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Archive for the ' Brain Health' Category

Folate and Vitamin B-12: Two Nutrients Critical for Brain Health

From NaturalNews.com

Recent research documents the critical nature of two nutrients, vitamin B-12 and folate, in brain health and the maintenance of cognitive functioning, including memory. Deficiencies of these key nutrients are markers of the neuropathology leading to cognitive decline, Alzheimer’s Disease, and stroke.Studies and Results

In the past decade, researchers have increasingly focused on an amino acid found in the blood stream called homocysteine, as a factor playing a role in poor memory and brain health.The January, 2008 edition of Neurobiology and Aging reports a study of the changes of plasma amyloid beta protein, homocysteine, and medical temporal lobe atrophy (MTI) in the transition from cognitive health to mild cognitive impairment and to Alzheimer’s disease in a cohort of 75 year-old individuals. Results indicate that whether persons with mild cognitive impairment develop Alzheimer’s Disease may depend on an accumulation of toxic metabolites such as homocysteine.A study in the January, 2008 edition of Prostaglandins, Leukotrienes and Essential Fatty Acids, concluded that low blood

folate and elevated homocysteine levels are associated with poor brain function. They found that folic acid enhances blood levels of DHA and EPA (essential omega-3 fatty acids), nutrients which also appear to have some beneficial effects for promoting healthy brain functioning.In the November, 2007 edition of Stroke, researchers report investigating the individual and combined effects of plasma folate, vitamin B12, and pyridoxal 5-phosphate levels on the risk of ischemic stroke and transient ischemic attack in a large German cohort. (Ischemic stroke is death to an area of the brain resulting from an inadequate supply of blood and oxygen to the brain as a result of blockage of an artery). They concluded that low vitamin B12 plasma levels, particularly in combination with low folate levels, increase the risk of cerebral ischemia.And as reported in the June, 2007 edition of the Journal of American College of Nutrition, researchers investigated serum levels of folate, B12 and total homocysteine in

elderly post-stroke patients, and the possible correlations with radiological markers of neuropathology. The data showed that folate deficiency and hyperhomocysteinemia are prevalent in elderly post stroke patients. These two conditions are strongly and independently associated with the development of brain atrophy.Folate and Folic Acid

The terms folate and folic acid are used interchangeably to describe this member of the B-vitamins. Folate is found in food as well as in metabolically active forms in the human body. Folic acid is the form more frequently used in supplements.

The role of folate in the body is to act as acceptor and donor of one-carbon units in a variety of reactions critical to the metabolism of nucleic acids and amino acids. It plays a vital role in DNA metabolism from its precursors, thymidine and purines, and is required for the synthesis of methionine, which is required for the synthesis of S-adenosylmethionine (SAM-e). SAM-e is a methyl donor used in many biological methylation reactions, including the methylation of sites within DNA and RNA. Methylation of DNA is seen as playing an important role in cancer prevention.The synthesis of the amino acid methionine requires folate as well as a vitamin B-12 dependent enzyme. So deficiency of folate can result in decreased synthesis of methionine and buildup of homocysteine, which may be a risk factor for heart disease as well as neuropathology. The amount of homocysteine in the blood is regulated by vitamin B-12, and vitamin B-6 as well as folate.Folate Deficiency

Folate deficiency is usually caused by dietary insufficiency although it can occur in other situations. Several medications may be contributory.

Folate deficiency is usually initially signaled by rising homocysteine levels. Rapidly dividing cells are particularly vulnerable to folate deficiency and may result in anemia and the hypersegmentation of neutrophils. Progression of such anemia leads to a decreased capacity of the blood to carry oxygen and may ultimately result in symptoms of fatigue, weakness, and shortness of breath. This type of anemia may also result from vitamin B-12 deficiency.Disease Prevention

Adequate levels of folate at time of conception have been shown to prevent spina bifida, a devastating birth defect, and may prevent the occurrence of other types of birth defects including certain heart defects and limb malformation. Low levels of folate has been associated with increased incidence of miscarriage as well as preeclampsia on placental abruption, the separation of the placenta from the uterus.

