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B-Vitamins And Memory

confused-young-womanFrancis Bacon, who was a philosopher in the 16th century, said that, “Some books are to be tasted, others swallowed, and some few to be chewed and digested.” The same principle can apply to the written word of the present. If we took everything we read in magazines or over the internet as gospel, conflicting words and ideas would create such confusion that the truth would be more elusive than it has been for decades. While we are able to identify and to reject half-truths in the spoken word, we tend to give them credence if they appear in print. Such is the case with news and reports about the human body and its health and maintenance, and the things we can do and take to guarantee them.

Reports from Fox, Reuters and Medline, among other news services, have said that
B-vitamins can boost memory. Seeing that headline is all some folks need to draw a hasty conclusion, hoping that their loved ones with Alzheimer’s or some other neurological irregularity will be cured. At best, such a conclusion might be drawn following a syllogistic approach, a form of reasoning that relies on major and minor premises:  if this causes this, and if that causes that, then this causes that. Whether or not this is true depends on acceptance of the phrases, “some of the time” and “all of the time.”  Let’s see if we can make sense of the original proposition, that B-vitamins can boost memory.

The study cited by the news services was conducted by Dr. Janine Walker, a mental health researcher from the Australian National University, who reported in the American Journal of Clinical Nutrition that long-term supplementation with folic acid and vitamin B12 promotes improvement in cognitive functioning. (Walker, 2012)  What the headline doesn’t tell us is that the study lasted two years, and that physical exercise was part of the protocol. You have to read the small print, which means the details of the study need to be chewed and digested. The confounding factors and specific provisions must be considered.

Homocysteine (Hcy) is such a factor–and a provision if it’s measureable. Homocysteine is a homologue of the amino acid, cysteine, differing by an additional methylene group (CH2). It’s best known as a marker for inflammation associated with increased risk of cardiovascular disease. Whether or not lowering homocysteine will also lower CVD risk is still under examination, but it has been accepted that raised Hcy is associated with poor cognitive performance in the general population, not only in the elderly. Increases in serum folic acid levels are accompanied by decreases in Hcy levels. (Durga, 2007)  But this doesn’t mean that cognitive function will automatically improve. It takes time, another factor to be weighed. After three years of folic acid supplementation, Durga and his Dutch colleagues learned that the molecule, did, in fact, improve specific domains of cognitive function, particularly those that decline with age. What we are not told is that folic acid (vitamin B9) works best in the company of vitamins B12 and B6, where its role as a promoter of brain function can be fully realized.

If there is a pin to be put into this balloon, it comes courtesy of the Cochrane Database and its systematic reviews of primary research in health care and health policy. One of its 2008 reviews examined the effects of folic acid on demented people and their cognitive shortcomings, only to announce that no consistent evidence supports the use of folic acid—with or without vitamin B12—to effect improvement. They are carefully deliberate to add, however, that long-term use of folic acid (also known as folate in foods) does appear to improve the cognitive function of those individuals with elevated homocysteine levels. (Malouf, 2008)  Do you see the factor?  Long-term use.

Many elderly present with movement disorders to some degree. Swedish investigators looked at a population of community-dwelling septuagenarians who suffered both movement and cognitive disadvantages, treating them with vitamins B9, B6, and B12. More than 60% of the men and almost 50% of the women had high Hcy levels and high methylmalonic acid (MMA) concentrations, the latter indicating B12 deficiency. Vitamin therapy lowered both markers, but failed to mitigate both the movement and cognitive deficits. This does not mean the therapy is useless, though. The report allows that dosage could have been too low to prove effective, or that the physical and mental declines could have become irreversible. (Lewerin, 2005)  If such decline is recognized at all, could it / should it have been identified years—or even decades—sooner?   With all illness and debility, isn’t that ounce of prevention worth lots more than the pounds of cure?   To be considered also is that stores of nutrients decline sharply with age. For how long were they deficient?  How about the form of the nutrient?  Methylcobalamin is the much preferred form of vitamin B12, but the Swedish study used cyanocobalamin, a form that is unnatural to plants and animals. And, it contains an “insignificant” amount of cyanide that still must be eliminated from the body. Isn’t the mere four months duration of this study too little time to come to a righteous conclusion?  The factor?  Time.

