There has been much excitement over the past week or so since a study emerged that showed taking simple B vitamins to lower homocysteine risk also appears to halve the rate of brain shrinkage associated with cognitive decline and Alzheimer’s. Here are my comments and recommendations, links to homocysteine tests and the correct type of B Complex needed, plus the full research report First, here is a useful summary from Biocare’s clinical team:
“The University of Oxford study shows that daily B vitamin supplements can halve the rate of brain atrophy in elderly people who suffer from Mild Cognitive Impairment (MCI).
The two year randomised double-blind clinical trial is the largest to study the effect of B vitamins on MCI and is excitingly one of the first disease-modifying trials in the Alzheimer’s field to show positive results in humans. The study assessed the progression of disease by measuring brain atrophy rate following 168 volunteers with mild memory problems, half of whom took the combined high dose B vitamin tablets for two years and the other half a placebo tablet. MRI scans were used to measure rate of brain shrinkage over the two-year period.
The research team set out to see whether taking supplements of the B vitamins required for maintaining and lowering homocysteine levels could slow the higher rate of brain atrophy observed in MCI or Alzheimer’s.
They found that on average the brains of those taking the folic acid, vitamin B6 and B12 treatment shrank at a rate of 0.76% a year, while those in the placebo group had a mean brain shrinkage rate of 1.08%. Significantly the subjects with the highest levels of homocysteine benefited most, showing atrophy rates on treatment that were half of those on placebo.
Co-leader of the trial, Professor David Smith of the Department of Pharmacology, Oxford University, explained, “It is our hope that this simple and safe treatment will delay the development of Alzheimer’s disease in many people who suffer from mild memory problems. Today there are about 1.5 million elderly in UK, 5 million in USA and 14 million in Europe with such memory problems.”
The study was co-funded by the Alzheimer’s Research Trust, Rebecca Wood, Chief Executive for the Trust said, “These are very important results, with B vitamins now showing a prospect of protecting some people from Alzheimer’s in old age. The strong findings must inspire an expanded trial to follow people expected to develop Alzheimer’s, and we hope for further success.”
High homocysteine levels are prevalent in Alzheimer’s sufferers who also commonly have a low B12 and folate nutritional status. This combination can be a predictor to the risk of developing Alzheimer’s and age-related memory problems. High homocysteine is associated with more rapid progression of the disease and may damage both the brain and arteries supplying blood to the brain.
The new research set out to discover whether giving B vitamins that lower homocysteine could both arrest abnormal brain shrinkage in those with age-related memory and slow down memory decline in those with mild or early stage Alzheimer’s.
The study used supplements of folic acid 800mcg, B6 20mg, and B12 500mcg which were given to 270 people with age-related memory decline, but not yet diagnosed with Alzheimers. They also tested their homocysteine levels and did an MRI brain scan in most of the participants at the beginning and end of the 24-month placebo controlled trial.
The results showed that in the placebo group the higher the homocysteine level the greater was the rate of brain shrinkage, with those above 13 µmol/L (in the top quarter of the population) had double the rate of brain shrinkage (1.5 per cent per year) compared to 0.8 per cent in those with homocysteine levels below 10.
The rate of brain shrinkage was strong predictor of cognitive function. In those with levels above 13 µmol/L the B vitamins led to a 53 per cent reduction in the rate of shrinkage, compared to placebo. Since the brain does normally shrink with age this reduction was equivalent to stopping any abnormal shrinkage characteristic of those who go on to develop Alzheimer’s disease. Previous work by this group had shown that brain shrinkage is associated with a person’s B12 status; those with low-B12 status showing the most rapid shrinkage. These results provide the strongest evidence yet that keeping your homocysteine low may protect or slow down the onset of Alzheimer’s disease.
Other diet and lifestyle factors consistent with lowering homocysteine are avoiding coffee, eating more greens and beans, exercising regularly, not smoking, and reducing stress levels. Increasing antioxidant and omega 3 intake is also consistent with reducing Alzheimers risk.”
Smith A.D. et al., ‘Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment. A randomized controlled trial’ PLoS ONE (2010)
It seems then that low levels of B6, B12 and folate may be good early indicators of brain atrophy which causes cognitive function decline. In the trial, a correlation was found between people who had low levels of Bs and high homocysteine. My feeling is that the high homocysteine is because of the B vits being low, and that means measuring homocysteine levels can give a good indication if the B vits are low too. Basically, the truth appears to be high homocysteine = low B vits = greater risk of brain atrophy.
Guess what I’m going to recommend for people over about 45?! A homocysteine test to check if your level is over 10, and a B Complex insurance dosage.
Here is a link to the lab homocysteine test which costs £73, and there is also a fingerprick test if you don’t want the hassle of going to get blood taken, which costs £99 so let me know if you prefer this one as I have a couple in stock. Best to know and deal with it as early as poss.
Re B vits, you can see in the trial that the levels of B vits used were 20mg B6, 800mcg folic acid and 500mcg B12.
Check if your multi contains that and top them up if need be. Or take a B Complex that contains those levels. The one I normally recommend that contains a high enough level of the B12 without having to take separate items is Thorne Basic B Complex which, at 1 twice a day, will give you 20mg B6, 800mcg Folic acid and 800mcg B12. The B vits are also, importantly, in the right absorbable forms such as P5P B6 which is far superior to normal B6. You can get those as normal at Natural Dispensary.
Hope that helps.