Vitamin B pills help Alzheimer’s disease Vitamins B12, B6 and Folic Acid (B9

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The vitamins B12, B6 and folic acid pill is the first effective “drug” to slow down the progression of Alzheimer’s disease he concept loo!s promising The "roceedings of the #ational Academ$ of %ciences recentl$ pu&lished information a&out a stud$ on aging volunteers that has demonstrated how this com&ination of B vitamins has, in their trials, slowed atroph$ of gra$ matter in &rain areas affected &$ Alzheimer’s disease 'n the words of senior stud$ author A (avid %mith, professor emeritus of pharmacolog$ at )*ford +niversit$ in ,ngland, “'t’s a &ig effect, much &igger than we would have dreamt of ”

According to an article on Bloom&ergBusinesswee! com, volunteers for the "#A% stud$ were given either a place&o or a com&ination of - . milligrams of vitamin B12, 2milligrams of vitamin B6 and - / milligrams of folic acid At the start of the trial, the participant’s &rains were scanned using magnetic0resonance imaging Blood levels of the protein homoc$steine were also measured The tests were repeated two $ears later The two 12' scans were compared to see how much gra$ matter was lost in &rain regions most affected &$ Alzheimer’s disease 'n doing so, the researchers could see that the participants ta!ing the vitamin coc!tail showed a significantl$ smaller amount of &rain shrin!age in those specific regions than in the control su&3ects The "#A% stud$ trac!ed 1.6 people ages 4- and older who had mild memor$ loss and high levels of homoc$steine, which has &een lin!ed to dementia Among people with elevated homoc$steine, the stud$ found that the amount of gra$ matter declined . 2 percent in those ta!ing a place&o, compared with - 6 percent in those who too! the vitamin coc!tail %mith declared that, “'t’s the first and onl$ disease0modif$ing treatment that’s wor!ed 5e have proved the concept that $ou can modif$ the disease ”

The aging brain
As people age their &rains shrin! appro*imatel$ - . percent a $ear from the age of 6- 'f there is a deficienc$ of B12, or if mild cognitive impairment 617'8 or Alzheimer’s disease is present, the rate of shrin!age is accelerated These researchers sa$ that slowing the shrin!age of the &rain ma$ dela$ the disease’s progression “so that older people can en3o$ &etter lives until the$ die from another cause ” 9ess %mith, who is a research communications officer at the Alzheimer’s %ociet$ in the + : sa$s that, “'f $ou dela$ the onset &$ five $ears, $ou can halve the num&er of people d$ing from it ” 9ess %mith is not related to A (avid %mith

A health$ diet leaning toward a 1editerranean diet, regular e*ercise, an active &rain and socialization have &een considered &$ man$ scientists to &e the &est e*isting defense against developing the s$mptoms of Alzheimer’s 'f studies continue to show that supplementing a health$ lifest$le with a com&ination of vitamins B12, B6 and folic acid could potentiall$ slow &rain shrin!age and the s$mptoms of Alzheimer’s disease, man$ of us could have a &etter chance of en3o$ing the ;ualit$ of our later $ears of life )f course, there’s much more to &e learned <owever, this stud$ gives us hope that a relativel$ ine*pensive method to assist in protecting our &rains is at hand =or as long as he can remem&er, 9ohn <ough has suffered from a poor memor$ >' hated learning poems at school ? after a few lines it had all gone,’ sa$s the /@0$ear0old retired electrical engineer from Ban&ur$ <is memor$ onl$ worsened with age ><e’s alwa$s &een forgetful,’ sa$s :athleen, his /-0 $ear0old wife, who 3ust happens to have a photographic memor$ But, increasingl$, she was finding herself having to remind him a&out things >5e have had our differences over memor$,’ she adds diplomaticall$ But &oth are firml$ agreed on one thingA the letter five $ears ago inviting 9ohn to ta!e part in a trial to test whether high doses of several B vitamins could protect his ageing memor$ was a godsend =or although :athleen, a retired universit$ lecturer in ph$siolog$, still has to remind her hus&and to ta!e his vitamins, she is happ$ to do so >&ecause ' reall$ noticed the difference when he stopped ta!ing them’ This has &een reinforced &$ research pu&lished $esterda$ in the top 3ournal "roceedings of the #ational Academ$ of %ciences, which showed that people in the trial who got the B vitamins were almost entirel$ protected from the &rain shrin!age suffered &$ those who onl$ got a place&o pill A rapidl$ shrin!ing &rain is one of the signs of a raised ris! for Alzheimer’s Those ta!ing the B vitamins had B- per cent less shrin!age in their &rains And the research showed the areas of the &rain that were protected from damage are almost e*actl$ the same Alzheimer’s t$picall$ destro$s This >Alzheimer’s footprint’ includes areas that control how we learn, remem&er and organise our thoughts, precisel$ those that graduall$ atroph$ as the ghastl$ disease progresses >'’ve never seen results from &rain scans showing this level of protection,’ sa$s "aul Thompson, professor of neurolog$ and head of the 'maging Cenetics 7enter at +7DA %chool of 1edicine, 7alifornia

