not folic acid itself that protects the heart and brain. However, folic acid lowers the blood’s level of the harmful amino acid homocysteine, which attacks blood vessels.

Approximately 10% of the population has, without knowing it, a hereditary increase in homocysteine (and therefore needs more folic acid). Recently, it has been shown that these 10% suffer from stroke significantly more often than others. 5, 6). It was already known that exactly the same is true for blood clots in the heart. 7)

No one has yet conducted blinded trials where supplementation has effectively lowered blood levels of homocysteine. This is now encouraged. 8) However, with the existing knowledge, it seems wise to take a supplement.
The ideal is perhaps 0.8 mg (800 micrograms) per day.

By: Vitality Council

References:
1. Forman JP, Rimm EB, Stampfer MJ, Curhan GC. Folate intake and the risk of incident hypertension among US women. JAMA. 2005 Jan 19;293(3):320-9.
2. American Heart Association’s 44th annual Conference on Cardiovascular Disease Epidemiology and Prevention. carole.bullock@heart.org
3. Endres M, Ahmadi M, Kruman I, Biniszkiewicz D, Meisel A, Gertz K. Folate deficiency increases postischemic brain injury. Stroke. 2005 Feb;36(2):321-5. Epub 2004 Dec 29.
4. Taivani A et al. Folate and vitamin B6 intake and risk of acute myocardial infarct in Italy. Eur J Clin Nutr 2004;58:1266-72.
5. Al-Delaimy WK, Rexrode KM, Hu FB, Albert CM, Stampfer MJ, Willett WC, Manson JE. Folate intake and risk of stroke among women. Stroke. 2004 Jun;35(6):1259-63.
6. Casas JP et al. Homocysteine and stroke: Evidence on a causal link from mendelian randomisation. The Lancet 2005;365: 224-32.
7. Klerk M, Verhoef P, Clarke R, Blom HJ, Kok FJ, Schouten EG; MTHFR Studies Collaboration Group. MTHFR 677C– T polymorphism and risk of coronary heart disease: a meta-analysis. JAMA. 2002 Oct 23-30;288(16):2023-31.
8. S Schwammenthal et al. Homocysteine, B-vitamin supplementation, and stroke prevention. From observational to interventional trials. Lancet Neurol. 2004;3(8):493.

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Deficiency in B-vitamin Causes Dementia

Claus Hancke

April 18, 2005

According to one American study, folic acid weakens the memory of the elderly. According to another study, the opposite happens. Nearly all studies, however, indirectly indicate that folic acid prevents both arteriosclerosis and dementia.

It is a well-known fact that the B-vitamin folic acid prevents congenital neural tube defects. However, it can also lower the blood’s content of homocysteine; a biproduct in human metabolism that promotes atherosclerosis, among other things. Having an increased level of homocysteine is just as dangerous as cholesterol: Up to 40% of all individuals with premature atherosclerosis have increased blood levels of homocysteine.

The fact that homocysteine also damages the brain is indicated by more than 20 different studies. It has been found with almost unerring certainty that demented old people have more homocysteine in their blood than others and that the ones who score highest on memory tests are the ones with the least homocysteine in their blood. This is a clear argument for taking folic acid.

However, completely unexpectedly, a fly in the ointment has now appeared. A study at Rush University in Chicago has shown that the exact opposite might be the case. If you are elderly and you get more than the typical 0.4mg. of folic acid a day, your memory will decline more rapidly.

A total of 3,718 trial subjects over 65 years of age were followed for five to six years after having reported their eating habits. They were then mentally tested three times during the course of the 5 – 6 years. The results were the same whether they got folic acid from their diet or from dietary supplements: In the people taking folic acid, memory declined more rapidly than in the others.

Are these results the result of a coincidence? Anyhow, it does make you wonder that the 20% who got the most folic acid (0.7 mg. a day) did far better on the mental tests than the rest. Granted, their memory deteriorated more rapidly, but they obviously had a better memory to begin with. Why was that so, if folic acid is actually harmful?

In addition to this, doctors from the UCLA in February 2005 published results stating the exact opposite. Among 499 well-functioning 70 – 79 year-olds, most folic acid was found in the blood of the ones who had the best memory. And equally importantly: Seven years later, they were in better posession of all their faculties.

No explanation
What is true, then? If the truth lies in the Chicago study, it might be based on the co-operation between vitamin B12 and folic acid. Both vitamins reduce blood levels of homocysteine and the major task of both of them is to produce small, chemical units – which only contain a single carbon atom – for building other molecules.

Folic acid delivers its units to vitamin B12 which are then further delivered to – homocysteine. In this way, homocysteine is neutralized and is transformed into a harmless amino acid and the blood level of homocysteine will drop.

