Studies suggest that an inadequate amount of vitamin B12 may be a risk factor for brain atrophy (shrinking) and possible cognitive impairment. Studies also show that individuals with Down syndrome commonly have low levels of B12 and Folic/Folinic Acid (or folate). In one study, typical seniors who took B12 supplements did a better job of holding cognitive declines at bay than placebo. Since the brain of a person with DS has similar qualities of a brain of an elderly person, we need to pay attention to studies about seniors. Supplementing with B12 and Folinic Acid also helps to normalize metabolism.
Folic/Folinic Acid (or folate) is particularly important within our population since it is needed for the synthesis of DNA and RNA, which are the building blocks of cells. They also help prevent changes to the DNA that could lead to cancer such as leukemia, which our population is particularly susceptible to. It is also needed in both children and adults to be able to make normal red blood cells and prevent anemia. Specifically, B12 and Folinic Acid are used in a metabolic cycle called the SAM cycle.
Please visit Changing Minds Foundation's page on B12 and Down syndrome for more details.
Dr. Oz recently did a great show on B12, not specific to T21, but a nice overview: http://www.doctoroz.com/episode/americas-b12-deficiency
Types of Folic Acid, Folinic Acid and Folates
Folinic acid also known as Calcium Folinate has been shown to have positive effects on children with DS whether or not they have the MTHFR variation.
Folate is a broad term, it may refer to Calcium Folinate, "naturally occuring folate" which may be folinic acid or could be a form of l-5-methylfolate. If it's not clear on the label, I'd contact the company to make sure of the source.
Calcium Folinate has been shown to have positive effects on children with DS whether or not they have the MTHFR variation. It's not recommended for the typical population who has the MTHFR variation.
L-5-MTHFR, l-5-methyltetrahydrofolate, 5-methylfolate, etc. is the folate of choice for those with the MTHFR variation. (This is what I take. Jett has both DS and MTHFR so I give him both, just in case. Hopefully I'll eventually learn which is best but I'm covering my bases.)
For more info on types, see Cerebral folate deficiency in Down syndrome
Dosage
B12
Birth to 2 years: 200-400mcg
Children 2- 12 years old: 400-1000mcg
Teen/Adults: 1000-2000mcg
Folinic Acid
Birth to 2 years: 200 mcg
Children 2- 12 years old: 400-800 mcg
Teen/Adults: 800-2000 mcg
For products, see the DS Day to Day Store.
B12
Different children need different forms of B12. If your child has one or more of the MTHRF mutation, the methylcobalamin is preferable (40% of the typical population has this mutation. Jett does). With some kids, if you give the full dose the first day, it causes hyperactivity. If you see this happening, reduce the dose and slowly increase each day until you reach the full dose. If problems still occur with methylcobalamin, look into the hydoxocobalamin form (see healthy awareness article below).
B12 can be difficult to metabolize so you don't want to give it in food or have them shallow it. Instead, buy sublingual drops or mouth or nose spray or other easy to assimilate form. It also needs to be taken on an empty stomach, first thing in the morning works well. If your child still has low levels of B12, you can look into the B12 shots (watch out for extra ingredients in the shot, however).
Methylcobalamin B12
Different children need different forms of B12. If your child has one or more of the MTHRF mutation, the methylcobalamin is preferable (40% of the typical population has this mutation. Jett does). With some kids, if you give the full dose the first day, it causes hyperactivity. If you see this happening, reduce the dose and slowly increase each day until you reach the full dose. If problems still occur with methylcobalamin, look into the hydoxocobalamin form (see healthy awareness article below).
B12 can be difficult to metabolize so you don't want to give it in food or have them shallow it. Instead, buy sublingual drops or mouth or nose spray or other easy to assimilate form. It also needs to be taken on an empty stomach, first thing in the morning works well. If your child still has low levels of B12, you can look into the B12 shots (watch out for extra ingredients in the shot, however).
