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

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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