Whether you lack vitamin B12, folic acid, or both, the transport of the single-carbon units will be complicated. In all three cases, the result will be a specific type of anaemia (pernicious anaemia) which is characterized by the red blood cells being abnormally large.

However, the symptoms in vitamin B12 deficiency and folic acid deficiency are not quite similar. In folic acid deficiency, neuritis – i.e. nerve damage – will not occur. In vitamin B12 deficiency, it will. The anaemia in vitamin B12 deficiency can be removed by taking folic acid, but the neuritis cannot. Vitamin B12 has an affect on nervous tissue that folic acid cannot imitate.

In up to 30% of all elderly people, vitamin B12 deficiency can be demonstrated. Imagine large amounts of folic acid enhancing the B12 deficiency in the nervous system by blocking the small amounts of vitamin B12 with single-carbon compounds. This could correlate to another finding in the Chicago study: Memory declined by 25% less in the ones with the largest consumption of vitamin B12.

The leader of the study, Martha Clare Morris, believes that folic acid might mask the very common vitamin B12 deficiency in the elderly. This is more or less the same thing. In both cases, the consequence should be that the elderly get more vitamin B12 and not less folic acid which can have a protective effect in other areas.

This is the message – that is if you do not choose to believe that the new finding is a coincidence and that the truth is the exact opposite – which is actually also quite likely!

For the time being, however, Morris’ conclusion is simple: “We don’t know yet what is going on,” she says.

Up to every third elderly person may have demonstrable signs of mild vitamin B12 deficiency. If the results of the Chicago study are truthful, elderly persons possibly should not reduce their folic acid intake but rather focus on getting enough vitamin B12.

By: Vitality Council

References:
1. Morris MC et al. Dietary folate and vitamin B12 and cognitive decline among community-dwelling older persons. Arch Neurol 2005;62:641-5
2. Austin RC et al. Role of hyperhomocysteinemia in endothelial dysfunction and atherthrombotic disease. Cell Death and Differentiation 2004;11:S56-S64
3. Morris MS. Homocysteine and Alzheimers disease. Lancet Neurol 2003;2:425-8
4. Kado DM et al. Homocysteine versus the vitamins folate, B6, and B12 as predictors of cognitive function and decline in older high-functioning adults: Mac Arthur Studies of Successfull Aging. Am J Med 2005;118:161-7
5. Garcia A et al. Homocysteine and cognitive function in elderly people. CMAJ, Oct. 12, 2004; 171 (8).

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Supporting Evidence: B-vitamins Strengthen the Bones

Claus Hancke

March 18, 2005

A year ago a correlation between osteoporosis, folic acid and Vitamin B12 deficiency was discovered. It might have been a statistical coincidence, but a Japanese study discovered that the two vitamins reduced the risk of bone fracture by 80%.

Just a year ago, Dutch and American researchers demonstrated that at high homocysteine level – which is very common and most often a consequence of folic acid or vitamin B12 deficiency – the risk of breaking the hip doubles. It was only a statistical context, but was there also a causal link?

Can folic acid and/or vitamin B12 really reduce the risk of hip fracture, i.e. the most dangerous consequence of osteoporosis?

Few have considered this possibility before, but for now it seems to be a possibility. Japanese doctors have suspected this for at least five years. In 2000, they began a two-year treatment trial to investigate the matter.

The trial included 628 particularly vulnerable, elderly patients who received a solid dose of the two vitamins: 5 mg folic acid and 1.5 mg vitamin B12 per day. However, half received placebo (inactive tablets). The 628 were selected because they had had a stroke and were still more or less paralyzed on one side after a year. In this situation, the risk of breaking the hip is doubled, especially since the risk of falling is high.

Over the two years, it was recorded how often the participants in the two groups fell. They did so equally often. But the consequences were much milder in those who received the supplement. Only six of them suffered a hip fracture, while the same happened to 27 in the control group. The risk was therefore reduced by more than 80%. In the treated group, the blood level of homocysteine fell by a good 30%, while it increased by the same amount in those who received the inactive tablets.

B deficiency destroys connective tissue
There is a lot of talk about the argument that homocysteine is dangerous for bones. The new thing is that it is useful to lower it if it is high. Not because it will add more calcium to the bones. According to a Dutch study from 2004, it does not. On the other hand, there are good reasons to believe that the bone tissue you have will become stronger.

Biochemical experiments have shown that homocysteine attacks both elastic and other fibers in bone and connective tissue, so that the structure becomes looser, the interweaving of fibers less tight and the bones more rigid. Fibers of the same type are also found in the arteries, which can also be damaged, and chemically similar proteins participate in blood coagulation. Some believe that this explains the increased tendency for blood clots in the heart, etc., which is seen with elevated homocysteine.

