Folate and B12 Reduce Homocysteine

A new analysis has found that a high-dose combination of folate and vitamin B12 is needed to lower homocysteine plasma levels and thereby perhaps lowering the risk of stroke, coronary disease, and death in certain high-risk patients.

The analysis was presented in an article that indicates that a growing population of B12-deficient individuals, primarily the elderly, may have elevated levels of total homocysteine (tHcy) and may benefit from high doses of oral B12. The article appeared in the January 2006 edition of Stroke Journal.

Homocysteine is an amino acid in the blood derived from methionine, which is contained in dietary protein. It increases clotting of the blood, damages the artery lining, and increases the risk of strokes and heart attacks. Elevated tHcy levels are also associated with Alzheimer's and other forms of dementia. In many individuals, tHcy is maintained at normal levels through diet alone. However, certain high-risk individuals, such as those not able to properly metabolize folic acid or those with B12 malabsorption may require larger doses.

"High doses of B12, i.e. 1 mg or higher, are needed in elderly patients with B12 levels at the low end of the ‘normal' range (below 220 pmol/l),” said Dr. David Spence, M.D., director of the Stroke Prevention and Atherosclerosis Research Centre (London, Canada; www.robarts.ca/sparc/) and co-author of the article.

"Folate and B12 are the two key ingredients in reducing homocysteine. While fortification of the grain supply [in the U.S.] with folic acid has helped reduce levels of homocysteine in the general population, certain individuals also need super physiological doses of folate and B12,” said Dr. Meir Stampfer M.D., Ph.D., chair of epidemiology at the Harvard School of Public Health and co-author of the article.




Related Links:
Stroke Prevention and Atherosclerosis Research Centre