Three pills ith startling res!lts
The new research unded &$ the Covernment’s 1edical 2esearch 7ouncil ran for two $ears &$ )"T'1A 6)*ford "ro3ect to 'nvestigate 1emor$ and Ageing8 at )*ford +niversit$, and involved 241 people with earl$ signs of a fading memor$, !nown as mild

cognitive impairment This can &e a precursor to Alzheimer’s The stud$ was designed to discover whether giving high doses of three B vitamins ? B6, B12 and folic acid ? could slow the rate at which the participants’ memor$ worsened As well as giving the participants standard memor$ and cognitive tests, the researchers scanned some of the volunteers’ &rains at the &eginning and end of the stud$ to see what effect, if an$, there was on the rate these were shrin!ing 5e all lose &rain cells as we get older, normall$ a&out half a per cent a $ear 'f $ou have mild cognitive impairment, that rises to 1  per cent, and when Alzheimer’s sets in, the atroph$ speeds up to 2E per cent

"o it slo s brain shrin#age
5h$ do e*perts thin! B vitamins might &e the answerF The lin! is that the$ effectivel$ help !eep in chec! our levels of an amino acid called homoc$steine #ormall$ we don’t have much of this &ecause it is ;uic!l$ turned into two important &rain chemicals, including acet$lcholine, which is essential for la$ing down memories There have &een lots of studies showing that Alzheimer’s patients have unusuall$ high levels of homoc$steine in their &loodstream The$ also have low levels of acet$lcholine 6in fact, the most common Alzheimer’s drug wor!s &$ &oosting acet$lcholine8

%o it seems that the usual conversion of homoc$steine into acet$lcholine is going wrong And that’s where the B vitamins are thought to come in )lder people are particularl$ li!el$ to &e deficient in these nutrients That’s &ecause, as we age, our &odies &ecome less good at getting it from food, and certain widel$0used drugs, such as proton pump inhi&itors for acid reflu*, ma!e the e*traction process even more difficult %o the thin!ing is, &oost B vitamins and $ou &oost the conversion of homoc$steine into acet$lcholine Another theor$ is that high levels of homoc$steine ma$ actuall$ trigger &rain shrin!age A further reason B vitamins could help is given &$ "rofessor Teodoro Bottiglieri Ba$lor, at the 'nstitute of 1eta&olic (isease in (allas, Te*as >The lin! &etween &rain deterioration ? memor$ loss, cognitive deficits ? and B vitamin deficienc$ is standard neurolog$ te*t&oo! stuff,’ he sa$s >Gou get it with various disorders that prevent B vitamins functioning properl$, such as severe alcoholism and pernicious anaemia ’ <owever, the )*ford trial was the first time the vitamin B theor$ had &een tested in a proper trial 5hen the initial results were pu&lished in the leading 3ournal "Do% )#, in 2-1-, two findings attracted a lot of attention =irst, the vitamins appeared to halve shrin!age across the whole &rain compared with the &rains of the people ta!ing the place&o pill But second, and ver$ significantl$, the vitamins onl$ &enefited people who had a high homoc$steine level ? over 1@ 6a health$

