Guest guest Posted November 8, 2000 Report Share Posted November 8, 2000 There is a lot of very good information here. There is information on B vitamins and Lupus, CFIDS, artherosclerosis, Alzheimer's disease, Shaking Leg syndrome, ulcers, heart attack, and stroke. IM injections of B12 are not always necessry. This has been known for a long time. According to research from England, even some people with pernicious anemia may be able to absorb enough B12 if the oral dose is high enough. However, there are some people who cannot. I found the first section on H pylori bacteria (stomach ulcers) interfering with B12 absorption very interesting. PWCs (People With CFIDS) tend to have absorption problems not only with oral B12 but with oral magnesium (even when combined with malic acid) and with other vitamins and minerals. People who take a lot of antiacids may have trouble absorbing enough B12 as the contents of the stomach are not acidic enough to start the proper breakdown of food. Leaky Gut Syndrome (lining of the intestines compromised) may also have problems absorbing enough oral B12 no matter how high the dose. People on B12 supplementation need to have their levels of folic acid (another B vitamin) checked routinely as B12 can " crowd out " folic acid and vice versa, much in the same way that magneisum can " crowd out " calcium in the body and vice versa. However, up to a point B12 helps the efficiency of folic acid in much the same way that up to a point Mg absorption and utilization are enhanced by Ca, and Ca absorption and utilization are enhanced by Mg. Note: In some people high dosages of injected B12 over indefinite time periods can lead to symptoms of polycythemia vera (too many red blood cells). B12 also reduces percentages of nondiscoytes - misshapen, inflexible red blood cells which have trouble making it through the smallest capillaries. A number of medical problems are characterized by high percentages of nondiscocytes. (See the work of L.O. Simpson, MD, New Zealand for more info on red blood cells and B12.) Victoria >Vitamin B-12 (cobalamin).htm > > > > INTERNATIONAL HEALTH NEWS DATABASE > > > > >Vitamin B12 > > Summaries of the latest research concerning vitamin B12 > > > Helicobacter pylori and vitamin B12 deficiency > ANKARA, TURKEY. It is estimated that more than 50 per cent of adults >in developed countries are infected with the Helicobacter pylori bacterium. >H pylori has been implicated in stomach ulcers, indigestion (dyspepsia), >gastritis (inflammation of the stomach lining), stomach cancer, and MALT >lymphoma. About 10-15 per cent of adults over 60 years of age are affected >by a vitamin B12 (cobalamin) deficiency. Researchers at the Turkish >Military Medical Academy now provide convincing evidence that the two are >linked. A detailed study of 138 patients with vitamin B12 deficiency and >anemia discovered that 77 (58 per cent) of the patients had a H pylori >infection. Eradication of this infection successfully cured the anemia and >reversed the vitamin B12 deficiency in 31 (40 per cent) of the 77 infected >patients. The researchers conclude that a H pylori infection can cause a >vitamin B12 deficiency and that this deficiency, in many cases, can be >totally eliminated by eradicating the infection. EDITOR'S NOTE: Memory >loss, fatigue, and mental confusion are often the first indicators of a >vitamin B12 deficiency. > Kaptan, Kursad, et al. Helicobacter pylori - Is it a novel causative >agent in vitamin B12 deficiency? Archives of Internal Medicine, Vol. 160, >May 8, 2000, pp. 1349-53 > Stopeck, Alison. Links between Helicobacter pylori infection, >cobalamin deficiency, and pernicious anemia. Archives of Internal Medicine, >Vol. 160, May 8, 2000, pp. 1229-30 (editorial) > > Supplement recommendations for chronic fatigue syndrome > BERKELEY, CALIFORNIA. Dr. Melvyn Werbach, MD of the UCLA School of >Medicine has just published a thorough review of nutritional deficiencies >involved in chronic fatigue syndrome (CFS). These include deficiencies in >vitamin C, coenzyme Q10, magnesium, zinc, sodium, l-tryptophan, >l-carnitine, essential fatty acids, and various B vitamins. He points out >that there is some evidence that the deficiencies are caused by the disease >itself rather than by an inadequate diet. He suggests that the deficiencies >not only contribute to the symptoms of CFS but also impair the healing >process. Although the results of supplementation trials involving CFS >patients have been inconclusive so far Dr. Werbach nevertheless recommends >that CFS patients be given large doses of certain supplements for at least >a trial period to see if their symptoms improve. His recommendations are: > > > a.. Folic acid: 1-10 mg/day for 3 months > b.. Vitamin B12: 6-70 mg (intramuscular injection) per week for 3 >weeks > c.. Vitamin C: 10-15 grams/day > d.. Magnesium: 600 mg/day + 2400 mg/day of malic acid for 8 weeks > e.. Zinc: 135 mg/day for 15 days > f.. 5-hydroxytryptophan: 100 mg three times daily for 3 months (if >fibromyalgia is present) > g.. L-carnitine: 1-2 grams three times daily for 3 months > h.. Coenzyme Q10: 100 mg/day for 3 months > i.. Essential fatty acids: 280 mg GLA and 135 mg EPA daily for 3 >months > The supplements should be administered with medical supervision and >accompanied by a high-potency vitamin/mineral supplement for the duration >of the trial. [95 references] > Werbach, Melvyn R. Nutritional strategies for treating chronic >fatigue syndrome. Alternative Medicine Review, Vol. 5, No. 2 April 2000, >pp. 93- 108 > > Vitamin B12 resolves shaky-leg syndrome > MADRID, SPAIN. Dr. Julian Benito-Leon MD, a physician at the >Hospital General de Mostoles, reports the case of a 68-year-old man with >the shaky-leg syndrome. The shaking (tremor) would begin immediately after >the patient stood up and subside as soon as he began walking. A detailed >examination revealed that the patient had a very low blood level of vitamin >B12 (132 ng/L versus normal range of 222 to 753 ng/L) and a Schilling test >demonstrated malabsorption of vitamin B12. The patient was put on the >anticonvulsant clonazepam (1 mg/day) and was