Can vitamin B therapy help the mentally ill as well as lower the risk of stroke?

Can holistic health remedies using vitamin B therapy help the mentally ill? Can the B complex vitamins also help prevent strokes or aid stroke victims to recover faster?

Adding supplements to antipsychotic medication alleviated negative symptoms in patients with specific gene variants, in a new study. Adding the dietary supplements folate and vitamin B12 to treatment with antipsychotic medication improved a core symptom component of schizophrenia in a study of more than 100 patients.

The study focused on negative symptoms of schizophrenia – which include apathy, social withdrawal, and a lack of emotional expressiveness. While the level of improvement across all participants was modest, results were more significant in individuals carrying specific variants in genes involved with folate metabolism. The report from a team based at Massachusetts General Hospital (MGH) will soon appear in the journal JAMA Psychiatry (formerly Archives of General Psychiatry) and recently has been issued online.

"The symptoms of schizophrenia are complex, and antipsychotic medications provide no relief for some of the most disabling parts of the illness. These include negative symptoms, which can be particularly devastating," says Joshua Roffman, MD, MMSc, of the MGH Department of Psychiatry, corresponding author of the JAMA Psychiatry paper, in the March 6, 2013 news release, Folate and vitamin B12 reduce disabling schizophrenia symptoms in some patients.

"Our finding that folate plus vitamin B12 supplementation can improve negative symptoms opens a new potential avenue for treatment of schizophrenia. Because treatment effects differed based on which genetic variants were present in each participant, the results also support a personalized medical approach to treating schizophrenia."

An essential nutrient, folate (or folic acid) is required for the synthesis of DNA and neurotransmitters

Folate or folic acid also plays a role in the control of gene expression. Adequate folate intake during pregnancy can reduce the risk of birth defects – in particular neural tube defects – and studies have suggested that folate deficiency during pregnancy significantly increases the risk of schizophrenia among offspring. Earlier research by members of the MGH-based team associated low blood folate levels with more severe negative symptoms among patients with schizophrenia.

The current study was designed specifically to investigate whether supplementation with folate and B12 – which can magnify the effects of folate – reduced negative symptoms of schizophrenia. A 2011 pilot study found symptom improvement only among patients carrying a variant in a folate-pathway gene called MTHFR that reduced the gene's activity. To get a clearer picture of folate's effect on negative symptoms, the current study enrolled 140 patients with schizophrenia at community mental health centers in Boston, Rochester, N.Y., and Grand Rapids, Mich.

Patients took vitamin B (folate), and also vitamin B12 along with their antipsychotic medications

Participants were all taking antipsychotic medications – which have been shown to alleviate positive symptoms, such as hallucinations and delusions, but not negative symptoms – and were randomized to receive daily doses of either folate and vitamin B12 or a placebo for 16 weeks. Every two weeks their medical and psychiatric status was evaluated, using standard symptom assessment tools along with measurements of blood levels of folate and homocysteine, an amino acid that tends to rise when folate levels drop.

Nutritional information was compiled to account for differences in dietary intake of the nutrients. Participants' blood samples were analyzed to determine the variants they carried of MTHFR and three other folate-pathway genes previously associated with the severity of negative symptoms of schizophrenia.

Among all 140 participants in the study protocol, those receiving folate and vitamin B12 showed improvement in negative symptoms, but the degree of improvement was not statistically significant compared with the placebo group. But when the analysis accounted for the variants in the genes of interest, intake of the two nutrients did provide significant improvement in negative symptoms, chiefly reflecting the effects of specific variants in MTHFR and in a gene called FOLH1. Variants in the other two genes studied did not appear to have an effect on treatment outcome.

While a low-functioning variant in FOLH1 had been associated with more severe negative symptoms in previous research, in this study it was the high-functioning FOLH1 variant that predicted a better treatment outcome. Measurement of participants' blood folate levels throughout the study provided an explanation for this unexpected finding.

Those with the low-functioning FOLH1 variant started the trial with substantially lower folate levels, suggesting a problem with folate absorption. Although supplementation enabled their blood folate levels to eventually catch up with those of participants with the high-functioning variant, it was probably too late to produce symptom improvement during the 16-week trial period.

"For participants who did show a benefit, it took the full 16 weeks of treatment for that benefit to appear," Roffman explains in the news release, Folate and vitamin B12 reduce disabling schizophrenia symptoms in some patients. "While we don't know why this is the case, changes in gene expression – which take time – are a likely explanation. Folate plays a critical role in DNA methylation, which regulates gene expression, so it's plausible that its effects on negative symptoms act through gene expression changes.

Participants with the low-functioning FOLH1 variant might eventually show a benefit of folate supplementation if treated for a longer period of time, but that needs to be investigated in future studies." He adds in the news release, Folate and vitamin B12 reduce disabling schizophrenia symptoms in some patients, that while the benefits of supplementation for the overall group were modest, the lack of effective treatment for negative symptoms and the safety of folate and vitamin B12 supplementation support the need for larger-scale trials. Further research (trials) are needed.