“Over the short or medium term,” announces a Glasgow paper, cognitions did not improve with the vitamin cocktail. This study population, older than sixty-five and comparatively small at 185 participants, suffered ischemic vascular disease, that which decreases blood supply to an organ by constricting a blood vessel. Since all ischemia is not the same for all people, that condition might just confound the matter. This study lasted three months to one year. Here is a senior population with constrictive vascular disease, probably taking one or more medications, whose compliance is not monitored, with unknown dietary habits and unmentioned polypharmacy, and possibly experiencing other health issues. (MacDonald, 2005). Are we expected to accept the conclusion without question?

In ameliorative protocols where the patient is ambulatory, exercise is warranted, either as an isolated or as a supportive element. (Wen, 2010)  (Harkcom, 1085)  (Kirkcaldy, 1990)  Nonetheless, the administration of selected B-vitamins has an effect on the factors that interfere with brain function and memory, if only because they can mitigate the adverse effects of inflammation. Homocysteine is a documented CVD factor that is related to both vascular dementia and Alzheimer’s disease. (Stabler, 2003)  It appears that the attenuation of Hcy with folic acid, vitamin B6 and vitamin B12, accompanied by a modicum of exercise, and conducted over a reasonable period of time, can yield the desired result in cognitive change. IF homocysteine is related to cognitive decline, and IF a B-vitamin cocktail reduces homocysteine, THEN the cocktail may be able to reverse faulty cognition (in certain circumstances). Because these supplements are water-soluble, toxicity is of little concern regardless of the elevated dosage required.

References

Durga J, van Boxtel MP, Schouten EG, Kok FJ, Jolles J, Katan MB, Verhoef P.
Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial.
Lancet. 2007 Jan 20;369(9557):208-16.

Feng L, Ng TP, Chuah L, Niti M, Kua EH.
Homocysteine, folate, and vitamin B-12 and cognitive performance in older Chinese adults: findings from the Singapore Longitudinal Ageing Study.
Am J Clin Nutr. 2006 Dec;84(6):1506-12.

Ford AH, Flicker L, Alfonso H, Thomas J, Clarnette R, Martins R, Almeida OP.
Vitamins B(12), B(6), and folic acid for cognition in older men.
Neurology. 2010 Oct 26;75(17):1540-7.

Garcia A, Zanibbi K.
Homocysteine and cognitive function in elderly people.
CMAJ. 2004 Oct 12;171(8):897-904.

Thomas M. Harkcom MD, Richard M. Lampman PhD, Barbara Figley Banwell PT, C. William Castor MD
Therapeutic value of graded aerobic exercise training in rheumatoid arthritis
Arthritis & Rheumatism. Volume 28, Issue 1, pages 32–39, January 1985

Kirkcaldy, Bruce D.;Shephard, Roy J.
Therapeutic implications of exercise.
International Journal of Sport Psychology, Vol 21(3), Jul-Sep 1990, 165-184.

Lewerin C, Matousek M, Steen G, Johansson B, Steen B, Nilsson-Ehle H.
Significant correlations of plasma homocysteine and serum methylmalonic acid with movement and cognitive performance in elderly subjects but no improvement from short-term vitamin therapy: a placebo-controlled randomized study.
Am J Clin Nutr. 2005 May;81(5):1155-62.

Lonn E, Yusuf S, Arnold MJ, Sheridan P, Pogue J, Micks M, McQueen MJ, Probstfield J, Fodor G, Held C, Genest J Jr; Heart Outcomes Prevention Evaluation (HOPE) 2 Investigators.
Homocysteine lowering with folic acid and B vitamins in vascular disease.
N Engl J Med. 2006 Apr 13;354(15):1567-77.

Malouf R, Grimley Evans J.
Folic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people.
Cochrane Database Syst Rev. 2008 Oct 8;(4):CD004514.

