Supplements for Brain Health Support Series Week 20
Paul Holcroft
Ericksonian Hypnotherapist, Health Researcher, Nutritional Thriver, Fundraiser, Photographer & Actor at Players Theatre
Welcome to the Brain Health Support Series where each week we will bring you one scientifically studied nutritional supplement to help support brain function including stress and mood elevation.
This week we are looking at: Vitamin B9 Folic Acid aka Folate aka Folacin
One insidious way mood and stress affect your body and brain is by depleting essential vitamins and minerals just when you need those most. Stress consumes excessive key vitamins and minerals and, if you don’t replace them with the right foods and supplements, stress, anxiety and mood swings can worsen.
The production of stress hormones and neurotransmitters consume a big chunk of these nutrients’ reserves and because stress largely shuts down the digestive system, less of them get absorbed from the food you eat. Consequently, your supply of anti-stress vitamins and minerals is decreased … and your tolerance to stress is lowered.
Many bad habits that people gravitate to when they’re stressed and anxious, like alcohol, caffeine, smoking, sugar, and recreational drugs, also deplete ital nutrients and unfortunately, so do many prescription drugs. Ironically, this includes anti-anxiety medications!
How can you stop this downward spiral? You can start by eating a diet rich in the right vitamins and minerals as a first step, and then supplement with quality, high-purity supplements that will top-up any deficiencies.
The following nutritional supplementation information purported to help support stress and anxiety issues is based on my own research online through articles, medical papers, and online seminar events. You are welcome to do your own research.
B vitamins are critical for efficient liver detoxification of dangerous chemicals such as heavy metals, hormones (especially estrogen) and bacterial toxins that could be at the root of your immune, neurological and hormonal challenges.
B-complex vitamins also have dramatic mood-elevating effects—more so than almost any other nutrient!
Vitamin B9 Folic Acid aka Folate aka Folacin
It is becoming clear that folic acid affects mood and cognitive function, especially in older people. Edward Reynolds draws together the evidence
Folic acid is important for functioning of the nervous system at all ages.1–4 In the fetus the relation between maternal folate status and the risk of neural tube defects is well established: clinical trials have shown that periconceptual preventive treatment with 400 μg or higher of folic acid significantly reduces the risks of such defects.
In neonates, infants, children, and adolescents, inborn errors of folate transport and metabolism are associated with a variety of overlapping syndromes which are influenced by age of clinical presentation.
These include developmental delay, cognitive deterioration, motor and gait abnormalities, behavioural or psychiatric symptoms, seizures, signs of demyelination or failure of myelination, and vascular changes seen on magnetic resonance imaging or postmortem examination. Less commonly, subacute combined degeneration and peripheral neuropathy may also occur.
In adult patients presenting with megaloblastic anaemia due to folate deficiency, approximately two thirds have neuropsychiatric disorders which overlap considerably with those associated with anaemia due to vitamin B-12 deficiency. However, depression is commoner in patients with folate deficiency, and subacute combined degeneration with peripheral neuropathy is more frequent in those with vitamin B-12 deficiency.
The degree of anaemia is poorly correlated with the presence of neuropsychiatric disorders, but if these anaemias were left untreated nearly all patients would eventually develop neuropsychiatric complications.
Over the past 35 years numerous studies have shown a high incidence of folate deficiency correlated with mental symptoms, especially depression and cognitive decline in epileptic, neurological, psychiatric, geriatric, and psycho geriatric populations. Furthermore, recent studies in elderly people suggest a link between folic acid, homocysteine, ageing, depression, and dementia, including Alzheimer's disease and vascular disease.
Folates are important in the nervous system at all ages and there is growing evidence of their involvement in the ageing brain, especially in mood and cognitive function.
Within the wide spectrum of depressive disorders, a subgroup has been identified in which folate and related methylation processes are involved. With respect to dementia, there is evidence that folate deficiency may contribute to the cognitive impairment of the ageing brain, sometimes leading to reversible dementia but also increasing the risk of Alzheimer's disease and vascular dementia, perhaps by methylation related processes or by homocysteine mediated vascular or neurotoxic mechanisms. It is well known that depression may be a precursor of dementia in a range of neuropsychiatric syndromes.
Neurological patients
Several of the earliest reports of neurological disease associated with severe folate deficiency emphasise the importance of dementia and depression reversible with vitamin therapy. For example, Botez et al described 16 patients whose impaired intellectual function, confirmed on neuropsychological testing, was strikingly improved after six to 12 months of folic acid therapy.
On the basis of clinical, neuropsychological, computed tomography, and radionuclidecisternographic findings, they concluded that chronic folate deficiency could induce cerebral atrophy In general medical patients admitted acutely to hospital, 71% of those with severe folate deficiency had organic brain syndrome, compared with 31% of a control group.
Runcie, who described 10 cases and reviewed the literature, emphasised that the syndrome of folate responsive dementia and depression, sometimes with additional cord or peripheral nerve signs, was much commoner in geriatric and psychogeriatric units than was (or still is) recognised.