Can folate help conditions such as dementia or cardiovascular disease?

The impact of genotype on this study's results suggests the need to investigate the role of folate pathway variants in conditions such as dementia and cardiovascular disease, in which low folate appears to increase risk, but supplementation trials have had inconclusive results. Would the effects of specific supplements depend upon the participant's genetic variants? Do supplements affect different people based on their genes? That remains to be seen in other studies.

"We are now conducting a clinical trial of 1-methylfolate, which bypasses some of these folate-pathway enzymes and might have greater efficiency among individuals with low-functioning variants," explains Roffman, in the news release, Folate and vitamin B12 reduce disabling schizophrenia symptoms in some patients.

"Understanding more about the basic neural mechanisms of folate in patients with schizophrenia could help us generate more targeted and effective interventions to reduce and possibly even prevent symptoms." Dr. Roffman is an assistant professor of Psychiatry at Harvard Medical School. The senior author of the JAMA Psychiatry report is Donald Goff, MD, formerly of MGH Psychiatry and now at the Nathan Kline Institute and New York University School of Medicine.

Additional co-authors are Gail Galendez, Lisa Raeke, Noah Silverstein, Jordan Smoller, MD, ScD, and Michelle Hill, MD, MGH Psychiatry; Eric Macklin, PhD, MGH Biostatistics Center; Steven Lamberti, MD, University of Rochester Medical Center, and Eric Achtyes, MD, MS, Michigan State University College of Human Medicine. The National Institute of Mental Health grant R01MH070831 primarily supported the study.

Can vitaimin B3 and other B complex vitamins help lower the risk of stroke?

Vitamin B3 and other B complex vitamins may help prevent or lower the risk of stroke, according to the article, "Vitamin B3 and Other Nutrients Could Help Prevent Stroke." A recent study assessed the use of extended release vitamin B3 which is also called niacin in rats who demonstrated ischemic stroke. The researchers found that the rats receiving the niacin exhibited new blood vessels and sprouting nerve cells in the brain, according to the study.

Basically, if you only take one B vitamin, it pulls out the other B vitamins. So you'd need a B complex of all the B vitamins, if you decide to look into B vitamin therapy, but always talk first with your health care team to see whether your condition permits the vitamins or interactions. That's why you need to research your own body's needs as a result of your medical exams to see what deficiencies you have. According to the studies, apparently niacin has some type of healing effect on brain cells, but the studies were done on laboratory animals.

The implications of these results point to niacin having a healing effect on brain cells. Niacin is known to be effective medicine in current clinical use for increasing high-density lipoprotein cholesterol (HDL-C), which helps certain types of fatty deposits. You'd need to find out what type of niacin worked -- the flush kind rather than the flushless with inositol? Check out the studies to see whether the regular type of vitamin B-3 was studied instead of the flushless type. The study only mentions vitamin B 3 -- niacin.

Vitamin therapy to reduce risk of stroke studied in Sacramento and Davis

Vitamin therapy is still being used to help reduce risk of stroke. Locally in the Sacramento and Davis regional areas, U.C. Davis studies the role of vitamin B in possibly lowering the risk of stroke. See, Ralph Green - UC Davis Health System: Bio. Dr. Green is an expert in clinical pathology, with particular interest in diseases of the blood. He is internationally recognized for his research.

During his 35-year career, he has served as an adviser to numerous editorial boards and the U.S. Food and Drug Administration, Centers for Disease Control, American Heart Association and National Institutes of Health. In Sacramento studies were done at UC Davis on the role of B vitamins in helping to reduce the risk of the incidence of dementia and cognitive impairment. See the U.C. Davis study's abstract, Homocysteine, B vitamins, and the incidence of dementia and cognitive impairment: studies from the Sacramento Area Latino Study on Aging.

Dr. Green specializes in examining how deprivation of B-complex vitamins, iron and other nutritional elements affects the cardiovascular and nervous systems as well as the aging process. He has studied the role of nutrient deficiencies in dementia, coronary artery disease and stroke, as well as other chronic degenerative diseases, including cancer. He recently served on the expert panel appointed by the Institute of Medicine of the National Academy of Sciences to recommend levels of daily intake for B-vitamins and currently is serving as a consultant to the World Health Organization.

Also, in a new study at another university, you can read more information on this topic. The Journal of the American Medical Association recently published a commentary on how vitamin B therapy can still reduce the incidence of stroke. Check out the December 21, 2011 article, JAMA commentary contends vitamin therapy can still reduce stroke, which is published in the Journal of the American Medical Association (JAMA) commentary from a University of Western Ontario study that contends vitamin therapy can still reduce stroke.

The commentary by Dr. David Spence of the University of Western Ontario and Dr. Meir Stampfer of the Harvard School of Public Health in today's Journal of the American Medical Association (JAMA) argues that vitamin therapy still has a role to play in reducing stroke.

This commentary by Dr. David Spence of The University of Western Ontario and Dr. Meir Stampfer of the Harvard School of Public Health in today's Journal of the American Medical Association (JAMA) argues that vitamin therapy still has a role to play in reducing stroke. Vitamin B therapy works for those who need it.