McCaddon A, Hudson P, Davies G, Hughes A, Williams JH, Wilkinson C
Homocysteine and cognitive decline in healthy elderly.
Dement Geriatr Cogn Disord. 2001 Sep-Oct;12(5):309-13.

McCaddon, Andrew
Homocysteine and cognitive impairment; a case series in a General Practice setting
Nutrition Journal. 15 February 2006, 5:6

Oulhaj A, Refsum H, Beaumont H, Williams J, King E, Jacoby R, Smith AD.
Homocysteine as a predictor of cognitive decline in Alzheimer’s disease.
Int J Geriatr Psychiatry. 2010 Jan;25(1):82-90.

Sally P Stabler
Vitamins, homocysteine, and cognition
American Journal of Clinical Nutrition, Vol. 78, No. 3, 359-360, September 2003

A. David Smith, Stephen M. Smith, Celeste A. de Jager, Philippa Whitbread, Carole Johnston, Grzegorz Agacinski, Abderrahim Oulhaj, Kevin M. Bradley, Robin Jacoby, Helga Refsum
Homocysteine-Lowering by B Vitamins Slows the Rate of Accelerated Brain Atrophy in Mild Cognitive Impairment: A Randomized Controlled Trial
PLoS ONE. September 8, 2010; 5(9): e12244.

Stott DJ, MacIntosh G, Lowe GD, Rumley A, McMahon AD, Langhorne P, Tait RC, O’Reilly DS, Spilg EG, MacDonald JB, MacFarlane PW, Westendorp RG.
Randomized controlled trial of homocysteine-lowering vitamin treatment in elderly patients with vascular disease.
Am J Clin Nutr. 2005 Dec;82(6):1320-6.

van Uffelen JG, Chin A Paw MJ, Hopman-Rock M, van Mechelen W.
The effect of walking and vitamin B supplementation on quality of life in community-dwelling adults with mild cognitive impairment: a randomized, controlled trial.
Qual Life Res. 2007 Sep;16(7):1137-46.

van Uffelen JG, Chinapaw MJ, van Mechelen W, Hopman-Rock M.
Walking or vitamin B for cognition in older adults with mild cognitive impairment? A randomised controlled trial.
Br J Sports Med. 2008 May;42(5):344-51.

Walker JG, Batterham PJ, Mackinnon AJ, Jorm AF, Hickie I, Fenech M, Kljakovic M, Crisp D, Christensen H.
Oral folic acid and vitamin B-12 supplementation to prevent cognitive decline in community-dwelling older adults with depressive symptoms–the Beyond Ageing Project: a randomized controlled trial.
Am J Clin Nutr. 2012 Jan;95(1):194-203.

Wen D, Xu J, Xie X, Zhang J, Zhong Y, Sun Y, Duan Y.
Effect of physical exercise on the efficacy of mitoxantrone-loaded nanoparticles in treating early breast cancer.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2010 Feb;27(1):109-12.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Brain Fog On Your Mind?

brain-ringCharity begins at home, and the brain is no stranger to this maxim. The brain is not only immunologically active on its own behalf, but also plays a role in protecting the rest of the body. The brain directs cell-to-cell communications, but those messages do not always host good news. Sometimes they carry the black cloud of inflammation, which is supposed to be a protective response to an insult, injury, or destruction of tissue, but it also may lead to loss of some kinds of function, including thought.  The chemicals that coordinate the inflammatory process are called cytokines, and they amplify immunological activity.

Given the role of cytokines in the neuroimmune process, it has been suggested that these molecules influence cognitions—the mental processes of knowing, which is an exercise that includes awareness, perception, reasoning and judgment.  Investigators at the St. Vincent Hospital, in Indianapolis, studied the relationship between inflammation and cognition and found that, “There is abundant evidence that inflammatory mechanisms within the central nervous system contribute to cognitive impairment via cytokine-mediated interactions between neurons and glial cells,” adding that there is a growing awareness of the role of cytokines in “…the inflammatory processes in neurodegenerative diseases…”  (Wilson. 2002)  A considerable volume of such activity results from stress and its effect on immunity.