The argument is supported by the fact that blood clots and weakened bones occur particularly early in people with the congenital disease “homocystinuria,” in which the blood level of homocysteine is 10 times higher than normal. The difference between them and others, it is said, is only the time at which the damage occurs.

If the Japanese study is confirmed, folic acid and vitamin B12 are simply the most effective protection against osteoporosis known! In any case, it is certainly not unwise to have your homocysteine level measured in your blood. It should not be much higher than 10 micromol/liter.

By: Vitality Council

References:
1. Sato Y, Honda Y, Iwamoto J, Kanoko T, Satoh K. JAMA. 2005 Mar 2;293(9):1082-8. Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial.
2. Krumdieck CL et al. Mechanisms of homocysteine toxicity on connective tissues: Implications for the morbidity of aging. J Nutr. 2000;130:365S-368S.
3. Van Meurs Joyce B J et al. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med 2004;350:2033-41.
4. Mc Lean Robert R et al. Homocysteine as a predictive factor for hip fracture in older persons, N Engl J Med 2004;350:2042-9.

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B Vitamin (Folic Acid) May Strengthen the Bones

Claus Hancke

August 2, 2004

The vitamin B substance folic acid (Vitamin B9) may be able to counteract osteoporosis. This is concluded by an American and a Dutch population study, which were simultaneously publisized in the medical magazine The New England Journal of Medicine.

Folic acid prevents neural tube defect (spina bifida) which is a serious and relatively frequent congenital malformation. Moreover, it is assumed that the vitamin counteracts coronary thrombosis, strokes, and other sequelae from atherosclerosis. Folic acid deficiency is quite widespread. One of the results of folic acid deficiency is that the blood level of the amino acid homocysteine is raised to abnormal high levels.

In the Netherlands, a group of 2,406 people above the age of 55 located in Rotterdam and Amsterdam were followed over a period of up to nine years.

In the American study which was part of the well-known Framingham study, 1,999 elderly people participated and were followed for 15 years. In addition to fractures, a large number of other significant factors in the development of osteoporosis were registered: Smoking habits, age, height and weight, consumption of coffee and alcohol, calcium- and vitamin D intake, oestrogen supplements, etc.

The two studies demonstrated that a high level of homocysteine was linked to an increased risk of suffering hip fractures. Both studies showed that people who belong to the top 25% with regards to high homocysteine levels in their blood have twice as large a risk of breaking their hip as the ones who have much lower levels of homocysteine.

Several conditions point towards a cause and effect relationship here. For example, it was statistically rejected that the risk was related to and biased by other known causes of osteoporosis, such as smoking, a lack of dietary calcium, etc.

It is also known that osteoporosis is a pronounced phenomenon in the hereditary disease homocystinuria in which the levels of homocysteine are particularly high. Finally, it has been demonstrated in laboratory experiments that homocysteine weaken the cross-links in the wickerwork of connective tissue around which the bones are built.

According to the Dutch results, a high level of homocysteine – and thereby a resulting lack of folic acid – might be the cause of approximately 19% of all hip fractures!

By: Vitality Council

References:
1. Van Meurs Joyce B J et al. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med 2004;350:2033-41.
2. Mc Lean Robert R et al. Homocysteine as a predictive factor for hip fracture in older persons, N Engl J Med 2004;350:2042-9.
3. (Editorial) Raisz LG. Homocysteine and osteoportic fractures – culprit or bystander? N Engl J Med 2004;350:2089-90.

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Folic Acid Supplementation may Minimize the Risk of Three of the Biggest Circulatory Diseases

Per Larsen

November 23, 2002

A study, a so called meta analysis of 92 studies involving 20,669 patients, was published in the British Medical Journal (BMJ) the 23 November 2002.

Earlier studies have found a connection with a too high value of the substance Homocysteine in the body with coronary diseases like blood clots in the heart, blood clots in the legs, and in the brain.

Homocysteine is increased by deficiency of several vitamin Bs, especially vitamin B12, vitamin B6 and folic acid, and by a common genetic defect that reduces the activity of an enzyme in the folic acid metabolism. The result of this defect is a condition called “functional vitamin B deficiency”, which means a need for greater intake of folic acid in the exposed ones.

Increased homocysteine – no matter the cause – has shown to be significantly related to the three following diseases. By a reduction in the homocysteine of the blood of 3 mikromol/L it was possible to decrease the incidents of heart diseases with 16%. Deep venous thrombosis, with or without lung emboli, with 25%. The reduction in the frequency of blood clots in the brain (stroke) was 24%.

The authors conclude:
That by reducing the homocysteine concentration with 3 mikromol/L (which alone can be obtained by increasing the folic acid intake, editor) the risk of heart disease can be reduced with 16%, the risk of deep venous thrombosis with 25%, and the risk of stroke with 24%.

By: Per Tork Larsen, DSOM

Reference:
British Medical Journal; Nov, 2002.

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