given vitamin B12 injections >(1 mg daily for two weeks, then weekly for two months, and once a month >thereafter). This treatment completely eliminated the tremor. After one >year clonazepam was discontinued without reoccurrence of the shaky-leg >syndrome. Dr. Benito-Leon and his colleagues conclude that the problem was >a result of disturbances in the cerebellum or related brain structures >caused by a vitamin B12 deficiency. They believe that the vitamin B12 >injections were responsible for resolving it. > Benito-Leon, Julian and Porta-Etessam, Jesus. Shaky-leg syndrome and >vitamin B12 deficiency. New England Journal of Medicine, Vol. 342, No. 13, >2000, p. 981 (correspondence) > > > > Please Support Our Research - Subscribe to International >Health News > > > > Niacin treatment increases homocysteine levels > INDIANAPOLIS, INDIANA. Niacin (vitamin B3) has been used effectively >to reduce elevated cholesterol levels. Niacin therapy is particularly >desirable because it reduces the level of low-density lipoproteins (LDL - >the " bad " cholesterol) and increases the level of high-density lipoproteins >(HDL - the " good " cholesterol). A recent trial which evaluated the effect >of treating high cholesterol levels with both niacin and the >cholesterol-lowering drug colestipol found that the treated patients >increased their blood plasma levels of homocysteine. High homocysteine >levels have been associated not only with an increased risk for heart >disease, but also with an increased risk for stroke, intermittent >claudication, and hypothyroidism. > Researchers at the Eli Lilly Research Laboratories and the Oregon >Health Sciences University have now completed a study designed to determine >whether it was the colestipol or the niacin which caused the increase in >homocysteine levels. The trial involved 52 patients with peripheral >vascular (arterial) disease who were randomized to receive a placebo or up >to 3000 mg/day of crystalline niacin for 48 weeks. At 18 weeks after the >start of the study the average blood level of homocysteine had increased by >55 per cent (from 13.1 micromol/L to 21.1 micromol/L) in the niacin group. >This increase is highly significant and according to other research >corresponds to an increase in the risk of coronary artery disease of about >80 per cent. Of course, this increase in risk would be at least partially >offset by the reduction in risk caused by the cholesterol reduction due to >niacin therapy. The researchers point out that homocysteine levels can be >effectively lowered by supplementation with folic acid and vitamins B6 and >B12. They urge further studies to determine whether supplementation with >these vitamins would be beneficial to patients undergoing long-term niacin >therapy. > Garg, Rekha, et al. Niacin treatment increases plasma homocysteine >levels. American Heart Journal, Vol. 138, December 1999, pp. 1082-87 > > B vitamins and atherosclerosis > TAIPEI, TAIWAN. High blood levels of the amino acid homocysteine >have been associated with an increased risk of atherosclerosis. >Homocysteine is formed in the body from methionine (an amino acid found in >proteins) in a process that can be blocked by folic acid and vitamins B6 >and B12. High homocysteine levels can induce endothelial dysfunction (a >narrowing of the arteries) which in turn is believed to be a precursor of >atherosclerosis. Researchers at the National Taiwan University Hospital now >report that homocysteine-induced endothelial dysfunction can be avoided or >very significantly ameliorated by supplementing with folic acid and >vitamins B6 and B12. > > The study involved two men and fourteen women between the ages of 41 >and 55 years. At the start of the study all participants had their blood >levels of homocysteine and their blood flow through the brachial artery >measured after a 10-14 hour overnight fast. They were then given an oral >methionine loading test to simulate the intake of a high protein meal. Four >hours later their average homocysteine level had increased from 7 >micromol/L to 22.7 micromol/L and the blood flow (flow-mediated >vasodilation) had decreased by 40 per cent. The experiment was repeated, >but this time 5 mg of folic acid was given together with the methionine; >the results were similar to those obtained in the first experiment >indicating that folic acid does not act immediately as an " antidote " to a >high intake of methionine. The participants were then given 5 mg of folic >acid, 100 mg of vitamin B6, and 0.5 mg of vitamin B12 daily for five weeks. >At the end of the five weeks their average homocysteine level had decreased >to 5.2 micromol/L. The methionine loading test was repeated. Four hours >later the average homocysteine level among the participants had increased >to 17 micromol/L, but there was no statistically significant difference in >blood flow before and after the methionine loading test. The researchers >conclude that short-term (five weeks) administration of folic acid and >vitamins B6 and B12 will reduce post-methionine load homocysteine levels >and eliminate or ameliorate endothelial dysfunction (an early manifestation >of atherosclerosis). > Chao, Chia-Lun, et al. Effect of short-term vitamin (folic acid, >vitamins B6 and B12) administration on endothelial dysfunction induced by >post-methionine load hyperhomocysteinemia. American Journal of Cardiology, >Vol. 84, December 1, 1999, pp. 1359-61 > > Vitamin E protects vitamin B-12 > LITTLE ROCK, ARKANSAS. Adenosylcobalamin is an important coenzyme >which is involved in the metabolism of branched-chain amino acids, >cholesterol, methionine, and odd-chain fatty acids. It is synthesized in >the cell nucleus from vitamin B-12 (cyanocobalamin). Now researchers at the >University of Arkansas have found that the synthesis of adenosylcobalamin >is impaired if the cell membranes have been subjected to peroxidative (free >radical) attack. They also found, through experiments with cell cultures, >that vitamin E effectively prevents the peroxidation and thereby allows the >enzyme synthesis to proceed unhindered. > Turley, Charles P. and Brewster, Marge A. Alpha-tocopherol