Psychiatric patients
On the basis of serum or red cell assays, folate deficiency has been reported in up to one third of psychiatric outpatients or inpatients, more so in the former. Carney and colleagues emphasised the link with depression and “organic” mental change, and a closer association with endogenous than neurotic depression.
Depressed patients with folate deficiency had higher depression scores, higher affective morbidity indices, lower Marke-Nyman (drive) scores, and a poorer response to standard treatment with antidepressants.Although folate deficiency is widely regarded as a secondary dietary consequence of psychiatric illness, nutritional studies have not confirmed this view.
Poor diet no doubt contributes to some, perhaps many, cases. Other factors are drugs, including antiepileptic drugs; chronic illness; increased demand; and malabsorption, and in some patients the cause is unexplained.
Bottiglieri et al identified a biological subgroup of patients with depression, raised plasma homocysteine concentration, folate deficiency, and impaired monoamine neurotransmitter metabolism.16 The observation of raised plasma homocysteine in 20-30% of depressed patients is in keeping with the earlier studies of folate concentrations.3,4
The few controlled clinical trials of vitamin therapy in addition to standard psychotropic medication have all reported positive effects on patients' mental state. In a double blind placebo controlled trial in depressive patients treated with lithium, the addition of 200 μg of folic acid for one year significantly improved affective morbidity.
Similarly, the addition of 500 μg of the vitamin to fluoxitine for 10 weeks significantly improved antidepressant response, especially in women. In a double blind placebo controlled trial Godfrey et al added 15 mg of methylfolate to standard psychotropic medication and reported significant and increasing clinical and social recovery of folate deficient depressed and schizophrenic groups over six months.
Earlier Botez et al had reported improvement in both mood and neuropsychological function in a controlled trial of folic acid 15 mg daily alone for four months in depression.20
-Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123448/
B vitamins are critical for the production of neurotransmitters in the brain, and insufficiency is associated with cognitive decline. Folate has a number of mechanisms by which it can enhance cognitive performance. These include lowering inflammation and reducing homocysteine. Elevated homocysteine and chronic inflammation are linked to degenerative brain disorders.
Perhaps the most far-reaching implication of folate in the brain is its ability to modify gene expression. This means that folate plays a role in turning a gene “on” or “off.” Without enough folate, genes involved in the production of beta-amyloid are “turned on. Studies show that adding folate to brain cell cultures can silence—or “turn off”— genes that produce toxic beta-amyloid proteins.
The takeaway from these studies is that folic acid performs a host of functions that support youthful brain cell structure and function.
Folate’s Anti-Dementia Properties
The primary sources of folate (vitamin B9) include vegetables like broccoli, asparagus, spinach and Brussels sprouts. Cooking vegetables causes folate loss, which means we consume less of this nutrient than we might think.
One research group has been studying folate supplementation in older adults for half a decade. Their research has demonstrated folate’s beneficial effect on cognitive function. In their latest study, they explored the cognitive effect of supplementing with folate for an average of two years.
The study included 180 subjects with mild cognitive impairment.1 Half received folic acid (400 mcg/day), while the other half received standard care (guidance on nutrition and activity aimed at enhancing memory late in life).
After 24 months, the people in the folate group experienced three encouraging results:
1. Improvements in cognitive testing
By the end of the study, the folate group demonstrated significant increases in cognitive test scores, including full-scale IQ (which indicates a person’s average intelligence), verbal IQ, and measures of memory.
Combined treatment scores for the six verbal IQ tests were also significantly higher in the folate group, as was the combined treatment score for all 11 tests (full-scale IQ).
2. Improvements in markers of DNA methylation
Folate supplementation was shown to beneficially affect genes involved in DNA methylation, thereby assisting the body to metabolize homocysteine.
In the supplemented group, two important blood markers were increased: Folate levels and S-adenosylmethionine levels (SAMe, a natural compound that helps in the production of several key neurotransmitters and alleviates depression).
At the same time, two blood markers associated with poor cognitive outcomes were reduced:
· Homocysteine, a harmful amino acid that can lead to stroke, coronary disease, and dementia
· S-adenosyl homocysteine (SAH) levels, the precursor for homocysteine
The important ratio of SAMe/SAH was also increased, indicating a return to a healthy methylation.
3. Reduced levels of brain-toxic proteins
Toxic beta-amyloid plaques are a hallmark of Alzheimer’s disease. These distorted proteins accumulate in the brain, where they damage brain cells and interrupt the communication between neurons. The result is loss of memory and brain function.
Folate can help prevent beta-amyloid plaques from forming...
This study showed that subjects in the folate group had significantly lower blood levels of molecules involved in forming these brain-damaging plaques.1 Blood levels of these plaque-forming molecules reflect their accumulation in the brain. The presence of plaque-forming molecules may predict early Alzheimer’s disease or cognitive decline.
Overall, this study showed that folic acid supplementation significantly improved cognitive performance as seen by the increases in cognitive test scores. In addition, folic acid also reduced the abundance of beta-amyloid that directly damages brain cells.