A dab of semantic guidance might be appropriate.  First, glial cells are a kind of scaffolding that supports and surrounds nerve cells.  Each neuron is surrounded by several.  In the brain, glia account for about forty percent of brain volume.  They’re smaller than neurons, maintaining the capacity to divide and form part of the blood-brain barrier that is designed to regulate the passage of matter between the blood and the central nervous system.  Second, cytokines have multiple tasks, including blood clotting, growth and development, and, of course, immunity.  They comprise several groups.  There are those that regulate T-cells and B-cells in the immune system, called interleukins; those that block pathogens such as viruses, called interferons; and those that promote cell proliferation, called transforming growth factors, among others.

Cytokines can get excited by physical, mental, spiritual, biochemical, and psychological stress.  That runs the gamut from strenuous activity to poor diet to arguing with the kids to sickness or disease, all of which can lead to lack of mental clarity, confusion, tiredness, difficulty in concentrating, and forgetfulness—brain fog.   The cytokines can interfere with complex cognitive processes at the molecular level, where the regulation of neurotransmitters is disturbed and memory is distorted.  (McAfoose. 2009)   Recent studies in the Netherlands found that women are more prone to cognitive deficiencies caused by inflammation than men.  (Trollor. 2011)

When markers of inflammation are elevated they offer an explanation for the subsequent brain fog.  Of the several markers, C-reactive protein (CRP) is one of the most commonly measured.  Its elevation denotes the presence of inflammation somewhere in the body.  Not all inflammation is as painful as that from an ingrown toenail with its accompanying redness, swelling and pain.  But high CRP may account for, and even predict, memory impairment.  (Noble. 2010)  The diseases that are attributed to old age, such as arthritis, and the recruitment of the immune system, such as during a viral or bacterial attack, will increase circulating interleukins as well as CRP, both of which affect memory, attention, abstract thinking, the initiation and inhibition of appropriate actions, and planning.  (Hoth. 2008)

The factors that cause brain fog have a more profound effect as we age. If, however, we learn to control those factors now, it makes geriatric life a breeze. Removing dietary insults is one step.  The hardest slap comes from sugar and refined carbohydrates.  Supplementation with the B vitamins, the stress fighters, helps to maintain nerve integrity and function.  Sleep, a little exercise, counseling, and meditating on those things that are just, pure, lovely and of good report can ameliorate those little irritations that accumulate into seemingly insurmountable roadblocks to peace and the mental clarity that ensues.  By the way, keeping your teeth in good shape can help. (Kamer. 2011)

References

Wilson CJ, Finch CE, Cohen HJ.
Cytokines and cognition–the case for a head-to-toe inflammatory paradigm.
J Am Geriatr Soc. 2002 Dec;50(12):2041-56.

Neurosci Biobehav Rev. 2009 Mar;33(3):355-66. Epub 2008 Oct 18.
Evidence for a cytokine model of cognitive function.
McAfoose J, Baune BT.

Julian N Trollor, Evelyn Smith, Emmeline Agars, Stacey A Kuan, Bernhard T Baune
The association between systemic inflammation and cognitive performance in the elderly: the Sydney Memory and Ageing Study.
Age Dordrecht Netherlands (2011) Issue: 95, Pages: 1-10

Noble JM, Manly JJ, Schupf N, Tang MX, Mayeux R, Luchsinger JA.
Association of C-reactive protein with cognitive impairment.
Arch Neurol. 2010 Jan;67(1):87-92.

Karin F. Hoth, PhD, Andreana P. Haley, PhD, John Gunstad, PhD, et al
Elevated C-Reactive Protein Is Related to Cognitive Decline in Older Adults with Cardiovascular Disease
J Am Geriatr Soc. 2008 October; 56(10): 1898–1903.