protects >against a reduction in adenosylcobalamin in oxidatively stressed human >cells. Journal of Nutrition, Vol. 123, July 1993, pp. 1305-12 > > Vitamin B deficiencies are common in elderly people > LEUVEN, BELGIUM. An international team of researchers have confirmed >that elderly people often suffer from a deficiency of vitamins B-6, B-12 >and folic acid. Their investigation involved 99 healthy young people (aged >19-55), 64 healthy elderly subjects (aged 65-88), and 286 elderly >hospitalized patients (aged 61-97). The researchers measured the blood >concentrations of the vitamins in all subjects as well as the concentration >of certain metabolic products which tend to build up if a vitamin >deficiency is present. They found that 9% of the healthy elderly subjects >had a low vitamin B-6 level as compared to more than 51% for the >hospitalized patients. Corresponding numbers for vitamin B-12 and folic >acid were 6% and 5%, and 5% and 19% respectively. Of perhaps greater >significance was the finding that in 63% of the healthy elderly subjects >and in 83% of the elderly patients the researchers observed an increased >serum concentration of one or more of the metabolic products which indicate >a deficiency in vitamin B-6, B-12 or folate. Thus an elevated level of the >metabolite (methylmalonic acid) which indicates a B-12 deficiency was found >in 23% of the healthy elderly people and in 39% of the elderly hospitalized >patients. Recent experiments have shown that weekly injections of vitamin >B-12, B-6, and folate are highly effective in normalizing the elevated >metabolite concentrations in elderly people. > Joosten, Etienne, et al. Metabolic evidence that deficiencies of >vitamin B-12 (cobalamin), folate, and vitamin B-6 occur commonly in elderly >people. American Journal of Clinical Nutrition, Vol. 58, No. 3, September >1993, pp. 468-76 > > Vitamin B12 deficiency implicated in Alzheimer's disease > CLWYD, NORTH WALES. Suspicion has been growing that a lack of >vitamin B12 is somehow implicated in the development of Alzheimer's >disease. Now researchers in the United Kingdom have confirmed this >suspicion. They evaluated members of a family with a genetic predisposition >towards Alzheimer's disease. They found that four out of six (67 per cent) >of family members with confirmed Alzheimer's disease had abnormally low >vitamin B12 levels in their blood. This compares to only one out of 12 (8 >per cent) among the family members who were at equal genetic risk for >developing Alzheimer's disease but did not. The researchers speculate that >a vitamin B12 deficiency could result in impaired methylation reactions in >the central nervous system - a characteristic feature in Alzheimer's >disease. They also consider the possibility that the genetic predisposition >to Alzheimer's disease may actually be related to a genetic impairment in >the ability to absorb vitamin B12. Vitamin B12 deficiency in itself often >causes disorientation and confusion and thus mimics some of the prominent >symptoms of Alzheimer's disease. > McCaddon, A. and Kelly, C.L. Familial Alzheimer's disease and >vitamin B12 deficiency. Age and Ageing, Vol. 23, July 1994, pp. 334-37 > > Vitamin B12 deficiency common among elderly people > NEW YORK, NY. Researchers at Columbia University have confirmed that >elderly people often suffer from a lack of vitamin B12 (cobalamin). The >deficiency is usually only discovered when patients develop megaloblastic >anemia. However, before this stage is reached, cobalamin-deficient >individuals may develop neuropsychiatric damage and show signs of >disorientation and confusion. The researchers evaluated 548 men and women >aged 67 to 96 years and compared their cobalamin and folate status to that >of 117 healthy, younger control subjects. They found that 40.5 per cent of >the elderly people suffered from a vitamin B12 deficiency versus only 17.9 >per cent in the younger group. There was no significant difference in >folate status among the two groups. The researchers also found that people >who took oral supplements containing vitamin B12 and folate (6 micrograms >and 400 micrograms per day respectively) were much less likely to suffer >from a deficiency than were people who did not supplement. They point out >that as people age they become less and less able to absorb vitamin B12 >from food and therefore are likely to develop a deficiency. As gastric >atrophy progresses vitamin B12 status can only be maintained by taking high >oral doses of cobalamin (500-1000 micrograms daily) or by routine >intramuscular injections providing 1 mg per month. The researchers also >point out that a vitamin B12 deficiency leads to an accumulation of >homocysteine in the blood. An increased serum concentration of homocysteine >and its derivatives is now recognized as a major risk factor in heart >disease and stroke. > Lindenbaum, John, et al. Prevalence of cobalamin deficiency in the >Framingham elderly population. American Journal of Clinical Nutrition, Vol. >60, July 1994, pp. 2-11 > Allen, Lindsay H. and Casterline, Jennifer. Vitamin B-12 deficiency >in elderly individuals: diagnosis and requirements. American Journal of >Clinical Nutrition, Vol. 60, July 1994, pp. 12-14 > > Folic acid helps prevent coronary heart disease > SEATTLE, WASHINGTON. A high level of homocysteine in the blood has >been clearly implicated in heart disease, stroke and peripheral vascular >disease. Homocysteine is an amino acid which is not found in protein as >such, but is involved in the metabolism of other amino acids (methionine >and cysteine). The average blood level of total homocysteine in male adults >is about 10 micromol/L. Now researchers at the University of Washington >confirm that people with a higher than normal level of homocysteine have a >greater risk of developing vascular disease. The researchers evaluated 17 >studies dealing with the link between homocysteine levels and the risk of >coronary artery disease (CAD). They found that men with a level of 15 >micromol/L had a 60 per cent greater risk of developing CAD while the >increased risk for women was 80 per cent. The