What’s interesting about this study is the low-dose of folate used. Many older people are deficient in folic acid and other B vitamins and essential nutrients, meaning their levels of the bioactive form of folate, called 5-MTHF (5-methyltetrahydrofolate), are also perilously low.
People with elevated homocysteine often take 1,000 mcg to 10,000 mcg of 5-MTHF daily along with vitamins B12, B6 and B2. A number of previous studies have shown better results using 5-MTHF than standard folic acid.
Summary
This new study has demonstrated that even low-dose folic acid supplementation produces changes in gene function and in biochemistry that benefit the aging brain.
The favourable change in gene expression results in reduced production of toxic (beta-amyloid) proteins implicated in dementia.
Additionally, folate lowers the high homocysteine levels that often accompany brain aging and dementia. As a result, folic acid supplementation helps preserve cognitive function in adults with mild cognitive impairment.
Slowing the progress of mild cognitive impairment could delay the onset of dementia like Alzheimer’s and Parkinson’s diseases.
There is no reason for people to be deficient in folic acid as it is a remarkable low-cost nutrient. -Source: https://www.lifeextension.com/Magazine/2018/9/Folate-Improves-Brain-Function/Page-01
Folic Acid’s Role in Brain Health
Though folate plays an important role in many aspects of body health, its functions in the brain are just only beginning to be fully understood. Beyond its integral role in the proper formation of the nervous system during fetal development, folic acid’s importance has become evident in children and adolescents, as those suffering from metabolic abnormalities impacting folate transport have been diagnosed with a variety of developmental delays and cognitive deterioration, as well as behavioral and psychological problems.
Adults who suffer from folate deficiency have been shown to have a higher risk of neuropsychiatric disorders, depression, and even epilepsy, and numerous studies have linked folic acid supplementation in the elderly to better control of homocysteine in the blood system, resulting in both reduced risk of heart problems and improvements of cognitive performance and memory and fending off Alzheimer’s disease and mood disorders.
Folic Acid’s Role in Brain Development
Women who are pregnant are immediately put on a prenatal vitamin regimen that includes a folic acid supplementation because it helps to prevent neural tube defects including spina bifida and anencephaly.
Research has shown that folic acid levels are essential in the very earliest stages of fetal development, which has lead the Centers for Disease Control and Prevention (CDC) to recommend that women take the recommended daily dose of folic acid for at least a full month prior to conception and throughout the entirety of the first trimester in order to optimize its preventive effects.
And a study conducted in the Netherlands showed that children between the ages of 6 and 8 who were born to women who tested as folate deficient during the earliest stages of their pregnancy were shown to have smaller brain volume and scored lower on language and visual spatial tests.
Folic Acid’s Role in Severe Teen Depression
Groundbreaking research on teens diagnosed with severe depression has found that many for whom therapy, medication, and hospitalization have not worked are suffering from metabolic deficiencies that prevent their body from properly converting and absorbing folic acid.
According to a study published in the American Journal of Psychiatry, of 33 patients diagnosed with treatment-resistant depression, twenty-one suffered from a metabolic deficiency, with the most common deficiency being cerebral folate.
Treatment with folinic acid, which is the form of folate found naturally in food, yielded dramatic improvement. According to Dr. Lisa Pan, a psychiatrist at the Western Psychiatric Institute and Clinic and author of the study, “If the folate isn’t there, you can’t make healthy white matter.” (Tonic)
Folic Acid in Psychiatric Patients
The role of folic acid deficiency is particularly stark in patients diagnosed with depression. Multiple studies have shown that up to one third of psychiatric outpatients suffer from folate deficiency, and that their depression scores tend to be higher than those whose folic acid levels are normal.
Though folic acid supplementation cannot stand alone as a treatment for depression and mood disorders, studies have shown that patients treated with antidepressants and folic acid experienced a significantly better response than those treated with antidepressants alone. (Psychology Today)
Folic Acid and Memory
Though initial studies suggesting that folic acid might boost memory ability have since been disproven, there is significant evidence suggesting that it can help prevent or slow memory loss associated with aging.
A study conducted by researcher Jane Durga of Wageningen University in the Netherlands showed that high doses of folic acid administered to healthy participants between the ages of 50 and 75 resulted in memory test scores comparable to those of people 5.5 years younger, and cognitive speed scores similar to people 1.9 years younger, representing a significant level of brain protection. (Science Direct)
Folic Acid and the Aging Brain
The demographic group with the highest incidence of folate deficiency is the elderly. One of the key factors in brain atrophy in older individuals is an increased level of oxidative stress and DNA damage caused by increased levels of homocysteine, an amino acid that is regulated by the presence of adequate folic acid.
When folic acid levels drop, homocysteine levels increase, and the combination is a proven risk factor for cognitive impairment and Alzheimer’s disease. Low folate levels have also been associated with depression, dementia, apathy, and lack of motivation in this population.
One study of a geriatric unit showed that its dementia patients had lower folate concentrations than any other diagnostic group in residence, and that there was a significant correlation between the patients’ folate concentrations and the severity of their dementia.
Another study found that administering folinic acid to deficient patients yielded striking transformations in both mood and cognitive function. (British Medical Journal)
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