Folate and vitamin B biomarkers in NHANES: history of their measurement and use
NHANES measured folate and vitamin B status biomarkers, starting Unmetabolized serum folic acid and its relation to folic acid intake from Folate, cancer risk, and the Greek god, Proteus: a tale of two chameleons. Additional research is needed to assess the health effects of folic acid supplement use . B12 deficiency, as assessed by hematological indices, relation to environmental science and with respect Folate, cancer risk, and the Greek god. Learn the warning signs and symptoms of a vitamin B12 deficiency, what causes Additionally, folic acid may “mask” B12 deficiency by correcting for blood changes I mean god forbid you ever desperately needed it what would you do??.
Vitamin D is recognized as important in maintaining bone health and people with RA are at significantly increased risk for osteoporosis and bone loss due to RA disease processes and glucocorticoid use.
Adequate vitamin D intake also appears to protect against developing RA. Remember to consult with your doctor before you take any supplement. This is especially important with vitamin D, because taking too much of this vitamin can pose a danger to your health. These molecules are very unstable because they are constantly trying to pair their unpaired electron. This causes them to react with other substances in the body, causing what is sometimes called oxidative damage.
You can get the RDA of antioxidant vitamins by eating 3 to 4 servings of vegetables and 2 to 4 servings of fruits every day. However, you can also take supplements to ensure that you are getting adequate amounts of these vitamins.
Dietary sources of calcium include dairy products, leafy vegetables, and fortified foods like cereal.
Natural remedies, vitamins, and supplements for RA
People with RA are at increased risk for bone loss, so adequate calcium intake is crucial RDA for adults: However, calcium taken in excess may result in toxic effects. Selenium is one of the minerals that is frequently seen at low levels in people with RA.
Talk to your doctor about if you should take selenium supplements and at what recommended dose. Magnesium is important in many functions in the body, including the production of protein, management of blood sugar, regulation of blood pressure, and the normal function of muscles, nerves and the rhythm of the heart. Magnesium is found in leafy green vegetables, legumes, nuts, seeds, and whole grains.
Magnesium is also available in a supplement as powder or tablets. Dietary sources of zinc include poultry, meat, beans, and nuts. Although no study has implicated low levels of zinc as a cause of RA, results from studies have shown that some people with RA have low levels of zinc and that the metabolism of zinc may be impaired in individuals with RA. These supplements and preparations are available in different formulations, including as raw herbs freshly harvested, extracts in liquid or powder form, infusions made by steeping an herb or plant in boiling water like a teatinctures made by steeping an herb in alcohol, and topical preparations.
Herbal supplements and preparations listed below are categorized by their main effects, including anti-inflammatory, analgesic, and sleep-promoting effects. Anti-inflammatory herbal supplements Alfalfa — Although alfalfa has shown anti-inflammatory properties, there is insufficient evidence to recommend it for RA. In addition, some research suggests it may increase symptoms of auto-immune diseases like RA. Data from laboratory research suggests that some of the compounds in Angelica sinensis may have anti-inflammatory and anti-rheumatic properties.
However, additional studies are needed to confirm these effects in people with RA. However, there is insufficient evidence to recommend using bladderwrack for RA or any other condition. In addition, it contains significant amounts of iodine, which may be harmful to certain people, and may contain heavy metals, which can lead to heavy metal poisoning.
There is conflicting evidence on whether it is effective for osteoarthritis, and there is no evidence to show it has any benefit in RA. Curcumin has been studied in several clinical trials, and data suggests it may be beneficial in reducing pain and inflammation in people with RA.
A synthesized form of chondroitin given as an oral supplement often combined with glucosamine, another component of cartilage is used in patients with osteoarthritis where it has resulted in moderate to major improvements in joint symptoms, including decreased pain and improved function.
However, there is no evidence to show it benefits people with RA.How can folate mask a vitamin B12 deficiency?
It has shown to be beneficial for people with osteoarthritis; however, there is no research to prove its use in people with RA. It has demonstrated anti-inflammatory and pain relieving characteristics, and some research suggests it may help prevent migraine attacks. The survey collects information with the use of interviews, medical and physical examinations, and clinical tests under standardized conditions through home interviews and at mobile medical examination centers.
The findings provide the basis for national reference standards for measurements such as height, weight, and blood pressure.
Researchers also use these data to assess the prevalence of major diseases and inadequate or excessive nutritional status among US population groups and to identify correlates of these disease and health risks. Interrelated changes in science, user needs, and population-based environments occur concurrently but independently across survey time spans.
The NCHS must therefore update and revise NHANES content and measurement procedures frequently and in a manner that addresses user needs while it maintains sound science within the survey's mission, resource, and logistic limits.