Kamer AR, Morse DE, Holm-Pedersen P, Mortensen EL, Avlund K
Periodontal Inflammation in Relation to Cognitive Function in an Older Adult Danish Population.
J Alzheimers Dis. 2011 Nov 1. [Epub ahead of print]

Grassi-Oliveira R, Bauer ME, Pezzi JC, Teixeira AL, Brietzke E.
Interleukin-6 and verbal memory in recurrent major depressive disorder.
Neuro Endocrinol Lett. 2011;32(4):540-4.

Ridker PM, Hennekens CH, Buring JE, Rifai N.
C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women.
N Engl J Med. 2000 Mar 23;342(12):836-43.

Marioni, Riccardo Emilio
Inflammation and cognition : the association between biomarker levels, their genetic determinants, and age-related cognitive decline.
The University of Edinburgh. 2010
http://hdl.handle.net/1842/4436

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Iodine Deficiency

iodinebookBeyond its role in antisepsis and breast health, iodine is perhaps best known for its regulatory function in the thyroid gland. Educators at the Linus Pauling Institute reiterate the mineral’s essentiality to the thyroid hormones, commonly listed as T3 and T4 on a blood test. T3 is the physiologically active form, while T4 is the more abundant circulating form. In targeted tissues, T4 is converted to T3 by enzymes that depend on selenium for their activity. In this manner, the thyroid comes to control growth and development, metabolism, and reproductive function. Can you see the need for selenium? In the absence of sufficient iodine, the pituitary gland will secrete thyroid-stimulating hormone (TSH) in an attempt to set things straight by increasing iodine trapping mechanisms. If TSH levels are persistently elevated, the thyroid gland may enlarge and form what is known as a goiter.

The World Health Organization (WHO) estimates that about a third of the world’s population is deficient in iodine, a deficit that is the most common cause of preventable brain damage in the world. The Food and Nutrition Board of the Institute of Medicine declares that iodine is responsible for myelination of the developing central nervous system, and that deficiency is associated with mental retardation, and in extreme cases, cretinism. More than thirty percent of children under twelve has insufficient iodine intake. Although iodized salt was intended to prevent iodine deficiency, the modern diet has put it away in favor of salts whose iodine values are inconsistent and perhaps even absent, as might be the case with the kosher salts that took over the culinary arts. The American Journal of Hypertension and its Polish counterpart report that those adults who choose to avoid salt in any form to control their sodium-sensitive high blood pressure may be realizing small benefit in the long run unless they fortify their diets with iodine from other sources.

Just as we are barraged with loud TV commercials for products in which we have little or no interest, we are likewise assaulted with chemicals and synthetic agents about which we know nothing and whose ubiquitous presence is hidden. Manufacturers of consumer goods apparently feel the need to add things to their products for our own good when, in truth, it’s for their bottom line. Among these ruinous substances is bromine, a member of the chemical family called halides, a group that includes fluorine, chlorine, iodine and astatine, the last having no biological value whatsoever to humans.  Bromine hides in a few forms—as methyl bromide and ethylene dibromide, used as fumigants. In the produce business, they relieve fresh fruits and vegetables of their B vitamins. Bromide is found in cleaners, dyes, water sanitation processes, pharmaceuticals, flame retardants in our kids’ PJs, and in our foods as brominated flour, brominated vegetable oil (BVO) and who knows what else.  BVO is used to make citrus-flavored soft drinks cloudy-looking by emulsifying ingredients to keep the flavoring suspended in the liquid.  Bromine, which has zero use by the body, pushes iodine out of the thyroid gland. Because it acts like iodine and chlorine, the body accepts it. Puzzlement is that bromine is listed in the Hazardous Substances Data Bank of the National Library of Medicine, yet is allowed as a food additive in the Federal Code. In one of his blog postings, Dr. David Brownstein, a celebrated holistic physician, explains that it is vital to maintain optimal iodine levels. Our constant exposure to chemicals like bromine requires daily iodine supplementation because bromine will either prevent iodine absorption or push out that which is already there. At 150 micrograms a day, the RDA for iodine is woefully inadequate to address our physiological needs.  Knowing that bromine is present in some psychotropic drugs helps us to understand why some patients never get well. They are iodine depleted.