More than 80 studies have shown that even moderately elevated levels of homocysteine in the blood increase the risk of cardiovascular diseases, while folate-rich diets have been associated with a decreased risk of cardiovascular disease. Of the three vitamins that regulate homocysteine levels, folic acid has been shown to have the greatest effect in lowering basal levels of homocysteine in the blood when no deficiency of vitamin B-12 or vitamin B-6 is present.Since cancer is thought to arise from DNA damage in excess of ongoing DNA repair and/or the inappropriate expression of critical genes, it is possible for folate intake to affect both DNA repair and gene expression because of the important roles played by folate in DNA and RNA synthesis and methylation. Consuming at least five servings of fruits and vegetables daily has been shown to decrease incidence of cancer. Fruits and vegetables are excellent sources of folate, which may play a role in their anti-carcinogenic effect. Folate from foods and folic acid supplements have been shown to be inversely associated with colorectal cancer risk. Studies of folate and breast cancer have yielded mixed results.As the noted studies indicate, folate in nucleic acid synthesis and methylation is essential for normal brain function. Several studies have documented the associations between decreased folate levels and cognitive impairment in

the elderly. Individuals with low serum folate levels were more likely to have dementia, be institutionalized, and be depressed. Low folate levels were also associated with increased likelihood of short-term memory problems in the elderly.Food Sources and Supplements

Green leafy vegetables are rich in folate as well as fruit juices, legumes, barley, beef, bran, brewer’s yeast, brown rice, cheese, chicken, dates, lamb, lentils, salmon, tuna, liver, pork, wheat germ, whole grains, and whole wheat.

The supplemental form of folate is primarily folic acid. It is available in single ingredient and combination products such as B-complex vitamins. The typical dose is 400 mcg.Vitamin B-12

Vitamin B-12 is unique in having the largest and most complex structure of all the vitamins, and in containing a metal ion, cobalt. Methylcobalamin and 5-deoxyadenosyl cobalamin are the forms of vitamin B-12 used in the body. Another form, cyanocobalamin, is converted in the body.

Methylcobalamin, along with folate, is required for methionine synthase to function properly as discussed above.

Vitamin B-12 Deficiency

Absorption of vitamin B-12 from food requires normal function of the stomach, pancreas, and small intestine. The most common causes of deficiency are the autoimmune disorders, pernicious anemia, and malabsorption from food sources.

Vitamin B-12 deficiency results in impairment of the activities of B-12 requiring enzymes, and may result in impaired activity of methionine synthase.

The neurologic symptoms of a vitamin B-12 deficiency include tingling of the legs or arms, numbness, difficulty walking, memory loss, disorientation, and dementia. Tongue soreness, appetite loss, and constipation are also associated with vitamin B-12 deficiency.

Disease Prevention

A study of 195 women later diagnosed with breast cancer and 195 age-matched women who were not diagnosed with breast cancer concluded that among women who were postmenopausal, the association between blood levels of vitamin B-12 and breast cancer suggested a threshold effect. The risk of breast cancer was more than doubled in women with serum vitamin B-12 levels in the lowest quintile compared to women in the four highest quintiles. Another study reported that breast cancer risk for women in the highest quartile of vitamin B-12 intake was 68% lower than those in the lowest quartile.

As the studies have shown, people with Alzheimer’s disease often have low blood levels of vitamin B-12. One study found lower B-12 levels in the cerebrospinal fluid of Alzheimer’s patients than in patients with other types of dementia.

Observational studies have documented as many as 30% of patients hospitalized for depression were deficient in vitamin B-12. A cross sectional study of 700 women over the age of 65 found that B-12 deficient women were twice as likely to be severely depressed as non-deficient women.

Food Sources and Supplements

Only bacteria in the mouth and gut can synthesize vitamin B-12. Food sources are animal products. Individuals over the age of 50 should obtain their B-12 from supplements because of the increased likelihood of food-bound B-12 malabsorption.

Over-the-counter supplements are usually made of cyanocobalamin, but methylcobalamin is also available and is considered the better choice. Available forms are B-12 alone, or as part of a B vitamin complex.

