Maximize Your Brain Power: All the B Vitamins, especially B-12
Folic Acid Therapy
Surveys have found repeatedly that older people are often deficient in two B vitamins - folic acid and B12. Several investigators have reported that patients with symptoms of senility or dementia (the terms are synonymous) and who had low folic acid blood levels, showed improvement after therapy with folic acid.
Scientists in England found that supplementing the diets of patients with folic acid resulted in shorter stays at their mental hospital. Fortunately for the patients but unfortunately for acceptance within the medical community, this study was not a controlled study (which meant that it had no control group compared to an experimental group).
Residents of nursing homes and chronic wards of mental hospitals are at considerable risk for folic acid deficiency. These institutions, if they serve folate-rich green vegetables at all, are likely to do so in fairly unpalatable fashion. To compound the problem, many older people have chewing and digestive difficulties. Research shows a folic acid deficiency is often unrecognized in some elderly patients. Therefore, supplementation with B-complex vitamins, including folic acid and sublingual B12, may be helpful to those in nursing homes, suffering from senility or dementia.
Vitamin B12 Therapy
Deficiency of vitamin B12, which results in pernicious anemia, is a common vitamin deficiency. In the vast majority of cases, a person may be getting adequate B12 in his or her diet, but lacks a stomach-produced substance called the "intrinsic factor" which is necessary for absorption of the vitamin. B12 is difficult to absorb, which is why people are often given B12 injections.
A deficiency of hydrochloric acid (HCl) production in the stomach is known to impair vitamin B12 and folic acid absorption. Up to 50 percent of people age 60 and older experience seriously diminished hydrochloric acid production. Adding hydrochloric acid to the diets of the elderly normalizes vitamin B12 and folic acid absorption, according to Jonathan Wright, M.D.
A vitamin B12 deficiency is related to some cases of mood disorders. Most elderly have symptoms of intellectual impairment, manifested as poor memory for recent events, difficulty in concentrating, and difficulty at work. Some will have symptoms of a burning sensation, unsteadiness, fatigue, and sometimes urinary incontinence. A broad spectrum of psychiatric symptoms, from irritability to apathy to psychosis with hallucinations, may also occur.
A Widespread B12 Deficiency?
A deficiency in this vitamin may be more widespread than is generally recognized by the medical profession, because the range considered "normal" for serum cobalamin (B12) is probably lower than it should be. In many cases, senile dementia of the Alzheimer's type and "chronic fatigue syndrome," which may very well be linked to a B12 deficiency, could be reversed through B12 therapy if diagnosed early enough.
It may be that a high serum maintenance level is preferable to a merely adequate one, especially since the B-vitamins are water-soluble and any excess is excreted by our bodies through the urine.
Nursing Homes. Recent studies suggest that a small but significant percentage of patients who are presently institutionalized in nursing homes or state hospitals for psychosis or senility actually have B12 deficiencies, a treatable condition.
For many years, the medical profession held to the opinion that mental symptoms did not occur in the absence of anemic changes in the red blood cells. Thus, many physicians discounted the possibility of B12 deficiency as the cause of memory problems if the complete blood count was normal. We now know that the mental symptoms can occur before any changes are evident in red cells.
Vitamin B12 Injections. Vitamin B12 is a completely safe and inexpensive treatment. Dr. Alan Gaby says, "We usually forego the test in favor of a therapeutic trial of vitamin B12 injections. If the patient improves after a series of four to eight injections, we recommend continuing them on an as-needed basis."
The usual recommendation is that a person take oral doses of B12 in the range of 1,000 to 2,500 micrograms a day. It is also available sublingually (under the tongue) which can deliver more of the B12 to the blood stream. As Dr. Gaby suggests, ask your physician about regular B12 injections for a few months. Good dietary sources for vitamin B12 are organ meats (especially kidney and liver), eggs, beef, pork, fish and dairy products. Vegetarians are often deficient in B12 and need to take it in supplement form since it is primarily found in animal products.
- Botez, M. I., et al. "Neuropsychological correlates of folic acid deficiency: Facts and hypotheses." M. I. Botez, E. H. Reynolds, eds. Folic Acid in Neurology, Psychiatry and Internal Medicine (New York: Raven Press, 1979).
- Braverman, E. R. and C. C. Pfeiffer. The Healing Nutrients Within. New Canaan, CT: Keats Publishing, Inc., 1987, page 59.
- Goodwin, James S., M.D. "On Nutrition & Memory." Executive Health (October 1984).
- Pary, T. E. "Folate Responsive Neuropathy." La Presse Medicale 23.3 (Jan 29, 1994): 131–137.
- Wright, Jonathan V., M.D. and Alan Gaby, M.D. Nutrition & Healing 2.3 (March 1995):9.
- Hendler, Sheldon Saul, M.D., Ph.D. The Doctors’ Vitamin and Mineral Encyclopedia. New York: Simon and Schuster, 1990, page 69.
- Beck, W. S. "Cobalamin and the nervous system (editorial)." New England Journal of Medicine 318 (1988): 1752–1754.
- Garcia, C. A., M. J. Reding, and J. P. Blass. "Over diagnosis of dementia." Journal of the American Geriatrics Society 29 (1981): pages 407–410.
- Dommisse, J. "Subtle vitamin B12 deficiency and psychiatry: A largely unnoticed but devastating relationship?" Medical Hypotheses 34 (1991): 131–140.
- "Vitamin B12 deficiency often overlooked." News (University of Colorado Health Sciences Center, June 30, 1988).
- Craig, G. M., C. Elliot, and K. R. Hughes. "Masked vitamin B12 and folate deficiency in the elderly." British Journal of Nutrition 54 (1985): pages 613–619.
- Murray, Michael, N.D. and Joseph Pizzorno, N.D. Encyclopedia of Natural Medicine. Rocklin, CA: Prima Publishing, 1990, page 133.
- van Tiggelen, C. J. M., et al. "Assessment of vitamin B12 status in CFS." American Journal of Psychiatry 141 (1984): 136. As found in Nutrition & Healing.
- Wright, Jonathan V. and Alan R. Gaby. Nutrition & Healing 2.3 (March 1995).
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