Methylcobalamin B12
B12 drops
This is what I use for myself. I just put the drops under my tongue first thing in the morning and try not to swallow, rather allow it to dissolve in my mouth.
B12 spray
This is what I use for Jett first thing in the morning. It sprays a fine film all over his mouth so that it's more likely to be absorbed in his mouth rather than to go down his throat.
More B12 Liquid versions
Designs for health super liquid folate
This one has BOTH good types of folinic/folate AND B12: Methyl Protect by Biogenesis Nutraceuticals
My stepson, with ASD, uses the sublingual lozenge that he sucks on while getting ready for school in the mornings. (I don't necessarily trust that he won't swallow the liquid and spray.)
Hydoxocobalamin B12
(The brand ProHealth has sorbitol in its tablets so I haven't included them in this list.)
sublingual drops $40
Revelation Health Hydroxo-B12
(I've sent them an email for their list of ingredients to see if this product can stay on this list.)
Sublingual spray $60 for 3 month supply
Blue Rock Holistics Hydroxade
(I've sent them an email for their list of ingredients to see if this product can stay on this list.)
Here's a great page that gives more information about the different forms of B12: http://www.healthyawareness.com/articles/about-vitamins-minerals/about-vitamin-b12.aspx
Calcium folinate
Source Naturals MegaFolinic™ -- 800 mcg - 120 Tablets
Kirkman's Folinic Acid
L-5MTHF
Metagenics FolaPro® -- 60 Tablets is the l-5MTHF type of folate.
Neurobiologix Methyl Folate with Activating Co factors
I haven't tried this yet, but it sounds good. It has both
5-methyltetrahydrofolate and folinic acid as well as niacinamide which helps with the symptoms you may get from using a lot of 5-MTHF. I did get the adverse symptoms when I first took l-5-MTHF and this product would have been nice to have then.
Seeking Health's l-5-mthf
This is what I use for myself. I just put the drops under my tongue first thing in the morning and try not to swallow, rather allow it to dissolve in my mouth.
B12 spray
This is what I use for Jett first thing in the morning. It sprays a fine film all over his mouth so that it's more likely to be absorbed in his mouth rather than to go down his throat.
More B12 Liquid versions
Designs for health super liquid folate
This one has BOTH good types of folinic/folate AND B12: Methyl Protect by Biogenesis Nutraceuticals
My stepson, with ASD, uses the sublingual lozenge that he sucks on while getting ready for school in the mornings. (I don't necessarily trust that he won't swallow the liquid and spray.)
Hydoxocobalamin B12
(The brand ProHealth has sorbitol in its tablets so I haven't included them in this list.)
sublingual drops $40
Revelation Health Hydroxo-B12
(I've sent them an email for their list of ingredients to see if this product can stay on this list.)
Sublingual spray $60 for 3 month supply
Blue Rock Holistics Hydroxade
(I've sent them an email for their list of ingredients to see if this product can stay on this list.)
Here's a great page that gives more information about the different forms of B12: http://www.healthyawareness.com/articles/about-vitamins-minerals/about-vitamin-b12.aspx
Calcium folinate
Source Naturals MegaFolinic™ -- 800 mcg - 120 Tablets
Kirkman's Folinic Acid
L-5MTHF
Metagenics FolaPro® -- 60 Tablets is the l-5MTHF type of folate.
Neurobiologix Methyl Folate with Activating Co factors
I haven't tried this yet, but it sounds good. It has both
5-methyltetrahydrofolate and folinic acid as well as niacinamide which helps with the symptoms you may get from using a lot of 5-MTHF. I did get the adverse symptoms when I first took l-5-MTHF and this product would have been nice to have then.
Seeking Health's l-5-mthf
Articles
Brain Takes Multiple Hits from Low B12 Levels
By Crystal Phend, Senior Staff Writer, MedPage Today
Published: September 26, 2011
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.
Excerpts:
Excerpts:
Low levels of vitamin B12 may contribute to cognitive problems for older adults in more than one way, according to a cross-sectional study….