risk for cerebrovascular >disease (stroke) was found to be almost twice as high in men and women with >elevated (15 micromol/L) homocysteine levels. The risk of developing >peripheral vascular disease (eg. intermittent claudication) was found to be >almost seven times higher among people with elevated homocysteine levels. >The researchers conclude that a high homocysteine level is an independent >risk factor for vascular disease and that a 5 micromol/L elevation results >in the same increase in CAD risk as a cholesterol increase of 0.5 mmol/L >(20 mg/dL). > > The researchers also evaluated 12 studies concerning the connection >between dietary intake of folic acid and homocysteine level. They found >that folic acid is very effective in lowering homocysteine levels. An >intake of 400 micrograms per day (the level found in most supplements) >lowers the homocysteine level by about 6 micromol/L. The researchers >conclude that over 44,000 lives could be saved every year if just half the >population of the United States were to supplement with 400 micrograms per >day of folic acid. Unfortunately, recent surveys have shown that 88 per >cent of American adults have a daily intake of folic acid below 400 >micrograms. The researchers warn that an increased intake of folic acid may >mask a vitamin B-12 deficiency and recommend that 1 mg of vitamin B-12 be >added to all supplements containing 400 micrograms of folic acid. They also >recommend that consideration be given to fortifying grain products with 350 >micrograms of folic acid per 100 grams of grains. This strategy would have >the added advantage of making it easier to prevent neural tube defects in >new born babies. > Boushey, Carol J., et al. A quantitative assessment of plasma >homocysteine as a risk factor for vascular disease. Journal of the American >Medical Association, Vol. 274, No. 13, October 4, 1995, pp. 1049-57 > > Elevated homocysteine levels linked to stroke risk > LONDON, ENGLAND. Evidence is rapidly accumulating to the effect that >a high homocysteine level in the blood is a potent risk factor for >cardiovascular disease. Homocysteine is an amino acid formed in the >metabolism of methionine. A high level of homocysteine can be inherited, >but far more often is due to a deficiency of the vitamins required to >metabolize it (folic acid, vitamin B-6, and vitamin B-12). A team of >British and Norwegian medical researchers now report that men with a high >homocysteine level have a vastly increased risk of suffering a stroke >(ischemic). Their study involved 5,661 middle-aged men whose blood was >sampled in the period 1978 to 1980. By 1991 141 of the men had suffered a >stroke. The researchers compared the homocysteine level in the blood from >the stroke victims with the level in blood from matched controls who had >not had a stroke or heart attack during the follow-up period. They found >that men with a total homocysteine level of more than 15.4 micromol/liter >had an almost five times greater risk of having a stroke than did men with >a more normal level of less than 10.3 micromol/liter. The increased stroke >risk held true even after adjusting for obesity, hypertension, diabetes, >cigarette smoking, alcohol consumption, social class, lung capacity, and >level of HDL cholesterol. Elevated homocysteine levels can be normalized by >ensuring an adequate intake of folic acid and other B vitamins. > Perry, I.J., et al. Prospective study of serum total homocysteine >concentration and risk of stroke in middle-aged British men. The Lancet, >Vol. 346, November 25, 1995, pp. 1395-98 > > Vitamin B-12 deficiency common after stomach surgery > PHILADELPHIA, PENNSYLVANIA. It is becoming increasingly clear that a >vitamin B-12 deficiency can have serious consequences, particularly in >elderly people. A vitamin B-12 deficiency can be misdiagnosed as >Alzheimer's disease, amyotrophic lateral sclerosis (Lou Gehrig's disease), >spinal cord compression, or alcoholic or diabetic peripheral neuropathy. A >vitamin B-12 deficiency is also associated with elevated homocysteine >levels which in turn have been linked to a significantly increased risk for >atherosclerosis and heart disease. The elderly are at special risk for >being deficient in vitamin B-12 and, as researchers at the Philadelphia >Veterans Affairs Medical Center report, so are people who have had stomach >surgery for peptic ulcers and similar conditions. The study involved 61 >patients with a mean age of 63 years who had undergone gastric surgery as >far back as 30 years ago and 107 controls. The researchers found that 31 >per cent of the surgery group had a vitamin B-12 deficiency as compared to >2 per cent among the controls. The presence of a deficiency was established >through measurements of the levels of vitamin B-12, total homocysteine, and >methylmalonic acid in the blood. The deficiencies were corrected by daily >injections of 1000 micrograms of vitamin B-12 for five days followed by >monthly injections. Folic acid supplementation (1 mg/day) was also used. >The researchers recommend that physicians ensure that those of their >patients who had gastric surgery, no matter how long ago, be checked >periodically for a vitamin B-12 deficiency. If one is found, the patients >should be given lifelong vitamin B-12 therapy (periodic intramuscular >injections). > Sumner, Anne E., et al. Elevated methylmalonic acid and total >homocysteine levels show high prevalence of vitamin B-12 deficiency after >gastric surgery. Annals of Internal Medicine, Vol. 124, No. 5, March 1, >1996, pp. 469-76 > > Vitamins prevent heart attacks > BOSTON, MASSACHUSETTS. Researchers at the Harvard Medical School >confirm that a high blood level of homocysteine is a potent risk factor for >a first heart attack (myocardial infarction). Homocysteine is an amino acid >formed during the metabolism of methionine (an amino acid found in >proteins). The researchers measured the blood plasma levels of >homocysteine, vitamin B-6, vitamin B-12, and folate (folic acid) in 130 >Boston area residents who had suffered a first heart attack. The results >were compared to levels found in 118 matched