To help with this effort, the NCHS and the Office of Dietary Supplements of the National Institutes of Health recently convened a roundtable expert panel to review the scientific and public health issues involved in past, current, and future measurement of folate and vitamin B status biomarkers in NHANES. 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. Nutritional strategies for treating chronic fatigue syndrome. Alternative Medicine Review, Vol. It is common medical dogma that patients suffering from pernicious anaemia are unable to absorb sufficient vitamin B from their diet and therefore require intramuscular injections of the vitamin on a regular basis.
Recent research is questioning this assumption. Elia of the Dunn Clinical Nutrition Centre persuasively outlines the reasons why oral supplementation is at least as effective as intramuscular injections.
Elia points out that vitamin B 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 ingested in the diet.
The other does not need intrinsic factor which is absent in pernicious anaemia patients and only leads to absorption of about 1 per cent of the ingested amount.
The body needs about He points out that mild vitamin B deficiency, which can lead to abnormalities in cognitive function and increased risk of cardiovascular disease, affects per cent of all elderly people in the United States where the average daily vitamin B intake is about six micrograms - well above the RDA.
Oral or parenteral therapy for B12 deficiency. Pernicious anaemia can be treated with intramuscular injections of cobalamin vitamin B The problem, according to Dr. Lederle performed a survey among Minneapolis internists in and again in In none of the respondents used oral cobalamin in the treatment of pernicious anaemia.
A subsequent survey in showed that 19 per cent of the internists responding were now using oral cobalamin. However, even in71 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 Lederle concludes that the majority of Minneapolis interns are still unaware of the oral treatment option.
Oral cobalamin for pernicious anemia: Older people are often found to have a vitamin B deficiency even though they do not suffer from pernicious anaemia. The body's ability to absorb vitamin B from food decreases markedly with age probably because of a lack of stomach acid.
Vitamin B12 and Folic Acid Benefits
The conventional way of correcting a vitamin B 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 levels.
Their experiment involved 94 patients without pernicious anaemia with a mean age of 84 years who through repeated tests had been found to have an average vitamin B level in serum of After 10 days 69 per cent of the patients had normal vitamin B levels The researchers conclude that older patients with a vitamin B deficiency unrelated to pernicious anaemia can be successfully treated with orally administered vitamin B Normalization of low vitamin B serum levels in older people by oral treatment.
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 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. Alpha-tocopherol protects against a reduction in adenosylcobalamin in oxidatively stressed human cells. Journal of Nutrition, Vol. Deficiency of vitamin B12 is common among older people. As this vitamin is crucial for brain and nervous system functioning, researchers have proposed that supplementation may have beneficial effects on cognitive function in this group.
However, randomized trial results have so far been inconclusive. Researchers from Wageningen University carried out a large study with a long duration and rigorous cognitive tests. They investigated the effects of daily oral supplementation with vitamin B12 at a high dose 1,ug on adults aged 70 years or above with a mild deficiency. High-dose vitamin B12 supplements are considered to be safe and no upper safety level has been set in the US or Europe.
Among the group of participants, some were given ug folic acid alongside the vitamin B12, and others a placebo. Compliance was very high, with a mean of 99 per cent. After 24 weeks, vitamin B12 status and cognitive function were assessed. Vitamin B12 supplementation reversed deficiency, and those taking folic acid showed raised folic acid levels in their red blood cells. Both supplementation groups had lower homocysteine levels, which is beneficial in terms of heart disease risk.
Homocysteine was lowered to a greater extent in the combined supplement group, as expected based on knowledge of how the two nutrients interact. However, neither supplement was linked to better results than placebo on tests of cognitive performance which covered attention, construction, sensomotor speed, memory, and executive function.
Participants in all three groups showed improved memory, but the researchers concluded that the supplementation regimes used in this study did not lead to improved cognitive function.
This may be because a longer course of vitamin B12 is necessary to repair any existing cognitive damage. Despite the results, the authors write, these findings cannot exclude beneficial effects on cognitive function from longer-term vitamin B12 supplementation. Individuals who have had mild cognitive impairment for less than six months may also be more likely to respond to treatment with vitamin B Effect of oral vitamin B with or without folic acid on cognitive function in older people with mild vitamin B deficiency: Two years ago researchers at the Massachusetts General Hospital reported that the antibiotic clioquinol inhibited and even reduced the build-up of amyloid plaques in the brain of mice engineered to developed Alzheimer-like deposits.
Now researchers at the Harvard Medical School and the University of Melbourne are about to release the results of a phase II trial involving the use of clioquinol in human Alzheimer's patients. So far the findings are extremely promising.
Clioquinol treatment slowed down the disease and significantly reduced the accumulation of beta-amyloid plaques, a cardinal feature of Alzheimer's. Ashley Bush of the Harvard Medical School believes that Alzheimer's disease begins when iron, copper and zinc accumulates in the brain and turns beta-amyloid into a rogue enzyme that catalyses the production of hydrogen peroxide which then attacks and destroys brain cells.