There is little doubt among researchers that iodine deficiency is epidemic. Dr. Mark Sircus acknowledges the toxicity of another halogen—fluoride.  He points out that all the halogens use the same receptors in the body, and that the toxic ones will displace iodine at the first opportunity, but also that the intake of supplemental iodine can increase the excretion of the other halides, and even of heavy metals. Note that the toothpaste tube admonishes us not to let a child swallow his fluoridated dentifrice. Adults, likewise, are warned not to swallow more than used on the brush.  Hailed as one of the greatest health achievements of the 20th century, fluoridation of water is now limited, being cited as harmful to the liver and kidneys.

If you or a loved one is concerned about thyroid function, know that fluoride is used in Europe to treat hyperthyroidism because it reduces thyroid activity. If you have symptoms of hypothyroid—fatigue, sensitivity to cold, constipation, dry skin, puffiness, muscle weakness, thinning hair, slowed heart rate and mental fog—look at your toothpaste, your municipal or well water supply, black tea, pesticides, Teflon, moisture barriers, some drugs, refrigerants, certain medical scanning procedures, and your dentist.

An oddity of halogens is that their clinical activity is in inverse proportion to their atomic weights. A lighter one will displace a heavier one. The opposite does not hold. Of those in the body, iodine is the heaviest. Regular use of iodine will mitigate the damage from the others. Knowing that liquid iodine preparations work more efficiently than the solid forms can help you to make the right supplement choice.

References

Victoria J. Drake, Ph.D.
Iodine
Linus Pauling Institute Micronutrient Information Center. Mar 2010. Update
http://lpi.oregonstate.edu/infocenter/minerals/iodine/

Dunn JT.
What’s happening to our iodine?
J Clin Endocrinol Metab. 1998;83(10):3398-3400.
Fluoride history
http://www.fluoride-history.de/p-insecticides.htm

Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002. Available at: www.nap.edu/books/0309072794/html/.
http://toxnet.nlm.nih.gov/cgi-bin/sis/search/f?./temp/~6PSNGt:1

Grzesiuk W, Dabrowska J, Osikowska-Loksztejn M, Kondracka A, Kolasińska K, Bar-Andziak E.
Effectiveness of iodine prophylaxis in hypertensive patients on salt restricted diet
Pol Arch Med Wewn. 2005 Feb;113(2):147-54.

Hetzel BS, Clugston GA. Iodine. In: Shils M, Olson JA, Shike M, Ross AC, eds.
Modern Nutrition in Health and Disease.
9th ed. Baltimore: Williams & Wilkins; 1999:253-264.

Larsen PR, Davies TF, Hay ID. The thyroid gland. In: Wilson JD, Foster DW, Kronenberg HM, Larsen PR, eds. Williams Textbook of Endocrinology. 9th ed. Philadelphia: W.B. Saunders Company; 1998:389-515.

R. L. Metcalf . From the “Introduction” to Chapter 7, “Fluorine-containing insecticides”, (Handbook of  Experimental Pharmacol. XX.1, pp. 355-386, Springer, Berlin-Heidelberg-New York, 1966):

Dr. Mark Sircus blogs
http://www.greenmedinfo.com/gmi-blogs/[email protected]

Santoyo-Sanchez MP, Del Carmen Silva-Lucero M, Arreola-Mendoza L, Barbier OC.
Effects of Acute Sodium Fluoride Exposure on Kidney Function, Water Homeostasis, and Renal Handling of Calcium and Inorganic Phosphate.
Biol Trace Elem Res. 2013 Feb 12. [Epub ahead of print]

Tayie FA, Jourdan K.
Hypertension, dietary salt restriction, and iodine deficiency among adults.
Am J Hypertens. 2010 Oct;23(10):1095-102.

World Health Organization. Eliminating Iodine Deficiency disorders. World Health Organization, [Web page]. 04/09/2003. http://www.who.int/nut/idd.htm. Accessed 04/11/2003.

Zhao P, Guo X, Zheng C.
Removal of elemental mercury by iodine-modified rice husk ash sorbents.
J Environ Sci (China). 2010;22(10):1629-36.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.