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How lack of sleep may be bad for the brain

FromLos Angeles Times

Both night-shift work and chronic sleep deprivation are increasingly implicated in mental and cognitive problems.

* Alzheimer’s risk: Abnormal insulin levels (common in shift workers and sleep-deprived people) may increase the risk for certain neurodegenerative disorders, such as Alzheimer’s disease, scientists at the University of Washington have found. Normally, insulin acts on the brain to promote learning and memory. However, insulin resistance may cause inflammation in the brain, a key process in the development of Alzheimer’s.

Related Stories

* Learning: Proper alignment between sleep times and internal circadian time is crucial for optimal cognitive performance. And numerous recent studies show learning is enhanced if it’s immediately followed by restorative sleep. In other words, students who pull all-nighters studying for an exam are doing themselves more harm than good.

* Mood: Even moderate changes in sleep times can have a big effect on mood. Diane Boivin of the Centre for Study and Treatment of Circadian Rhythms at Douglas Mental Health University Institute in Montreal published research last year in the journal Sleep showing that serotonin levels — a key substance for mood stability — are lower in shift workers than day workers. Other studies have found that exposure to bright light in the morning can lift the moods of people with depression, and that prescribed periods of sleep deprivation can interrupt a bout of depression.

* Bipolar disorder: Flawed circadian rhythms may be to blame for bipolar disorder. In a study published last year in the Proceedings of the National Academy of Sciences, scientists from the University of Texas Southwestern Medical Center identified a gene that, if disrupted, causes mice to behave as if they have bipolar disorder. Correcting the gene mutation could lead to a therapy for the illness, the scientists said.

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Can a Drug That Helps Hearts Be Harmful to the Brain?

From Health Journal - WSJ.com

Cognitive side effects like memory loss and fuzzy thinking aren’t listed on the patient information sheet for Lipitor, the popular cholesterol-lowering drug. But some doctors are voicing concerns that in a small portion of patients, statins like Lipitor may be helping hearts but hurting minds.

SIDE EFFECTS OF STATINSLike every medication, statins also have side effects such as muscle aches and memory loss that can be difficult to measure. What’s your experience been with statins? Join a discussion.

Like every medication, statins also have side effects such as muscle aches and memory loss that can be difficult to measure. What’s your experience been with statins? .Health Mailbox: Melinda Beck reviews the procedure recommended to care for someone who is unconscious.

“This drug makes women stupid,” Orli Etingin, vice chairman of medicine at New York Presbyterian Hospital, declared at a recent luncheon discussion sponsored by Project A.L.S. to raise awareness of gender issues and the brain. Dr. Etingin, who is also founder and director of the Iris Cantor Women’s Health Center in New York, told of a typical patient in her 40s, unable to concentrate or recall words. Tests found nothing amiss, but when the woman stopped taking Lipitor, the symptoms vanished. When she resumed taking Lipitor, they returned.

“I’ve seen this in maybe two dozen patients,” Dr. Etingin said later, adding that they did better on other statins. “This is just observational, of course. We really need more studies, particularly on cognitive effects and women.”

Quotes & Research for PFE’);return true” onmouseout”window.status(”);return true” href=”http://renegadeneurologist.com/quotes/main.html?typedjn&symbolpfe” mce_href=”http://renegadeneurologist.com/quotes/main.html?typedjn&symbolpfe” >Pfizer Inc.’s Lipitor is the world’s best-selling medicine, with revenues of $12.6 billion in 2007. The company says that its safety and efficacy have been demonstrated in more than 400 clinical trials and 145 million patient years of experience, and that the extensive data “do not establish a causal link between Lipitor and memory loss.” Pfizer also says it draws conclusions about adverse events from a variety of sources “as opposed to anecdotal inferences by individual providers with a limited data pool.”