...Note that previous studies have suggested that poor vitamin B12 status may be a risk factor for brain atrophy and possibly cognitive impairment.
Note that in this study, concentrations of vitamin B12–related markers (methylmalonate, cystathionine, homocysteine) were associated with global cognitive function and with total brain volume….
...Although her group's observational study couldn't say whether boosting B12 would prevent or reverse cognitive effects, a prior randomized trial demonstrated that high-dose B complex supplements could slow down brain atrophy in older adults.
In that study, dubbed VITACOG, supplements did a better job of holding cognitive declines at bay than placebo among those with high homocysteine levels.
"So at least from this one clinical trial it appears that [supplementation] may have some benefit," Morris argued.
Her group dug deeper into their Chicago Health and Aging Project (CHAP), measuring vitamin B12-related markers in relation to brain MRI and neuropsychological test results 4.6 years later in 121 residents of Chicago's South Side, ages 65 and older.
After adjustment for age, sex, education, race, and serum creatinine levels to control for renal function problems that could have an impact on homocysteine, all of the B12-related markers affected global cognitive scores….
..."You might be in the normal range, say in the low normal range, of vitamin B12 in your blood but still have evidence of insufficient vitamin B12 based on these biomarkers," she told MedPage Today….
Primary source: NeurologySource reference:Tangney CC, et al "Vitamin B12, cognition, and brain MRI measures: A cross-sectional examination" Neurology 2011; 77: 1276–1282.
Also:
Low Vitamin B12 Tied to Brain Atrophy, Cognitive Impairment
Study
Total blood mercury and serum measles antibodies in US children, NHANES
2003-2004. <http://www.ncbi.nlm.nih.gov/
pubmed/21992842>
Gallagher CM, Smith DM, Meliker JR.
Sci Total Environ. 2011 Dec 1;410-411:65-71. Epub 2011 Oct 10.
Background: Environmental toxins, pathogens and host susceptibility cofactors may interact to contribute to disease. In vitro mercury exposure inhibited antiviral cytokines in human cells; however, little
is known about the relationship between mercury and viruses in children. Children are susceptible to mercury toxicity; lower vitamin B-12 and folate levels and higher homocysteine levels may represent susceptibility cofactors.
This study aimed to evaluate associations between total blood mercury (Hg) and measles antibodies in children, and the influence of these susceptibility cofactors.
Design: Cross-sectional data on serum measles antibodies, Hg, homocysteine, methylmalonic acid (MMA, indicator of B-12 deficiency), and folate were obtained from the 2003--2004 NHANES for children aged 6--11 years with measles seropositivity (n=692). We used linear regression to evaluate relationships between measles antibodies and Hg, stratified by sex, MMA ?, folate b, and homocysteine?sample medians, adjusted for demographic, nutritional and environmental cofactors.
Results: Hg (range: 0.10--19.10 ?g/L) was inversely associated with measles antibodies (range: 1.00--28.24 units) in non-stratified analysis (n=692), yet positively associated among the subset of boys with higher MMA and lower folate (n=98). Among this subset with higher homocysteine levels (n=61), correlations were positive across all Hg quartiles relative to Q1 (Hg?0.20 ?g/L): Q2:?=6.60 (3.02, 10.19); Q3:?=8.49 (6.17, 10.81);
Q4 (HgN0.80 ?g/L):?=4.90 (2.12, 7.67) (ptrend=0.077).
Conclusion: Stratification by susceptibility cofactors revealed opposing directionality for correlations between Hg and measles antibodies, with positive effect estimates at lowest exposures only among boys with higher MMA, lower folate and higher homocysteine levels.
Related Posts
Folic Acid Cut Alzheimer's Risk by Half
Alzheimer's Disease & Down syndrome
Jett's Supplement List
Thyroid Issues & DS Go Hand in Hand
Which Multivitamin?
Anemia Causes & Cures
Natural Ways to Help with ADD
Cerebral folate deficiency in Down syndrome