controls. The homocysteine >levels were an average 11 per cent higher in the heart attack victims than >in the controls. A high homocysteine level (>11.2 micromol/L) corresponded >to a five-fold increase in heart attack risk over the incidence rate at a >low level (<7.2 micromol/L). The increase in risk was linear with a 3 >micromol/L increase in homocysteine level corresponding to a 35 per cent >increase in heart attack risk. The researchers also found that high blood >levels of vitamin B-6 and folic acid provide significant protection against >heart attacks. No clear assocation was found between vitamin B-12 levels >and heart attack risk. There was a strong inverse relationship between >homocysteine levels and folate levels indicating that an adequate folate >intake is essential to normalizing homocysteine levels. The researchers >found that homocysteine levels were lowest at a folate intake of 350-400 >micrograms/day and recommend a daily folate intake of 400 micrograms/day >(the current RDA is 200 micrograms/day). > Verhoef, Petra, et al. Homocysteine metabolism and risk of >myocardial infarction: relation with vitamins B-6, B-12, and folate. >American Journal of Epidemiology, Vol. 143, No. 9, May 1, 1996, pp. 845-59 > > Vitamin B-12 deficiency common in older people > MOLNLYCKE, SWEDEN. Swedish researchers have discovered that many >older people are deficient in vitamin B-12. Their study involved 368 men >and women aged 75 years or older. Analysis of blood serum showed that 11 >per cent of the participants were deficient in cobalamins (vitamin B-12). >The researchers point out that a vitamin B-12 deficiency has been linked to >neuropsychiatric disorders such as memory loss and dementia. The >researchers discovered several cases of gastritis (inflammation of the >lining of the stomach) and two cases of celiac disease among patients with >low serum values of cobalamins. They conclude that routine screening for a >vitamin B-12 deficiency is justified in the case of older people. > > In a separate letter to the Journal of the American Geriatrics >Society doctors from the Union Memorial Hospital in Baltimore report on a >case of vitamin B-12 deficiency. The patient, an 85-year-old man, had >developed progressive memory loss and lethargy over a two-year period. >Although his serum level of vitamin B-12 was within the currently accepted >range, the doctors decided to proceed with vitamin B-12 therapy. The >patient received an intramuscular injection of 1000 micrograms of vitamin >B-12 for three consecutive days, then 1000 micrograms weekly for a month, >and then one injection every month. By the fifth injection his mental >status had vastly improved and his lethargy had completely vanished. The >doctors conclude that the levels of serum vitamin B-12 concentrations >currently considered normal in the United States may be too low and should >be reassessed. The lower limit of 200 pg/mL is based on the level which >causes abnormalities in the blood (pernicious anemia). In contrast the >lower limit in Japan and some European countries is 500-550 pg/mL and is >based on the level which causes mental manifestations such as dementia and >memory loss. The doctors suggest that a trial of vitamin B-12 therapy is >warranted in patients with borderline cobalamin serum levels as it is >effective and inexpensive. > Eggersten, Robert, et al. Prevalence and diagnosis of cobalamin >deficiency in older people. Journal of the American Geriatrics Society, >Vol. 44, No. 10, October 1996, pp. 1273-74 > Goodman, Mark, et al. Are U.S. lower normal B-12 limits too low? >Journal of the American Geriatrics Society, Vol. 44, No. 10, October 1996, >pp. 1274- 75 > > Vitamins may help prevent strokes in lupus patients > BALTIMORE, MARYLAND. Systemic lupus erythematosus (SLE) patients >have an increased risk of suffering strokes, heart attacks, and other >arterial thrombotic events such as gangrene of the fingers. It is believed >that this higher risk is at least partially related to a greater propensity >among SLE patients to develop premature atherosclerosis. High >concentrations of homocysteine (a sulphur-containing amino acid) have >previously been linked to an increased risk of stroke and coronary artery >disease. Now researchers at the Johns Hopkins Medical Institutions report >that many SLE patients have high homocysteine levels and that these higher >levels correspond to a significantly increased risk for stroke and other >thrombotic events. The study involved 337 SLE patients who were followed >for an average of 4.8 years. The average age of the patients was 35 years >and 93 per cent of them were women. The researchers found that 15 per cent >of the patients had raised homocysteine levels (greater than 14.1 >micromol/liter). They also noted a strong inverse correlation between >homocysteine levels and the levels of folic acid and vitamin B-6 in the >blood. After adjusting for other relevant risk factors the researchers >conclude that SLE patients with elevated homocysteine levels have a 2.4 >times higher risk of having a stroke and a 3.5 times higher risk of having >an arterial thrombotic event. The researchers suggest that supplementation >with folic acid and vitamin B-6 may help prevent thrombotic events in SLE >patients. Other studies have found a clear inverse correlation between >homocysteine levels and vitamin B-12 levels. This correlation was not >observed in the present study - most likely because the patients were >relatively young and therefore less likely to be deficient in vitamin B- >12. > Petri, Michelle, et al. Plasma homocysteine as a risk factor for >atherothrombotic events in systemic lupus erythematosus. The Lancet, Vol. >348, October 26, 1996, pp. 1120-24 > > Oral administration of vitamin B-12 is effective > BRUSSELS, BELGIUM. Older people are often found to have a vitamin >B-12 deficiency even though they do not suffer from pernicious anemia. The >body's ability to absorb vitamin B-12 from food decreases markedly with age >probably because of a lack of stomach acid. The conventional way of >correcting a vitamin B-12 deficiency has been through intramuscular >injection of the vitamin. Now researchers at the Universities of Brussels >and Antwerp report that oral administration of free vitamin B-12 is >effective in normalizing low vitamin B-12 levels. Their experiment involved >94 patients without pernicious anemia with a mean age of 84 years who >through repeated tests had been found to have an average vitamin B-12 level >(in serum) of 146.5 ng/L. The patients were treated for one month with 100 >micrograms/day of vitamin B-12 taken as an oral solution of the vitamin in >water (10 ml of a solution containing 1 mg vitamin B-12 in 100 ml water). >After 10 days 69 per cent of the patients had normal vitamin B-12 levels >(271.5 ng/L average) and after 30 days 88 per cent had achieved normal >levels (371.2 ng/L average). The researchers conclude that older patients >with a vitamin B-12 deficiency unrelated to pernicious anemia can be >successfully treated with orally administered vitamin B- 12. > Verhaeverbeke, I., et al. Normalization of low vitamin B-12 serum >levels in older people by oral treatment. Journal of the American >Geriatrics Society, Vol. 45, No. 1, January 1997, p. 124 (letter to the >editor) > > Vitamin B12 deficiency linked to neuropsychiatric abnormalities > KINGSTON, CANADA. Dr. Dianne Delva, MD, Assistant Professor of >Family Medicine at Kingston University, reviews the evidence for and >against routine supplementation with vitamin B12 (cobalamin) in the >elderly. Several studies have shown that anywhere from 5 to 15 per cent of >elderly people suffer from a vitamin B12 deficiency. Although the only >formally recognized disorder linked to a cobalamin deficiency is >megaloblastic anemia, it is now becoming clear that many neurologic and >psychiatric symptoms may also be caused by a vitamin B12 deficiency. Ataxia >(shaky movements and unsteady gait), muscle weakness, spasticity, >incontinence, hypotension, vision problems, dementia, psychoses, and mood >disturbances are but a few of the disorders which have recently been linked >to possible vitamin B12 deficiencies. Dr. Delva points out that these >disorders may occur at vitamin B12 levels just slightly lower than normal >and considerably above the levels normally associated with anemia. She also >cautions that the blood level of cobalamin is an unrealiable indicator of >deficiency and that tissue levels of the vitamin may be quite low even >though the blood levels are normal. The best test of cobalamin deficiency >involves measuring the blood levels of homocysteine and methylmalonic acid. >If the level of these two precursors to the metabolic reactions controlled >by cobalamin are high then the vitamin B12 level is low. Vitamin B12 >deficiencies may be treated by injections of the vitamin or by oral >supplementation. Oral supplementation is just as effective as injections in >most people and a lot less expensive. An oral dose of 100-250 >micrograms/day is usually adequate although patients with absorption >difficulties may need 1000 micrograms/day. Cobalamin has no known toxic >effects. > Delva, M. Dianne. Vitamin B12 replacement - To B12 or not to B12? >Canadian Family Physician, Vol. 43, May 1997, pp. 917-22 > > Major new risk factor for heart disease discovered > VANCOUVER, CANADA. It is becoming increasingly evident that an >elevated blood level of homocysteine is a potent risk factor for >cardiovascular disease. Recent studies also suggest that high homocysteine >levels may be associated with kidney disease, psoriasis, breast cancer, and >acute lymphoblastic leukemia. Extensive past research has shown a close >link between the development of neural-tube defects in babies and the >mother's homocysteine level prior to and during pregnancy. Researchers at >the University of British Columbia have just released a major report which >summarizes the current knowledge about homocysteine and its effect on >health. Homocysteine is formed in human tissues during the metabolism of >methionine, a sulfur-containing essential amino acid. A normal, desirable >level is 10 micromol/L or less. A level of 12 micromol/L is considered >borderline and levels of 15 micromol/L or above are considered to be >indicative of increased risk for cardiovascular disease. Several factors >(age, smoking, vitamin deficiencies, and genetic abnormalities) have been >linked to increased homocysteine levels. Medications that interact with >folate such as methotrexate, carbamazepine, phenytoin, and >colestipol/niacin combinations have also been linked to increased >homocysteine levels. The researchers reviewed 23 studies dealing with the >association between atherosclerosis and homocysteine levels and found that >patients with vascular diseases had an average level of homocysteine that >was 26 per cent higher than the level in healthy subjects. One study found >that a homocysteine level of 4 micromol/L above normal corresponds to a 41 >per cent increase in the risk of developing vascular disease. Another study >estimates that the lives of 56,000 Americans could be saved every year if >average homocysteine levels were lowered by 5 micromol/L. The researchers >conclude that abnormally high homocysteine levels are a potent risk factor >for cardiovascular and several other diseases. They point out that elevated >homocysteine levels can, in most cases, be safely and effectively lowered >by supplementation with as little as 400 micrograms per day of folic acid. >Other researchers have found that a combination of folic acid (0.4-10 >mg/day), vitamin B-12 (50-1000 micrograms/day), and vitamin B-6 (10-300 >mg/day) is highly effective in lowering homocysteine levels. (153 >references). Medical doctors at the University of Wisconsin echo the >findings of the Canadian researchers in a separate report and describe a >case of a 57-year-old man who lowered his homocysteine level from 29 >micromol/L to 2 micromol/L by supplementing with 800 micrograms/day of >folic acid for two months. > Moghadasian, Mohammed H., et al. Homocysteine and coronary artery >disease. Archives of Internal Medicine, Vol. 157, November 10, 1997, pp. >2299-2308 > Fallest-Strobl, Patricia C., et al. Homocysteine: A new