level is said to &e &etween a&out seven and ten8 >'t was a useful finding,’ sa$s (avid %mith, professor emeritus of pharmacolog$ at )*ford, and lead researcher on the trial >'t showed $ou’ll onl$ &enefit from the vitamins if $our homoc$steine level is high, &ut it also told us that when it rises a&ove a health$ level it can damage &rain cells ’ But the trial didn’t answer an important ;uestionA (oes &rain shrin!age ma!e $ou lose $our memor$F 't sounds ver$ plausi&le that it should, and tests showed that the memor$ of people getting the vitamins stopped getting worse <owever, the researchers couldn’t sa$ for certain this was &ecause their &rains weren’t shrin!ing as ;uic!l$ That’s where the latest stud$ comes in 't involved a much more sophisticated anal$sis of the &rain scans from the first stud$, &$ a new team from the =unctional 1agnetic 2esonance 'maging 7entre at )*ford This anal$sis showed that the protection against shrin!age was even more effective than reported previousl$ ? not 3ust halving it, &ut reducing it &$ B- per cent The old stud$ had loo!ed at the whole &rainH this one onl$ loo!ed at the effect in the Alzheimer’s footprint and found that in there, 3ust where help was needed, the vitamins had an even greater impact The new stud$ also made the connection &etween less shrin!age and greater cognitive improvement A new statistical anal$sis esta&lished that slowing the rate of &rain atroph$ was directl$ responsi&le for slowing the rate at which the memor$ deteriorates

$ho’s li#el% to bene&it'
The studies ma!e a clear connection &etween too much homoc$steine and poorer memor$ The ne*t step might &e for homoc$steine to &e a new &iomar!er for Alzheimer’s ris!, tested for and lowered if necessar$

>The stud$ needs to &e repeated &ecause there’s a lot to learn a&out wh$ homoc$steine is damaging and whether lowering it can stop people with memor$ pro&lems progressing to Alzheimer’s,’ sa$s "rofessor Thompson >But if the results survive retesting, homoc$steine level could &e a useful &iomar!er for Alzheimer’s ris! ’ %o could B vitamins stop $ou developing Alzheimer’sF >5e can’t tell from this research &ecause it didn’t go on long enough,’ sa$s "rofessor %mith >'t would cost a&out I6  million to do the stud$ to prove it, &ut we haven’t &een a&le to get the funding %urel$ it would &e well worth it ’ (r Cwenaelle (ouaud, an imaging and neuroscience e*pert and leader of the new stud$, sa$sA >%lowing the progression is the <ol$ Crail of Alzheimer’s research >5e !now some people with mild cognitive impairment will go on to develop

Alzheimer’s and the &est mar!er of raised ris! at the moment is the amount of shrin!age in an area called the medial temporal lo&e This is right in the middle of the Alzheimer’s footprint ? the area B vitamins protect ’

There are a num&er of theories a&out how high homoc$steine harms the &rain >There is some evidence that it stimulates the growth of the “tangles” of protein in the &rain that are one sign of Alzheimer’s,’ sa$s (r (ouaud >Another possi&ilit$ is it could &e stopping the growth of new &rain cells in the hippocampus, a crucial region for ma!ing memories ’ The impressive results from this latest stud$ raise ;uestions that need more research The$ do suggest that it might &e worth having $our homoc$steine level tested to see if it is too high But it is not an eas$ test to get done