Inc.’s Lipitor is the world’s best-selling medicine, with revenues of $12.6 billion in 2007. The company says that its safety and efficacy have been demonstrated in more than 400 clinical trials and 145 million patient years of experience, and that the extensive data “do not establish a causal link between Lipitor and memory loss.” Pfizer also says it draws conclusions about adverse events from a variety of sources “as opposed to anecdotal inferences by individual providers with a limited data pool.”World-wide, some 25 million people take statins, including Zocor, Mevacor, Crestor, Pravachol and Vytorin. As a group, they are widely credited with reducing heart attacks and strokes in people at high risk, though the benefits are less clear in people who are not at high risk, particularly women and the elderly. Some 15% of patients complain of side effects; muscle aches and liver toxicity are the most recognized to date. But anecdotes linking statins to memory problems have been rampant for years.

On balance, most cardiologists see little cause for concern. “The benefits far outweigh the risks,” says Antonio Gotto, dean of the Weill-Cornell Medical School and past president of the American Heart Association. Dr. Gotto, who has consulted for most of the statin makers and been involved in many of the trials, says “I would hate to see people frightened off taking statins because they think it’s going to cause memory loss.”

Thinking and memory problems are difficult to quantify, and easy for doctors to dismiss. Many people who take statins are elderly and have other conditions and medications that could have cognitive side effects.

Still, the chronology can be very telling, says Gayatri Devi, an associate professor of neurology and psychiatry at New York University School of Medicine, who says she’s seen at least six patients whose memory problems were traceable to statins in 12 years of practice. “The changes started to occur within six weeks of starting the statin, and the cognitive abilities returned very quickly when they went off,” says Dr. Devi. “It’s just a handful of patients, but for them, it made a huge difference.”

Researchers at the University of California at San Diego are nearing completion of a randomized controlled trial examining the effects of statins on thinking, mood, behavior, and quality of life. Separately, the UCSD researchers are collecting anecdotal experiences of patients, good and bad, on statins; memory problems are the second most common side effect, after muscle aches, in about 5,000 reports to date.

“We have some compelling cases,” says Beatrice Golomb, the study’s lead researcher. In one of them, a San Diego woman, Jane Brunzie, was so forgetful that her daughter was investigating Alzheimer’s care for her and refused to let her babysit for her 9-year-old granddaughter. Then the mother stopped taking a statin. “Literally, within eight days, I was back to normal — it was that dramatic,” says Mrs. Brunzie, 69 years old.

Doctors put her on different statins three more times. “They’d say, ‘Here, try these samples.’ Doctors don’t want to give up on it,” she says. “Within a few days of starting another one, I’d start losing my words again,” says Mrs. Brunzie, who has gone back to volunteering at the local elementary school she loves and is trying to bring her cholesterol down with dietary changes instead.

“I feel very blessed — I got about 99% of my memory back,” she adds. “But I worry about people like me who are starting to lose their words who may think they have just normal aging and it may not be.”

Of course, not every case of mental decline can be reversed by stopping statins. In fact, there’s some evidence that statins may ward off Alzheimer’s by reducing plaque and inflammation in the brain.

DRUG RESEARCHLearn more at these sites:

The University of California-San Diego Statin Effects Study: www.statineffects.com

The University of California-San Diego Statin Effects Study: www.fda.gov/medwatch

Drug information from health-care organizations. The FDA’s Adverse Event reporting program: www.nlm.nih.gov/medlineplus/druginformation.html

On the other hand, the brain is largely cholesterol, much of it in the myelin sheaths that insulate nerve cells and in the synapses that transmit nerve impulses. Lowering cholesterol could slow the connections that facilitate thought and memory. Statins may also lead to the formation of abnormal proteins seen in the brains of Alzheimer’s patients.

The cognitive changes can affect men as well as women. But women on statins are often simultaneously losing estrogen due to menopause, which can also cause cognitive changes. “Women are getting hit with a double whammy,” says Elizabeth Lee Vliet, a women’s health physician in Tucson, Ariz., who has a background in neuroendochronology.

Side effects are always highly individual. Most patients tolerate statins very well, and heart disease remains the leading cause of death in the U.S. for men and women.

But it pays to think hard about whether you really need to be on a statin — or if you could accomplish your goals with diet and exercise instead. “Some people want to take a pill and think they can eat whatever they want,” says Nieca Goldberg, a cardiologist and medical director of the Women’s Heart Program at the New York University School of Medicine. She says she typically prescribes statins for women who have elevated cholesterol and have already had a heart attack. But for younger women with high cholesterol and no other risk factors, she encourages lifestyle changes.