risk factor >for atherosclerosis. American Family Physician, Vol. 56, October 15, 1997, >pp. 1607-12 > > Oral vitamin B12 and pernicious anemia > MINNEAPOLIS, MINNESOTA. Pernicious anemia can be treated with >intramuscular injections of cobalamin (vitamin B12). These injections can >be painful and expensive, but are still widely used despite the fact that >research done 30 years ago clearly established that oral doses of one >mg/day of vitamin B12 are effective in treating pernicious anemia and other >cobalamin deficiency disorders. The problem, according to Dr. Frank >Lederle, MD of the Minneapolis Veterans Affairs Medical Center, is that >physicians are unaware that oral cobalamin works. Dr. Lederle performed a >survey among Minneapolis internists in 1989 and again in 1996. In 1989 none >of the 245 respondents used oral cobalamin in the treatment of pernicious >anemia. In 1991 a review of the use of oral cobalamin was published in the >Journal of the American Medical Association. A subsequent survey in 1996 >showed that 19 per cent of the 223 internists responding were now using >oral cobalamin. However, even in 1996, 71 per cent of the internists still >held the incorrect view that sufficient quantities of cobalamin cannot be >absorbed from oral supplements (91 per cent of the internists held this >view in 1989). Dr. Lederle concludes that the majority of Minneapolis >interns are still unaware of the oral treatment option. > Lederle, Frank A. Oral cobalamin for pernicious anemia: back from >the verge of extinction. Journal of the American Geriatrics Society, Vol. >46, September 1998, pp. 1125-27 > > Vitamin B-12 increases efficiency of folic acid > BONN, GERMANY. There is increasing evidence that high blood levels >of the amino acid homocysteine increases the risk of vascular disease, >coronary heart disease, neural tube defects, and Alzheimer's disease. Folic >acid supplementation is known to lower homocysteine levels and laws have >recently been passed in the United States mandating folic acid >fortification of bread and cereal. Now researchers at the University of >Bonn report that folic acid's homocysteine lowering capacity can be >markedly increased by also supplementing with vitamin B-12 (cobalamin). >Their study involved 150 young, healthy women (average age of 24 years) who >after a four-week washout period were randomized into three groups. Group 1 >received a daily supplement of 400 micrograms of folic acid, group 2 >received 400 micrograms/day of folic acid and 6 micrograms/day of vitamin >B-12, and group 3 received 400 micrograms/day of folic acid and 400 >micrograms/day of vitamin B-12. After four weeks the average concentration >of plasma homocysteine had dropped by 11 per cent in group 1, 15 per cent >in group 2, and 18 per cent in group 3. The researchers noted that study >participants with high initial homocysteine concentrations benefitted more >from supplementation than did women with lower initial homocysteine levels. >It was also noted that vitamin B-12 levels increased significantly over the >four-week period in the women whose supplements included vitamin B-12. This >provides further proof that oral vitamin B-12 is indeed adequately >absorbed. The researchers conclude that the benefits of folate >supplementation can be markedly enhanced by the addition of vitamin B- 12. >They point out that vitamin B-12 deficiency is widespread especially among >the elderly. The addition of vitamin B-12 to folic acid supplements also >prevents the possibility that supplementation with just folic acid could >mask pernicious anemia resulting from a vitamin B-12 deficiency which in >turn may lead to irreversible nerve damage. > Bronstrup, Anja, et al. Effects of folic acid and combinations of >folic acid and vitamin B-12 on plasma homocysteine concentrations in >healthy, young women. American Journal of Clinical Nutrition, Vol. 68, >November 1998, pp. 1104-10 > > Vitamin B-12 - Is oral supplementation effective? > CAMBRIDGE, UNITED KINGDOM. It is common medical dogma that patients >suffering from pernicious anemia are unable to absorb sufficient vitamin >B-12 from their diet and therefore require intramuscular injections of the >vitamin on a regular basis. Recent research is questioning this assumption. >In a commentary in The Lancet Dr. M. Elia of the Dunn Clinical Nutrition >Centre persuasively outlines the reasons why oral supplementation is at >least as effective as intramuscular injections. Dr. Elia points out that >vitamin B- 12 is absorbed from the intestine via two different routes. One >involves intrinsic factor and is estimated to lead to absorption of about >60 per cent of the amount of vitamin B-12 ingested in the diet. The other >does not need intrinsic factor (which is absent in pernicious anemia >patients) and only leads to absorption of about 1 per cent of the ingested >amount. The body needs about 1-2.5 micrograms/day so oral supplementation >with 100-200 micrograms/day should be adequate. However, Dr. Elia suggests >a daily intake of 1000 micrograms/day is needed to ensure successful long >term results in patients with pernicious anemia. A recent study showed that >oral supplementation with 2000 micrograms/day was three times as effective >as intramuscular injections in increasing vitamin B-12 levels in pernicious >anemia patients. Dr. Elia also questions whether the current RDA >(Recommended Dietary Allowance) of 1-2.5 micrograms/day is adequate for >older people. He points out that mild vitamin B-12 deficiency, which can >lead to abnormalities in cognitive function and increased risk of >cardiovascular disease, affects 12-15 per cent of all elderly people in the >United States where the average daily vitamin B-12 intake is about six >micrograms - well above the RDA. > Elia, M. Oral or parenteral therapy for B12 deficiency. The Lancet, >Vol. 352, November 28, 1998, pp. 1721-22 (commentary) > > A daily vitamin pill helps combat atherosclerosis > CLEVELAND, OHIO. A high blood level of the amino acid homocysteine >has been linked to an increased risk of atherosclerosis and thrombosis. It >is known that oral supplementation with