Do you need a combination of vitamin B12 and other B vitamins in a B complex vitamin? And are your vitamins even absorbed by your body? It all depends on what your body needs for optimum health.

Vitamin B therapy was once widely used to lower homocysteine levels. Too much of this amino acid in the bloodstream was linked to increased risk of stroke and heart attack. But several randomized trials found lowering homocysteine levels with B vitamins did not result in a cardiovascular benefit. And a study by Dr. Spence, a scientist with the Robarts Research Institute at Western's Schulich School of Medicine & Dentistry, found Vitamin B therapy actually increased cardiovascular risk in patients with diabetic nephropathy.

Dr. Spence says this commentary provides insights that overturn the widespread belief that "homocysteine is dead." He says, according to the December 21, 2011 news release, JAMA commentary contends vitamin therapy can still reduce stroke, that two key issues have been overlooked in the interpretation of the clinical trials: the key role of vitamin B12, and the newly recognized role of renal failure.

"It is now clear that the large trials showing no benefit of vitamin therapy obscured the benefit of vitamin therapy because they lumped together patients with renal failure and those with good renal function.

The vitamins are harmful in renal failure, and beneficial in patients with good renal function, and they cancel each other out," says Dr. Spence (in the press release). Dr. Spence is the author of the book, How to Prevent Your Stroke. The authors also contend most of the trials did not use a high enough dose of vitamin B12. See, How to Prevent Your Stroke (9780826515377): J. David Spence.

Danger of Vitamin B1 Deficiency in Non-Dairy Infant Formula

Back in November of 2003 in Etah Tikva, Israel, problems were found regarding a soy-based infant formula. The label on the formula read that it contained adequate supplies of vitamin B1, but what was on the label wasn't found in the nondairy formula.

Infants were examined for Vitamin B1 deficiency after being fed with Remedia, a soya-based infant formula, at Schneider Childrens' Hospital on November 11, 2003 in Petah Tikva, Israel. The reason was that according to the Israeli Health Ministry, three babies had died and 17 others fallen seriously ill from neurological and cardiological complications back in 2003 after being fed the non-dairy baby formula that lacked essential Vitamin B1 despite packaging claims.

That's why when taking any type of vitamins, you need to be sure what's on the label is what's in the contents. The formula was produced by the German manufacturer Humana for the Israeli Remedia company which is partly owned by the Heinz international food company. So the point of this news is to find other sources than a label to see whether the product has been tested and what's in the bottle or can is the same as what's on the label, especially when it comes to vitamins in infant formulas or your own vitamin supplements.

Resources on wellness studies

Studies on the B complex vitamins and brain health

Green R, Miller JW. Vitamin B12. In: Zempleni J, Rucker RB, Eds. Handbook of Vitamins, Fourth Edition, Boca Raton, Florida, Taylor and Francis, pp. 413-457, 2007.

Haan MN, Miller JW, Aiello AE, Whitmer RA, Jagust WJ, Mungas DM, Allen LH, Green R. Homocysteine, B vitamins and incidence of dementia and cognitive impairment: Results from the Sacramento Area Latino Study on Aging. American Journal of Clinical Nutrition, 85(2):511-517, 2007.

Luchsinger JA, Tang MX, Miller J, Green R, Mayeux R. Higher folate intake is related to lower risk of Alzheimer's disease in the elderly. Arch Neurol, 64(1):86-92, 2007.

Luchsinger JA, Tang MX, Miller J, Green R, Mehta PD, Mayeux R. Relation of plasma homocysteine to plasma amyloid beta levels. Neurochem Res, 32:775-781, 2007.

Miller JW, Garrod MG, Rockwood AL, Kushnir MM, Allen LH, Haan MN, Green R. Measurement of total vitamin B12 and holotranscobalamin, singly and in combination, in screening for metabolic vitamin B12 deficiency. Clin Chem, 52:278-85, 2006.

Carkeet C, Dueker SR, Lango J, Buchholz BA, Miller JW, Green R, Hammock B, Roth JR, Anderson PJ. Specific 14C-labeling of cobalamin and accelerator mass spectrometry underlie a quantitative test for B12 absorption in humans. Proceedings of the National Academy of Sciences of the United States of America, 103(15):5694-5699, 2006.

Campbell AK, Jagust WJ, Mungas DM, Miller JW, Green R, Haan MN, Allen LH. Low erythrocyte folate, but not plasma vitamin B-12 or homocysteine, is associated with dementia in elderly Latinos. J Nutr Health Aging, 9:39-43, 2005.

Green R, Miller JW. Vitamin B12 deficiency is the dominant nutritional cause of hyperhomocystine anemia in a folic acid-fortified population. Clin Chem Lab Med, 43:1048-51, 2005.

Ramos MI, Allen LH, Mungas DM, Jagust WJ, Haan MN, Green R, Miller JW. Low folate status is associated with impaired cognitive function and dementia in the Sacramento Area Latino Study on Aging. Amer J Clin Nutr, 82:1346-52, 2005.