“I try to initiate diet modifications and physical activity in all my patients — even if they still need medication, I can give them a lower dose,” says Dr. Goldberg. “I try to make the point that we are all in this together.”

If you do need to be on cholesterol-lowering medication, pay close attention to any side effects and talk with your doctor. You may have a different experience with a different dose or different statin. Also remember that the doctor taking care of your heart condition may not be as experienced in other body parts. “You really need a balanced approach,” says Dr. Vliet. But “each physician may be looking at only one part of the elephant — that’s the way medicine is practiced in the U.S.

As Jane Brunzie says, “I learned through this experience that you have to use your own brain, as well as your doctor’s brain, when it comes to your health.”

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Hypertension Linked to Risk of Mild Cognitive Impairment

Study suggests it may cause the effect through cerebrovascular diseaseFrom HealthScout-Consumer Health News

High blood pressure may be associated with increased risk for mild cognitive impairment, says a study by researchers at the Columbia University Medical Center in New York City.

High

may be associated with increased risk for mild cognitive impairment, says a study by researchers at the Columbia University Medical Center in New York City.Mild cognitive impairment, which causes learning and thinking difficulties, has “attracted increasing interest during the past years, particularly as a means of identifying the early stages of Alzheimer’s disease as a target for treatment and prevention,” the study authors wrote.

They followed 918 Medicare recipients aged 65 and older (average age 76.3) who were assessed every 18 months for an average of 4.7 years. None of the participants had mild cognitive impairment at the start of the study, but 334 of them developed the condition during the study period.Of those, 160 developed amnestic mild cognitive impairment (which involves low scores on memory portions of neuropsychological tests), and 174 developed non-amnestic mild cognitive impairment. Hypertension was associated with an increased risk of all types of mild cognitive impairment, especially non-amnestic mild cognitive impairment, the researchers said.

The findings are published in the December issue of the Archives of Neurology.

“The mechanism by which blood pressure affects the risk of cognitive impairment or dementia remains unclear. Hypertension may cause cognitive impairment through cerebrovascular disease. Hypertension is a risk factor for subcortical white matter lesions found commonly in Alzheimer’s disease. Hypertension may also contribute to a blood-brain barrier dysfunction, which has been suggested to be involved in the cause of Alzheimer’s disease. Other possible explanations for the association are shared risk factors,” including the formation of cell-damaging compounds known as free radicals, the study authors wrote.

“Our findings support the hypothesis that hypertension increases the risk of incident mild cognitive impairment, especially non-amnestic mild cognitive impairment,” the researchers concluded. “Preventing and treating hypertension may have an important impact in lowering the risk of cognitive impairment.”

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Link between statins and dementia complex

From News - Revolution Health

Previous studies of a link between statins, a cholesterol lowering medication, and cognitive decline have produced mixed results. New research suggests that the relationship between statin use and cognitive decline appears even more complex than originally thought.

The study involved 1,146 African Americans aged 70 and older living in Indianapolis whose cognitive status was assessed in 2001 and again in 2004.

The Indianapolis-based researchers found that cognitive decline in people who took statins was less than in those who did not take statins.

However, those who continued to take statins from 2001 to 2004 had greater cognitive decline than those who were taking statins in 2001 but were no longer taking them in 2004. If statin use were directly associated with a reduction in cognitive decline, continuously taking statins would presumably produce the greatest effect.

“The relationship between statin use and cognitive decline is complex and subjected to unknown confounders,” Dr. Stanley Szwast, of Indiana University School of Medicine, and colleagues note in a report in the journal Neurology. “This effect may not be associated with the cholesterol lowering or anti-inflammatory action of statins.”

“We know that taking statin medication can protect against cardiovascular events such as heart attacks by lowering blood cholesterol. The question at hand is what effects do these medications have on brain function. Our study along with others shows promising results but larger controlled studies are needed,” Szwast noted in a statement.

SOURCE: Neurology, November 6, 2007

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