folic acid will lower homocysteine >levels to acceptable norms, but it is not clear just how much folic acid is >required to achieve this effect. Now researchers at the Cleveland Clinic >Foundation report that the amount of folic acid (400 micrograms) found in >most multivitamin preparations is sufficient to lower homocysteine levels >in heart disease patients. Their experiment involved 95 patients who had >either had a heart attack or suffered from advanced atherosclerosis. The >patients were divided into four groups with one group receiving 400 >micrograms/day (0.4 mg/day) of folic acid, one group receiving 1 mg/day, >one group receiving 5 mg/day, and the fourth group receiving a placebo. All >patients receiving folic acid also received 12.5 mg of vitamin B6 per day >and 500 micrograms of vitamin B12. After 90 days the plasma homocysteine >levels had dropped from 13.8 to 9.6 micromol/L in the 400 micrograms/day >folic acid group, from 13.0 to 9.8 micromol/L in the 1 mg/day group, and >from 14.8 to 9.7 micromol/L in the 5 mg/day group. Also after 90 days the >plasma levels of folic acid had risen from 28 nanomol/L in the placebo >group to 63 nmol/L in the 400 micrograms/day supplement group, to 80 nmol/L >in the 1 mg/day group, and to 162 nmol/L in the 5 mg/day group. Vitamin B6 >levels rose from 75 nmol/L to about 250 nmol/L in the supplemented groups >and vitamin B12 levels rose from about 300 picomol/L to 525 picomol/L. The >researchers conclude that a daily dose of 400 micrograms of folic acid >combined with vitamins B6 and B12 will normalize homocysteine levels in >heart disease patients. > Lobo, Arlene, et al. Reduction of homocysteine levels in coronary >artery disease by low-dose folic acid combined with vitamins B6 and B12. >American Journal of Cardiology, Vol. 83, March 15, 1999, pp. 821-25 > > Vitamin B12 deficiency and breast cancer > BALTIMORE, MARYLAND. Researchers at the Johns Hopkins University >report that women with breast cancer tend to have lower vitamin B12 levels >in their blood serum than do women without breast cancer. The researchers >determined vitamin B12 concentrations in blood samples obtained in 1974 and >in 1989 and compared the levels found in 195 women who later developed >breast cancer with the levels found in 195 women free of cancer. They found >that postmenopausal women with the lowest serum levels of vitamin B12 had a >2.5-4.0 times greater likelihood of being in the breast cancer group than >did women with the highest levels. The researchers found no correlation >between breast cancer risk and serum levels of folic acid, vitamin B6, and >homocysteine. > > In a subsequent review of the findings Dr. Sang-Woon Choi, MD of >Tufts University points out that serum levels of folate are a poor >indicator of levels in tissues and that it may well be that there is a >correlation between folate levels in breast tissue and breast cancer risk. >Dr. Choi speculates that a vitamin B12 deficiency may lead to breast cancer >because it could result in less folate being available to ensure proper DNA >replication and repair. > Wu, K., et al. A prospective study of folate, B12, and pyridoxal >5'-phosphate (B6) and breast cancer. Cancer Epidemiol. Biomarkers Prev., >Vol. 8, March 1999, pp. 209-17 > Choi, Sang-Woon. Vitamin B12 deficiency: a new risk factor for >breast cancer? Nutrition Reviews, Vol. 57, August 1999, pp. 250-60 > > Vegetarians are vitamin B12 deficient > SYDNEY, AUSTRALIA. It is generally assumed that vitamin B12 >deficiencies are rare among people consuming a varied diet. However, there >is some question whether vegetarians get enough B12 as it is not present in >plants. Researchers at the Sydney Adventist Hospital have just completed a >study aimed at resolving this question. Their study involved 245 Adventist >ministers who were either lactoovovegetarians or vegans. The average age of >the ministers was 46 years (range 22 to 80 years) and most of them had been >vegetarians for over 20 years. The study participants filled out a diet >questionnaire and had a fasting blood sample drawn for a 20-test >biochemical profile including vitamin B12 concentrations. The mean vitamin >B12 level was 199 pmol/L and 73 per cent of the ministers had a level below >the recommended lower limit of 221 pmol/L. Vitamin B12 concentrations were >also measured in a control group of 53 ministers who consumed fish, poultry >or red meat on a regular basis. In this group 40 per cent had vitamin B12 >concentrations below the recommended lower limit; this indicates that >vitamin B12 deficiency is widespread even among non-vegetarians. > > Additional tests showed that the vitamin B12 deficiencies observed >among lactoovovegetarians were due to dietary deficiencies rather than to >malabsorption. The researchers conclude that as many as 73 per cent of >Australian vegetarians are vitamin B12 deficient and recommend that they >increase their intake either from vitamin B12-containing foods (animal >products), from supplements or from vitamin B12-fortified foods. > Hokin, Bevan D. and Butler, Terry. Cyanocobalamin (vitamin B-12) >status in Seventh-day Adventist ministers in Australia. American Journal of >Clinical Nutrition, Vol. 70, September 1999, pp. 576S-78S > > > > End of Group > > > > > FOLIC ACID RESEARCH REPORT VITAMIN B12 > > > > > MESSAGE TO THE EDITOR HOMEPAGE SUBSCRIPTION INFORMATION > > > > > International Health News is published monthly by Hans R. Larsen, >1320 Point Street > Victoria, BC, Canada V8S 1A5 > Phone: (250) 384-2524 > E-mail: health > URL: http://www.yourhealthbase.com > ISSN 1203-1933..... 2000 by Hans R. Larsen > International Health News does not provide medical advice. Do not >attempt self- diagnosis or self-medication based on our reports. Please >consult your health-care provider if you wish to follow up on the >information presented. > > > _______________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com. Share information about yourself, create your own public profile at http://profiles.msn.com. Quote Link to comment Share on other sites More sharing options...
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