$hat abo!t side(e&&ects'
>1ost C"s are not ver$ familiar with homoc$steine ris!s, and it’s not a standard test, although $ou can get it done privatel$,’ sa$s (r %io&hain Juinn, a ps$chiatrist specialising in older mental patients at %t "eter’s <ospital, in 7hertse$, %urre$ ><owever, testing for B12 is ;uite common in the elderl$ and it is standard practice to give ta&lets or in3ections if it is too low %o that could &e a wa$ of getting treatment, &ut pro&a&l$ not in the high doses used in the )*ford trial ’ "rofessor (avid %mith &elieves it would &e wrong not to offer high0dose vitamins to someone with memor$ pro&lems and raised homoc$steine <is pu&lished papers state that he is named as an inventor on two patents held &$ the +niversit$ of )*ford on the use of folic acid to treat Alzheimer’s disease But 2o&in 9aco&$, emeritus professor of old0age ps$chiatr$ at )*ford, who was also involved in the first stud$, cautionsA >As a medical scientist ' wouldn’t advise an$one to ta!e high doses of B vitamins $et to protect their &rain without first consulting their C" >There is a lin! &etween high levels of folic acid and cancer, although the ris! is low ’ (r ,ric :arran, director of research at Alzheimer’s 2esearch +:, also doesn’t thin! the evidence is good enough $et >+ntil further trials have confirmed these findings, we would recommend people thin! a&out a health$ and &alanced diet along with controlling weight and &lood pressure, as well as ta!ing e*ercise,’ he sa$s Because this new stud$ depends on results of &rain scans, it is worth mentioning a criticism of the original stud$, pu&lished in 2-12esearchers said although 241 people had ta!en part, onl$ 16/ had scans This suggested a large num&er dropped out or disappeared from final results, which made findings ver$ unrelia&le "rofessor %mith e*plained at the time the$ weren’t dropouts and he had e*pected fewer

people to have scans and allowed for it >,ver$one was as!ed if the$ were prepared to have two scans and ;uite a num&er said the$ weren’t %o we !new who was going to &e scanned and we randomised them to vitamins or place&o, ma!ing the results perfectl$ valid ’ As for the <oughs, the$ need little convincing >' dread to thin! what '’d &e li!e now without m$ dail$ pill,’ 9ohn remar!ed when he heard a&out the latest stud$ After the trial finished, he stopped ta!ing the vitamins for si* months, and he and :athleen said the difference was o&vious and he started ta!ing them again Although he also regularl$ forgets where he’s put his >&looming’ wal!ing stic!, 9ohn’s ver$ clear a&out other things >The memor$ clinic 3ust sent me an appointment for 1a$ 24,’ he sa$s 5ithout consulting his diar$, he addsA >That’s a Ban! <olida$ '’ll have to chec! it with them ’

")$ *+," V-TA*-. B'
<igh levels of the amino acid homoc$steine are lin!ed to &rain shrin!age and an increased ris! of Alzheimer’s B vitamins are !nown to suppress homoc$steine 'n a 2-1- stud$,2 participants received relatively high doses of B vitamins, includingA • • • /-- micrograms 6mcg8 folic acid 00 +% 2(A is K-- mcgLda$ .-- mcg B12 6c$anoco&alamin8 M +% 2(A is onl$ 2 K mcgLda$ 2- mg B6 6p$rido*ine h$drochloride8 00 +% 2(A 1 @01 . mgLda$

The stud$ was &ased on the presumption that &$ controlling the levels of homoc$steine, $ou might &e a&le to reduce the amount of &rain shrin!age, which tends to precipitate AlzheimerNs 'ndeed, after two $ears those who had received the vitamin0B regimen suffered significantl$ less &rain shrin!age compared to those who had received a place&o 'n those who had the highest levels of homoc$steine at the start of the trial, their &rains shran! at half the rate of those ta!ing a place&o The latest stud$ ta!es this research a step further, showing not onl$ that B group vitamins ma$ slow &rain shrin!age &ut that it ma$ specificall$ slow shrin!age &$ as much as seven0fold in &rain regions specificall$ !nown to &e most impacted &$ Alzheimer’s disease

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