In the process beta-amyloid forms into the long chain of insoluble plaque so characteristic of Alzheimer's. Bush believes that clioquinol works by removing chelating? This, in turn, stops the formation of hydrogen peroxide and thus the destruction of brain cells and also prevents the beta-amyloid particles from clumping together.
There is some concern that clioquinol depletes vitamin-B12 in the body so vitamin B12 supplementation is a must when taking clioquinol. An antibiotic to treat Alzheimer's?
You must remember this… New Scientist, August 3,p. Vitamin B12 deficiency is associated with the development of megaloblastic anemia, mental dysfunction, and dementia resembling Alzheimer's disease.
Vitamin-B12 cobalamin is a very important cofactor in several biochemical reactions including the conversion of homocysteine to methionine and the synthesis of SAMe S-adenosylmethionine. These reactions are believed to be crucial in maintaining neurological health. Researchers at the University of Milan now report that a vitamin B12 deficiency is associated with higher levels of the inflammatory cytokine, tumour necrosis factor-alpha TNF-alpha and reduced levels of epidermal growth factor EGF.
It is believed that high levels of TNF-alpha speed up the progression of Alzheimer's disease thus explaining the association between low vitamin B12 levels and Alzheimer's. Vitamin B12 deficiency is widespread among older people. Taking a 1 mg sublingual B12 tablet daily could prevent a lot of future health problems. Vitamin B12 deficiency, tumor necrosis factor-alpha and epidermal growth factor: Some studies have found a correlation between low vitamin B12 levels and the development of Alzheimer's disease AD and dementia; other studies have found no such correlation.
Researchers at the Karolinska Institute now provide convincing evidence that a deficiency of either vitamin B12 or folic acid folate is associated with an increased risk of AD and dementia. Their study involved non-demented people aged 75 years and older who were not supplementing with vitamin B12 or folate. The participants were tested at baseline to determine mental status and had blood samples drawn for analysis of vitamin-B12 and folate levels. Only subjects who showed no signs of dementia was included in the follow-up group.
Three years later 77 of the participants had developed dementia; of these 59 were diagnosed with AD. Compared with participants with normal levels of vitamin B12 and folate the participants with low levels of at least one of the vitamins had a 2. These risk estimates were obtained after adjusting for other risk factors such as age, sex, and educational attainment.
The researchers speculate that homocysteine, a known neurotoxin, may be involved in the development of AD and that vitamin B12 and folic acid help prevent this effect by reducing homocysteine levels in the body. Wang, H-X, et al.
Vitamin Bfolate interrelationships.
Vitamin B12 and folate in relation to the development of Alzheimer's disease. 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 B Vitamin B12 deficiency in itself often causes disorientation and confusion and thus mimics some of the prominent symptoms of Alzheimer's disease.
Familial Alzheimer's disease and vitamin B12 deficiency. Age and Ageing, Vol. Since it has been mandatory to fortify grain-based foods with folic acid in the United States.
Recent reports indicate that this measure has resulted in a 19 per cent decrease in the incidence of neural tube defects. A similar fortification program is being considered in the UK. Irish researchers now suggest that the fortification protocol should include not only folic acid, but also vitamin B They point out that folic acid supplementation also lowers the level of homocysteine, a potent risk factor for heart and vascular disease.
However, a recent trial carried out by the Dublin researchers clearly showed that as blood levels of folic acid increased through supplementation, blood levels of vitamin-B12 became the limiting factor. In other words, additional folic acid as well as additional vitamin B12 is required in order to attain the maximum reduction in homocysteine levels.
Four to five hundred micrograms per day of folic acid were found to increase folic acid levels by 80 to per cent and lower homocysteine levels by about 30 per cent in both men and women.
Both folate and homocysteine levels tended to revert to their pre-supplementation levels after 10 weeks of no supplementation; this shows that continuous supplementation is necessary in order to keep homocysteine levels under control. Importance of both folic acid and vitamin B12 in reduction of risk of vascular disease.
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 B High homocysteine levels can induce endothelial dysfunction a narrowing of the arterieswhich 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 B 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 hour overnight fast. They were then given an oral methionine-loading test to simulate the intake of a high protein meal. 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, mg of vitamin B6, and 0. At the end of the five weeks their average homocysteine level had decreased to 5.
The methionine-loading test was repeated. 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.
- Always check with your doctor first
- Basics about vitamins and minerals
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. 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 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. All patients receiving folic acid also received After 90 days the plasma homocysteine levels had dropped from The researchers conclude that a daily dose of 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 B 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 cobalamin. Their study involved young, healthy women average age of 24 years who after a four-week washout period were randomized into three groups.
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 benefited more from supplementation than did women with lower initial homocysteine levels.
It was also noted that vitamin B levels increased significantly over the four-week period in the women whose supplements included vitamin B This provides further proof that oral vitamin B is indeed adequately absorbed. The researchers conclude that the benefits of folate supplementation can be markedly enhanced by the addition of vitamin B They point out that vitamin B deficiency is widespread especially among the elderly.